The National Health Service (General Dental Services) Regulations 1992

• (ii) if relevant to the referral, details of the care and treatment he has provided or intends to provide in order to secure and maintain the patient’s oral health, to that other dentist or, as the case may be, that hospital or other service, either at the time of referral or as soon as practicable afterwards;

• (b) include with those details a statement of the amount paid to him by the patient under the National Health Service (Dental Charges) Regulations 1989[^f00027] in respect of any care and treatment already provided in the course of the care and treatment during which the referral is made; and

• (c) indicate in his claim for remuneration in respect of that course of care and treatment that the patient has been referred for the required care and treatment.

Treatment on referral

13

• (1) Subject to sub-paragraph (5), a dentist who accepts a patient referred to him by another dentist who is providing dental services to that patient (whether or not pursuant to the Act) otherwise than under Part III of this Schedule for particular care and treatment shall—

• (a) at the time at which he accepts the patient, provide him with a form of acceptance supplied for that purpose by the FHSA which shall specify—

• (i) the name of the patient;

• (ii) the name of the dentist;

• (iii) particulars of the places where the patient will receive care and treatment; and

• (iv) the telephone number at which the dentist or a deputy may be contacted during normal surgery hours, or at other times in an emergency if different;

• (b) at the time of his first examination of the patient, provide the patient with a plan for treatment on a form supplied for that purpose by the FHSA which shall specify—

• (i) details of the care and treatment which, in the opinion of the dentist, at the date of that examination, is necessary for him to provide having regard to the reason for the referral;

• (ii) his estimate of the NHS charge, if any, in respect of that care and treatment;

• (iii) any proposals he may have for private care and treatment as an alternative to the care and treatment proposed under general dental services, including particulars of the cost to the patient;

• (c) where, in the opinion of the dentist, the care and treatment included in the plan for treatment under head (b) of this sub-paragraph needs to be varied, provide the patient with a revised plan for treatment in accordance (except as to the time of its provision) with head (b) of this sub-paragraph;

• (d) complete the care and treatment, which is referred to in head (b)(i) of this sub-paragraph;

• (e) until such time as the treatment on referral has been completed, provide the patient with emergency cover in accordance with paragraph 6(1) and (2), but only to the extent that the patient requires prompt care and treatment in relation to the particular care and treatment for which he has been referred; and

• (f) repair or replace, in accordance with sub-paragraph (2), any restoration which requires repair or replacement.

• (2) Subject to sub-paragraphs (3) and (4), in repairing or replacing a restoration in the course of treatment on referral, a dentist shall repair or replace at no charge to the patient any of the following restorations, namely, a filling, root filling, inlay, pinlay or crown which has to be repaired or replaced and which was provided by him in the course of the treatment on referral.

• (3) A dentist shall not be under an obligation to repair or replace any restoration under sub- paragraph (2) where—

• (a) within 12 months of the date on which the restoration was provided—

• (i) a dentist has provided private treatment, or

• (ii) another dentist has provided occasional treatment otherwise than of a temporary nature,

on the tooth in respect of which the restoration was provided;

• (b) the dentist advised the patient at the time of the restoration and indicated on any plan for treatment provided to the patient in accordance with sub-paragraph (1)(b) or (c) and on the patient record—

• (i) that the restoration was intended to be temporary in nature; or

• (ii) that, in his opinion, a different form of restoration was more appropriate but, notwithstanding that advice, the patient insisted on the restoration which was provided;

• (c) in the opinion of the dentist, 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

• (d) the repair or replacement is required as a result of trauma.\

• (4) The obligation to repair or replace any restoration under sub-paragraph (2) shall cease 12 months after the date on which the restoration was provided or when the treatment on referral has been completed, whichever is the sooner.

• (5) Sub-paragraph (1) shall not apply where the dentist refers a patient for examination and advice only.

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

14

If, owing to any cause beyond his control, the dentist is unable to complete any care and treatment which has been commenced under a continuing care arrangement or a capitation arrangement or treatment on referral, he shall forthwith notify the Board in writing of the extent of the care and treatment or treatment on referral provided and of the reason for his inability to complete the remainder.

Care and treatment summaries

15

Where a patient who has been receiving care and treatment under a continuing care arrangement or a capitation arrangement requests the dentist to provide him with a summary of the care and treatment he has received from the dentist under that arrangement because he intends to enter into such an arrangement with another dentist, the dentist shall provide such a summary as he considers appropriate (including details of any care and treatment which could not be easily observed on a visual examination) to the patient on a form supplied for that purpose by the FHSA, within 28 days of the request.

Mixing of general dental services and private care and treatment

16

• (1) Subject to sub-paragraph (3), a dentist may, with the consent of the patient, provide privately any part of the care and treatment—

• (a) necessary under a continuing care arrangement or a capitation arrangement to secure and maintain the oral health of a patient; or

• (b) to be provided as part of treatment on referral.

• (2) A dentist shall not, with a view to obtaining the agreement of a patient to undergo care and treatment privately—

• (a) advise a patient that the care and treatment which is necessary in his case—

• (i) under the continuing care agreement or the capitation arrangement to secure and maintain oral health, or

• (ii) having regard to the reason given for referral,

is not available from that dentist under general dental services; or

• (b) seek to mislead the patient about the quality of care and treatment available under general dental services.

• (3) Sub-paragraph (1) shall not apply—

• (a) where the treatment necessary to secure oral health relates to a single tooth, in which case the treatment shall be provided wholly under general dental services or wholly privately; and

• (b) in respect of orthodontic care and treatment in which case:—

• (i) the assessment, diagnosis and planning of treatment in connection with the orthodontic care and treatment shall be provided wholly under general dental services or wholly privately; and

• (ii) the orthodontic treatment shall be provided wholly under general dental services or wholly privately.

