Legalize / United Kingdom / Wales / Welsh-Statutory-Instrument

The National Health Service (General Dental Services Contracts and Patient Charges) (Wales) Regulations 2026

Type Welsh-Statutory-Instrument

Publication 2026-02-09

Last updated 2026-03-11

State In force

Jurisdiction Wales

Department King's Printer of Acts of Parliament

Source legislation.gov.uk

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(d) a requirement that a contractor may acquire a new active patient where—

(i) that patient has attended for an urgent care appointment and requires a further appointment,

(ii) that patient agrees that the further appointment can be at the contractors practice, and

(iii) the contractor has sought and been given permission from the Local Health Board to accept a new patient, and

(e) a requirement that a contractor may acquire a new active patient if the patient is the child or grandchild of an existing active patient in which case permission does not need to be sought but the contractor must notify the Local Health Board.

Minimum requirements for new patient assessments

10

A new patient assessment must include—

(a) completion of an ACORN assessment,

(b) a full review of the patient’s medical, dental and lifestyle history (including relevant social history),

(d) a clinical examination including periodontal assessment, caries detection, and an oral soft tissue examination,

(e) an inspection of each tooth for signs of cracks, wear, chips and caries,

(f) an examination of existing restorations and prosthetics for integrity, fit and damage,

(g) a radiographic examination where the need for one is clinically indicated,

(h) risk allocation between low, moderate, or high categories in accordance with paragraphs 31 to 33,

(i) an occlusion assessment including an orthodontic assessment for children when clinically indicated,

(j) a temporomandibular joint examination when clinically indicated,

(k) provision of tailored preventative advice and oral health promotion using evidence-based guidance,

(l) formulation of a personalised care package or combination of care packages where further treatment is necessary, and

(m) comprehensive clinical records and outcome measures.

Payments

11

The Local Health Board must arrange for each contractor to be remunerated for each new patient assessment appointment in accordance with directions issued by the Welsh Ministers under section 60 of the 2006 Act.

PART 3 — Care packages

12

The contract must include the following requirements as to the provision of care packages.

Care package content

13

A contractor may only provide a care package of a type listed in Schedule 2.

Content of care package

14

Each care package must include—

(a) the relevant services indicated in the second column of the table in Schedule 2 which, in the clinical judgment of the dental practitioner, are most appropriate for the treatment of the patient,

(b) preventative interventions appropriate to the patient’s risk profile,

(d) definitive treatment for diagnosed conditions,

(e) a recall interval based on clinical risk, and

(f) patient education and self-care support.

Treatment plans

15

(1) A contractor which provides a care package to be delivered over more than one appointment must, at the time of the first examination of the patient, ensure that the patient is provided with a treatment plan on a form supplied for that purpose by the Local Health Board specifying—

(a) the name of the patient,

(b) the name of the contractor,

(c) the details of the places where the patient is intended to receive the course of treatment under the care package to be provided to them by the contractor,

(d) the telephone number at which the contractor may be contacted during its normal surgery hours,

(e) details of the services which are at the date of that examination considered to be necessary for the contractor to provide having regard to the reason for and the risk allocation of the care package, and

(f) any proposals the contractor may have for private dental services as an alternative to the services proposed under the contract, including details of the cost to the patient if they were to accept the provision of private dental services.

(2) If the patient, having considered the treatment plan provided in accordance with sub-paragraph (1), decides to accept the provision of private dental services in place of all or part of services under the contract, the contractor must ensure that the patient signs that plan in the appropriate place to indicate that they have understood the nature of private dental services to be provided and their acceptance of those private dental services.

(3) Where the services included in the treatment plan need to be varied for clinical reasons, the contractor must provide the patient with a revised referral treatment plan in accordance with sub-paragraph (1).

(4) The contractor must, subject to the termination of the contract, or being unable to complete a course of treatment in accordance with paragraph 6(5) or (6) of Schedule 3 (course of treatment), provide the services which are detailed in the referral treatment plan, or where a revised treatment plan is provided pursuant to sub-paragraph (3), pursuant to that revised treatment plan.

Missed appointments

16

When a contractor puts a patient onto a care package they must communicate orally and in writing that the contractor must, unless it is satisfied that the missed appointments were caused because of something beyond the control of the patient, begin the de-listing process in accordance with paragraph 17, where a patient during the course of a care package—

(a) fails to attend two consecutive appointments, or

(b) fails to attend three appointments in total.

De-listing notification – care packages

17

Upon initiating de-listing, the contractor must—

(a) notify the patient in writing of the intention to remove them from their list of active patients, including the reasons and the number of missed appointments,

(b) provide the patient with an opportunity to respond within 14 clear days and, if they do respond, consider whether the de-listing process should be stopped, and

De-listing

18

If no response that allows the contractor to be satisfied in accordance with paragraph 16 is received within the period specified in paragraph 17(b), or if the patient confirms they no longer wish to continue care, the contractor must—

(a) de-list the patient from the care package, and

(b) advise the patient to re-apply through the Dental Access Portal for re-allocation.

Payments

19

(1) Subject to sub-paragraph (2) the Local Health Board must arrange for each contractor to be remunerated for the delivery of care package in accordance with directions issued by the Welsh Ministers under section 60 of the 2006 Act.

(2) The contract must provide that—

(a) periodontal care packages are limited to two a year for each patient, and

(b) total provision of crown, bridge, inlay, onlay and veneer care packages must not exceed 10% of annual contract value annually unless prior written approval has been obtained from the Local Health Board.

Payments after de-listing

20

(1) Subject to sub-paragraph (2), the contract must provide that—

(a) where a patient is de-listed under paragraph 17(b), the contractor may claim the full value of the care package, provided that—

(i) the patient had attended at least one appointment,

(ii) the contractor can demonstrate that they made adequate efforts to ensure the patient’s attendance and have written to the patient to explain that the care package has ended and that the patient must register to be reallocated through the Dental Access Portal, and

(iii) evidence of the efforts made is retained for 24 months by the contractor and made available on request for audit purposes;

(b) the contractor may claim the full value of the care package where a care package has been ended by—

(i) the contractor where—

(aa) the circumstances referred to in paragraph 3(1) of Schedule 3 (violent patients) occur and notice that it is no longer willing to provide services to the patient has been given to the Local Health Board,

(bb) the patient has refused to pay a charge in the circumstances referred to in paragraph 4 of Schedule 3 (patients who refuse to pay NHS charges before the start of, or during, treatment), or

(cc) in the reasonable opinion of the contractor, there has been an irrevocable breakdown in the relationship between the patient and that contractor and, notice of such a breakdown has been given to the patient and the Local Health Board,

(ii) the patient, or

(iii) a person specified in paragraph 1(2) of Schedule 3 acting on the patient’s behalf.

