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

Type Scottish-Statutory-Instrument

Publication 2010-05-20

Last updated 2026-01-31

State In force

Jurisdiction Scotland

Department King's Printer for Scotland

Source legislation.gov.uk

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(7) Where the SDPB has authorised a payment to a pilot scheme provider for providing personal dental services to a patient, it shall not authorise any payment under these Regulations in relation to the same patient to the same pilot scheme provider, or to any dentist performing personal dental services in connection with that pilot scheme, unless the patient has been referred under these Regulations for treatment by way of personal dental services under that pilot scheme.

Drugs

24

The fees payable by a Health Board to a contractor in respect of listed drugs under paragraph24 of Schedule 1 for use before a supply can otherwise be obtained under paragraph24 of that Schedule, shall be calculated in accordance with the provisions of the Drug Tariff prepared by the Scottish Ministers under regulation 9 of the National Health Service (Pharmaceutical Services) (Scotland) Regulations 2009[^f00044], or under any corresponding provision replacing, or otherwise derived from, those regulations.

Recovery of overpayments

25

(1) Where the SDPB, the Agency or a Health Board considers that it has made a payment to a person owing to an error or in circumstances where it was not due, it shall, except to the extent that the Scottish Ministers on the application of the SDPB, the Agency or the Health Board direct otherwise, draw the overpayment to the attention of the person to whom that payment was made and the amount overpaid shall be recoverable as a debt by any lawful means.

(2) Recovery of an overpayment under the provisions of this regulation shall be without prejudice to the investigation of an alleged breach of the terms of service.

PART IV — PAYMENTS IN CONSEQUENCE OF SUSPENSION

Payments to dentists or bodies corporate suspended by a Health Board or by direction of the Tribunal

26

(1) A Health Board shall authorise the Agency to make payments to any dentist or body corporate suspended by the Health Board or by direction of the Tribunal, in accordance with the Scottish Ministers’ Determination for the time being in force in relation to such payments.

(2) The Scottish Ministers shall make the Determination in accordance with paragraphs (3) and (4) after consultation with the organisations as appear to them to be representative of persons providing general dental services, and the Determination shall be published with the Statement of Dental Remuneration.

(3) Subject to paragraph (4), the Scottish Ministers’ Determination—

(a) shall determine any sum payable by reference to remuneration which the dentist or body corporate might have received during the period that person was suspended and may provide that the assessment of such remuneration shall take into account such factors and evidence as may be specified; and

(b) may also determine any sum payable by reference to any other payment received or which might have been received by the dentist or body corporate had that person not been suspended and may provide that the assessment of such remuneration shall take into account such factors and evidence as may be specified.

(4) The Scottish Ministers’ Determination may include provision that payments under the Determination are not to exceed a specified amount in any specified period.

(5) The Scottish Ministers may from time to time after consultation with organisations that appear to them to be representative of persons providing general dental services, amend a Determination under this regulation or any part thereof and shall publish any such amendment with the Statement of Dental Remuneration.

(6) Where the Agency considers that it has made a payment to a dentist or body corporate owing to an error or in circumstances where it was not due, the Agency shall, except to the extent that the Scottish Ministers on the application of the Health Board direct otherwise, draw the overpayment to the attention of the dentist or body corporate and the amount overpaid shall be recoverable as a debt by any lawful means.

(7) If a dentist or body corporate (as the case may be) is dissatisfied with a decision of a Health Board (“the original decision”)—

(a) not to authorise the Agency to make a payment to, or in respect of, that person pursuant to a determination under this regulation;

(b) to authorise the Agency to make a payment to, or in respect of, that person pursuant to a determination under this regulation, but at a lower level than the level to which the suspended dentist or body corporate (as the case may be) considers to be correct; or

that person may ask the Health Board to review the original decision and, if that person does so, the Health Board shall reconsider the original decision, and once it has done so, it must notify that person in writing of the outcome of that reconsideration (“the reconsidered decision”) and give that person notice of the reasons for the reconsidered decision.

PART V — PRIOR APPROVAL (PATTERNS OF TREATMENT) AND SURVEYS

Prior approval - patterns of treatment

27

(1) Where in the opinion of the SDPB a dentist’s pattern of treatment in respect of all or any particular description of treatment provided as part of general dental services in the area of any Health Board, differs so substantially from the local or national pattern of treatment of other dentists as to warrant further investigation, the SDPB may, after consulting the Agency about the matter, write to the dentist and any person by whom that dentist is employed or engaged in the provision of, or assistance with the provision of, general dental services (“the employer”)—

(a) giving details of the dentist’s pattern of treatment in respect of all or any particular description of treatment and stating the extent to which it differs from the local or national pattern of treatment of other dentists;

(b) inviting the dentist to submit to the SDPB in writing the reasons why the dentist’s pattern of treatment differs from that local or national pattern; and

(i) the dentist fails to reply within 28 days; or

(ii) the dentist’s reply discloses no reasonable grounds, in the opinion of the SDPB, for the dentist’s pattern of treatment to differ from that local or national pattern of treatment;

the SDPB may give a direction as mentioned in paragraph (2).

(2) Where the dentist fails—

(a) to reply within 28 days; or

(b) to disclose the reasonable grounds as mentioned in paragraph (1)(c)(ii),

the SDPB may direct the dentist not to provide or assist in the provision of treatment, or a description of treatment specified in the direction, for a period between 3 months and 9 months as specified in the direction, without obtaining prior approval of an estimate from the SDPB, but nothing in any such direction shall prevent the dentist, without such approval, from providing or assisting in the provision of treatment following trauma or in an emergency, any private treatment or, in the course of any single consultation, treatment of a patient consisting of one examination and the taking of no more than 2small radiographs, each of a size not exceeding 16square centimetres.

