The National Health Service (General Dental Services) (Scotland) Regulations 2010

• (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;

• (c) take all reasonable steps to agree with the contractor and the representative of the care home either—

• (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;

• (c) no measures or further steps are agreed at a meeting arranged under sub-paragraph (4).

• (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.

• (9) Where the contractor notifies the Health Board under sub-paragraph (7) of the termination of a capitation arrangement, the Health Board must take reasonable steps to inform the care home resident concerned.

• (10) Where no measures or further steps are agreed at a meeting arranged under sub-paragraph (4), the Health Board may treat the contractor as having given notification to the Health Board of the contractor’s wish to terminate its capitation arrangement with the care home resident and the Health Board may notify the contractor and the care home resident that the capitation arrangement between them is terminated.

• (11) Where a further incident of the kind described in sub-paragraph (1) is caused by a care home resident, about whom measures agreed under this paragraph have previously been implemented, the contractor may notify the Health Board of this further incident and the Health Board must either—

• (a) send a notice to the contractor agreeing to allow the contractor to terminate the capitation arrangement with the care home resident and take all reasonable steps to inform the care home resident of this termination; or

• (b) arrange a further meeting under sub-paragraph (4).

Referral to another contractor or to a hospital or other service

Referral to dental students

Treatment on referral

Inability of contractor to complete care and treatment under a capitation arrangement or treatment on referral

Care and treatment summaries

Mixing of general dental services and private care and treatment

PART VII — ADDITIONAL TERMS OF SERVICE FOR DOMICILIARY CARE DENTISTS

Attendance at the care home

50

• (1) A domiciliary care dentist must, within 14 days of being assigned to a care home, write to the care home manager of the assigned care home to ask if there are any days and times at which it would be inconvenient to the manager or other care home staff for the contractor to attend the care home (“protected times”).

• (2) Except in the case of an emergency, the domiciliary care dentist must—

• (a) only attend an assigned care home during the in-hours period;

• (b) not attend an assigned care home within protected times of which they have been informed.

• (3) Where a care home resident (or a person acting on their behalf) who resides in a care home to which the domiciliary care dentist is assigned applies to enter into a capitation arrangement, the domiciliary care dentist must, within 6 weeks beginning with the day on which the application was made, examine and accept the patient in accordance with paragraph 5 of this schedule.

• (4) The domiciliary care dentist must examine care home residents with whom they have a capitation arrangement not less frequently than—

• (a) in the case of dentate patients, once every 6 months

• (b) in the case of edentulous patients, once every 12 months.

• (5) The domiciliary care dentist must offer to provide topical fluoride treatment as a part of their regular examination of dentate care home residents with whom they have a capitation arrangement.

In-hours emergencies

51

• (1) A domiciliary care dentist must personally provide prompt care and treatment to care home residents with whom they have a capitation arrangement during the in-hours period, except where the domiciliary care dentist is absent from their enhanced skills in domiciliary care duties.

• (2) The domiciliary care dentist must enter, and maintain in effect, emergency cover arrangements with one or more other dentists which, in the event that the domiciliary care dentist is absent from their enhanced skills in domiciliary care duties, will—

• (a) cover the in-hours period on each working day; and

• (b) provide sufficient emergency care provision to each of the care homes to which the domiciliary care dentist is assigned.

• (3) A domiciliary care dentist must receive approval from the Health Board for any proposed emergency cover arrangement, or proposed change to an existing emergency cover arrangement, before that arrangement or change can take effect.

• (4) A request for the approval of the Health Board under sub-paragraph (3) must provide—

• (a) the name of the dentist with whom the contractor proposes to make the arrangement;

• (b) the address of that dentist’s practice premises;

• (c) the proposed duration of the arrangement (if this duration is not indefinite); and

• (d) the days and times during which that dentist will provide emergency cover under the proposed arrangement.

• (5) The Health Board must within 28 days beginning with the day on which it receives a request under sub-paragraph (3) make its decision on the request and write to the domiciliary care dentist to inform them that—

• (a) the request is approved; or

• (b) the request is refused and to give the reasons for that refusal.

• (6) The domiciliary care dentist must give the Health Board not less than 7 days’ notice of the termination of an emergency cover arrangement.

Continuing professional development

52

A domiciliary care dentist must complete update training on the legal and ethical responsibilities of a dentist when treating adults with incapacity provided by NHS Education for Scotland not less than once every five years.

Procedure for withdrawing from assigned care home

53

A domiciliary care dentist who is assigned to a care home may withdraw from their position as an assigned domiciliary care dentist for that care home by giving the Health Board and the care home manager not less than 6 months’ notice in writing.

Voluntary removal of designation as a domiciliary care dentist

54

• (1) A domiciliary care dentist may request to withdraw from being designated as a domiciliary care dentist in the area by giving the Health Board not less than 6 months’ notice in writing.

• (2) A Health Board must grant a request made under sub-paragraph (1) if the domiciliary care dentist has served notice—

• (a) to terminate the capitation arrangements with all care home residents with whom they have an arrangement;

• (b) to withdraw from acting as the assigned domiciliary care dentist for all of the care homes to which they are assigned.

Procedure for assignment to additional care homes

55

• (1) A domiciliary care dentist may apply to the Health Board to be assigned to one or more care homes in addition to the care homes to which the domiciliary care dentist has been assigned under paragraph 5 of schedule B1.

• (2) Within 28 days beginning with the day on which it receives a request under sub-paragraph (1), the Health Board must write to the domiciliary care dentist to—

• (a) inform the domiciliary care dentist that there are currently no care homes in the area which would benefit from an assigned domiciliary care dentist, or as the case may be, an additional assigned domiciliary care dentist; or

• (b) invite the domiciliary care dentist to a meeting to discuss the suitability of the domiciliary care dentist to be assigned to an additional care home.