(2) The amount claimed under sub-paragraph (1)(a) and (b) must be reduced in circumstances where the patient charge calculated in accordance with Schedule 5, in addition to the sum claimed, means payment in excess of the value of the care package is due so that the combined payment and charge is not more than the value of the care package.

PART 4 — Prevention services

Requirement to provide prevention services

21

The contract must include a requirement that the contractor provides prevention services to new patients and active patients in accordance with this Part.

22

The purpose of prevention services is to—

(a) reduce the number of cases of oral disease,

(b) promote good oral health behaviours,

(d) support patients in maintaining optimal oral health.

Scope of prevention services

23

Prevention services must include the provision of tailored preventative advice and interventions appropriate to the patient’s age, risk profile, and clinical needs.

services

24

Prevention services must be provided—

(a) as part of every new patient assessment,

(b) as part of every recall appointment,

(d) as a standalone intervention where clinically indicated.

25

Prevention services must include, as appropriate to the individual patient’s needs, advice and interventions relating to—

(a) oral hygiene instruction, including—

(i) tooth brushing technique and frequency;

(ii) interdental cleaning methods;

(iii) tongue cleaning where appropriate;

(iv) denture care where applicable;

(b) dietary advice, including—

(i) the role of sugar in dental disease;

(ii) frequency and timing of sugar consumption;

(iii) acidic food and drink consumption;

(iv) healthy eating for oral health;

(i) fluoride toothpaste concentration appropriate to age and risk;

(i) fluoride varnish application where clinically indicated;

(ii) fluoride supplements where appropriate;

(iii) other topical fluoride products where indicated;

(d) lifestyle factors, including—

(i) smoking cessation advice and signposting to support services;

(ii) alcohol consumption and its effects on oral health;

(iii) recreational drug use and oral health impacts;

(e) oral cancer awareness, including—

(i) risk factors for oral cancer;

(ii) self-examination techniques;

(iii) when to seek professional advice;

(f) trauma prevention, including—

(i) mouthguard use for sports and recreational activities;

(ii) prevention of dental injuries in children;

(g) age-specific advice, including—

(i) for infants and young children: teething, bottle feeding, dummy use, and early childhood caries prevention;

(ii) for adolescents: orthodontic care, wisdom teeth, oral piercing risks;

(iii) for pregnant women: oral health during pregnancy and early childhood oral health;

(iv) for older adults: dry mouth management, denture care, medication effects on oral health.

Content of prevention services

26

(1) A contractor must deliver prevention services—

(a) in a way appropriate to the patient’s age, understanding, and communication needs,

(b) using language that is clear and accessible to the patient,

(d) with written reinforcement of key messages where clinically indicated, and

(e) with demonstration of techniques where appropriate.

(2) A contractor may deliver prevention services—

(a) face-to-face during clinical appointments,

(b) through remote digital technology where appropriate and with the patient’s consent,

(d) through a combination of the above methods.

Delivery of prevention services

27

Prevention services may be delivered by any appropriately trained member of a contractor’s dental team, including—

(a) dentists,

(b) dental therapists,

(d) dental nurses with extended duties in oral health education, or

(e) other dental care professionals as appropriate.

Team-based delivery

28

Where prevention services are delivered by a dental care professional other than a dentist, the contractor must ensure appropriate supervision arrangements are in place in accordance with professional regulatory requirements.

Other dental care professional’s supervision

29

The contractor must deliver prevention services in accordance with current evidence-based guidance, including—

(a) the guidance set out in “Delivering Better Oral Health” as updated from time to time,

(b) guidance issued by the National Institute for Health and Care Excellence (NICE) in particular the guidance entitled “Dental recall— Recall interval between routine dental examinations”,

(d) any guidance given by the Welsh Ministers or the Local Health Board.

Evidence-based practice

30

The contractor must tailor the intensity and frequency of prevention services to the patient’s risk profile (high, moderate, low in accordance with paragraphs 31 to 33) as decided through clinical assessment.

Risk-based prevention

31

For patients assessed as high-risk, prevention services must include—

(a) more frequent preventative interventions,

(b) enhanced preventative advice and support,

(d) consideration of additional preventative measures such as fissure sealants, and

(e) more frequent monitoring and review.

High risk patients

32

For patients assessed as moderate-risk, prevention services must include—

(a) regular preventative advice at each appointment,

(b) application of fluoride varnish where clinically indicated,

(d) monitoring of risk factors.

Moderate risk patients

33

For patients assessed as low-risk, prevention services must include—

(a) preventative advice appropriate to maintaining low-risk status,

(b) reinforcement of good oral health behaviours, and

Low risk patients

34

Where clinically indicated, prevention services may include the following interventions—

(a) application of fluoride varnish,

(b) application of fissure sealants,

(d) professional tooth cleaning (scale and polish) where this forms part of a preventative strategy,

(e) dietary analysis and counselling,

(f) smoking cessation support and referral, and

(g) other evidence-based preventative interventions as appropriate.

Specific preventative interventions

35

The contractor must ensure that the following information is recorded in the patient’s clinical record in relation to prevention services—

(a) the date on which prevention services were provided,

(b) the member of the dental team who provided the prevention services,

(d) the patient’s risk assessment in relation to oral disease,

(e) any preventative products recommended or provided,

(f) any onward referrals made (e.g., to smoking cessation services),

(g) the patient’s response to preventative advice where relevant, and

(h) the planned preventative strategy for future appointments.

Documentation requirements

36

(1) The contractor must ensure that appropriate patient information materials are available to support the delivery of prevention services, including—

(a) written information on oral hygiene techniques,

(b) dietary advice for oral health,

(d) smoking cessation resources,

(e) oral cancer awareness materials, and

(f) age-specific oral health information.

(2) Patient information materials must be—

(a) evidence-based and consistent with current guidance,

(b) available in Welsh and English,

(d) culturally appropriate, and

(e) updated regularly to reflect current evidence and guidance.

Patient information materials

37

(1) The Local Health Board must monitor the contractor’s delivery of prevention services by conducting a minimum of three of the following actions in each financial year—

(a) review of clinical records,

(b) patient feedback and surveys,

(d) audit of preventative interventions provided, and

(e) assessment of compliance with evidence-based guidance.