(2A) The SDPB may give a direction to a dentist under paragraph (2) by an electronic communication.

(3) Where the SDPB gives a direction under paragraph (2), the direction shall inform the dentist of the dentist’s right to appeal under regulation29 and the direction shall have no effect until the expiry of the period allowed by that regulation for the bringing of an appeal and, if such an appeal is brought, until the determination of the appeal.

(4) The SDPB shall not give a direction to a dentist under paragraph (2) in consequence of having written to him under paragraph (1) more than 12 months previously.

(5) Where the SDPB gives a direction to a dentist under paragraph (2), it shall not give a further direction under that paragraph in relation to that dentist in respect of any treatment specified in the earlier direction for a period of 9 months beginning with the expiry of the period specified in the earlier direction or, where the dentist appeals that earlier direction and the appeal is allowed, the date on which the appeal is allowed.

(6) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(7) Where, on the date on which the SDPB gives a direction under paragraph (2), the name of the dentist in respect of whom the direction is given is not included in any dental list, the period specified in the direction shall not begin until the day after the dentist’s name is again included in a dental list .

(8) For the purpose of computing the date on which the period specified in any direction given under paragraph (2) comes to an end, no account shall be taken of any day on which the dentist’s name is not included in any dental list.

(9) In this regulation—

(a) “pattern of treatment” means—

(i) the number of instances in which an item or items of treatment are provided by or on behalf of a dentist; or

(ii) the ratio which the number of instances relating to one such item bears to the number of instances relating to another such item;

(b) “local”, in relation to pattern of treatment, means in the Health Board’s area; ...

(d) “in writing”, “write to” and “written to” include by an electronic communication.

Surveys of the provision of general dental services

28

The SDPB may conduct or commission surveys or other research relating to the provision of general dental services.

PART VI — APPEALS FROM DECISIONS OF THE SDPB

Appeals from decisions of the SDPB

29

(1) This regulation applies to appeals which are permitted by paragraph (2) against decisions of the SDPB.

(2) Subject to paragraph (3), an appeal may be made to a Health Board in whose dental list the name of the contractor or dentist concerned is included—

(a) by any person aggrieved by a decision of the SDPB concerning the treatment or intended treatment by the dentist concerned of a patient; or

(b) by any contractor aggrieved by a decision of the SDPB concerning fees in respect of that contractor’s provision or intended provision of general dental services; or

(3) Where the name of the contractor or dentist concerned in any appeal under paragraph (2) is included in the dental list of more than one Health Board, the appeal may be made—

(a) in the case of an appeal under paragraph (2)(a), to the appropriate Health Board in whose area the treatment or intended treatment of the patient is or would be provided;

(b) in the case of an appeal by a contractor under paragraph(2)(b) to the appropriate Health Board in whose area the treatment or intended treatment of the patient is or would be provided;

(i) in which the decision of the SDPB under regulation 27 was based on its opinion that the dentist’s pattern of treatment in question differed substantially from the local pattern of treatment of other dentists, to the appropriate Health Board in whose area the pattern of treatment of other dentists has been the subject of comparison; or

(ii) in which the decision of the SDPB under regulation 27 was based on its opinion that the dentist’s pattern of treatment in question differed substantially from the pattern of treatment of other dentists throughout Scotland, to any of the Health Boards in whose dental list the dentist’s name is included,

and the Health Board to which the appeal is made is referred to in this regulation as “the relevant Health Board”.

(4) For the purposes of this regulation, the parties to an appeal are the SDPB and the appellant, being the aggrieved person, or contractor or dentist as the case may be.

(5) Notice of appeal shall—

(a) be given to the relevant Health Board in writing;

(b) except where the relevant Health Board is satisfied that the lateness of the appeal is due to illness or other reasonable cause, be given within 4 weeks from the date on which the appellant received notice of the decision of the SDPB;

(d) contain a concise statement of the facts and contentions upon which it is intended to rely.

(6) The relevant Health Board shall, within 4 weeks from the date of receipt of the notice of appeal, request from the SDPB a written statement of the reasons for its decision and the SDPB shall, within 4 weeks from the date of receipt of that request, send such a statement to the relevant Health Board.

(7) Subject to paragraph (8), the relevant Health Board shall consider the notice of appeal and the statement of the SDPB and—

(a) where the appeal is against a refusal of the SDPB to approve an estimate or claim for remuneration on the ground that the services to which the estimate or claim relate cannot be provided as part of general dental services, it shall refer the notice of appeal and the SDPB’s statement to the Scottish Ministers, and on referring the appeal the relevant Health Board shall inform the parties of the referral;

(b) where, in an appeal by a contractor against a decision of the SDPB concerning fees, the SDPB certifies in its statement that it authorised those fees and that they were fees or maximum fees prescribed by Determination I of the Statement of Dental Remuneration for the services provided or to be provided, the relevant Health Board shall dismiss the appeal forthwith unless it is of the opinion that it involves a dispute as to the item or sub-item of treatment in that Determination applicable to those services;

(c) except where an appeal is dismissed or referred in accordance with the preceding provisions of this paragraph, the relevant Health Board shall, within 4 weeks from the date of receipt of the SDPB’s statement, appoint—

(i) where the appeal is made under paragraph (2)(c), 3 dentists, and where such an appeal is made in connection with orthodontic treatment, one of the dentists shall be an orthodontist;

(ii) in an appeal under paragraph (2)(a) or (b), 2 dentists, and where such an appeal is made in connection with orthodontic treatment, one of the dentists shall be an orthodontist; and

(iii) a chairperson who is not a dentist and who may be legally qualified,

as referees to determine the appeal.