PART III — OCCASIONAL TREATMENT

17

• (1) A dentist may provide as occasional treatment any of the items of treatment mentioned in sub-paragraph (2).

• (2) The items of treatment referred to in sub-paragraph (1) are—

• (a) examination (including advice);

• (b) extractions of not more than 2 permanent teeth;

• (c) extractions of not more than 4 deciduous teeth, except that, where a general anaesthetic is used, there shall be no limit as to the number of deciduous teeth that may be extracted;

• (d) dressing of deciduous or permanent teeth including any preparatory treatment;

• (e) incising an abscess;

• (f) opening one or more root canals for drainage;

• (g) pulp extirpation and dressing to seal the cavity;

• (h) arrest of haemorrhage;

• (i) treatment of infected sockets;

• (j) removal of plugs or sutures;

• (k) palliative treatment that is immediately necessary (including the treatment of sensitive cementum or dentine, the stoning and smoothing of the surface of a tooth, the provision of a temporary crown or the removal of the fractured portion of a natural crown, where its dissection from supporting soft tissues is necessary prior to the provision of a permanent restoration);

• (l) refixing or recementing a crown, inlay or bridge;

• (m) repair of, or alterations to, dentures or other appliances not requiring the prior approval of the Board;

• (n) treatment for acute conditions of the gingivae or oral mucosa (including treatment for pericoronitis or for ulcers and herpetic lesions) and any necessary oral hygiene instruction in connection with such treatment;

• (o) any treatment immediately necessary as a result of trauma;

• (p) provision of general anaesthesia in connection with the items of treatment specified in heads (b) to (g) and (o);

• (q) provision of sedation in connection with the items of treatment specified in heads (b) to (g), (k), (l) and (o);

• (r) taking of radiographs in connection with the items of treatment specified in heads (b) to (l) and (o);

• (s) issuing a prescription in connection with the items of treatment specified in heads (a) to (o).

• (3) Where a patient has entered into a continuing care arrangement or a capitation arrangement with a dentist, another dentist who is not acting on behalf of that dentist may provide (in addition to the items of treatment specified in sub-paragraph (2)) as occasional treatment to that patient the following items of treatment—

• (a) permanent fillings to not more than 2 retained deciduous teeth or permanent teeth;

• (b) root fillings to not more than 2 permanent teeth;

• (c) replacement of a denture or temporary bridge where the original is lost or damaged beyond repair, or provision of a new denture where it is needed because of trauma or extraction;

• (d) where the patient is under the age of 18, conservation of not more than 2 deciduous teeth; and

• (e) provision of sedation and taking of radiographs in connection with the items of treatment specified in heads (a), (b) and (d).

• (4) If, owing to any cause beyond his control, the dentist is unable to complete any occasional treatment which has been commenced, he shall forthwith notify the Board in writing of the extent of the occasional treatment provided and of the reason for his inability to complete the remainder.

Referral for occasional treatment

18

• (1) Where a patient requires any occasional treatment and the dentist does not have the necessary facilities, experience or expertise to provide that occasional treatment, he shall, if the patient agrees, refer him in accordance with sub-paragraph (2) for the provision of that occasional treatment by another dentist under general dental services or by a hospital or other service provided under Part I of the Act.

• (2) In referring a patient under sub-paragraph (1) to another dentist or to a hospital or other service for that occasional treatment, the dentist shall—

• (a) give details of the oral condition of the patient and the reason for the referral to that other dentist or, as the case may be, that hospital or other service, either at the time of referral or as soon as practicable afterwards;

• (b) include with those details a statement of the amount paid to him by the patient under the National Health Service (Dental Charges) Regulations 1989[^f00028] in respect of any occasional treatment already provided in the course of the occasional treatment during which the referral is made; and

• (c) indicate in his claim for remuneration in respect of that course of occasional treatment that the patient has been referred for the required occasional treatment.

• (3) A dentist who accepts a patient referred to him under sub-paragraph (1) shall provide only the occasional treatment which, in the opinion of the dentist, it is necessary for him to provide having regard to the reason for referral.

PART IV — ADDITIONAL TERMS OF SERVICE FOR ALL DENTISTS

Remuneration

19

• (1) Except as otherwise provided in the Regulations (including the terms of service) or the National Health Service (Dental Charges) Regulations 1989[^f00029], a dentist shall not claim or accept the payment of any fee or other remuneration in respect of any treatment—

• (a) which he has provided under general dental services; or

• (b) which has not been provided or for which another claim has already been submitted to the Board.

Standards of care

20

• (1) In providing general dental services, a dentist shall—

• (a) employ a proper degree of skill and attention;

• (b) save as is provided in paragraphs 12, 18, 21, 29, 35 and 38, give all treatment personally;

• (c) use only materials which are suitable for the purpose for which they are used;

• (d) except in the case of occasional treatment and treatment on referral, provide, subject to sub-paragraph (2), care and treatment, to such extent, and at such intervals, as may be necessary to secure and maintain the oral health of the patient.

• (2) When providing general dental services a dentist shall not provide care and treatment in excess of that which is necessary to secure and maintain oral health.

General anaesthesia and sedation

21

• (1) Where a dentist undertakes, in the course of providing general dental services, any procedure for which general anaesthesia of the patient is necessary, he shall arrange—

• (a) for a doctor or another dentist experienced in the administration of general anaesthesia to administer the general anaesthetic and to remain with the patient throughout the procedure and until the return of the patient’s protective reflexes; and

• (b) for another person with suitable training and experience to remain with the patient until the recovery phase is complete.