(2) The contractor must—

(a) participate in audits of the prevention services delivered, as required by the Local Health Board,

(b) provide evidence of the prevention services delivered upon request,

(d) participate in quality improvement activities relating to prevention, and

(e) carry out continuing professional development in preventative dentistry.

Monitoring and audit

38

Failure by a contractor to provide prevention services in accordance with this Part may constitute a breach of contract and may result in the Local Health Board—

(a) finding a contract breach and the issuing of a remedial notice or breach of contract notice, as defined by paragraph 69 of Schedule 3,

(b) issuing requirements to carry out remedial action,

(d) issuing requirements for additional training or professional development, or

(e) taking other contractual consequences measures as specified in Schedule 3.

Breach of prevention requirements

39

The Local Health Board must arrange for each contractor to be remunerated for the provision of prevention services through a capitation payment in accordance with paragraph 40 and any directions issued by the Welsh Ministers under section 60 of the 2006 Act.

Payments

40

(1) The contract must provide that—

(a) the contractor receives a capitation payment equivalent to 5% of the annual contract value to cover the provision of prevention services to all patients;

(b) the capitation payment is made in equal monthly instalments throughout the contract year;

(c) the capitation payment may not be subject to financial recovery based on activity levels, provided that the contractor is delivering prevention services in accordance with this Part;

(d) where monitoring or audit by or on behalf of the Local Health Board reveals that the contractor is not delivering prevention services in accordance with this Part, the Local Health Board may—

(i) require remedial action to be taken within a specified timeframe,

(ii) withhold future capitation payments until compliance is demonstrated,

(iii) recover capitation payments already made in respect of periods during which prevention services were not properly provided, or

(iv) take other action in accordance with the breach of contract provision in Schedule 3.

(2) The capitation payment under paragraph 40(1) remunerates the contractor for—

(a) preventative advice and interventions provided as part of new patient assessments,

(b) preventative advice and interventions provided as part of recall appointments,

(d) standalone preventative appointments where clinically indicated,

(e) application of fluoride varnish where clinically indicated,

(f) provision of patient information materials,

(g) time spent by all members of the dental team in delivering prevention services, and

(h) administrative costs associated with documenting and monitoring prevention service delivery.

Capitation payment for prevention appointments that occur within 18 months of a previous appointment

41

(1) The contract must provide that—

(a) the contractor receives a capitation payment equivalent to 3% of the annual contract value to remunerate the contractor for the provision of recall appointments which are over 18 months later than the previous appointment;

(b) the capitation payment is made in equal monthly instalments throughout the contract year;

(c) subject to paragraph (d), the capitation payment cannot be subject to financial recovery based on activity levels, provided that the contractor is delivering prevention services in accordance with this Part;

(d) where monitoring or audit reveals that the contractor is not delivering prevention services in accordance with sub-paragraph (2)(a) below, the Local Health Board may—

(i) require remedial action to be taken within a specified timeframe,

(ii) withhold future capitation payments until compliance is demonstrated,

(iii) recover capitation payments already made in respect of periods during which prevention services were not properly provided, or

(iv) take other action in accordance with the breach of contract provisions in Schedule 3.

(2) The capitation payment under paragraph 41(1) remunerates the contractor for—

(a) the recall of at least 80% of low risk active patients who are subject to recall intervals of between 18 and 24 months,

(b) preventative advice and interventions provided as part of those low risk patient recall appointments, and

Capitation payments for recalls when it is 18 months since the previous appointment

42

Specific preventative interventions that form part of a care package (such as fissure sealants or extensive dietary counselling) are remunerated through the care package payment under paragraph 19 and not through the prevention capitation payments under paragraph 40 or 41 as the case may be.

Preventative intervention during a care package

43

(1) The contractor must ensure that all members of the dental team involved in delivering prevention services carry out regular continuing professional development in preventative dentistry, including—

(a) updates on evidence-based preventative guidance,

(b) training in behaviour change techniques,

(d) training in the use of digital technology for prevention service delivery, and

(e) other relevant professional development as appropriate.

(2) The contractor must retain evidence of continuing professional development in preventative dentistry for 24 months from the date the continuing professional development was undertaken and make this available to the Local Health Board upon request for audit purposes.

Continuing professional development

44

Upon initiating de-listing, the contractor must—

(a) notify the patient in writing of the intention to remove them from their list of active patients, including the reasons and the number of missed appointments,

(b) provide the patient with an opportunity to respond within 14 clear days and if they do respond consider whether the delisting process should be stopped, and

De-listing notification – prevention services

45

If an active patient has not attended an appointment with the contractors practice for a period of 36 months the contractor must—

(a) de-list the patient, and

(b) advise the patient to register on the Dental Access Portal for reallocation.

De-listing after 36 months

46

The contract must require that contractors make arrangements to pursue National Priorities in accordance with the National Priorities Scheme.

PART 5 — National priorities

47

The National Priorities Scheme means making arrangements for the delivery of selected items from the list below in accordance with directions issued by the Welsh Ministers under section 60(3)(b)(i) of the 2006 Act—

(a) quality improvement,

(b) quality management

(d) improving access to services for targeted cohorts of patients,

(e) developing new service delivery models including integrated care for management of chronic disease,

(f) developing the use of a variety of dental professionals to deliver dental care more effectively and efficiently,

(g) digital delivery of services,

(h) improving infection prevention and control, and

(i) sustainability (greener dentistry).

48

(a) quality improvement,

(b) quality management

(d) improving access to services for targeted cohorts of patients,

(e) developing new service delivery models including integrated care for management of chronic disease,

(f) developing the use of a variety of dental professionals to deliver dental care more effectively and efficiently,

(g) digital delivery of services,

(h) improving infection prevention and control, and

(i) sustainability (greener dentistry).