(d) the relevant Health Board shall select one of the dentists from a panel of dental practitioners who are engaged in the provision of general dental services and who is nominated by the area dental committee, failing which the area dental committee for the area of another Health Board.

(8) Where, after considering the notice of appeal and the statement of the SDPB, the relevant Health Board is of the opinion that the notice of appeal discloses no reasonable grounds of appeal or that the appeal is otherwise trivial or vexatious, the relevant Health Board may determine the appeal by dismissing it forthwith.

(9) Where the relevant Health Board dismisses an appeal under paragraph (7) or (8), it shall—

(a) send the parties a copy of the decision together with its reasons for it; and

(b) in the case of a dismissal under paragraph (7)(b), send the appellant a copy of the SDPB’s statement.

(10) Where an appeal is referred to the Scottish Ministers under paragraph (7)(a), the Scottish Ministers shall—

(a) determine the appeal in such manner as they think fit; and

(b) as soon as may be practicable after they have determined the appeal, which shall be final and conclusive, send the parties and the relevant Health Board a copy of their decision together with their reasons for it.

(11) Where, under paragraph (7)(c), the relevant Health Board appoints referees to determine the appeal, the Health Board shall—

(a) fix a date for the hearing of the appeal;

(b) at least 2 weeks before the hearing (or within such shorter period as the parties may agree), give notice in writing to the parties of the date, time and place of the hearing and of the names of the referees;

(i) the referees and the appellant with a copy of the SDPB’s statement; and

(ii) the referees and the SDPB with a copy of the notice of appeal.

(12) Where the parties to an appeal, to whom notice of a hearing has been sent under paragraph(11), notify the relevant Health Board in writing prior to the date of the hearing, that they do not intend to make oral representations at a hearing—

(a) the relevant Health Board shall inform the referees forthwith; and

(b) the referees shall thereafter determine the appeal without holding a hearing.

(13) Subject to paragraph (14), if in the course of a hearing a party introduces any issue which in the opinion of the referees was not sufficiently disclosed in the notice of appeal by the appellant or statement by the SDPB, the referees may as they think fit admit or refuse to admit such issue.

(14) Where the referees intend to admit an issue under paragraph (13), the hearing shall be adjourned for such period as the referees consider necessary unless the other party requests that the hearing should proceed and the referees agree to do so.

(15) As soon as may be practicable after being informed that—

(a) a hearing is not necessary; or

(b) a hearing has been held,

the referees shall determine the appeal and notify the relevant Health Board in writing of their decision, which shall be final and conclusive, and their reasons for it.

(16) After the relevant Health Board receives notice of the referees’ decision under paragraph (15), they shall, within 2 weeks from the date of receipt of that notice, send a copy of it to each of the parties.

PART VII — MISCELLANEOUS

Publication of particulars

30

Copies of the dental list, the local directory of dentists (as defined in regulation 9), these Regulations including the terms of service, the lists of listed drugs and the Statement of Dental Remuneration shall be kept revised and up to date and shall be made available for inspection at the offices of the Health Board and such other places in the Health Board’s area as appear to the Health Board to be convenient.

Service of notices etc

31

(1) Except where otherwise stated, any notice or document which is required or authorised by these Regulations to be sent to or served on any person or body may be sent or served as follows—

(a) in the case of the Scottish Ministers, by delivering it to them or sending it by post addressed to them at StAndrew’s House, Edinburgh;

(b) in the case of a Health Board, by delivering it to the Chief Executive or by sending it by post addressed to the Chief Executive at the Health Board’s principal office;

(c) in the case of a dentist, by delivering it to the dentist or by sending it by post addressed to the dentist at the practice premises stated in the dental list, or the dentist’s private address;

(d) in the case of a body corporate, by delivering it or sending it by post to the body corporate’s registered office, or to its practice premises stated in the dental list;

(e) in the case of any other person, by delivering it to that person or by sending it by post addressed to that person at that person’s usual or last known address.

(2) Unless the contrary is proved, any notice or document sent in accordance with this regulation shall be deemed to be received at the time at which a letter would be delivered in the ordinary course of post.

Signatures

32

(1) Any signature required by these Regulations (including the terms of service) shall be in handwriting and not by means of a stamp and the name and position of the signatory shall be clearly stated.

(2) Any signature required by these Regulations shall be the signature of the relevant dentist or, in the case of a body corporate, a director.

Revocations, savings and transitional provisions

33

(1) Subject to paragraphs (2) and (3), the Regulations specified in Schedule 7 (“the revoked Regulations”) are hereby revoked.

(2) In respect of any general dental services provided under the revoked Regulations, payments shall be made as though the revoked Regulations and determinations made under them and in force at the relevant time continue to be in force as regards those services.

(a) Sub-partA of the first part of a Health Board’s dental list on 2ndJuly 2010 shall be deemed to include the name of any dentist whose name was included in PartA of the dental list of that Health Board kept under regulation 4(1A) (dental list) of the 1996 Regulations[^f00045] (“the previous dental list”) on 1st July 2010, together with all the information relating to that person which is contained in the previous dental list;

(b) sub-partB of the first part of a Health Board’s dental list on 2nd July 2010 shall be deemed to include the name of any dentist whose name was included in PartB of the dental list of that Health Board kept under regulation 4(1B) (dental list) of the 1996 Regulations (“the previous dental list”) on 1st July 2010, together with all the information relating to that person which is contained in the previous dental list;

(c) a dentist whose name is deemed to be included in a Health Board’s dental list by virtue of sub‑paragraphs(a) or (b) shall be bound by the terms of service in these Regulations.

