"NHS (Scotland) 1978 Act Crackdown: Tough New Rules to Curb Patient Brokers and Unregulated Digital Healthcare starts 18th June 2025"

emcat55
May 22
3 min read

Updated: Jul 9

1. Although announced in June 2024 - enactment starts 1st June 2025

The Scottish Government amended the National Health Service (Scotland) Act 1978 to expand the regulatory powers of Healthcare Improvement Scotland (HIS). The key purpose of these amendments was to close regulatory loopholes around private, remote, and online healthcare providers, ensuring accountability and patient safety. Although this was announced in 2024, the date for enactment is June 2025 and they are progressing with Independent Medical Agency (IMA) registrations.

2. Introduction of Section 10Z9 – A Criminal Offence

Section 10Z9 now makes it a criminal offence to provide an independent healthcare service in Scotland without registration with Healthcare Improvement Scotland (HIS).

This includes both in-person services and those delivered remotely or online, as long as the patient is in Scotland.
Companies providing such services without registration are breaking the law and can face criminal prosecution.

3. Who Must Register?

Under HIS guidance, the definition of a provider has been clarified and significantly broadened. The following must register as an Independent Medical Agency (IMA) if they are involved in coordinating or facilitating care:

a. Entities That Arrange or Coordinate Care

This includes companies that organise treatment, book services, or act as intermediaries between patients and clinics.

b. Services Delivered by Subcontractors

Even if healthcare professionals are freelancers or subcontracted, the parent company is still considered the provider under the law.

c. Online or Remote Services

Any company offering healthcare services online or remotely (telemedicine, detox, counselling) to people based in Scotland must register.

It doesn’t matter where the company or practitioner is based. If the service reaches patients in Scotland, it must comply.

4. What Does “Providing a Healthcare Service” Mean?

Under HIS rules, you are providing a regulated service if you:

Deliver clinical or medical treatment,
Provide diagnostic services,
Offer therapeutic interventions (e.g. prescribing, detox, counselling),
Coordinate or arrange such services for patients.

Not regulated: Merely signposting or offering general advice.

Regulated: Actively referring, booking, or managing patient care pathways.

5. Real-World Examples

✅ Must Register: A rehab brokerage site connecting Scottish patients with detox clinics (even if based in England or online).
✅ Must Register: An online prescription or telehealth service treating Scottish residents.
✅ Must Register: A company coordinating remote therapy sessions for clients in Scotland.
❌ No Registration Needed: A site that only offers general advice or signposts to NHS services, without booking or coordinating care.

6. Why Is This Important?

These legal changes help address unethical patient brokerage and unregulated cross-border care—an area that has raised serious concerns around:

Lack of clinical oversight
Misleading advertising
No safeguarding or follow-up
Undisclosed commercial relationships

🔍 Reinforced by ASA Rulings – December 2024

In December 2024, the Advertising Standards Authority (ASA) ruled against multiple rehab brokerage websites for:

Falsely presenting themselves as impartial advisory services, while in fact receiving referral fees.
Failing to disclose commercial interests when referring patients to private clinics.
Misleading use of NHS-related branding or search engine ads to capture vulnerable users.

These rulings highlight the urgency and relevance of the HIS registration requirement. The law now offers legal backing to stop these unethical practices—not just through advertising rules but through criminal enforcement.