Schedule 2 — CARE PACKAGES

Title	Description
Simple Restorative Care Package	Includes fillings, temporary crowns, Hall crowns and extractions up to a total of 4 teeth.
Extensive Restorative Package	As per simple restorative package for 5 to 8 teeth. Composite material for anterior teeth (canine to canine). Posterior teeth to use clinically appropriate materials, which include both amalgam and amalgam alternatives.
Periodontal Care Package (maximum of two per patient per year)	Entry assessed on engagement from assessment, but patient must achieve minimum of 30% plaque score by 3rd Oral Health Education visit. Includes plaque score and tailored oral health instruction, 6 point pocket chart, professional mechanical plaque removal and pocket debridement. Contract holders expected to follow guidance such as the Society of British Periodontology guidance on managing patients with periodontal disease.
Denture Care Package	Excludes laboratory charges (to be paid directly by the patient, unless exempt from NHS charges). Includes upper and lower dentures, including Cobalt Chrome dentures if clinically indicated
Stabilisation Care Package	For patients who present with 7+ carious teeth, where at least two of the teeth have caries extending to close proximity or into the pulp and the patient is keen to engage. Includes extractions, DBOH prevention, glass ionomer intermediate restorations, pulp extirpation, removal of plaque retentive factors.
Anterior Root Canal Package	For up to two teeth 1-3, includes any permanent restorations.
Posterior Root Canal Package	Posterior and pre-molar root canal package, for up to two teeth. Includes second molars if the tooth is strategically necessary to maintain dentition (e.g. patients who have a lack of posterior support, a medical reason to retain etc.). Includes any cuspal coverage needed, excluding laboratory charge (paid by patients, unless exempt from NHS charges).
Crown Bridge, Inlay, Onlay and Veneer Care Package (limited to 10% of overall care package delivery)	Excludes temporary restorations. Up to a 3 unit bridge or up to two crowns or where a crown and bridge are both provided a single cantilever bridge and single crown would be provided under a single care package. Includes study models, posts and cores etc. Excludes laboratory charges.
Miscellaneous Care Package	For treatment and interventions for patients that fall outside a current care package or outside the guarantee period. Includes: denture repair/addition/reline, denture ease, study models, bite raising appliance, biopsy, repair/recement of a crown, bridge or veneer, removal of sutures, pericoronitis, ANUG, orthodontic urgent issues, arrest of haemorrhage (for extractions carried outside of a care package), dry socket (for extractions carried outside of a care package). Excludes any laboratory charge.

1

Periodontal care packages are limited to two a year for each patient.

2

Total provision of crown bridge, inlay, onlay and veneer care packages must not exceed 10% of annual contract value annually unless prior written approval has been obtained from the Local Health Board.

3

Urgent treatment for active patients may, where clinically appropriate, be delivered as a care package within the urgent appointment or subsequent appointments where necessary.

Schedule 3 — OTHER CONTRACTUAL TERMS

PART 1 — PATIENTS

Persons to whom mandatory services are to be provided

1

(1) Subject to sub-paragraphs (3) and (5), the contractor may agree to provide mandatory services under the contract to any new patient or active patient if a request is made for such services by—

(a) the person who requires the services, or

(b) a person specified in sub-paragraph (2), on behalf of the person who requires those services.

(3) For the purposes of sub-paragraph (1), a request for services may be made—

(a) on behalf of any child by—

(i) either parent,

(ii) a person duly authorised by a local authority to whose care the child has been committed under the 1989 Act, or

(iii) a person duly authorised by a voluntary organisation by which the child is being accommodated under the provisions of that Act, or

(b) on behalf of any adult who is incapable of making such a request or authorising such a request to be made on their behalf, by a relative or the primary carer of that person.

(4) The contractor may refuse to provide mandatory services in relation to a person falling outside a specified group of persons only where the contract provides for the contractor to provide such services to a specified group.

(5) The contractor may refuse to provide services under the contract to a person if it has reasonable grounds for doing so which do not relate to—

(a) any protected characteristics under the Equality Act 2010, social class, appearance or medical or dental condition²⁷, or

(b) a person’s decision or intended decision to accept or refuse private dental services in respect of himself or herself or a family member.

(6) Sub-paragraph (1) does not apply—

(a) where the contractor is providing mandatory services in a prison, or

(b) in any event to dental public health functions.

Patient preference of dental practitioner

2

(1) Where the contractor has agreed to provide services to a patient it must—

(a) inform the patient (or, in the case of a child or adult to whom paragraph 1(2)(b) applies, the person who made the request on their behalf) of the patient’s right to express a preference to receive services from a particular practitioner, and

(b) record in writing any such preference expressed by or on behalf of the patient.

(2) The contractor must endeavour to comply with any reasonable preference expressed under sub-paragraph (1) but need not do so if the preferred performer—

(a) has reasonable grounds for refusing to provide services to the patient, or

(b) does not routinely perform the services required by the patient within the practice.

(3) This paragraph does not apply—

(a) where the contractor is providing mandatory services in a prison, or

(b) in any event to dental public health functions.

Violent patients

3

(1) Where a patient of the contractor has—

(a) committed an act of violence against any of the persons specified in sub-paragraph (3),

(b) behaved in such a way against any of the persons specified in sub-paragraph (3) that the person has feared for their safety, or

(c) behaved in such a way that in the reasonable opinion of the contractor any of the persons specified in sub-paragraph (3) would be at risk if services were provided to that patient,

the contractor may refuse to provide services to the patient or may terminate the provision of services to the patient.

(2) If the circumstances described in sub-paragraph (1) have taken place and the contractor has decided it is no longer willing to provide services to that patient the contractor must notify the Local Health Board of this decision within 7 clear days of the decision being made and begin the de-listing process, if relevant.

(3) The reference to person in sub-paragraph (1) means—

(a) the contractor where it is an individual dental practitioner,

(b) in the case of a contract with two or more individuals practising in partnership, a partner in that partnership,

(c) in the case of a contract with a dental corporation, a director, chief executive, company secretary or member of, or a legal and beneficial owner of shares in, that corporation,

(d) a member of the contractor’s staff,

(e) a person engaged by the contractor to perform or assist in the performance of services under the contract, or

(f) any other person present—

(i) on the practice premises, or

(ii) in the place where services were provided to the patient under the contract.

(4) Notification under sub-paragraph (2) may be given by any means including telephone, fax or email but if not given in writing, must be confirmed in writing within 7 clear days (and for this purpose a faxed or email notification is not a written one).

(5) The time at which the contractor notifies the Local Health Board is the time at which it makes the telephone call or sends or delivers the notification to the Local Health Board.

(6) The Local Health Board must—

(a) acknowledge in writing receipt of the notice from the contractor under sub-paragraph (2),

(b) ensure the effect of the notice is recorded on the Dental Access Portal so as to prevent re-allocation of that patient to that contractor, and

Patients who refuse to pay NHS charges before the start of, or during, treatment

4

(1) If the contractor has, in accordance with Schedule 5, requested that the patient pay a charge in respect of that course of treatment and that patient has failed to pay that charge, the contractor may—

(a) refuse to begin a course of treatment, or

(b) terminate a course of treatment before its completion, and

where it has ended a course of treatment in accordance with sub-paragraph (a) or (b), begin the de-listing process.