(4) Any action taken by or on behalf of a Health Board before 2nd July 2010 in relation to its previous dental list (or in relation to the persons or entries thereon), shall have effect on and after 2nd July 2010 as if such action had been taken by that Health Board in relation to the first part of the dental list maintained by that Health Board on 2nd July 2010 or in relation to the persons or entries thereon; however this paragraph shall not have the effect of extending any time limit or period which governed any such action under the 1996 Regulations when such action is deemed to have taken place on 2nd July 2010.

(5) Any action taken by or on behalf of any other person before 2nd July 2010 in relation to the previous dental list of a Health Board (or in relation to the persons or entries thereon) shall have effect on and after 2nd July 2010 as if such action had been taken in relation to the first part of the dental list maintained by that Health Board on 2nd July 2010 or in relation to the persons or entries thereon; however this paragraph shall not have the effect of extending any time limit or period which governed any such action under the 1996 Regulations when such action is deemed to have taken place on 2nd July 2010.

(6) Any dentist whose name is deemed to be included in the dental list of a Health Board in terms of paragraph (3) shall no later than 1st October 2010—

(a) submit to the Health Board in whose area the dentist derives most income from general dental services an enhanced criminal certificate in relation to that dentist dated not earlier than 28 days before the date of the submission to the Health Board;

(b) for a dentist in sub-partA of the first part of a dental list provide the Health Board with the information, declarations, certificate, undertakings and consents specified in PartIA of Schedule 2 and the information contained therein insofar as this has not already been provided; and

(c) for a dentist in sub-partB of the first part of a dental list provide the Health Board with the information, declarations, certificate undertakings and consents specified in Part IB of Schedule2 and the information contained therein insofar as this has not already been provided.

(7) A Health Board which receives an enhanced criminal certificate under paragraph (6)(a) shall share the information contained in the certificate with any other Health Board in whose area the dentist provides general dental services.

(8) The Health Board may extend the period prescribed in sub-paragraph (6) for such time as it considers appropriate in the circumstances of the case if it thinks it is not reasonably practicable for that dentist to provide it with such certificate, declarations and consent within the prescribed period.

(9) Any dentist who wishes to be included in the second part of a Health Board’s dental list shall be entitled to assist in the provision of general dental services in the Health Board’s area without the name of that person being included in that list until 1st October 2010.

(10) The provisions of this regulation are without prejudice to the provisions of section16 or 17 of the Interpretation Act 1978[^f00046].

Consequential Amendments

34

The provisions listed in Schedule8 are amended as specified in that Schedule.

Schedules

35

Schedules ... 4 (prior approval of care and treatment) and 5 (information to be included in patient information leaflets) shall have effect.

SCHEDULE 1 — TERMS OF SERVICE FOR DENTISTS

PART I — GENERAL

Interpretation

1

In these terms of service, unless the context otherwise requires—

(a) “the Regulations” means the National Health Service (General Dental Services) (Scotland) Regulations 2010;

(b) any reference to a numbered regulation is a reference to the regulation bearing that number in the Regulations;

(c) any reference to a numbered paragraph is a reference to the paragraph bearing that number in these terms of service, and any reference in a paragraph to a numbered sub-paragraph is a reference to the sub-paragraph bearing that number in that paragraph;

(d) any reference to a numbered Schedule is a reference to the Schedule to the Regulations bearing that number.

Incorporation of provisions of Regulations

2

Any provisions of the following affecting the rights and obligations of contractors and dentists shall be deemed to form part of the terms of service:—

(a) the Regulations;

(b) so much of the National Health Service (Discipline Committees) (Scotland) Regulations 2006[^f00047] as relates to—

(i) the investigation of allegations that a contractor or a dentist has failed to comply with the terms of service, and other investigations to be made by the dental discipline committee and the joint discipline committee into the provision of general dental services and the action which may be taken by the Health Board as a result of such investigations;

(ii) any decision of the Scottish Ministers (whether on appeal or otherwise) in connection with any investigation referred to in head (i) of this sub-paragraph or with any decision of the Health Board; and

(iii) the investigation of record keeping;

(d) the National Health Service (Tribunal) (Scotland) Regulations 2004[^f00049] ; and

(e) the Patient Rights (Scotland) Act 2011 and any regulations or directions made under that Act, so far as relevant to contractors and dentists as providers of services under the health service.

General dental services

3

(1) In providing general dental services for any person under these Regulations a contractor shall provide for a person with whom a capitation arrangement has been entered into, care and treatment under that arrangement.

(2) A contractor may provide general dental services under these Regulations by way of treatment on referral for a person who is receiving dental services from another dentist (whether or not pursuant to the Act).

PART II — CONTINUING CARE ARRANGEMENT, CAPITATION ARRANGEMENT AND TREATMENT ON REFERRAL

A continuing care arrangement

4

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

A capitation arrangement

5

(1) A person may apply in writing (including by an electronic communication) to enter into a capitation arrangement with a contractor.

