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The Secretary of State for Health makes the following Regulations in exercise of the powers conferred upon her by sections 28L, 28M, 28O, 28P and 126(4) of the National Health Service Act 1977[1] and section 4(5) of the National Health Service and Community Care Act 1990[2]. Citation, commencement and application 1. —(1) These Regulations may be cited as the National Health Service (General Dental Services Contracts) Regulations 2005 and shall come into force on 1st January 2006. (2) These Regulations apply in relation to England only[3]. Interpretation 2. —(1) In these Regulations—
(b) dental public health services; (c) domiciliary services; (d) orthodontic services; and (e) sedation services;
(b) the repair of a dental appliance; (c) the arrest of bleeding; or (d) the removal of sutures,
which, by virtue of regulation 3(2)(d) or (e) of the NHS Charges Regulations, is provided free of charge to the patient;
(ii) where a treatment plan has to be provided to the patient pursuant to paragraph 7 of Schedule 3, all the treatment specified on that plan by the contractor (or that plan as revised in accordance with paragraph 7(3) of that Schedule) has been provided to the patient; and
(b) an orthodontic course of treatment, means that—
(ii) where the contractor has determined that orthodontic treatment should be provided following the case assessment, all of the orthodontic treatment specified on the orthodontic treatment plan by the contractor pursuant to paragraph 6 of Schedule 1 (orthodontic treatment plans) (or that plan as revised in accordance with paragraph 6(3) of that Schedule) has been provided to the patient,
and "completed" shall be construed accordingly;
(b) the provision of any planned treatment (including any treatment planned at a time other than the time of the initial examination) to that patient,
provided by, except where expressly provided otherwise, one or more providers of primary dental services, but it does not include the provision of any orthodontic services or dental public health services;
(b) a mobile surgery of any provider of primary dental services; or (c) a prison;
(b) a civil partner; (c) a person whose relationship with the registered patient has the characteristics of the relationship between husband and wife or civil partners; (d) a parent or step-parent; (e) a son; (f) a daughter; (g) a child of whom the person is—
(ii) the carer duly authorised by the local authority to whose care the child has been committed under the Children Act 1989[13]; or
(h) a grandparent;
(b) a decision under provisions in force in Scotland or Northern Ireland corresponding to section 49N of the Act; or (c) a decision by the NHS Tribunal which is treated as a national disqualification by the FHSAA by virtue of regulation 6(4)(b) of the Abolition of the National Health Service Tribunal (Consequential Provisions) Regulations 2001[19] or regulation 6(4)(b) of the Abolition of the National Health Service Tribunal (Consequential Provisions) Regulations 2002[20];
(b) the provision of any orthodontic treatment that the contractor determines should be provided to the patient in accordance with Part 2 of Schedule 1 (orthodontic services);
(b) a list of persons undertaking to provide general ophthalmic services or, as the case may be, pharmaceutical services prepared in accordance with regulations made under section 39, 42 or 43 of the Act[25]; (c) a list of persons approved for the purposes of assisting in the provision of any services mentioned in paragraph (b) or (d) prepared in accordance with regulations made under section 43D of the Act[26]; (d) a list of persons who undertook to provide general medical services or general dental services prepared in accordance with regulations made under section 29 or 35 of the Act[27]; (e) a services list which fell within the meaning of section 8ZA of the National Health Service (Primary Care) Act 1997[28]; (f) a list corresponding to a services list prepared by virtue of regulations made under section 41 of the Health and Social Care Act 2001[29]; or (g) a list corresponding to any of the above lists in Scotland or Northern Ireland;
(b) "young offender institution" means a place for the detention of offenders sentenced to detention in a young offender institution or to detention in a young offender institution as part of a longer custodial sentence, including custody for life;
(b) another provider of primary dental services under Part 1 of the Act,
for the provision of one or more of those services as part of that course of treatment;
(b) verbal contact with the patient is maintained in so far as is reasonably possible;
(b) measure in accordance with Part 1 of Schedule 2 the provision of,
mandatory services and advanced mandatory services provided under the contract;
(b) measure in accordance with Part 2 of Schedule 2 the provision of,
orthodontic services provided under the contract;
(b) treatment is provided only to the extent that is necessary to prevent that significant deterioration or address that severe pain; and
(2) In these Regulations—
(b) references to forms supplied by the Primary Care Trust to contractors includes electronic forms and forms which are generated electronically, but does not include prescription forms.