• (3) At a meeting arranged under sub-paragraph (2)(b), the Health Board must—

• (a) consider whether the domiciliary care 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 this schedule as those requirements apply to domiciliary care dentists—

• (i) in relation to the care homes currently assigned to the domiciliary care dentist;

• (ii) in relation to the additional care homes to which it is proposed to assign the domiciliary care dentist;

• (b) consider whether any other aspect of the performance of the general dental services usually undertaken by the domiciliary care dentist is likely to be negatively affected by assigning additional care homes to the dentist;

• (c) decide whether to assign the domiciliary care dentist to one or more additional care homes.

• (4) The Health Board must provide the domiciliary care dentist with confirmation in writing of the decision taken under sub-paragraph (3)(c) within 7 days beginning with the date of the meeting and must give the reasons for the decision.

Transfer of capitation arrangements

Termination of a capitation arrangement

4

Details of arrangements in an emergency.

5

Details of repairs and replacements which are provided free of charge.

6

Details of arrangements if the dentist with whom a patient has entered into a capitation arrangement is not available.

7

Details of care and treatment available under general dental services.

8

Explanation of NHS charges for general dental services and of entitlement to exemptions from and remission of these charges.

9

Explanation of the arrangements for cancelling appointments.

10

Explanation of the importance of regular care.

11

The consequences of termination of a capitation arrangement.

Inclusion in a dental list on a provisional basis

4A

• (1) The name of a dentist must be included in a dental list on a provisional basis (“listed provisionally”) in the circumstances specified in paragraph (2).

• (2) The circumstances are—

• (a) a Health Board has decided to include the dentist in its dental list further to an application under regulation 5(1),

• (b) that application—

• (i) included the information specified in regulation 5(1B),

• (ii) did not include a request for the dentist to be designated as a domiciliary care dentist, and

• (iii) did not state that the applicant is intending to practise as a single-handed practitioner, and

• (c) subject to regulation 4B, the dentist has not previously been listed provisionally.

• (3) A dentist may be listed provisionally for six consecutive calendar months.

• (4) Where a dentist who is listed provisionally satisfactorily completes—

• (a) Part 1 training, Part 2 training and the test of knowledge where the person is required to do this by regulation 5A(1), or

• (b) Part 2 training and the test of knowledge where the person is required to do this by regulation 5A(3),

the dentist must provide the listing Health Board with a certificate confirming this outcome within 7 working days of its issue.

• (5) Where a listing Health Board has received the certificate referred to in paragraph (4), it must remove the information included in the dental list in respect of that dentist under either regulation 4(4)(k) or 6(f).

• (6) Where a dentist who is listed provisionally does not satisfactorily complete—

• (a) Part 1 training, Part 2 training and the test of knowledge where the person is required to do this by regulation 5A(1), or

• (b) Part 2 training and the test of knowledge where the person is required to do this by regulation 5A(3),

within the exam diet, the dentist must notify the listing Health Board of this outcome within 2 working days of the end of the exam diet.

• (7) Where a listing Health Board has received the notification referred to in paragraph (6), it must remove the dentist’s name from its dental list with immediate effect and must notify the dentist as soon as practicable of the removal.

• (8) Where a listing Health Board has not received—

• (a) the certificate referred to in paragraph (4), or

• (b) the notification referred to in paragraph (6),

by the end of the period specified in paragraph (3), it must remove the dentist’s name from its dental list with immediate effect and must notify the dentist as soon as practicable of the removal.

• (9) Where a dentist who is listed provisionally is suspended by direction of the Tribunal or by the Health Board, the listing Health Board must remove the dentist’s name from its dental list with immediate effect and must notify the dentist as soon as practicable of the removal.

• (10) A dentist who is listed provisionally must provide the listing Health Board with any information that the listing Health Board requests relating to—

• (a) in a case where regulation 5A(1) applies to that dentist, Part 1 training, Part 2 training and the test of knowledge, or

• (b) in a case where regulation 5A(3) applies to that dentist, Part 2 training and the test of knowledge.

• (11) For the purposes of this regulation—

• “exam diet” means the period of six weeks from the satisfactory completion of—Part 1 training and Part 2 training under regulation 5A(1), orPart 2 training under regulation 5A(3),

during which period the dentist must satisfactorily complete the test of knowledge, and

• “listing Health Board” means the Health Board in whose dental list a dentist is listed provisionally.

Inclusion in a dental list on a provisional basis for a second time

4B

• (1) A dentist may be listed provisionally under regulation 4A(1) for a second period of six months, where that dentist is a person described in paragraph (2).

• (2) The person is—

• (a) a dentist who has previously been listed provisionally under regulation 4A(1), and, for some or all of that listing period, was—

• (i) performing relevant service,

• (ii) on statutory maternity, paternity or adoption leave,

• (iii) on statutory shared parental leave,

• (iv) unable to provide general dental services or assist with the provision of such services because of sickness, or

• (v) performing personal dental services in connection with a pilot scheme,

• (b) a dentist who has previously been listed provisionally under regulation 4A(1), and the Health Board referred to in regulation 4A(2)(a) is satisfied that exceptional circumstances exist which justify listing that dentist on a provisional basis for a second period of six months, or

• (c) a dentist who was removed from a dental list under regulation 4A(9), and following which, the suspension that led to that removal has been overturned either on appeal, or for any other reason.

Application for inclusion in the dental list and notification of changes

Mandatory training

Enhanced Skills in Domiciliary Care

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

Re-inclusion in dental list

Re-instatement of designation

Disclosure of information

Withdrawal from dental list

Information about assistants

Information about associateship agreements

Transfer of capitation arrangements

Emergency dental services

Arrangements for emergency cover

Health Board patient information leaflets