(2) A contractor who accepts a person for care and treatment under a capitation arrangement agrees to provide that care and treatment in order to manage the patient’s oral health and must—

(a) ensure that at the time at which the contractor accepts the patient or, where sub-paragraph (5) applies, at the time of a dentist’s first examination of the patient, a dentist examines the patient and charts the patient’s decayed, missing or filled teeth on the patient record,

(b) provide education and advice to the patient (or arrange for the provision of education and advice by a person with suitable training and experience) in connection with the patient’s oral health, including information about any relevant care programmes,

(i) in a manner determined by the contractor in discussion with the patient, and

(ii) within a clinically appropriate timescale,

(d) provide the patient with a treatment plan which sets out—

(i) any treatment required, an estimate of the NHS charge for that treatment and arrangements for how that treatment will be provided,

(ii) the approximate period following which a further examination is recommended by the dentist, and

(iii) any treatment to be provided by way of private care and treatment as an alternative to the care and treatment proposed under general dental services, including particulars of the cost of that treatment,

(e) provide the patient with emergency cover in accordance with paragraph 6, and

(f) repair or replace in accordance with paragraph 7 any restoration which requires repair or replacement.

(3) A contractor must provide a patient with a revised treatment plan where—

(a) in the opinion of the dentist, the care and treatment included in the treatment plan provided under sub-paragraph (2)(d) needs to be varied, or

(b) the patient requests a new treatment plan.

(4) Where a contractor accepts the transfer of a capitation arrangement the contractor must—

(a) consider whether the patient should be provided with a new treatment plan,

(b) other than where the transfer is between contractors providing general dental services at the same practice premises, assume the obligation in sub-paragraph (2)(a), and

(5) A dental nurse or dental therapist can, on behalf of a contractor, accept a patient under the age of three years of age for care and treatment under a capitation arrangement.

(6) Where a person falls within any of the descriptions in sub-paragraph (7)—

(a) an application under sub-paragraph (1) is to be made on their behalf by a person mentioned in the relevant description in sub-paragraph (7) (“the representative”),

(b) any information (including education and advice) that is to be provided under this paragraph is to be provided to that representative, and

(7) The descriptions are—

(a) a person under the age of 16 years, in which case the representative may be either parent, or in the absence of both parents, the guardian or other adult person who has care of the child,

(b) a person who is an adult with incapacity, in which case the representative may be—

(i) the primary carer of that person, or

(ii) a person authorised under the Adults with Incapacity (Scotland) Act 2000 to act on the person’s behalf,

(i) a local authority under the Children (Scotland) Act 1995, in which case the representative is a person duly authorised by that authority,

(ii) a voluntary organisation, in which case the representative is that organisation or a person authorised by it,

(d) a person in secure accommodation, in which case the representative is the provider of the secure accommodation or a person authorised by it,

(e) a person detained in a prison or young offenders institution, in which case the representative is a person authorised by the Scottish Ministers.

Emergency cover

6

(1) Subject to ... sub-paragraph (1A), in providing emergency cover under ... a capitation arrangement, a contractor shall make reasonable arrangements to secure that a patient requiring prompt care and treatment will receive such care and treatment as soon as appropriate either from the contractor or from another contractor or dentist.

(1A) Where the contractor is a domiciliary care dentist, the contractor must personally provide prompt care and treatment to a care home resident with whom they have a capitation arrangement unless—

(a) the need for prompt care and treatment arises outside of the in-hours period; or

(b) the exception in paragraph 51(1) applies.

(2) For the purposes of sub-paragraph (1) or sub-paragraph (1A) a patient requires prompt care and treatment where, in the opinion of a dentist—

(a) the patient’s oral health is likely to deteriorate significantly without such care and treatment; or

(b) the patient is in severe pain by reason of the patient’s oral condition,

but the provision of emergency cover does not include any obligation to repair or replace dentures.

(3) The obligation to provide emergency cover begins on the date on which the patient and the contractor enter into ... the capitation arrangement and ceases when that arrangement is terminated.

Repair or replacement of restorations

7

(1) Subject to sub-paragraph (3) the contractor shall, as part of a capitation arrangement, repair or replace at no charge to the patient any restoration specified in sub-paragraph (2) which the contractor or another contractor or dentist acting on the contractor’s behalf or from whom the capitation arrangement was transferred had provided by way of personal dental services in connection with a pilot scheme or has provided under general dental services under that capitation arrangement.

(2) The restorations referred to in sub-paragraph (1) are any filling, root filling, inlay, onlay or crown which, within 12 months of the date on which it was provided, has to be repaired or replaced to manage oral health.

(3) A contractor shall not be under an obligation to repair or replace any restoration under sub-paragraph (1) where—

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

(i) a dentist has provided private treatment; or

(ii) another contractor has provided ... treatment otherwise than of a temporary nature,

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

(b) the dentist who carried out the restoration advised the patient at the time of the restoration and indicated on any plan for treatment provided to the patient in accordance with paragraph 5(2)(d) or (3) and on the patient record that—

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

(ii) in the dentist’s opinion, a different form of restoration was more appropriate to manage oral health but, notwithstanding that advice, the patient insisted on the restoration which was provided;

(c) in the dentist’s opinion 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 (1) begins on the date on which the patient and the contractor enter into the capitation arrangement and ceases when that arrangement is terminated.

Duration of a continuing care arrangement

8

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Duration of a capitation arrangement

9

A capitation arrangement—

(a) may be terminated by the dentist or the Health Board in accordance with paragraph 10;

(b) shall terminate where—

(i) the patient enters into a capitation arrangement with another dentist;

(ii) the patient enters into an arrangement with the dentist or another dentist whereby the whole of the capitation arrangement is to be provided privately;

(iii) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(iv) the dentist is suspended by direction of the Tribunal and the Health Board does not within the period of one month beginning with the date of the Tribunal’s direction arrange for it to be transferred to another dentist under regulation 18.