Conditions: introductory 3. Subject to the provisions of any order made by the Secretary of State under section 173 of the Health and Social Care (Community Health and Standards) Act 2003[32] (general dental services: transitional), a Primary Care Trust may only enter into a contract if the conditions set out in—
(b) in the case of a contract to be entered into with a dental corporation on or after the coming into force for all purposes of article 39 of the Dentists Act Order (substitution of sections 43 and 44), regulation 5,
are met.
(b) subject to paragraph (4), he or it is disqualified or suspended (other than by an interim suspension order or direction pending an investigation) from practising by any licensing body anywhere in the world; (c) within the period of five years prior to the date the contract is to be commenced or, if earlier, the date on which the contract is to be signed—
(ii) he or it has been removed from, or refused admission to, a primary care list by reason of inefficiency, fraud or unsuitability (within the meaning of section 49F(2), (3) and (4) of the Act respectively[33]) unless his or its name has subsequently been included in such a list;
(d) he has been convicted in the United Kingdom of—
(ii) a criminal offence other than murder, committed on or after 14th December 2001, and has been sentenced to a term of imprisonment of over six months;
(e) subject to paragraph (6), he has been convicted outside the United Kingdom of an offence—
(ii) committed on or after 14th December 2001, which would if committed in England and Wales, constitute a criminal offence other than murder, and been sentenced to a term of imprisonment of over six months;
(f) he has been convicted of an offence referred to in Schedule 1 to the Children and Young Persons Act 1933[34] (offences against children and young persons with respect to which special provisions of this Act apply) or Schedule 1 to the Criminal Procedure (Scotland) Act 1995[35] (offences against children under the age of 17 years to which special provisions apply) committed on or after 1st April 2006;
(ii) been made the subject of a bankruptcy restrictions order or an interim bankruptcy restrictions order under Schedule 4A to the Insolvency Act 1986[36] unless that order has ceased to have effect or has been annulled; or (iii) made a composition or arrangement with, or granted a trust deed for, his or its creditors unless he or it has been discharged in respect of it;
(h) an administrator, administrative receiver or receiver is appointed in respect of it;
(ii) been removed under section 7 of the Law Reform (Miscellaneous Provisions) (Scotland) Act 1990[37] (powers of the Court of Session to deal with management of charities), from being concerned in the management or control of any body; or
(j) he is subject to a disqualification order under the Company Directors Disqualification Act 1986[38], the Companies (Northern Ireland) Order 1986[39] or to an order made under section 429(2)(b) of the Insolvency Act 1986[40] (failure to pay under county court administration order).
(4) A person shall not fall within paragraph (3)(b) where the Primary Care Trust is satisfied that the disqualification or suspension from practising is imposed by a licensing body outside the United Kingdom and it does not make the person unsuitable to be—
(b) a director, chief executive or secretary of a corporation entering into a contract, in the case of a contract with a dental corporation,
as the case may be.
(b) a director, chief executive or secretary of a corporation entering into a contract, in the case of a contract with a dental corporation,
as the case may be.
(b) financial penalty has been imposed under section 43B or 44 of the Dentists Act.
(2) Paragraph (1) shall not apply if the Primary Care Trust is satisfied that any offence under section 43 or penalty imposed under section 43B or 44 of the Dentists Act does not make the dental corporation unsuitable to be a contractor, whether by virtue of the time that has elapsed since any conviction or penalty was imposed, or otherwise. Pre-contract disputes 8. —(1) Subject to paragraphs (2) and (3), if, in the course of negotiations intending to lead to a contract, the prospective contracting parties are unable to agree on a particular term of the contract, either party may refer the dispute to the Secretary of State to consider and determine the matter in accordance with the procedure provided for in paragraphs 55(2) and (3) of Schedule 3. (2) Paragraph (1) does not apply in the case where both parties to the prospective contract are health service bodies (in which case section 4(4) of the 1990 Act (NHS contracts) applies). (3) Before referring the dispute for consideration and determination under paragraph (1), both parties to the prospective contract must make every reasonable effort to communicate and co-operate with each other with a view to resolving it. (4) Disputes referred to the Secretary of State in accordance with paragraph (1), or section 4(4) of the 1990 Act, shall be considered and determined in accordance with the provisions of paragraphs 55(4) to 55(13) and 56(1) of Schedule 3, and paragraph (5) (where it applies) of this regulation. (5) In the case of a dispute referred to the Secretary of State under paragraph (1), the determination—
(b) may require the Primary Care Trust to proceed with the proposed contract, but may not require the proposed contractor to proceed with the proposed contract; and (c) shall be binding upon the prospective parties to the contract.