(2) Where the contractor refuses to provide services or has terminated a course of treatment under sub-paragraph (1), the contractor must notify the Local Health Board within 7 clear days and if the contractor has initiated the de-listing process notify it of this.

(3) Notification under sub-paragraph (2) may be given by any means including telephone, fax or email but if not given in writing, must be confirmed in writing within 7 clear days (and for this purpose a faxed or email notification is not a written one).

(4) If the notification under sub-paragraph (2) confirms de-listing has been initiated the Local Health Board must—

(a) acknowledge in writing receipt of the notice from the contractor under sub-paragraph (2),

(b) ensure the effect of the notice is recorded on the Dental Access Portal so as to prevent re-allocation of that patient to that contractor, and

Irrevocable breakdown in relationship between contractor and patient

5

(1) The contractor must notify the Local Health Board within 7 days of making the decision that it is no longer willing to provide services to a patient under the contract where—

(a) in the reasonable opinion of the contractor, there has been an irrevocable breakdown in the relationship between the patient and that contractor, and

(b) notification of such a breakdown has been given to the patient by the contractor.

(2) Where a notification under sub-paragraph (1) has been sent to the Local Health Board the contractor must begin the de-listing process.

(3) The notification under sub-paragraph (1) and (1)(b) may be given by any means including telephone, fax or email but if not given in writing, must be confirmed in writing within 7 clear days (and for this purpose a faxed or email notification is not a written one).

(4) Upon receipt of the notification under sub-paragraph (1) the Local Health Board must—

(a) acknowledge in writing receipt of the notice from the contractor under sub-paragraph (1),

(b) ensure the effect of the notice is recorded on the Dental Access Portal so as to prevent re-allocation of that patient to that contractor, and

PART 2 — PROVISION OF SERVICES

Course of treatment

6

(1) Except in the case of dental public health functions, the contractor must provide mandatory services to a patient by providing a course of treatment to that patient.

(2) The contractor must use its best endeavours to ensure that a course of treatment is completed within a reasonable time from the date on which—

(a) the treatment plan was written in accordance with paragraph 7(1), or

(b) where a treatment plan is not required pursuant to that paragraph, the initial examination and assessment of the patient took place.

(3) Where a contractor provides urgent treatment to a patient, the urgent treatment provided constitutes a course of treatment and no other services are to be provided during that course of treatment.

(4) Any further services to be provided to that patient under the contract must be provided as a new course of treatment if a course of treatment is—

(a) ended before it has been completed, or

(b) otherwise not completed within a reasonable time.

(5) A course of treatment may only be ended by—

(a) the contractor—

(i) when the circumstances referred to in paragraph 3(1) of this Schedule (violent patients) occur and notice that it is no longer willing to provide services has been given to the Local Health Board,

(ii) where the patient has refused to pay a charge in the circumstances referred to in paragraph 4 of this Schedule (patients who refuse to pay NHS charges before the start of, or during, treatment), or

(iii) where, paragraph 5 (irrevocable breakdown in relationship between contractor and patient) applies and notice has been given to the patient and the Local Health Board,

(b) the patient, or

(6) If the contractor is unable to complete the course of the treatment which has been started for reasons beyond its control, the contractor must give notice to the Local Health Board within 14 clear days of the extent of the treatment so provided and the reason for the inability to complete the remainder.

Treatment plans

7

(1) Where the contractor agrees to provide a course of treatment as part of a care package to a patient, it must, at the time of the initial examination and assessment of that patient, ensure that the patient is provided with a treatment plan on a form supplied for that purpose by the Local Health Board which must specify—

(a) the name of the patient,

(b) the name of the contractor,

(d) the telephone number at which the contractor may be contacted during normal surgery hours,

(e) details of the services (if any) which are, at the date of the examination, considered necessary to secure the oral health of the patient,

(f) the NHS charge, if any, in respect of those services if provided pursuant to the contract, and

(g) any proposals the contractor may have for private dental services as an alternative to the services proposed under the contract, including details of the cost to the patient if they were to accept the provision of private dental services.

(2) If the patient, having considered the treatment plan provided pursuant to sub-paragraph (1), decides to accept the provision of private dental services in place of all or part of services under the contract, the contractor must ensure that the patient signs the treatment plan in the appropriate place to indicate that they have understood the nature of private dental services to be provided and their acceptance of those services.

(3) Where the services included in the treatment plan under this paragraph need to be varied, the contractor must provide the patient with a revised treatment plan in accordance with sub-paragraph (1).

(4) Subject to paragraph 6(5), the contractor must provide the services which are detailed in the treatment plan, or where the treatment plan is revised, the revised treatment plan.

(5) Where a patient requests the contractor to provide them with a summary of the care and treatment provided under the treatment plan because they intend to receive services from another contractor, the contractor must provide them with such a summary as they consider appropriate (including details of the care and treatment which could not easily be observed on visual examination).

(6) The summary referred to in sub-paragraph (5) must be supplied to the patient on a form supplied for that purpose by the Local Health Board within 28 clear days of that request.

Completion of courses of treatment

8

(1) The contractor must indicate on the form supplied to the Local Health Board pursuant to paragraph 38(3) whether the course of treatment was completed, and if the course of treatment was not completed, provide the reason for the failure to complete the course of treatment.

(2) If the Local Health Board—

(a) decides that the number of courses of treatment provided by the contractor which have not been completed is excessive, and

(b) does not consider that the reasons given by the contractor for the failure to complete the courses of treatment are satisfactory,

it is entitled to exercise its powers under paragraph 57(2) on the grounds that the contractor is not, pursuant to paragraph 6(2), using its best endeavours to ensure courses of treatment are completed.

Referral to another contractor, a hospital or other relevant service provider for advanced mandatory, domiciliary or sedation services

9

(1) Where a patient requires advanced mandatory services, domiciliary services or sedation services that are not provided under the contract by the contractor, the contractor must, if the patient agrees, refer that patient in accordance with sub-paragraph (2) for the provision of a referral service by an alternative contractor, a hospital or other relevant service provider under Part 1 of the 2006 Act.