Termination of a continuing care arrangement or a capitation arrangement

10

(A1) A contractor may terminate ... a capitation arrangement in accordance with this paragraph only on grounds which do not relate to the patient’s race, gender, social class, age, religion, sexual orientation, appearance, disability or medical condition.

(1) Subject to sub-paragraphs (1A), (4) and (7) and paragraph 11, a contractor who wishes to terminate ... a capitation arrangement before it terminates in accordance with paragraph9, shall give to the patient not less than 3 months’ notice in writing of the termination of the arrangement.

(1A) Where a contractor wishes to terminate a capitation arrangement under sub-paragraph (1) if—

(a) the contractor is a domiciliary care dentist; and

(b) the patient concerned is a care home resident,

the contractor must give not less than 6 months’ notice in writing of the termination of the arrangement.

(2) Where a contractor gives notice under sub-paragraph (1), it shall use its best endeavours to complete satisfactorily, or secure the satisfactory completion before the termination of the arrangement of, any care and treatment which it has been agreed the patient will receive and which is outstanding at the date of the notice and any further treatment that may be necessary to manage the oral health of the patient.

(2A) Where a contractor who is a domiciliary care dentist gives notice under sub-paragraph (1A) to a care home resident, the contractor must obtain the written consent of the Health Board before making any arrangements for another dentist to complete the treatment of the patient on the contractor’s behalf.

(3) Where a contractor gives notice under sub-paragraph (1), it shall at the same time advise the Health Board in writing that such notice has been given, and give details to the Health Board of any care and treatment which it has been agreed the patient will receive and which is outstanding at the date of the notice including any arrangements made for completion of that care and treatment.

(4) Subject to sub-paragraph (7) and paragraph 11, where a contractor wishes ... a capitation arrangement to be terminated on less than the applicable length of notice required by this paragraph, it shall apply in writing to the Health Board—

(a) asking for the Health Board’s consent to the contractor terminating the arrangement;

(b) setting out the reasons why it wishes the arrangement to be terminated; and

(c) giving details of any care and treatment which it has been agreed the patient will receive and which is outstanding including any arrangements made for completion of that care and treatment.

(5) Where a contractor applies to the Health Board under sub-paragraph (4), the Health Board may, after considering any representations made by the patient, consent to the termination of the arrangement on such date and on such terms as to completion of any outstanding care and treatment mentioned in sub‑paragraph(4)(c) as it thinks fit, save that, where an arrangement is terminated because the patient has refused to pay the NHS charge, the contractor shall not be obliged to complete that care and treatment.

(6) A Health Board which consents to the termination of an arrangement under sub-paragraph(5) shall so inform the patient, contractor and the SDPB in writing that the arrangement has been terminated with the Health Board’s consent.

(7) Where—

(a) under section 5 (approval of pilot schemes) of the 1997 Act the Scottish Ministers have approved a proposal for a pilot scheme under which personal dental services are to be provided, or such a proposal has been subsequently varied with agreement of the Scottish Ministers or, as the case may be, in a manner authorised by directions given by the Scottish Ministers under section 6 (making of pilot schemes) of that Act; and

(b) under the proposal (or the varied proposal) a patient would be treated under the pilot scheme and not under ... a capitation arrangement,

the pilot scheme provider shall give to him such notice of the termination of the arrangement as is required under the pilot scheme.

Violent patients

11

(A1) A domiciliary care dentist may not terminate a capitation arrangement with a care home resident in accordance with this paragraph.

(1) Where—

(a) a person, with whom a contractor has ... a capitation arrangement, has committed an act of violence against any dentist, dental care professional or any other person employed or engaged by the contractor or has behaved in such a way that such a person has feared for his or her safety; and

(b) the contractor or a person on the contractor’s behalf has reported the incident to the police,

the contractor may notify the Health Board that the contractor wishes the arrangement to be terminated immediately.

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

(3) The time at which the contractor notifies the Health Board shall be the time at which the contractor makes the telephone call or otherwise sends or delivers the notification to the Health Board.

(4) Where pursuant to this paragraph a contractor has notified the Health Board that it wishes ... a capitation arrangement with any person to be terminated immediately, the Health Board shall take all reasonable steps to inform the person concerned.

Referral to another contractor or to a hospital or other service

12

(1) Where a patient requires particular care and treatment under ... a capitation arrangement and the contractor with whom the patient has made the arrangement cannot provide the necessary facilities, experience or expertise to provide that care and treatment, it shall, if the patient agrees, refer the patient in accordance with sub-paragraph (2) for the provision of that care and treatment by another contractor under general dental services or personal dental services or by a hospital or other service provided under Part III of the Act.

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

(a) give details of—

(i) the oral condition of the patient and the reason for the referral; and

(ii) if relevant to the referral, details of the care and treatment the contractor has provided or intends to provide in order to manage the patient’s oral health,

to that other contractor 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 the contractor by the patient under the National Health Service (Dental Charges) (Scotland) Regulations 2003[^f00050] 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 the claim for remuneration in respect of that course of care and treatment that the patient has been referred for the required care and treatment.

Referral to dental students

13

(1) Where the conditions laid down in sub-paragraph (2) are met, and where a dentist considers it suitable to do so, the dentist may refer a patient for care and treatment by a dental student.