Health service body status 9. —(1) Where a proposed contractor elects in a written notice served on the Primary Care Trust at any time prior to the contract being entered into to be regarded as a health service body for the purposes of section 4 of the 1990 Act, it shall be so regarded from the date on which the contract is entered into. (2) If, in accordance with paragraph (1) or (5), a contractor is to be regarded as a health service body, that fact shall not affect the nature of, or any rights or liabilities arising under, any other contract with a health service body entered into by that contractor before the date on which the contractor is to be so regarded. (3) Where a contract is made with an individual dental practitioner or two or more persons practising in partnership, and that individual or that partnership is to be regarded as a health service body in accordance with paragraph (1) or (5), the contractor shall, subject to paragraph (4), continue to be regarded as a health service body for the purposes of section 4 of the 1990 Act for as long as that contract continues and irrespective of any change in—
(b) the status of the contractor from that of an individual dental practitioner to that of a partnership; or (c) the status of the contractor from that of a partnership to that of an individual dental practitioner.
(4) A contractor may at any time request a variation of the contract to include or remove provision from the contract that the contract is an NHS contract, and if it does so—
(b) the procedure in paragraph 60(1) of Schedule 3 shall apply (variation of a contract: general).
(5) Where, pursuant to paragraph (4), the Primary Care Trust agrees to a variation of the contract, the contractor shall—
(b) subject to paragraph (7), cease to be regarded,
as a health service body for the purposes of section 4 of the 1990 Act from the date that variation takes effect pursuant to paragraph 60(1) of Schedule 3.
(b) paragraph (5), it shall, if it or the Primary Care Trust has referred any matter to the NHS dispute resolution procedure before it ceases to be a health service body, be bound by the determination of the adjudicator as if the dispute had been referred pursuant to paragraph 54 of Schedule 3 (dispute resolution: non-NHS contracts); or (c) paragraph (6), it shall continue to be regarded as a health service body for the purposes of the NHS dispute resolution procedure where that procedure has been commenced—
(ii) after the termination of the contract, whether in connection with or arising out of the termination of the contract or otherwise,
for which purposes it ceases to be such a body on the conclusion of that procedure.
Parties to the contract 10. A contract must specify—
(b) in the case of a partnership—
(ii) the names of the partners and, in the case of a limited partnership, their status as a general or limited partner; and
(c) in the case of each party, the postal address to which official correspondence and notices should be sent.
NHS contracts
(b) the parties to the temporary contract may include such terms as to termination by notice as they may agree.
Mandatory services
(b) treatment, including urgent treatment; and (c) where appropriate, the referral of the patient for advanced mandatory services, domiciliary services, sedation services or other relevant services provided under Part 1 of the Act.
(3) A contractor must provide—
(b) all other services described in paragraph (2),
that are necessary to meet the reasonable needs of its patients during normal surgery hours.
(b) diagnosis; (c) advice and planning of treatment; (d) preventative care and treatment; (e) periodontal treatment; (f) conservative treatment; (g) surgical treatment; (h) supply and repair of dental appliances; (i) the taking of radiographs; (j) the supply of listed drugs and listed appliances; and (k) the issue of prescriptions,
but it does not include additional services.
(b) the address of each of the premises to be used by the contractor or any sub-contractor for the provision of such services, or, if the contractor is to provide services from a mobile surgery, that fact; and (c) the hours during which services that are not mandatory services are to be provided.
(2) The reference to premises in paragraph (1)(b) does not include any place in which a patient is residing.
(b) where the contract begins on a date other than 1st April, in the remainder of the financial year in which the contract begins, and in each financial year thereafter.
(2) A contract must contain terms which have the effect of those specified in Part 1 of Schedule 2 in relation to the calculation of the number of units of dental activity that the contractor will provide under the contract.
(b) where the contract begins on a date other than 1st April, in the remainder of the financial year in which the contract begins, and in each financial year thereafter.
(2) Where paragraph (1) applies, the contract must also contain terms which have the effect of those provisions specified in Part 2 of Schedule 2 in relation to the calculation of the number of units of orthodontic activity that the contractor will provide under the contract.
