(1) Subject to regulation 4A, a dentist who is applying for inclusion in sub-part A of the first part, or in the second part of a dental list, must satisfactorily complete Part 1 training, Part 2 training and the test of knowledge no more than 12 months before making an application under regulation 5, unless that dentist—

(a) falls within one of the grounds specified in paragraph (2), or

(b) is a dentist referred to in paragraph (3).

(2) The grounds are that the dentist—

(a) has provided or assisted in the provision of general dental services at any point in the 12 months before the application is made,

(b) is, at the point of making the application, undertaking Dental Core Training,

(c) will commence Dental Core Training or Specialty Training within 2 months following inclusion in a dental list further to the application, or

(d) will commence vocational training within 2 months following inclusion in the second part of a dental list, further to the application.

(3) Subject to regulation 4A, a dentist who is applying for inclusion in sub-part A of the first part, or in the second part of a dental list, must satisfactorily complete Part 2 training and the test of knowledge no more than 12 months before making an application under regulation 5, where that dentist has not provided or assisted in the provision of general dental services throughout the 12 months preceding the application but is included in an equivalent list in England, Wales or Northern Ireland.

General provision relating to the dental list

Grounds for refusal of application

Deferment of a decision on application

Local directory of dentists

Requirements with which a dentist or body corporate included in a dental list must comply

Suspension

Removal from dental list

Re-inclusion in dental list

Disclosure of information

Withdrawal from dental list

Information about assistants

Information about associateship agreements

Transfer of continuing care and capitation arrangements

Emergency dental services

Arrangements for emergency cover

Health Board patient information leaflets

SCHEDULE A1 — Topics on which questions may be asked in the test of knowledge

1

Radiology.

2

Managing medical emergencies including basic life support.

3

Consent.

4

The content and application of these Regulations and other relevant rules and law.

5

The Statement of Dental Remuneration.

6

Infection prevention and control.

7

Record keeping.

8

Managing and working within a dental practice.

9

Ethical obligations.

10

Health and Safety.

11

Prescribing.

12

Quality improvement.

Quality improvement activities

Electronic Communications

31A

Where a notice or document is sent by means of an electronic communication it is taken to have been received 24 hours after it is sent unless the contrary is proved.

Signatures

Revocations, savings and transitional provisions

Consequential Amendments

Schedules

Enhanced Skills in Domiciliary Care

5B

Schedule B1 has effect.

General provision relating to the dental list

Grounds for refusal of application

Deferment of a decision on application

Local directory of dentists

Requirements with which a dentist or body corporate included in a dental list must comply

Suspension

Removal from dental list

Removal of domiciliary care designation

12A

(1) Where a Health Board has determined that a domiciliary care dentist has not provided general dental services in a care home for the preceding 6 months, the Health Board may amend the dental list to remove that dentist’s designation as a domiciliary care dentist.

(2) Before removing a dentist’s designation under paragraph (1) the Health Board must—

(a) give the dentist 28 days’ notice of its intention to do so; and

(b) afford the dentist an opportunity to make representations to the Health Board in writing or in person.

(3) In calculating the period of 6 months referred to in paragraph (1), the Health Board must disregard any period during which—

(a) the dentist was performing relevant service;

(b) the dentist was on statutory maternity, paternity, adoption leave;

(d) the dentist was unable to provide general dental services in a care home because of sickness;

(e) the dentist was suspended by direction of the Tribunal or was suspended by the Health Board; or

(f) the dentist was performing personal dental services in connection with a pilot scheme.

(4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(5) A Health Board must remove the designation of a domiciliary care dentist if—

(a) a discipline committee established under regulation 3 of the National Health Service (Discipline Committees) (Scotland) Regulations 2006 recommends a sanction or warning which would place the domiciliary care dentist in breach of the eligibility criterion specified in paragraph 1(2)(d)(iv) of schedule B1 and the Health Board decides to apply that sanction or warning;

(b) the Tribunal disqualifies the domiciliary care dentist; or

(c) the Tribunal imposes conditional disqualification on the domiciliary care dentist which has the effect of prohibiting them from performing any aspect of enhanced skills in domiciliary care.

(6) Nothing in this regulation prejudices any right of a dentist to be designated again as a domiciliary care dentist.

Re-inclusion in dental list

Re-instatement of designation

13A

(1) Where a dentist has had their designation as a domiciliary care dentist removed under regulation 12A, and the occurrence that led to that removal is overturned, either on appeal, or for any other reason, the Health Board may designate that dentist as a domiciliary care dentist without a request being made in accordance with paragraph 1 of schedule B1 if the Health Board is satisfied that there is no further information which it should consider, and provided that the Health Board receives undertakings from that dentist to comply with these Regulations.

(2) Where the Health Board considers that further information is required, a dentist who wishes to be designated again as a domiciliary care dentist must provide that further information and undertakings or, at the option of the Health Board, submit a full request in accordance with paragraph 1 of schedule B1.