• (2) Where a dentist undertakes, in the course of providing general dental services, any procedure for which sedation of the patient is necessary he shall remain with the patient, and arrange for another person with suitable training and experience to remain with the patient, throughout the procedure.

• (3) In this paragraph “a person with suitable training and experience” means a person who has received such training and experience as to be capable of assisting the dentist in monitoring the clinical condition of the patient and in the event of an emergency.

Supply of drugs

22

• (1) A dentist may supply to a patient such listed drugs as are required for immediate use before a supply can otherwise be obtained under paragraph 23.

• (2) A dentist may personally administer to a patient any drug required for the treatment of that patient.

Issue of prescription forms

23

• (1) A dentist shall order such listed drugs (other than those supplied under paragraph 22) as are needed for the treatment of any patient for whom he is providing general dental services by issuing to the patient a prescription form.

• (2) The prescription form—

• (a) shall be signed by the dentist;

• (b) shall not refer to any previous prescription; and

• (c) shall not be issued to persons other than patients;

and a separate prescription form shall be issued for each patient.

Domiciliary visits

24

A dentist shall visit and treat a patient whose condition so requires at the place at which the patient normally resides or is temporarily resident provided that such place is not more than five miles from his practice premises, or in the case of a dentist who provides general dental services at a mobile surgery only, from any of the places regularly visited by him.

Records

25

• (1) A dentist shall keep a record in respect of—

• (a) the care and treatment given to each patient under a continuing care arrangement or a capitation arrangement and the fact of referral under such an arrangement under paragraph 12;

• (b) treatment on referral; or

• (c) occasional treatment,

in the patient record and shall include with that record details of any private care and treatment (to the extent that it is provided with care and treatment under general dental services for the purpose of securing and maintaining oral health), any practice record form and all radiographs, photographs and study models (being models in respect of orthodontic treatment) taken or obtained by him as part of the care and treatment under a continuing care arrangement or a capitation arrangement or treatment on referral or occasional treatment.

• (2) The records, radiographs, photographs and study models referred to in sub-paragraph (1) shall be retained for a period of 2 years after completion of any course of care and treatment under a continuing care arrangement or a capitation arrangement or treatment on referral or occasional treatment to which they relate.

• (3) The dentist shall, during the period in which he holds any records, radiographs, photographs and study models referred to in sub-paragraph (1), produce them to a dental officer or send them to the Board or the FHSA within 14 days of being required to do so by a dental officer, the Board or the FHSA.

• (4) A dentist may keep the records (other than the practice record form) referred to in sub- paragraph (1) in computerised form.

• (5) Nothing in sub-paragraph (1) shall be taken as removing any rights of property which the dentist may have in relation to the records, radiographs, photographs and study models referred to in that sub-paragraph.

Prior approval of treatment

26

• (1) Subject to sub-paragraphs (6), (7) and (10), where care and treatment is or includes prior approval treatment, the dentist—

• (a) shall submit, without unreasonable delay, to the Board for approval an estimate of the whole of the care and treatment, including details of any part of that care and treatment to be provided privately; and

• (b) otherwise than in an emergency, shall not, until he receives approval from the Board, proceed—

• (i) where prior approval is required by virtue of Part I of Schedule 4, with any item of treatment referred to in that Part; or

• (ii) where prior approval is required by virtue of Part II of Schedule 4, with any care and treatment mentioned in the estimate.

• (2) Subject to sub-paragraphs (6), (7) and (10), where in the course of providing any care and treatment to which, at its outset, sub-paragraph (1) does not apply, a dentist is of the opinion that a variation of or addition to such care and treatment is necessary, and by reason of the variation or addition the care and treatment includes or becomes prior approval treatment, the dentist—

• (a) shall submit, without unreasonable delay, to the Board for approval an estimate of the whole of the care and treatment (including that which the dentist has commenced) together with details of any part of that care and treatment provided or to be provided privately; and

• (b) otherwise than in an emergency, shall not, until he receives approval from the Board, proceed—

• (i) where prior approval is required by virtue of Part I of Schedule 4, with any item of treatment referred to in that Part; or

• (ii) where prior approval is required by virtue of Part II of Schedule 4, with any care and treatment mentioned in the estimate.

• (3) Subject to sub-paragraphs (6), (7) and (10), where a dentist has obtained the approval from the Board required by sub-paragraph (1) because the care and treatment is or includes an item of treatment referred to in Part I of Schedule 4, and in the opinion of the dentist a variation of or addition to such care and treatment is necessary, which variation or addition—

• (a) is or includes an item of treatment referred to in Part I of Schedule 4; or

• (b) has the effect that the care and treatment then falls within Part II of Schedule 4,

the dentist shall re-submit, without unreasonable delay, the estimate to the Board for approval, including details of any part of that care and treatment provided or to be provided privately.

• (4) Subject to sub-paragraphs (6), (7) and (10), where a dentist has obtained approval from the Board in accordance with sub-paragraph (1) because prior approval is required by virtue of Part II of Schedule 4 and in the opinion of the dentist a variation of or addition to such care and treatment is necessary, the dentist shall re-submit, without unreasonable delay, the estimate to the Board for approval together with details of any part of that care and treatment provided or to be provided privately.

• (5) Where the Board receives an estimate under sub-paragraphs (3) or (4) it may withdraw or vary its original approval in so far as the care and treatment has not yet been carried out in accordance with such approval, or add to its original approval, and, otherwise than in an emergency, the dentist shall not, until he receives approval from the Board, proceed—

• (a) in any case falling within sub-paragraph (3)(a), with any item of treatment referred to in Part I of Schedule 4; or

• (b) in any other case, with any of the care and treatment mentioned in the estimate.