(b) the number of units of orthodontic activity,
it is contracted to provide pursuant to a term of the contract giving effect to regulation 17 or 18 (as the case may be) where—
(ii) the contractor agrees to provide and does so provide the units it has failed to provide within such period as the Primary Care Trust specifies in writing, such period to consist of not less than 60 days.
(3) Paragraphs (1) and (2) shall not prevent the Primary Care Trust from taking action under Part 9 of Schedule 3 for breach of contract (including terminating the contract) on other grounds.
(b) to contribute to where provided as a referral service,
that involve the provision of domiciliary services or sedation services—
(ii) where the contract begins on a date other than 1st April, in the remainder of the financial year in which the contract begins, and in each financial year thereafter.
Finance
(b) the contractor to make payments promptly to the Primary Care Trust and in accordance with both the terms of the contract and any other conditions relating to payment contained in directions given by the Secretary of State under section 28N of the Act.
(2) The obligation referred to in paragraph (1) is subject to any right the Primary Care Trust has to set off against an amount payable to the contractor an amount that—
(b) has been paid to the contractor owing to an error or in circumstances when it was not due; or (c) the Primary Care Trust may withhold from the contractor in accordance with the terms of the contract or any other applicable provisions contained in directions given by the Secretary of State under section 28N of the Act.
(3) The contract must contain a term to the effect that where, pursuant to directions under section 17[44] (Secretary of State's directions: exercise of functions) or 28N of the Act, a Primary Care Trust is required to make a payment to a contractor under a contract but subject to conditions, those conditions are to be a term of the contract.
(b) any person who has requested services under the contract for himself or a family member, as a prerequisite to providing services under the contract to that person or his family member.
(3) The contract must contain a term that—
(b) provides for obligations imposed on the contractor by virtue of the NHS Charges Regulations to be terms of the contract.
(4) The contract must contain a term that requires the contractor in making a decision—
(b) to refer a patient for other services by another contractor, hospital or other relevant service provider under Part 1 of the Act,
to do so without regard to its own financial interests.
(b) which, other than as to the date and periods, have similar effect as those specified in paragraphs 58(3) to (8) and 59 of Schedule 3 in respect of the requirement and procedure for carrying out mid-year reviews.
Commencement of contract 25. The contract shall provide for services to be provided under it from any date after 31st March 2006. Signed by authority of the Secretary of State for Health Rosie Winterton Minister of State, Department of Health 6th December 2005 Provision of advanced mandatory services, domiciliary services and sedation services by the contractor 1. —(1) A contractor which provides domiciliary services or sedation services under the contract may only provide those services—
(b) as a referral service.
(2) A contractor may only provide advanced mandatory services under the contract as a referral service.
(b) the name of the contractor; (c) the particulars of the places where the patient will receive the referral service to be provided to him by the contractor; (d) the telephone number at which the contractor may be contacted during its normal surgery hours; (e) details of the services which are at the date of that examination considered to be necessary for the contractor to provide having regard to the reason for the referral; and (f) any proposals the contractor may have for private services as an alternative to the services proposed under the contract, including particulars of the cost to the patient if he were to accept the provision of private services.
(2) If the patient having considered the referral treatment plan provided in accordance with sub-paragraph (1), decides to accept the provision of private services in place of all or part of services under the contract, the contractor shall ensure that the patient signs that plan in the appropriate place to indicate that he has understood the nature of private services to be provided and his acceptance of those private services.
(b) the patient to whom the sedation is being administered.
Patients to whom orthodontic services may be provided 4. —(1) A contract that includes the provision of orthodontic services shall specify that orthodontic services may be provided to—
(b) only persons who have attained or are over the age of 18 years at the time of the case assessment; or (c) persons falling within paragraph (a) or (b).
(2) Where a contract specifies the matters referred to in sub-paragraph (1)(b) or (1)(c), it shall in addition specify the circumstances in which orthodontic services may be provided to a person over the age of 18 years at the time of a case assessment.
(b) grade 3 of the Dental Health Component of that Index with an Aesthetic Component of 6 or above,
unless the contractor is of the opinion, and has reasonable grounds for its opinion, that orthodontic treatment should be provided to a person who does not have such a treatment need by virtue of the exceptional circumstances of the dental and oral condition of the person concerned.
(b) the orthodontic course of treatment in which that orthodontic appliance was provided is being provided by another contractor, hospital or relevant service provider under Part 1 of the Act.