Disclosure of information

Withdrawal from dental list

Information about assistants

Information about associateship agreements

Transfer of continuing care and capitation arrangements

Emergency dental services

Arrangements for emergency cover

Health Board patient information leaflets

SCHEDULE B1 — Enhanced skills in domiciliary care

Request to become a domiciliary care dentist and eligibility

1

(1) A dentist who meets the eligibility criteria specified in sub-paragraph (2) may submit a request to a Health Board to become a domiciliary care dentist—

(a) in the case of a dentist whose name appears on the list of the Health Board to which they are making the request, in such form as the Health Board may require; or

(b) in the case of a dentist whose name does not appear on the list of the Health Board to which they are applying, as an addition to that dentist’s application to be included on the dental list under regulation 5.

(2) The eligibility criteria are that—

(a) for the period of three years ending with the date of the request, the name of the dentist has continuously appeared on sub-part A of the first part of a dental list maintained by any Health Board, or an equivalent part of a dental list maintained for England, Wales or Northern Ireland;

(b) the dentist has complied with the requirements of paragraph 40(1) of schedule 1 as they apply to the dentist;

(i) completed appropriate continuing professional development activities on the care of older people; or

(ii) provided general dental services to care home residents in care homes on a sufficient number of occasions,

to enable the Health Board to form the opinion that the dentist is likely to be a suitable person to be a domiciliary care dentist, following completion of the enhanced training and mentoring in domiciliary care;

(d) the dentist—

(i) is not suspended from the dental list under regulation 11;

(ii) is not suspended from the dental list under sections 32A or 32B of the Act;

(iii) is not conditionally disqualified under section 29B of the Act;

(iv) is not currently subject to a warning or sanction which was applied following an investigation under the National Health Service (Discipline Committees) (Scotland) Regulations 2006;

(v) is not subject to a corresponding decision made in England, Wales or Northern Ireland which has an equivalent effect to anything specified by (i) to (iv);

(vi) is not subject to undertakings under section 27A of the Dentists Act 1984 (“the 1984 Act”);

(vii) does not have conditions placed upon their registration under sections 27B or 28 of the 1984 Act;

(viii) is not suspended from the register of dentists under sections 27C, 30, or 32 of the 1984 Act;

(e) any practice premises from which the dentist provides general dental services were, at their most recent inspection by the Health Board for the area in which those premises are located, found to comply with the requirements of paragraph 42 of schedule 1 which relate to the standards of premises and equipment required for the provision of general dental services;

(f) the dentist is not listed provisionally.

(3) Where the Health Board receives a request from a dentist under sub-paragraph (1), the Health Board may—

(a) write to the dentist to offer them an initial interview in accordance with paragraph 2;

(b) write to the dentist to offer them a final interview in accordance with paragraph 4; or

(c) if the Health Board considers that additional domiciliary care dentists are not required in the area, write to the dentist to refuse their request.

(4) A Health Board may not offer a dentist an interview under sub-paragraph (3) if that dentist does not meet the eligibility criteria.

(5) Where a Health Board decides not to interview a dentist, the Health Board must, within 28 days beginning with the day on which it received the dentist’s request, write to the dentist to inform them of the decision and to give reasons for it.

(6) Where a Health Board has decided to offer an interview to a dentist who does not have a Certificate of Completion of Enhanced Skills Training (Domiciliary Care), the Health Board must offer the dentist an initial interview in accordance with paragraph 2.

(7) Where a Health Board has decided to offer an interview to a dentist who has a Certificate of Completion of Enhanced Skills Training (Domiciliary Care), the Health Board must offer the dentist a final interview in accordance with paragraph 4.

Initial Interview

2

(1) At an initial interview arranged under paragraph 1(3), the Health Board must—

(a) confirm whether the dentist meets the eligibility criteria specified in paragraph 1(2);

(b) consider whether the dentist has—

(i) completed appropriate continuing professional development activities on the care of older people; or

(ii) provided general dental services to care home residents in care homes on a sufficient number of occasions,

to enable the Health Board to form the opinion that the dentist is a suitable person to undertake the enhanced training and mentoring in domiciliary care;

(c) consider whether the dentist can demonstrate that they are able to make arrangements which would permit them to comply with the increased requirements of paragraph 6 (emergency cover) of schedule 1 as they would apply to that dentist if that dentist were a domiciliary care dentist in the Health Board area;

(d) decide whether a place on the enhanced training and mentoring in domiciliary care will be requested by the Health Board on behalf of the dentist.

(2) The Health Board must provide the dentist with confirmation in writing of the decision taken under sub-paragraph (1)(d) within 7 days beginning with the date of the interview and must give its reasons for the decision.

(3) The Health Board must submit a request for a place on the enhanced training and mentoring in domiciliary care to NHS Education for Scotland on behalf of each dentist for whom it decides to request a place after an initial interview conducted under sub-paragraph (1).

Enhanced training and mentoring in domiciliary care

3

The enhanced training and mentoring in domiciliary care must be composed of—

(a) training containing elements on—

(i) treating medically complex patients;

(ii) attending to patients with a physical or cognitive disability;

(iii) treating the ageing patient;

(iv) practical considerations when providing domiciliary care;

(v) communication skills;

(vi) delivering the oral health improvement programme for carers of older people;

(b) training on the legal and ethical responsibilities of a dentist when treating adults with incapacity;

(c) supported learning in which the dentist attends domiciliary care visits accompanied by a mentor selected by a Health Board.