• (6) Sub-paragraphs (1), (2), (3) and (4) shall not apply where the care and treatment to be provided under a capitation arrangement is care and treatment for which the dentist is remunerated in accordance with Section X (treatment under capitation) of Determination I of the Statement of Dental Remuneration dated 1st June 1991 and amended on 9th January 1992 and for which he receives no remuneration other than a capitation payment.

• (7) The dentist may proceed immediately with the care and treatment of merchant seamen, deep sea fishermen, or oil rig workers, about to go to sea for a period in excess of four weeks, or persons about to go abroad for a period in excess of four weeks, and in such event shall send an estimate to the Board for approval within 7 days of the commencement of the care and treatment.

• (8) Where, in consequence of any proceedings under the National Health Service (Service Committees and Tribunal) Regulations 1992[^f00030] in respect of general dental services provided in the locality of any FHSA, a dentist is required for any period to submit all estimates to the Board for approval, in respect of all treatment or any specified description of treatment, the dentist—

• (a) shall submit, without unreasonable delay, all such estimates (whether relating to treatment to be provided in that or any other locality) to the Board for approval; and

• (b) shall not proceed with such treatment until he receives approval from the Board, except that he may in the course of any single consultation, proceed with treatment consisting of one examination and the taking of no more than two small radiographs, each of a size not exceeding 16 square centimetres, or treatment in an emergency.

• (9) Where in consequence of a direction given by the Board under regulation 29 a dentist is directed, for any period, to submit all estimates to the Board for approval in respect of treatment or a description of treatment specified in the direction the dentist—

• (a) shall submit, without unreasonable delay, all such estimates (relating to treatment in the locality of any FHSA) to the Board for approval; and

• (b) shall not proceed with such treatment until he receives approval from the Board, except that he may in the course of any single consultation, proceed with treatment consisting of one examination and the taking of no more than two small radiographs, each of a size not exceeding 16 square centimetres, or treatment following trauma or in an emergency.

• (10) Nothing in this paragraph shall prevent a dentist carrying out any care and treatment privately.

Completion of an estimate

27

• (1) Subject to sub-paragraphs (2), (3) and (4), when submitting an estimate to the Board for approval in accordance with paragraph 26(1), (2), (3), (4), (8) or (9), a dentist shall in all cases, in addition to the information specified in those paragraphs, provide to the Board the following information—

• (a) his name and address and the number by which his arrangement with the FHSA is identified;

• (b) the patient’s name and address, sex and date of birth; and

• (c) details of the care and treatment proposed and the reasons why the dentist considers such care and treatment is necessary.

• (2) Subject to sub-paragraph (3), a dentist who is required as mentioned in sub-paragraph (1) to send an estimate to the Board may, by arrangement with the Board, use a computer to send that estimate to the Board.

• (3) Sub-paragraph (2) shall not apply to any estimate in respect of orthodontic care and treatment.

• (4) A dentist who, in accordance with sub-paragraph (2), uses a computer to send an estimate—

• (a) shall at the appropriate time secure the completion, so far as applicable, by the patient or by any person acting on behalf of the patient, of the practice record form;

• (b) shall use only such a computer program as the Board has approved as suitable for the purpose; and

• (c) shall include with that estimate—

• (i) all the information specified in sub-paragraph (1)(a), (b) and (c) except his name and address; and

• (ii) the personal identification number allocated to him by the Board for that purpose.

Completion of care and treatment under a continuing care arrangement or a capitation arrangement or treatment on referral

28

• (1) Subject to sub-paragraphs (2) and (4), the dentist shall complete within a reasonable time any course of care and treatment under a continuing care arrangement or a capitation arrangement or treatment on referral.

• (2) Where the dentist and the patient agree that the patient requires dentures, or new dentures, in consequence of treatment provided by that dentist involving the extraction of one or more teeth, the dentist shall provide such dentures within 12 months of the date of the relevant extraction or, as the case may be, the later or last such extraction.

• (3) In so far as any treatment relates to the provision of dentures, it shall not be regarded as completed unless the dentures have been delivered to, and remain in the possession of, the patient.

• (4) A dentist shall not be regarded as having failed to comply with sub-paragraphs (1) and (2) by reason of any delay in completing treatment where the Board is satisfied that the delay is due to the failure of the patient to attend for treatment or that there is some other sufficient reason for the delay.

• (5) Where a dentist—

• (a) has been notified that a patient has been requested to submit himself for examination by a dental officer; and

• (b) has not been notified that the examination has been carried out or cancelled,

he shall not, otherwise than in an emergency, provide any care and treatment to that patient and shall take all reasonable steps to facilitate the examination.

• (6) Where a dentist—

• (a) has been notified that a dental service committee, a joint services committee or a denture conciliation committee will investigate a complaint or reference relating to the provision of general dental services by him to a patient; and

• (b) has not been notified—

• (i) that the investigation has been completed; or

• (ii) that such committee has no objection,

he shall not, otherwise than in an emergency, provide any care and treatment to that patient and shall take all reasonable steps to facilitate the investigation.

• (7) Nothing in this paragraph shall prevent a dentist carrying out any care and treatment privately.

Dental auxiliaries

29

A dentist may in the provision of general dental services arrange for care and treatment to be given in accordance with the provisions of regulations having effect under section 45 of the Dentists Act 1984[^f00031] by a dental auxiliary to whom those regulations apply, and shall ensure that such care and treatment is properly completed.

Postgraduate education

30

A dentist shall in the provision of general dental services take reasonable steps to develop professional knowledge and skills through activities undertaken with a view to maintaining an up-to-date knowledge of dental science and practice.