(3) The contractor shall use its best endeavours to ensure that an orthodontic course of treatment is completed within a reasonable time from the date on which the orthodontic treatment plan was written in accordance with paragraph 6(1).
(b) otherwise not completed within a reasonable time,
any further orthodontic services to be provided to that patient under the contract must be provided as a new orthodontic course of treatment.
(ii) the patient has refused to pay a charge in the circumstances referred to in paragraph 4 of Schedule 3 (refusal to pay NHS Charges during treatment); or (iii) in the reasonable opinion of the contractor, there has been an irrevocable breakdown in the relationship between the patient and the contractor and, notice of such a breakdown has been given to the patient and the Primary Care Trust;
(b) the patient; or
Orthodontic treatment plans
(b) the name of the contractor; (c) particulars of the places where the patient will receive orthodontic treatment; (d) the telephone number at which the contractor may be contacted during normal surgery hours; (e) details of the orthodontic treatment which is, at the date of the examination, considered necessary to secure the oral health of the patient; (f) the NHS charge, if any, in respect of those services if provided pursuant to the contract; and (g) subject to paragraph 10 of Schedule 3 (mixing of services provided under the contract with private services), any proposals the contractor may have for private services as an alternative to the services proposed under the contract, including particulars of the cost to the patient if he were to accept the provision of private services.
(2) If the patient, having considered the treatment plan provided pursuant to sub-paragraph (1), decides to accept the provision of private services in place of orthodontic services under the contract, the contractor shall ensure that the patient signs the treatment plan in the appropriate place to indicate that he has understood the nature of private services to be provided and his acceptance of those private services.
(b) where the total number of orthodontic courses of treatment provided is greater than 20—
(ii) in addition, 10 per cent of the number of cases over 20,
of orthodontic courses of treatment it provides.
(4) The contract shall specify the period of time which is relevant for calculating the number of orthodontic courses of treatment that need to be monitored in accordance with this paragraph.
(b) taken at the completion of the orthodontic course of treatment,
using either the Clinical Outcome Monitoring Program software[48] or by applying the methodology set out in "An introduction to Occlusal Indices"[49].
(b) does not consider that the reasons given by the contractor for the failure to complete the orthodontic courses of treatment are satisfactory,
it shall be entitled to exercise its powers under paragraph 73 of Schedule 3 on the grounds that the contractor is not, pursuant to paragraph 5(3) of this Schedule, using its best endeavours to ensure orthodontic courses of treatment are completed. 1. —(1) Where the contractor provides a banded course of treatment, the contractor provides the number of units of dental activity specified in the appropriate row of Table A. (2) Where a banded course of treatment is commenced but not completed for whatever reason, the appropriate number of units of dental activity provided shall be calculated on the basis of the components of the course of the treatment which has been—
(b) commenced but not completed.
2.
Where the contractor provides a charge exempt course of treatment, the contractor provides the number of units of dental activity specified in the appropriate row of Table B.
Table B Units of dental activity provided under the contract in respect of charge exempt courses of treatment
3. —(1) Where the contractor provides an orthodontic course of treatment to a patient that solely consists of a case assessment, the contractor provides 1.0 unit of orthodontic activity. (2) Where the contractor provides an orthodontic course of treatment to a patient aged under 10 years that consists of—
(b) the provision of orthodontic treatment following the case assessment,
the contractor provides 4.0 units of orthodontic activity.
(b) the provision of orthodontic treatment following the case assessment,
the contractor provides 21.0 units of orthodontic activity.
(b) the provision of orthodontic treatment following the case assessment,
the contractor provides 21.0 units of orthodontic activity.
(b) the orthodontic course of treatment in which that orthodontic appliance was provided is being provided by another contractor, hospital or relevant service provider under Part 1 of the Act,
the contractor provides 0.8 units of orthodontic activity. Persons to whom mandatory services or additional services are to be provided 1. —(1) Subject to sub-paragraphs (3) and (5), the contractor may agree to provide mandatory or additional services under the contract to any person if a request is made for such services by—
(b) a person specified in sub-paragraph (2), on behalf of the person who requires those services.
(2) For the purposes of sub-paragraph (1), a request for services may be made—
(ii) a person duly authorised by a local authority to whose care the child has been committed under the Children Act 1989[51]; or (iii) a person duly authorised by a voluntary organisation by which the child is being accommodated under the provisions of that Act; or
(b) on behalf of any adult who is incapable of making such an application, or authorising such an application to be made on their behalf, by a relative or the primary carer of that person.