(2) In referring a patient pursuant to sub-paragraph (1), the contractor must provide—

(a) to the patient being referred, a referral notice on a form supplied for that purpose by the Local Health Board which must specify the services detailed on the treatment plan which are to be carried out by the alternative contractor, hospital or other relevant service provider, and

(b) to the alternative contractor, hospital or other relevant service provider, either at the time of referral or as soon as reasonably practicable thereafter—

(i) a copy of the treatment plan provided to the patient pursuant to paragraph 7,

(ii) a copy of the referral notice, and

(iii) a statement of the amount paid to it, or due to be paid to it, by the patient under the 2006 (Charges) Regulations in respect of the course of treatment during which the referral is made.

(3) Where the patient notifies the contractor, whether verbally or in writing, that they do not wish to be referred to the alternative contractor, hospital or other relevant service provider selected by the contractor, the contractor must, if requested to do so by the patient, use its best endeavours to refer the patient to another suitable contractor, hospital or other relevant service provider under Part 1 of the 2006 Act for the provision of the referral service.

Mixing of services provided under the contract with private dental services

10

(1) Subject to sub-paragraph 2, a contractor may, with the consent of the patient, provide privately any part of a course of treatment for that patient, including in circumstances where that patient has been referred to the contractor for a referral service.

(2) A contractor may not provide privately as part of a course of treatment under the contract any treatment that involves the administration of general anaesthesia or the provision of sedation.

(3) A contractor must not, with a view to obtaining the agreement of a patient to undergo services privately—

(a) advise a patient that the services which are necessary in their case are not available from the contractor under the contract, or

(b) seek to mislead the patient about the quality of the services available under the contract.

(4) In sub-paragraph (2), “provision of sedation” means the provision of one or more drugs to a patient in order to produce a state of depression of the central nervous system to enable treatment to be carried out.

Repair or replacement of restorations

11

(1) Subject to sub-paragraph (4), where a restoration specified in sub-paragraph (2) needs to be repaired or replaced the contractor must repair or replace the restoration at no charge to the patient.

(2) The restorations referred to in sub-paragraph (1) are any filling, root filling, inlay, porcelain veneer or crown provided by the contractor to a patient in the course of providing services under the contract, which within the relevant period has to be repaired or replaced to secure oral health.

(3) The repair or replacement of a restoration specified in sub-paragraph (2) is a course of treatment under a care package for the purposes of calculating the proportion of mandatory services under regulation 17 despite no charge being made or recovered in accordance with the 2006 (Charges) Regulations.

(4) Sub-paragraph (1) does not apply where—

(a) within the relevant period, a person other than the contractor has provided treatment on the tooth in respect of which the restoration was provided,

(b) the contractor advised the patient at the time of the restoration and it was recorded on the patient record that the restoration was intended to be temporary in nature,

(c) in the opinion of the contractor, the condition of the tooth in respect of which the restoration was provided is such that the restoration cannot satisfactorily be repaired or replaced and different treatment is now required, or

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

(5) In this paragraph, “the relevant period” means—

(a) the 12 month period beginning with the date on which the restoration was provided, and ending 12 months after that date in the case of treatment provided at an urgent care appointment, and

(b) the 24 month period beginning with the date on which the restoration was provided, and ending 24 months after that date in the case of treatment provided under a care package.

(6) In this paragraph “repair” or “replace” means the substitution of the same or a similar form of restoration.

Premises, facilities and equipment

12

(1) The contractor must ensure that the practice premises used for the provision of services under the contract are—

(a) suitable for the delivery of those services, and

(b) sufficient to meet the reasonable needs of the contractor’s patients.

(2) The obligation in sub-paragraph (1) includes providing proper and sufficient waiting-room accommodation for patients.

(3) The contractor must provide, in relation to all of the services to be provided under the contract, such other facilities and equipment as are necessary to enable it to properly perform that service.

(4) In this paragraph, “practice premises” includes a mobile surgery.

Telephone services

13

(1) The contractor must not be a party to any contract or other arrangement under which the number for their telephone services is a mobile telephone number or a premium rate number or charges the person calling more than the basic rate applicable to calls to geographic numbers if that number is used for—

(a) patients to contact the practice for any purpose related to the contract, or

(b) any other person to contact the practice in relation to services provided as part of the health service.

(2) In this paragraph, “mobile telephone number” means a telephone number which starts with the number 07 followed by a further 9 digits.

National Institute for Health and Care Excellence guidance

14

The contractor must provide services under the contract in accordance with any relevant guidance that is issued by the National Institute for Health and Care Excellence²⁸, in particular the guidance entitled “Dental recall— Recall interval between routine dental examinations”²⁹.

Infection control

15

The contractor must ensure that it has appropriate arrangements for infection control and decontamination in accordance with guidance given by the Welsh Ministers.

Treatment under general anaesthesia: prohibition

16

The contractor must not provide any services under the contract that involve the provision of general anaesthesia.

Welsh Language

17

(1) Where the contractor provides dental services under the contract through the medium of Welsh, it must notify the Local Health Board in writing.

(2) The contractor must make available a Welsh language version of any document or form for use by patients and/or members of the public, provided by the Local Health Board.

(3) Where the contractor displays a new sign or notice in connection with dental services provided under the contract, the text on the sign or notice must be in English and Welsh, and the contractor may use the translation service offered by the Local Health Board for this purpose.

(4) The contractor must encourage the wearing of a badge, provided by the Local Health Board, by those delivering dental services under the contract who are Welsh speaking, to convey that they are able to speak Welsh.

(5) The contractor must encourage those delivering dental services under the contract to use information and/or attend training courses and events provided by the Local Health Board, so that they can develop—

(a) an awareness of the Welsh language (including awareness of its history and its role in Welsh culture), and

(b) an understanding of how the Welsh language can be used when delivering dental services under the contract.

(6) The contractor must encourage those delivering dental services under the contract to establish and record the Welsh or English language preference expressed by or on behalf of a patient.

PART 3 — SUPPLY OF DRUGS AND PRESCRIBING

General

18

The contractor must ensure that any prescription form for listed drugs, medicines or dental appliances issued by a prescriber complies as appropriate with the requirements in this Part.

Supply of drugs

19

(1) A prescriber may supply to a patient such listed drugs, medicines or dental appliances as are required for immediate use before the issue of a prescription for such drugs, medicines or dental appliances in accordance with paragraph 20.

(2) A prescriber may personally administer to a patient any listed drug or medicine required for the treatment of that patient.

Issue of prescription forms

20

(1) A prescriber must order such listed drugs, medicines or dental appliances (except for those supplied under paragraph 19) as are required for the treatment of any patient to whom it is providing services under the contract by issuing to the patient a prescription form.