Notices

31

A dentist shall display in a prominent position at the practice premises a notice, in a form supplied or approved by the FHSA, indicating NHS charges which are payable under general dental services and entitlement to exemption from and remission of NHS charges.

PART V — ADDITIONAL TERMS OF SERVICE FOR DENTISTS OTHER THAN SALARIED DENTISTS

Patient information leaflets

32

• (1) Subject to sub-paragraph (4), a dentist shall compile and make available, to the FHSA (if it requires one) and to any person who may reasonably require one, a document about the provision of general dental services at his practice premises (in this paragraph called a “patient information leaflet”) which shall include the information specified in Schedule 5.

• (2) A dentist shall make any amendments to his patient information leaflet which he considers to be necessary to maintain its accuracy.

• (3) A dentist who practises in partnership or under an associateship agreement with other dentists whose names are included in the dental list satisfies the requirements of this paragraph if he makes available a patient information leaflet, compiled and, where appropriate, amended in accordance with sub-paragraphs (1) and (2), which relates to the partnership or associateship as a whole.

• (4) The requirements of sub-paragraph (1) shall not apply to any dentist to the extent that he provides general dental services to persons detained in a prison or a young offender institution.

Premises etc

33

• (1) Unless he provides general dental services from a mobile surgery only, a dentist shall provide proper and sufficient dental surgery and waiting-room accommodation for his patients.

• (2) A dentist who provides general dental services at a mobile surgery shall provide proper and sufficient mobile surgery and waiting-room accommodation.

• (3) A dental surgery and a mobile surgery shall be furnished with suitable equipment and a dentist shall provide treatment with suitable instruments.

• (4) A dentist, on receipt of reasonable notice in writing, shall at all reasonable times admit a dental officer or a person authorised by the FHSA for the purpose of inspecting any dental surgery, mobile surgery or waiting-room under the dentist’s control.

Remuneration

34

The provisions of paragraph 19 shall not have effect in relation to any claim made by a dentist in respect of loss of remuneration resulting from the failure of a patient to keep an appointment for general dental services.

Deputies and assistants

35

• (1) Where a dentist is prevented from providing care and treatment by reason of temporary absence through illness or other reasonable cause, such care and treatment may be given by a deputy or assistant.

• (2) In the case of two or more dentists practising in partnership or as a principal and assistant, care and treatment may at any time be given by a partner or an assistant of the dentist who is responsible for the patient’s care and treatment, if reasonable steps are taken to secure continuity of care and treatment.

• (3) A dentist shall not employ more than two assistants at any one time for the provision of general dental services in a locality without the consent of the FHSA for that locality, or on appeal the Secretary of State.

• (4) Before giving any consent under sub-paragraph (3) an FHSA shall consult the Local Dental Committee for its locality, and any consent given under that sub-paragraph shall be reviewed by the FHSA in consultation with the Local Dental Committee at least once a year and may be confirmed or withdrawn by the FHSA.

• (5) A dentist shall—

• (a) notify the FHSA of the employment of an assistant within 7 days of the first day of such employment;

• (b) forward to the FHSA such particulars concerning the assistant as the FHSA may reasonably require; and

• (c) on ceasing to employ an assistant, notify the FHSA within 7 days of the cessation of that employment.

• (6) A dentist shall not employ as an assistant any dentist who has the same address in the dental list as any of his own practice premises.

• (7) Where a dentist employs an assistant who to the dentist’s knowledge is subject to a requirement mentioned in paragraph 26(8) or (9) to submit estimates to the Board for prior approval in respect of treatment, he shall not allow the assistant to carry out the treatment unless the prior approval of the Board has first been obtained.

• (8) If a dentist intends to absent himself from his practice premises for more than 28 consecutive days he shall notify the FHSA of—

• (a) his intended absence; and

• (b) the name and address, if different to the practice premises, of the deputy or assistant (if any) responsible for providing general dental services during his absence.

• (9) A dentist who intends to be or is absent from his practice premises for more than two months—

• (a) shall notify the FHSA in writing; and

• (b) shall not employ an assistant for any period of absence in excess of two months without the consent of the FHSA.

• (10) A dentist shall not, without the consent of the Secretary of State, employ as a deputy or assistant for the purpose of the provision of general dental services any dentist who is disqualified for inclusion in the dental list of any FHSA by virtue of the provisions of section 36(2), 47(1) or 48(b) of the Act.

• (11) Except as provided in sub-paragraph (12), a dentist shall be responsible for all acts and omissions of any dentist acting as his deputy or assistant.

• (12) A dentist, whose name is included in a dental list, when acting as a deputy to another dentist whose name is also included in that list, shall be responsible for his own acts and omissions in relation to the obligations under these terms of service of the dentist for whom he acts as deputy and for the acts and omissions of any person employed by him or acting on his behalf.

• (13) A deputy may provide general dental services at places or at times other than those arranged by the dentist for whom he is acting, due regard being had to the convenience of patients.

36

A deputy or assistant who issues a prescription form for listed drugs under paragraph 23, shall, in addition to signing his own name on the prescription form, insert on the form the name of the dentist for whom he is acting.

37

A deputy or assistant who signs a claim for remuneration or an estimate or part thereof on behalf of the dentist for whom he is acting shall do so in his own name and, except where the person who signs is a partner whose name is included in the dental list, shall also insert the name of the dentist for whom he is acting.

Dentists suspended under section 28 or 32 of the Dentists Act 1984

38

Where a dentist’s registration in the register kept under section 14 of the Dentists Act 1984[^f00032] is suspended by a direction or order of the Health Committee under section 28 of that Act (health cases) or by an order under section 32 of that Act (interim suspension order), he shall secure that any dentist appointed by him to provide general dental services on his behalf during that period of suspension shall be a dentist whose name is included in the dental list.