(3) The contractor may refuse to provide mandatory or additional services in relation to a person falling outside a specified group of persons only where the contract provides for the contractor to provide such services to a specified group.
(b) a person's decision or intended decision to accept or refuse private services in respect of himself or a family member.
(5) Sub-paragraph (1) does not apply—
(b) in any event to dental public health services.
Patient preference of practitioner
(b) record in writing any such preference expressed by or on behalf of the patient.
(2) The contractor shall endeavour to comply with any reasonable preference expressed under sub-paragraph (1) but need not do so if the preferred performer—
(b) does not routinely perform the services required by the patient within the practice.
(3) This paragraph does not apply—
(b) in any event to dental public health services.
Violent patients
(b) the contractor has reported the incident to the police,
the contractor may notify the Primary Care Trust that it will no longer provide services to that patient under the contract.
(b) in the case of a contract with two or more individuals practising in partnership, a partner in that partnership; (c) in the case of a contract with a dental corporation, a director, chief executive, secretary or member of, or a legal and beneficial owner of shares in, that corporation; (d) a member of the contractor's staff; (e) a person engaged by the contractor to perform or assist in the performance of services under the contract; or (f) any other person present—
(ii) in the place where services were provided to the patient under the contract.
(3) Notification under sub-paragraph (1) may be given by any means including telephone, fax or email but if not given in writing shall subsequently be confirmed in writing within seven days (and for this purpose a faxed or email notification is not a written one).
(b) take all reasonable steps to inform the patient concerned as soon as is reasonably practicable.
Patients who refuse to pay NHS charges prior to the commencement of, or during, treatment
(b) terminate a course of treatment or orthodontic course of treatment prior to its completion,
if the contractor has, in accordance with the NHS Charges Regulations, requested that the patient pay a charge in respect of that course of treatment or orthodontic course of treatment, and that patient has failed to pay that charge.
(b) notice of such a breakdown has been given to the patient by the contractor,
the contractor may notify the Primary Care Trust that it will no longer provide services to that patient under the contract. Course of treatment 6. —(1) Except in the case of orthodontic services and dental public health services, the contractor shall provide mandatory and additional services to a patient by providing to that patient a course of treatment. (2) The contractor shall use its best endeavours to ensure that a course of treatment is completed within a reasonable time from the date on which—
(b) where a treatment plan is not required pursuant to that paragraph, the initial examination and assessment of the patient took place.
(3) Where a contractor provides urgent treatment to a patient, the urgent treatment provided shall constitute a course of treatment and no other services shall be provided during that course of treatment.
(b) otherwise not completed within a reasonable time,
any further services to be provided to that patient under the contract must be provided as a new course of treatment.
(ii) where the patient has refused to pay a charge in the circumstances referred to in paragraph 4 of this Schedule (refusal to pay NHS Charges during treatment); or (iii) where, in the reasonable opinion of the contractor, there has been an irrevocable breakdown in the relationship between the patient and the contractor and notice of such a breakdown has been given to the patient and the Primary Care Trust;
(b) the patient; or
(6) If the contractor is unable to complete the course of the treatment which has been commenced for reasons beyond its control, it shall give notice to the Primary Care Trust of the extent of the treatment so provided and the reason for its inability to complete the remainder.
(b) the name of the contractor; (c) particulars of the places where the patient will receive services; (d) the telephone number at which the contractor may be contacted during normal surgery hours; (e) details of the services (if any) which are, at the date of the examination, considered necessary to secure the oral health of the patient; (f) the NHS charge, if any, in respect of those services if provided pursuant to the contract; and (g) any proposals the contractor may have for private services as an alternative to the services proposed under the contract, including particulars of the cost to the patient if he were to accept the provision of private services.
(2) If the patient, having considered the treatment plan provided pursuant to sub-paragraph (1), decides to accept the provision of private services in place of all or part of services under the contract, the contractor shall ensure that the patient signs the treatment plan in the appropriate place to indicate that he has understood the nature of private services to be provided and his acceptance of those services.
(b) the patient has requested that he be provided with written details of the course of treatment to be provided or that has been provided to him, whether or not he specifically requests a treatment plan.