(2) The conditions referred to in sub-paragraph (1) are—

(za) that the patient is not a care home resident who has a capitation arrangement with a domiciliary care dentist;

(a) that the patient has been informed that the referral is for care and treatment by a dental student and the patient has consented to that referral; and

(b) that the dental student who will provide the care and treatment shall be a dental student under the supervision of a dentist.

Treatment on referral

14

(1) Subject to sub-paragraphs (2) and (3), a contractor may accept a patient who has been referred to the contractor by another dentist who is providing or assisting with the provision of dental services to that patient (whether or not pursuant to the Act) ... for particular care and treatment.

(2) Subject to sub-paragraph (3) a contractor shall not accept a patient for orthodontic treatment unless that patient has been referred to the contractor for such treatment by a dentist who is providing or assisting with the provision of dental services to that patient (whether or not pursuant to the Act) ....

(3) A contractor may only accept a patient who presents for orthodontic treatment without being referred under sub-paragraph(2) if the contractor has obtained the prior approval in writing (including by an electronic communication) of the SDPB to the effect that the SDPB is satisfied that there are exceptional circumstances which allow the patient to so present.

(4) Subject to paragraph (5) a contractor who accepts a patient for treatment under sub‑paragraphs (1), (2) or (3) shall—

(a) at the time at which the contractor accepts the patient, provide the patient with a form of acceptance , in writing, supplied by the Health Board, or a form to like effect, which shall specify—

(i) the name of the patient;

(ii) the name of the dentist who will carry out the care and treatment;

(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) ensure that at the time of the first examination of the patient by a dentist, the dentist provides the patient with a plan for treatment , in writing, on a form supplied by the Health Board, or a form to like effect, 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 the dentist to provide having regard to the reason for the referral;

(ii) the dentist’s estimate of the NHS charge (if any) in respect of that care and treatment;

(iii) any proposals the dentist 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) ensure that where, in the opinion of the dentist, the care and treatment included in the plan for treatment provided under paragraph (b) of this sub-paragraph needs to be varied, the dentist provides the patient with a revised plan for treatment in accordance (except as to the time of its provision) with paragraph (b) of this sub-paragraph;

(d) complete the care and treatment, which is referred to in paragraph (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 the patient has been referred or for which the patient has presented; and

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

(5) Subject to sub-paragraphs (3) and (4), a contractor shall in the course of treatment on referral repair or replace at no charge to the patient any of the following restorations, namely, filling, root filling, inlay, onlay or crown which has to be repaired or replaced and which was provided by or on behalf of the contractor in the course of the treatment on referral.

(6) A contractor shall not be under an obligation to repair or replace any restoration under sub‑paragraph (5) where—

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

(i) a dentist has provided private treatment; or

(ii) another contractor has provided ... treatment otherwise than of a temporary nature,

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

(b) the dentist who carried out the restoration 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 (4)(b) or (c) and on the patient record that—

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

(ii) in the dentist’s 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 dentist’s opinion, 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.

(7) The obligation to repair or replace any restoration under sub-paragraph (5) 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.

(8) Sub-paragraph (4)(b) shall not apply where a patient is referred to a dentist for examination and advice only.

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

15

If, owing to any cause beyond the contractor’s control, or to the contractor taking up the performance of personal dental services in connection with a pilot scheme, the contractor is unable to complete any care and treatment which has been commenced under ... a capitation arrangement or treatment on referral, the contractor shall forthwith notify the SDPB in writing (including by an electronic communication) of the extent of the care and treatment or treatment on referral provided and of the reason for the contractor’s inability to complete the remainder.

Care and treatment summaries

16

Where a patient who has been receiving care and treatment under ... a capitation arrangement requests the contractor to provide the patient with a summary of the care and treatment which the patient has received under that arrangement because the patient intends to enter into such an arrangement with another contractor, the contractor shall provide such a summary as the contractor considers appropriate (including details of any care and treatment which could not be easily observed on a visual examination), to the patient in writing (including by an electronic communication) on a form supplied by the Health Board, or a form to like effect, within 28 days of the request.

Mixing of general dental services and private care and treatment

17

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

(a) necessary under ... a capitation arrangement to manage the oral health of a patient; or

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

(2) A contractor or a dentist assisting that contractor in the provision of general dental services shall not, with a view to obtaining the agreement of a patient to undergo care and treatment privately—

(a) advise a patient falsely that the care and treatment which is necessary in the patient’s case—

(i) under the ... capitation arrangement with a contractor to manage oral health; or

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

is not available from that contractor 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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(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

Occasional treatment

18

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Referral for occasional treatment

19

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

PART IV — ADDITIONAL TERMS OF SERVICE FOR ALL DENTISTS

Remuneration

20

(1) Subject to regulation 22 (statement of dental remuneration) and this Schedule, a dentist or contractor shall not—

(a) claim a fee or accept payment of any fee from the Agency for any treatment provided otherwise than under general dental services;

(b) claim a fee or accept payment of any fee from the patient for any treatment provided under general dental services, for which a claim has been or will be submitted to the SDPB, except such fee as may be prescribed by the National Health Service (Dental Charges) (Scotland) Regulations 2003;

(c) claim a fee or accept payment of any fee from the Agency for any treatment provided under general dental services for which a fee has already been claimed under general dental services;

(d) claim a fee or accept payment of any fee for any treatment which has not been provided, (except such a fee as may be prescribed by regulation 6(3)(a) of the National Health Service (Dental Charges) (Scotland) Regulations 2003;

(e) claim, solicit or accept payment of any fee or other consideration or offer or promise any inducement as a prerequisite to providing, or agreeing to provide, or assisting or agreeing to assist with the provision of, general dental services, except such fee or other consideration as may be prescribed in the Statement of Dental Remuneration, the National Health Service (Dental Charges) (Scotland) Regulations 2003 or the National Health Service (Charges to Overseas Visitors) (Scotland) Regulations 1989[^f00052];

(f) claim a fee or accept payment of any fee from the Agency for any treatment provided to any person under a pilot scheme for personal dental services; or

(g) make the provision of general dental services to any person subject to any condition other than those specified in these Regulations, permitted in the National Health Service (Dental Charges) (Scotland) Regulations 2003 or otherwise required by law.