PART VI — ADDITIONAL TERMS OF SERVICE FOR SALARIED DENTISTS

Attendance

39

• (1) A dentist shall attend at such premises (being health centre premises) on such days and at such hours as he may agree with the FHSA.

• (2) Except where paragraph 16 applies a dentist may not, without the permission of the FHSA, provide at such premises any care and treatment which is not part of general dental services.

General anaesthetics

40

Where required to do so by the FHSA, or on behalf of that FHSA, the dentist shall pay to a doctor or another dentist, for the administration of general anaesthetic by virtue of arrangements made under paragraph 21, a fee not exceeding the fee in the Scale of Fees appropriate to the item of treatment provided.

Records

41

• (1) The records, radiographs, photographs and study models referred to in paragraph 25(1) shall be the property of the FHSA.

• (2) The dentist shall supply to the Board or a dental officer such information with regard to the care and treatment of patients as they may request within 7 days of the date of the request.

Drugs

42

Any drugs supplied under paragraph 22 shall be obtained by the dentist in such a manner as the FHSA may require.

Provision of FHSA patient information leaflets

43

A salaried dentist shall make available to any person who may reasonably require one the FHSA patient information leaflet compiled, and provided to him, by the FHSA pursuant to regulation 16.

Termination of services

44

• (1) Subject to sub-paragraph (2), any arrangement beween the FHSA and a salaried dentist for the provision of general dental services may be terminated by either party giving to the other three months' notice in writing.

• (2) If a dentist fails to comply with any of the terms of service that apply to a salaried dentist the FHSA may terminate the arrangement by giving him one month’s notice in writing.

• (3) The FHSA may at any time suspend a salaried dentist from the discharge of his duties but such suspension shall not affect the right of the salaried dentist to receive remuneration during the period of suspension.

SCHEDULE 2

PART I — Information and undertaking to be included in an application for inclusion in the dental list

1

Full name.

2

Sex.

3

Date of birth.

4

Private address.

5

Date of registration as a dental practitioner in the register kept under section 14 of the Dentists Act 1984[^f00033] and registration number, dental qualifications registrable under that Act and when obtained.

6

Address of proposed practice premises and in the case of any mobile surgery, the address to which correspondence may be sent.

7

Proposed days and hours of attendance and whether patients will be seen by appointment only and in the case of any mobile surgery, particulars of places to be visited regularly by the dentist and the times of those visits.

8

Undertaking to provide general dental services in the locality of the FHSA.

9

Whether intending to practise—

• (a) as a single-handed practitioner; or

• (b) as a partner and if so the name and address of each intended partner and whether or not his name is included in the FHSA’s dental list; or

• (c) as an associate and if so the name and address of each intended associate and whether or not his name is included in the FHSA’s dental list.

10

The names of any assistants he or any person referred to in paragraph 9(b) or (c) intends to employ or already employs at the proposed practice premises.

11

Present or most recent appointment and whether any previous experience in the provision of general dental services.

12

Whether the general dental services to be provided are restricted to orthodontic treatment.

13

Whether there is access to the proposed dental surgery without the use of stairs.

PART II — Information which may be included in an application for inclusion in the dental list

Details of any languages, other than English, spoken by the dentist.

SCHEDULE 3

Information to be provided about care and treatment under general dental services

1

Details of arrangements in an emergency.

2

Details of repairs and replacements free of charge.

3

Explanation of care and treatment to be provided.

4

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

5

Details of care and treatment available under general dental services.

6

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

7

Explanation of the arrangements for cancelling appointments.

8

Explanation of the importance of regular care.

9

The consequences of the termination of a continuing care arrangement or a capitation arrangement.

SCHEDULE 4 — PRIOR APPROVAL TREATMENT

PART I — Items of treatment

Any item of treatment specified in Determination I of the Statement of Dental Remuneration dated 1st June 1991 and amended on 9th January 1992 as being an item of treatment for which the prior approval of the Board is required.

PART II — Care and treatment

1

A course of care and treatment under a continuing care arrangement or a capitation arrangement or any treatment on referral, the cost of which exceeds or is likely to exceed £600.

2

Any orthodontic care and treatment to be provided by that dentist, the cost of which exceeds or is likely to exceed £600.

3

A reference in this Part of this Schedule, to the cost of care and treatment means the cost of such care and treatment calculated in accordance with the Scale of Fees, but does not include the cost of—

• (a) any care and treatment under a capitation arrangement for which the dentist is remunerated in accordance with Section X (treatment under capitation) in Determina tion I of the Statement of Dental Remuneration dated 1st June 1991 and amended on 9th January 1992 and for which he receives no remuneration other than a capitation payment;

• (b) in the case of orthodontic care and treatment, fees for diagnosis, study models and retention; and

• (c) any part of the care and treatment to be provided privately.

SCHEDULE 5 — INFORMATION TO BE INCLUDED IN PATIENT INFORMATION LEAFLETS

1

The following personal and professional details of the dentist:—

• (a) Name.

• (b) Sex.

• (c) Date of registration as a dental practitioner in the register kept under section 14 of the Dentists Act 1984[^f00034] and details of dental qualifications registrable under that Act.

2

The following additional information about the provision of general dental services at practice premises:—

• (a) The address of all the practice premises and where he provides general dental services at a mobile surgery only, the address to which correspondence may be sent.

• (b) Particulars of the days and hours when the dentist is or will be usually in attendance at the practice premises, and in the case of any mobile surgery, particulars of the places visited regularly by him and the times of those visits.