(6) Where a patient requests the contractor to provide him with a summary of the care and treatment provided under the treatment plan because he intends to receive services from another contractor, the contractor shall provide him with such a summary as he considers appropriate (including details of the care and treatment which could not easily be observed on visual examination).
(b) does not consider that the reasons given by the contractor for the failure to complete the courses of treatment are satisfactory,
it shall be entitled to exercise its powers under paragraph 59(2) on the grounds that the contractor is not, pursuant to paragraph 6(2), using its best endeavours to ensure courses of treatment are completed.
(b) to the alternative contractor, hospital or other relevant service provider, either at the time of referral or as soon as reasonably practicable thereafter—
(ii) a copy of the referral notice; and (iii) a statement of the amount paid to it, or due to be paid to it, by the patient under the NHS Charges Regulations in respect of the course of treatment during which the referral is made.
(3) Where the patient notifies the contractor, whether verbally or in writing, that he does not wish to be referred to the alternative contractor, hospital or other relevant service provider selected by the contractor, the contractor shall, if requested to do so by the patient, use its best endeavours to refer the patient to another suitable contractor, hospital or other relevant service provider under Part 1 of the Act for the provision of the referral service.
(b) in the case of an orthodontic course of treatment provide—
(ii) the orthodontic treatment wholly privately or wholly under the contract.
(3) A contractor shall not, with a view to obtaining the agreement of a patient to undergo services privately—
(b) seek to mislead the patient about the quality of the services available under the contract.
(4) In sub-paragraph (2)(a), "provision of sedation" means the provision of one or more drugs to a patient in order to produce a state of depression of the central nervous system to enable treatment to be carried out.
(b) the contractor advised the patient at the time of the restoration and it was recorded on the patient record that—
(ii) in its opinion, a different form of restoration was more appropriate to secure oral health but, notwithstanding that advice, the patient nevertheless requested the restoration which was provided;
(c) in the opinion of the contractor, the condition of the tooth in respect of which the restoration was provided is such that the restoration cannot satisfactorily be repaired or replaced and different treatment is now required; or
(6) In this paragraph, "the relevant period" means the 12 month period beginning on the date on which the restoration was provided, and ceasing twelve months after that date.
(b) sufficient to meet the reasonable needs of the contractor's patients.
(2) The obligation in sub-paragraph (1) includes providing proper and sufficient waiting-room accommodation for patients.
(b) any other person to contact the practice in relation to services provided as part of the health service,
starts with the digits 087, 090 or 091 or consists of a personal number, unless the service is provided free to the caller. General 17. The contractor shall ensure that any prescription form for listed drugs, medicines or appliances issued by a prescriber complies as appropriate with the requirements in this Part. Supply of drugs 18. —(1) A presciber may supply to a patient listed drugs, medicines or appliances as are required for immediate use before the issue of a prescription for such drugs, medicines or appliances in accordance with paragraph 19. (2) A prescriber may personally administer to a patient any drug or medicine required for the treatment of that patient. Issue of prescription forms 19. —(1) A prescriber shall order listed drugs, medicines or appliances (other than those supplied under paragraph 18) as are required for the treatment of any patient to whom it is providing services under the contract by issuing to the patient a prescription form. (2) Every prescription form shall—
(b) be issued separately to each patient to whom the contractor is providing services under the contract.
(3) For the purposes of this paragraph, "prescription form" means a form that is supplied for the purposes of this paragraph by the Primary Care Trust. Dental practitioners 21. A dental practitioner[54] may perform dental services under the contract provided—
(b) his inclusion in that list is not subject to a suspension.
Dental care professionals
(b) a dental therapist
may perform dental services under the contract provided he is enrolled in the appropriate register established in accordance with the Dental Auxiliaries Regulations 1986[56].
(b) a dental therapist; or (c) a professional or member of a class as specified in regulations made under section 36A(2) of the Dentists Act,
may perform dental services under the contract provided—
(ii) his registration in the dental care professional register established under section 36B[57] of the Dentists Act is not subject to a suspension.
Performers: further requirements
(b) a dental practitioner's inclusion in a dental performers list,
is subject to conditions, the contractor shall ensure compliance with those conditions in so far as they are relevant to the contract.
(b) the contractor has checked that the practitioner meets the requirements in paragraph 21.
(2) Where the employment or engagement of a dental practitioner is urgently needed and it is not possible to check the matters referred to in paragraph 21 in accordance with sub-paragraph (1)(b) before employing or engaging him he may be employed or engaged on a temporary basis for a single period of up to 7 days whilst such checks are undertaken.