(2) A prescription form must be—

(a) signed by the prescriber, and

(b) issued separately to each patient to whom the contractor is providing services under the contract.

(3) For the purposes of this paragraph, “prescription form” means a form that is supplied for the purposes of this paragraph by the Local Health Board.

Excessive prescribing

21

A prescriber must not prescribe listed drugs, medicines or dental appliances whose cost or quantity, in relation to any patient, is, by reason of the character of that drug, medicine or dental appliance, in excess of that which was reasonably necessary for the proper treatment of that patient.

PART 4 — PERSONS WHO PERFORM SERVICES

Dental practitioners

22

A dental practitioner may perform dental services under the contract provided—

(a) they are named in a dental performers list for a Local Health Board in Wales, and

(b) their naming in that list is not subject to a suspension.

Dental care professionals

23

A person may perform dental services under the contract provided they are—

(a) a dental hygienist,

(b) a dental therapist, or

(i) they are a dental care professional, and

(ii) their registration in the dental care professionals register established under section 36B of the 1984 Act is not subject to a suspension.

Performers: further requirements

24

(1) No dental care professional or other person other than one to whom paragraph 23 applies can perform clinical services under the contract unless they are appropriately registered with their relevant professional body and the registration is not subject to a suspension.

(2) Where—

(a) the registration of a dental practitioner, dental care professional or other health care professional, or

(b) a dental practitioner being included in a dental performers list,

is subject to conditions, the contractor must ensure compliance with those conditions in so far as they are relevant to the contract.

(3) No health care professional or other person may perform any clinical services under the contract unless they have such clinical experience and clinical training as are necessary to enable them to properly perform such services.

Conditions for employment and engagement: dental practitioners performing dental services

25

(1) A contractor must not employ or engage a dental practitioner to perform dental services under the contract unless—

(a) that dental practitioner has provided the contractor with the name and address of the Local Health Board on whose dental performers list their name appears, and

(b) the contractor has checked that the dental practitioner meets the requirements in paragraphs 22 and 23.

(2) Where the employment or engagement of a dental practitioner is urgently needed and it is not possible to check the matters referred to in paragraph 22 in accordance with sub-paragraph (1)(b) before employing or engaging them, they may be employed or engaged on a temporary basis for a single period of up to 7 clear days whilst such checks are made.

Conditions for employment and engagement: persons performing dental services other than dental practitioners

26

(1) The contractor must not employ or engage a dental care professional to perform dental services unless the contractor has taken reasonable steps to satisfy itself that the dental care professional has the clinical experience and clinical training necessary to enable them to properly perform dental services and the contractor has checked that—

(a) their name is included in the register of dental care professionals, and

(b) their registration in the register of dental care professionals is not subject to a suspension.

(2) Where the employment or engagement of a person specified in sub-paragraph (1) is urgently needed and it is not possible to check their registration in accordance with sub-paragraph (1) (where it applies) before employing or engaging them, they may be employed or engaged on a temporary basis for a single period of up to 7 clear days whilst such checks are made.

(3) When considering a person’s experience and training for the purposes of sub-paragraph (1), the contractor must have regard in particular to—

(a) any post-graduate or post-registration qualification held by that person, and

(b) any relevant training and any relevant clinical experience gained by them.

Conditions for employment and engagement: all persons performing dental services

27

(1) The contractor must not employ or engage a person to perform dental services under the contract unless—

(a) that person has provided two clinical references that relate to two recent posts (which may include any current post) exercising the profession in which they seek employment or engagement with the contractor which lasted for 3 months or more without a significant break, or where this is not possible, that person has provided a full explanation and alternative referees, and

(b) the contractor has checked and is satisfied with the references.

(2) Where the employment or engagement of a person falling within sub-paragraph (1) is urgently needed and it is not possible for the contractor to obtain and check the references in accordance with sub-paragraph (1)(b) before employing or engaging them, they may be employed or engaged on a temporary basis for a single period of up to 14 clear days whilst their references are checked and considered, and for an additional period of a further 7 clear days if the contractor believes the person supplying those references is ill, on holiday or otherwise temporarily unavailable.

(3) Where the contractor employs or engages the same person on more than one occasion within a period of 3 months starting from the first employment or engagement, the contractor may rely on the references provided on the first occasion, provided that those references are not more than 12 months old.

Conditions for employment and engagement: persons assisting in the provision of services under the contract

28

(1) Before employing or engaging any person to assist it in the provision of services under the contract, the contractor must take reasonable care to satisfy itself that the person in question is both suitably qualified and competent to discharge the duties for which they are to be employed or engaged.

(2) The duty imposed by sub-paragraph (1) is in addition to the duties imposed by paragraphs 25 to 27.

(3) When considering the competence and suitability of any person for the purpose of sub-paragraph (1), the contractor must have regard in particular to—

(a) that person’s academic and vocational qualifications,

(b) their education and training, and

Training

29

(1) The contractor must ensure that arrangements are in place for the purpose of maintaining and updating the skills and knowledge in relation to the services which they are performing or assisting in performing for any dental practitioner or dental care professional who is—

(a) performing dental services under the contract, or

(b) employed or engaged to assist in the performance of such services.

(2) The contractor must give each employee reasonable opportunities to carry out appropriate training with a view to maintaining that employee’s competence.

Level of skill

30

The contractor must carry out its obligations under the contract with reasonable care and skill.

Appraisal and assessment

31

The contractor must ensure that any dental practitioner performing services under the contract—

(a) participates in the appraisal system (if any) provided by the Local Health Board unless they participate in the appraisal system provided by another health service body, and

(b) co-operates with an assessment by the NHS Wales Shared Services Partnership, Health Education and Improvement Wales, the Public Services Ombudsman for Wales, NHS Resolution or an equivalent body when requested to do so by the Local Health Board.

Sub-contracting of clinical services

32

(1) The contractor must not sub-contract any of its rights or duties under the contract to any person in relation to clinical services unless—

(a) it has taken reasonable steps to satisfy itself that—

(i) it is reasonable in all the circumstances, and

(ii) that the person is qualified and competent to provide the service, and

(b) it is satisfied in accordance with paragraphs 77 and 78 that the sub-contractor holds adequate insurance.

(2) Where the contractor sub-contracts any of its rights or duties under the contract in relation to clinical services, it must—

(a) inform the Local Health Board of the sub-contract as soon as is reasonably practicable, and

(b) provide the Local Health Board with such information in relation to the sub-contract as it reasonably requests.