• (c) The names of all dentists at the practice premises including partners, associates and assistants and details for them as specified in paragraph 1 of this Schedule.

• (d) Whether a dental hygienist is employed at the practice premises.

• (e) Whether there is access to the dental surgery without the use of stairs.

• (f) Whether the practice premises (including the dental surgery and toilets) are accessible to wheelchairs.

• (g) Whether the dentist or any person referred to in sub-paragraph (c) provides only orthodontic treatment.

• (h) Provided the dentist consents to their inclusion, details of any languages, other than English, spoken by the dentist.

SCHEDULE 6 — INFORMATION TO BE INCLUDED IN FHSA PATIENT INFORMATION LEAFLETS

1

The following personal and professional details of any salaried dentist providing general dental services at a health centre:—

• (a) Name.

• (b) Sex.

• (c) Date of registration as a dental practitioner in the register kept under section 14 of the Dentists Act 1984[^f00034] and details of dental qualifications registrable under that Act.

2

The following additional information about the provision of general dental services at health centres:—

• (a) The addresses of all the health centres within its locality at which general dental services are provided.

• (b) Particulars of the days and hours when general dental services are provided at the health centre and, where an FHSA make arrangements for a salaried dentist to provide general dental services at a mobile surgery, particulars of the places visited regularly by the salaried dentist and the times of those visits.

• (c) Whether a dental hygienist is employed at the health centre.

• (d) Whether there is access to the dental surgery at the health centre without the use of stairs.

• (e) Whether the health centre (including the dental surgery and toilets) is accessible to wheelchairs.

• (f) Provided the salaried dentist consents to their inclusion, details of any languages, other than English, spoken by the salaried dentist.

SCHEDULE 7 — REVOCATIONS

(1)	(2)	(3)
Regulations revoked	References	Extent of revocation
The National Health Service (General Dental Services) Regulations 1973	S.I. 1973/1468	The whole Regulations
The National Health Service (General Dental Services) Amendment Regulations 1980	S.I. 1980/986	The Whole Regulations in so far as they have not been revoked
The National Health Service (Linguistic Knowledge for General Medical Services and General Dental Services) Regulations 1981	S.I. 1981/774	The Whole Regulations
The National Health Service (General Dental Services) Amendment Regulations 1984	S.I. 1984/760	The Whole Regulations
The National Health Service (General Dental Services) Amendment (No. 2) Regulations 1984	S.I. 1984/1424	The Whole Regulations
The National Health Service (General Dental Services) Amendment Regulations 1985	S.I. 1985/1336	The Whole Regulations
The National Health Service (General Dental Services) Amendment Regulations 1986	S.I. 1986/1499	The Whole Regulations
The National Health Service (General Dental Services) Amendment Regulations 1987	S.I. 1987/736	The Whole Regulations
The National Health Service (General Dental Services) Amendment (No. 2) Regulations 1987	S.I. 1987/1512	The Whole Regulations
The National Health Service (General Dental Services) Amendment (No. 3) Regulations 1987	S.I. 1987/1965	The Whole Regulations
The National Health Service (General Dental Services) Amendment (No. 2) Regulations 1988	S.I. 1988/2265	The Whole Regulations
The National Health Service (General Dental Services) Amendment Regulations 1989	S.I. 1989/613	The Whole Regulations
The National Health Service (General Dental Services) Amendment (No. 2) Regulations 1989	S.I. 1989/832	The Whole Regulations
The National Health Service (General Dental Services) Amendment (No. 3) Regulations 1989	S.I. 1989/1629	The Whole Regulations
The National Health Service (General Dental Services) (Miscellaneous Amendments) Regulations 1990	S.I. 1990/1638	The Whole Regulations except regulations 15 and 17(4)
The National Health Service (General Dental Services) (Miscellaneous Amendments) (No. 2) Regulations 1990	S.I. 1990/1938	The Whole Regulations
The National Health Service (General Dental Services) Amendment Regulations 1990	S.I. 1990/2501	The Whole Regulations
The National Health Service (Dental Services) (Miscellaneous Amendments) Regulations 1991	S.I. 1991/581	The Whole Regulations except regulation 13
The National Health Service (General Dental Services) Amendment Regulations 1991	S.I. 1991/1348	The Whole Regulations
The National Health Service (General Dental Services) (Miscellaneous Amendments) Regulations 1992	S.I. 1992/24	The Whole Regulations

Signed

William Waldegrave — Secretary of State for Health — 10th March 1992

Explanatory note

(This note is not part of the Regulations)

These Regulations provide for the arrangements under which general dental services are provided under Part II of the National Health Service Act 1977. They supersede the National Health Service (General Dental Services) Regulations 1973 (“the 1973 Regulations”).

The provision made by these Regulations differs from that made in the 1973 Regulations in a number of respects.

Family Health Services Authorities (“FHSAs”) are to prepare, each year where necessary, an updated list (“the dental list”) of dentists providing general dental services in their localities (regulation 4(8)). FHSAs are to determine applications for inclusion in the dental list within 14 days, unless the dentist’s proposed practice premises are to be inspected by the FHSA, in which case the application is to be determined within 14 days of such inspection (regulation 5(2)). Regulation 7(2) prevents the inclusion of a dentist’s name in a dental list if the FHSA is not satisfied, following an inspection, that his proposed practice premises are of a satisfactory standard. An FHSA may remove a dentist’s name from the dental list on the grounds that he has not for the preceding six months provided general dental services, but in the calculation of that period any absence because of the dentist’s service in the armed forces or maternity leave or sickness is to be disregarded (regulation 8(5)). Provision is made for FHSAs to make arrangements with dentists to provide general dental services in urgent cases at times when general dental services are not normally available (regulation 14).