(b) from the coming into force of the first regulations under section 36A(2) of the Dentists Act, the contractor has checked that—
(ii) his registration in the dental care professional register is not subject to a suspension.
(2) Where the employment or engagement of a person specified in sub-paragraph (1) is urgently needed and it is not possible to check his registration in accordance with sub-paragraph (1) (where it applies) before employing or engaging him, he may be employed or engaged on a temporary basis for a single period of up to 7 days whilst such checks are undertaken.
(b) any relevant training undertaken by him and any relevant clinical experience gained by him.
Conditions for employment and engagement: all persons performing dental services
(b) the contractor has checked and is satisfied with the references.
(2) Where the employment or engagement of a person falling within sub-paragraph (1) is urgently needed and it is not possible for the contractor to obtain and check the references in accordance with sub-paragraph (1)(b) before employing or engaging him, he may be employed or engaged on a temporary basis for a single period of up to 14 days whilst his references are checked and considered, and for an additional period of a further 7 days if the contractor believes the person supplying those references is ill, on holiday or otherwise temporarily unavailable.
(b) his education and training; and (c) his previous employment or work experience.
Training
(b) employed or engaged to assist in the performance of such services,
arrangements are in place for the purpose of maintaining and updating his skills and knowledge in relation to the services which he is performing or assisting in performing.
(b) co-operates with an assessment by the NPSA when requested to do so by the Primary Care Trust.
Sub-contracting of clinical matters
(ii) that the person is qualified and competent to provide the service; and
(b) it is satisfied in accordance with paragraphs 81 and 82 that the sub-contractor holds adequate insurance.
(2) Where the contractor sub-contracts any of its rights or duties under the contract in relation to clinical matters, it shall—
(b) provide the Primary Care Trust with such information in relation to the sub-contract as it reasonably requests.
(3) Where the contractor sub-contracts clinical services in accordance with sub-paragraph (1), the parties to the contract shall be deemed to have agreed a variation to the agreement which has the effect of adding to the list of the contractor's premises any premises which are to be used by the sub-contractor for the purpose of the sub-contract and paragraph 60 shall not apply. Patient records 32. —(1) The contractor shall ensure that a full, accurate and contemporaneous record is kept in the patient record in respect of the care and treatment given to each patient under the contract, including treatment given to a patient who is referred to the contractor. (2) The patient record may be kept in electronic form. (3) The patient record shall include details of any private services (to the extent that they are provided with services under the contract) and shall be kept with—
(b) all radiographs, photographs and study casts taken or obtained by it as part of the services provided to that patient; (c) where an orthodontic course of treatment has been provided to a patient, a copy of the orthodontic treatment plan; (d) where information is to be submitted to the Primary Care Trust in accordance with paragraph 38 and that information is submitted electronically—
(ii) a note of the evidence in support of that declaration; and
(e) the statement concerning any custom-made devices provided by any person as a consequence of regulation 15 of the Medical Devices Regulations 2002[58] (procedures for custom-made devices) in respect of services being provided to that patient.
(4) The patient record and the items referred to in sub-paragraph (3) shall be retained for a period of 2 years beginning with—
(ii) a course of treatment or an orthodontic course of treatment is completed; or
(b) in respect of courses of treatment or orthodontic courses of treatment not falling within paragraph (a)(i) or (ii) the date by which no more services can be provided as part of that course of treatment or orthodontic course of treatment by virtue of paragraph 5(4)(b) of Schedule 1 (orthodontic course of treatment) or paragraph 6(4)(b) of this Schedule.
(5) Nothing in this paragraph shall affect any property right which the contractor may have in relation to the records, radiographs, photographs and study models referred to in this paragraph.
(b) such information relating to NHS Charges as is supplied by the Primary Care Trust for the purposes of providing information to patients; and (c) information about the complaints procedure which it operates in accordance with Part 6, giving the name and title of the person nominated by the contractor in accordance with paragraph 50(2)(a).
(2) The contractor shall—
(b) review its patient information leaflet at least once in every period of 12 months and make any amendments necessary to maintain its accuracy; and (c) make available a copy of the leaflet, and any subsequent updates, to its patients and prospective patients.
(3) The requirements in sub-paragraph (2) do not apply to any contractor to the extent that it provides services to persons detained in prison.
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