Final Interview

4

(1) A Health Board must conduct a final interview if—

(a) the Health Board has decided to offer an interview to a dentist who has a Certificate of Completion of Enhanced Skills Training (Domiciliary Care); or

(b) the Health Board receives notice that a dentist for whom they requested a place on the enhanced training and mentoring in domiciliary care has been awarded a Certificate of Completion of Enhanced Skills Training (Domiciliary Care).

(2) At the final interview the Health Board must—

(a) if the dentist is being interviewed under the circumstances described in sub-paragraph (1)(a)—

(i) consider whether the dentist meets the eligibility criteria specified in paragraph 1(2);

(ii) consider whether the previous provision of enhanced skills in domiciliary care by the dentist is sufficient to enable the Health Board to form the opinion that the dentist has the necessary competence to provide enhanced skills in domiciliary care in the area;

(b) if the dentist is being interviewed under the circumstances described in sub-paragraph (1)(b), consider whether the performance of the dentist at the enhanced training and mentoring in domiciliary care was sufficient to enable the Health Board to form the opinion that the dentist has the necessary competence to provide enhanced skills in domiciliary care in the area;

(c) consider whether the dentist has demonstrated that they are able to make arrangements which would permit them to comply with the increased requirements of paragraph 6 (emergency cover) of schedule 1 as they would apply to that dentist if that dentist were to be designated as a domiciliary care dentist for the area;

(d) decide whether the dentist should be designated as a domiciliary care dentist for the area.

(3) The Health Board must provide the dentist with confirmation in writing of the decision taken under sub-paragraph (2)(d) within 7 days of the date of the interview and must give the reasons for the decision.

(4) A decision taken by the Health Board under sub-paragraph (2)(d) will have effect from such date as the Health Board may specify in writing to the dentist.

Designating a new domiciliary care dentist

5

Where the Health Board decides to designate a dentist as a domiciliary care dentist for the area the Health Board must—

(a) amend the information on the dental list in respect of that dentist to indicate that they are a domiciliary care dentist for the area;

(b) identify a salaried dentist with sufficient experience of domiciliary care to provide support and advice to the dentist in the dentist’s enhanced skills in domiciliary care duties;

(c) if the Health Board is aware of one or more care homes which the Health Board believes would benefit from having the dentist assigned to them, assign the dentist to that care home or those care homes;

(d) inform the dentist that it has taken these actions.

Violent behaviour against domiciliary care dentists

11A

(1) Where a care home resident who is receiving enhanced skills in domiciliary care commits an act of violence against any dentist, dental care professional or any other person employed or engaged by the contractor, or has behaved in such a way that such a person has feared for their safety, the contractor may notify the Health Board and care home manager that an incident has occurred.

(2) Notification to the Health Board under sub-paragraph (1) or sub-paragraph (11) may be given by any means including telephone, e-mail or fax, but if it is not given in writing the contractor must subsequently confirm it in writing before the end of the period of seven days beginning with the date of the notification under sub-paragraph (1) or sub-paragraph (11) (and, for this purpose a faxed or e-mailed confirmation is not a written one).

(3) Notification to the Health Board under sub-paragraph (1) or sub-paragraph (11) must confirm that the contractor has also notified the care home manager.

(4) The Health Board must, before the end of the period of 7 days beginning with the date on which the notification was given under sub-paragraph (1) or sub-paragraph (11), arrange for a meeting between the contractor, the Health Board and a representative of the care home.

(5) The Health Board must take all reasonable steps to ensure that a meeting arranged under sub-paragraph (4) takes place before the end of the period of 35 days beginning with the date of the notification under sub-paragraph (1) or sub-paragraph (11).

(6) At a meeting arranged under sub-paragraph (4) the Health Board must—

(a) discuss the incident about which the contractor has given notification under sub-paragraph (1) or sub-paragraph (11);

(b) discuss measures which can be taken to reduce the likelihood of a further incident;

(i) the measures (if any) which will be implemented; or

(ii) the further steps to be taken with a view to reaching agreement on such measures;

(d) if measures are agreed under sub-paragraph (c)(i), agree with the contractor and the representative of the care home the dates by which the agreed measures will be implemented;

(e) if further steps are agreed under sub-paragraph (c)(ii), agree with the contractor and the representative of the care home the dates by which the further steps will be completed.

(7) Subject to sub-paragraph (8), the contractor may, by notification to the Health Board, terminate its capitation arrangement with a care home resident about whom it has given notification under sub-paragraph (1) or sub-paragraph (11) if—

(a) a measure agreed at a meeting arranged under sub-paragraph (4) is not implemented by the date agreed;

(b) a further step agreed at a meeting arranged under sub-paragraph (4) is not completed by the date agreed;

(8) The contractor may not terminate a capitation arrangement under sub-paragraph (7) if the contractor agreed at a meeting arranged under sub-paragraph (4) that no measures were required.

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