FHSAs are required, from 1st October 1992, to prepare patient information leaflets (“FHSA patient information leaflets”) about the provision of general dental services at any health centre in their locality (regulation 16 and Schedule 6). Prison governors (and in the case of a contracted out prison, the director or controller) may make an application to dentists for general dental services on behalf of persons detained in prison or at young offender institutions (regulation 18). Provision for payments to dentists during periods where their registration is suspended under the Dentists Act 1984 (by an interim suspension order or a direction of the Health Committee) is extended and the amounts payable are increased (regulation 26). Provision is also made for the Dental Practice Board to conduct or commission surveys or other research relating to the provision of general dental services (regulation 30).

The terms of service under which dentists provide general dental services to their patients are set out in Schedule 1. The principal changes to these terms of service are as follows.

The provision relating to the mixing of general dental services and private care and treatment is extended to salaried dentists (paragraph 16). Paragraph 21 imposes special obligations on dentists in connection with the administration of sedation. Provision is also made regarding dental records, which must be retained for a period of 2 years but may be kept on computer (paragraph 25). A dentist must allow the FHSA to inspect his practice premises provided that he has been given reasonable notice of its intention to do so (paragraph 33).

Other provisions of these Regulations (including the terms of service) differ from those of the 1973 Regulations in minor respects, or in consequence of other changes which are mentioned above.

Copies of Determination 1 of the Statement of Dental Remuneration, which is referred to in these Regulations, may be obtained from the Department of Health, Room 528, Portland Court, 160 Great Portland Street, London W1N 5TB.

Footnotes

[^f00001]: 1977 c. 49; in section 128(1) see the definitions of “prescribed” and “regulations”. Section 15(1)(b) was amended by the National Health Service and Community Care Act 1990 (c. 19) (“the 1990 Act”), section 12. Section 35(1) was substituted by S.I. 1985/39, article 7(9). Section 36 was amended by S.I. 1981/432, article 3(3), the Health and Social Security Act 1984 (c. 48), section 5(4) and Schedule 3, paragraph 5, S.I. 1985/39, article 7(10), the Health and Medicines Act 1988 (c. 49) (“the 1988 Act”), section 25(1) and Schedule 2, paragraph 4 and the 1990 Act, section 24 and was extended by section 17 of the 1988 Act. Section 37 was renumbered so as to become section 37(1) by section 12(2) of, section 37(1)(a) was amended by section 25 of, and Schedule 3 to, and subsections (1A) and (1C) were inserted by section 12(3), of the 1988 Act. Section 43(1) was amended by the Health Services Act 1980 (c. 53), section 21(2) and Schedule 1, paragraph 55, S.I. 1985/39, article 7(15) and the 1990 Act, section 66(1) and Schedule 9, paragraph 18(2). Section 126(4) was amended by the 1990 Act, section 65(2).

[^f00002]: S.I. 1992/662.

[^f00003]: See section 10(1) of the National Health Service Act 1977 (c. 49), amended by the Health and Social Security Act 1984 (c. 48), section 5 and section 2 of the National Health Service and Community Care Act 1990 (c. 19).

[^f00004]: Section 41 was amended by the Health Services Act 1980 (c. 53), section 20, Schedule 1, paragraphs 53 and 96 and Schedule 7, S.I. 1985/39, article 7(13) and the National Health Service and Community Care Act 1990 (c. 19), Schedule 9.

[^f00005]: Section 44 was amended by section 12 of the National Health Service and Community Care Act 1990 (c. 19).

[^f00006]: S.I. 1989/394 amended by S.I. 1990/1638, 1991/581 and 1992/369.

[^f00007]: 1988 c. 49.

[^f00008]: 1984 c. 24.

[^f00009]: See section 15(1A) of the National Health Service Act 1977 (c. 49) inserted by section 12(1)(c) of the National Health Service and Community Care Act 1990 (c. 19).

[^f00010]: See S.I. 1990/1525.

[^f00011]: 1978 c. 29.

[^f00012]: S.I. 1980/362; the relevant amending instrument is S.I. 1981/1205.

[^f00013]: S.I. 1980/1177.

[^f00014]: 1984 c. 24.

[^f00015]: Section 46 was amended by the Health and Social Security Act 1984 (c. 48), section 24 and Schedule 8 and S.I. 1985/39, article 7(16).

[^f00016]: 1989 c. 41.

[^f00017]: 1991 c. 53.

[^f00018]: S.I. 1989/394, amended by S.I. 1990/1638, 1991/581 and 1992/369.

[^f00019]: See S.I. 1991/580.

[^f00020]: S.I. 1992/664.

[^f00021]: 1984 c. 24.

[^f00022]: 1984 c. 24.

[^f00023]: S.I. 1992/664.

[^f00024]: S.I. 1992/664.

[^f00025]: S.I. 1992/664.

[^f00026]: S.I. 1989/394 amended by S.I. 1990/1638, 1991/581 and 1992/369.

[^f00027]: S.I. 1989/394 amended by S.I. 1990/1638, 1991/580 and 1992/369.

[^f00028]: S.I. 1989/394 amended by S.I. 1990/1638, 1991/580 and 1992/369.

[^f00029]: S.I. 1989/394 amended by S.I. 1990/1638, 1991/580 and 1992/369.

[^f00030]: S.I. 1992/664.

[^f00031]: 1984 c. 24; section 45 was amended by Order in Council S.I. 1991/1705 and see S.I. 1986/887 amended by S.I. 1991/1706.

[^f00032]: 1984 c. 24.

[^f00033]: 1984 c. 24.

[^f00034]: 1984 c. 24.