(3) Where the contractor sub-contracts clinical services in accordance with sub-paragraph (1), the parties to the contract are to be deemed to have agreed a variation to the contract which has the effect of adding to the list of the contractor’s premises any premises which are to be used by the sub-contractor for the purpose of the sub-contract and paragraph 60 does not apply.

(4) A contract with a sub-contractor must prohibit the sub-contractor from sub-contracting the clinical services it has agreed with the contractor to provide.

PART 5 — RECORDS, INFORMATION, NOTIFICATIONS AND RIGHTS OF ENTRY

Patient records

33

(1) The contractor must ensure that a full, accurate and contemporaneous record is kept in the patient record in respect of the care and treatment given to each patient under the contract, including treatment given to a patient who is referred to the contractor.

(2) The patient record must be stored in electronic form, but the contemporaneous record may be recorded electronically or otherwise.

(3) Physical records, for example handwritten contemporaneous notes and study casts, must be stored appropriately and indexed to the electronic record.

(4) The patient record must include details of any private dental services (to the extent that they are provided with services under the contract) and must be kept with—

(a) a copy of any treatment plan or referral treatment plan given to the patient in accordance with paragraph 7 of this Schedule,

(b) all radiographs, photographs and study casts taken or obtained by it as part of the services provided to that patient,

(i) the written declaration form prescribed by the Local Health Board, in respect of exemption under section 126 of the 2006 Act, and

(ii) a note of the evidence in support of that declaration, and

(d) the statement concerning any custom-made devices provided by any person as a consequence of regulation 15 of the Medical Devices Regulations 2002³⁰ (procedures for custom-made devices) in respect of services being provided to that patient.

(5) The patient record and the items referred to in sub-paragraphs (3) and (4) must be retained for a period of 7 years beginning with—

(a) the date on which—

(i) a course of treatment is ended, or

(ii) a course of treatment is completed, or

(b) in respect of courses of treatment not falling within paragraph (a)(i) or (ii) the date by which no more services can be provided as part of that course of treatment by virtue of paragraph 6(4)(b) of this Schedule.

(6) Nothing in this paragraph affects any property right which the contractor may have in relation to the records, radiographs, photographs and study models referred to in this paragraph.

Confidentiality of personal data

34

The contractor must nominate a person with responsibility for practices and procedures relating to the confidentiality of personal data held by it and produce an internal privacy policy.

Information to patients

35

(1) The contractor must ensure that there is displayed in a prominent position in its practice premises, in a part to which patients have access, and on its website (if it has one)—

(a) in respect of its practice based quality assurance system referred to in paragraph 76, a written statement relating to its commitment to the matters referred to in paragraph 76(4),

(b) such information relating to NHS Charges as is supplied by the Local Health Board for the purposes of providing information to patients,

(c) information about the procedure for notifying concerns in accordance with Part 6 giving the name and title of the person nominated in accordance with paragraph 49(2)(a) or, in the case of a notification of a concern, the name of the person designated as the senior investigations manager under regulation 8 of the 2011 Regulations, and

(d) details of how to access the practice’s privacy policy.

(2) The contractor must—

(a) compile a document (in this paragraph called a “patient information leaflet”) which must include the information specified in Schedule 4,

(b) review its patient information leaflet at least once in every period of 12 months and make any amendments necessary to maintain its accuracy, and

(c) make available a copy of the leaflet, the practice’s privacy policy and any updates, to its patients and prospective patients.

(3) The requirements in sub-paragraph (2) do not apply to any contractor to the extent that it provides services to persons detained in prison.

Provision of and access to information: Local Health Board

36

The contractor must, at the request of the Local Health Board—

(a) produce information to the Local Health Board or to a person authorised in writing by the Local Health Board in such format, and at such intervals or within such period, as the Local Health Board specifies, or

(b) allow the Local Health Board, or a person authorised in writing by it to access—

(i) any information which is reasonably required by the Local Health Board for the purposes of or in connection with the contract,

(ii) workforce information, and

(iii) any other information which is reasonably required in connection with the Local Health Board’s functions, including the contractor’s patient records.

Inquiries about prescriptions and referrals

37

(1) The contractor must, subject to sub-paragraphs (2) and (3), sufficiently answer any inquiries whether oral or in writing from the Local Health Board concerning—

(a) any prescription form issued by a prescriber,

(b) the considerations by reference to which prescribers issue such forms,

(d) the considerations by reference to which the contractor makes such referrals or provides for them to be made on its behalf.

(2) An inquiry referred to in sub-paragraph (1) may only be made for the purpose either of obtaining information to assist the Local Health Board to discharge its functions or of assisting the contractor in the discharge of its obligations under the contract.

(3) The contractor is not obliged to answer any inquiry referred to in sub-paragraph (1) unless it is made—

(a) in the case of sub-paragraph (1)(a) or (1)(b), by a qualified health care professional, or

(b) in the case of sub-paragraph (1)(c) or (1)(d), by a qualified dental practitioner,

appointed in either case by the Local Health Board to assist it in the exercise of its functions under this paragraph and that person produces, on request, written evidence that they are authorised by the Local Health Board to make such inquiry on its behalf.

Notification of a course of treatment etc.

38

(1) The contractor must, within 2 months of the date upon which—

(a) it completes a course of treatment in respect of mandatory services,

(b) a course of treatment in respect of mandatory services is ended, or

(c) in respect of courses not falling within sub-paragraph (a) or (b), no more services can be provided by virtue of paragraph 6(4)(b) of this Schedule,

send to the Local Health Board the information specified in sub-paragraph (2).

(2) The information referred to in sub-paragraph (1) consists of—

(a) details of the patient to whom it provides services,

(b) details of the services provided (including any dental appliances provided) to that patient,

(d) in the case of a patient who is an exempt patient, such details of that exemption and the basis of that exemption as the Local Health Board may reasonably request.

(3) In the case of a patient to whom sub-paragraph (2)(d) applies, the contractor must also provide the Local Health Board (or a person authorised on the Local Health Board’s behalf) with the written declaration form.

(4) The contractor must send the information required in sub-paragraph (2) to the Local Health Board by means of electronic submission, but the Local Health Board may accept submission of that information in paper form in such exceptional circumstances as the Local Health Board may reasonably decide.

(5) In this paragraph, “electronic submission” means information submitted electronically via a computer system approved by the Local Health Board.

Annual report and review

39

(1) The Local Health Board must provide to the contractor an annual report in accordance with regulation 24.

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