(2) Subject to sub-paragraph (2A), any claim for a fee or other remuneration for the provision of general dental services must be submitted by an electronic communication and—

(a) if the care and treatment was provided on behalf of a contractor by a dentist who is also a contractor, the claim must contain the PIN allocated to that dentist;

(b) if the care and treatment was provided on behalf of a contractor by a dentist whose name is included in the second part of the dental list, the claim must contain the PIN allocated to that dentist; and

(c) where the care and treatment was provided by a contractor who is a dentist, the claim must contain the PIN allocated to that contractor.

(2A) Any claim for a fee or other remuneration for the provision of orthodontic treatment submitted before 1 January 2020 must be submitted in accordance with either head (a) or (b):

(a) where the claim is submitted by post or by hand it must be signed—

(i) if the care and treatment was provided on behalf of a contractor by a dentist who is also a contractor, by that dentist, who must also give the name of the contractor on whose behalf the care and treatment was provided;

(ii) if the care and treatment was provided on behalf of a contractor by a dentist whose name is included in the second part of the dental list, by that dentist, who must also give the name of the contractor on whose behalf the care and treatment was provided; and

(iii) in other cases where the care and treatment was provided by a contractor who is a dentist, by the contractor;

(b) where the claim is submitted by an electronic communication—

(i) if the care and treatment was provided on behalf of a contractor by a dentist who is also a contractor, the claim must contain the PIN allocated to that dentist;

(ii) if the care and treatment was provided on behalf of a contractor by a dentist whose name is included in the second part of the dental list, the claim must contain the PIN allocated to that dentist; and

(iii) where the care and treatment was provided by a contractor who is a dentist, the claim must contain the PIN allocated to that contractor.

(3) When submitting a claim by way of an electronic communication under sub-paragraph (2) or (2A) a person shall make use only of such computer program as the SDPB has approved as suitable for that purpose.

(4) In this paragraph a “PIN” shall mean the personal identification number allocated to the contractor (or in the case of an assistant, the identification number allocated to the contractor for the assistants use) by the SPDB.

Surveys

21

A Health Board may conduct or commission surveys or other research relating to the provision of general dental services at no less than six monthly intervals and, when requested to do so by the Health Board, a contractor shall within a timescale specified by the Health Board, provide the Health Board with information of the provision of general dental services for the purpose of such surveys or other research.

Standards of care

22

(1) In providing, or assisting with the provision of, care and treatment under general dental services a dentist shall—

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

(b) save as is provided in paragraphs 12, 13, ... 23, 33 and 44, give all treatment personally;

(d) except in the case of ... treatment on referral, provide or assist with the provision of care and treatment to such extent and at such intervals as may be necessary to manage the oral health of the patient; and

(e) not provide or assist with the provision of care and treatment in excess of that which is reasonably necessary to manage the oral health of the patient.

(2) A body corporate, in undertaking to provide general dental services, shall ensure that any dentist employed or engaged by it to treat patients shall—

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

(b) save as is provided in paragraphs 12, 13, ... 23, 33 and 44, give all treatment personally;

(d) except in the case of ... treatment on referral, provide or assist with the provision of care and treatment to such extent and at such intervals as may be necessary to manage the oral health of the patient;

(e) not provide or assist with the provision of care and treatment in excess of that which is reasonably necessary to manage the oral health of the patient; and

(f) comply with the provisions of the terms of service.

Sedation

23

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

(2) 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

24

(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 25.

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

Issue of prescription forms

25

(1) A dentist shall order such listed drugs (other than those supplied under paragraph 24) as are needed for the care and treatment of any patient for whom the dentist is providing or assisting with the provision of 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 a separate prescription form shall be issued for each patient.

Domiciliary visits

26

(1) A contractor may, where requested to do so by or on behalf of a patient who is unable to leave home unaccompanied because of physical or mental illness or disability, agree to provide general dental services at a place at which the patient normally resides.

(2) Subject to sub-paragraph (3), a contractor shall, where requested to do so by or on behalf of a patient who is unable to leave home unaccompanied because of physical or mental illness or disability, provide general dental services at a place at which the patient normally resides provided that such a place is not more than fivemiles from the contractor’s practice premises, or in the case of a contractor who provides general dental services at a mobile surgery only from any of the places regularly visited by the contractor.

(3) Where the contractor is a domiciliary care dentist who is assigned to a care home, the contractor must make visits to the residents of that care home regardless of the distance between the care home and the contractor’s practice premises.

Records

27

(1) A contractor shall keep a complete, accurate and up to date record in respect of—

(a) the care and treatment given to each patient under ... a capitation arrangement and the fact of referral under such an arrangement under paragraph 12 or 13;

(b) treatment on referral;

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 managing oral health), any practice record form and all radiographs, photographs and study models (being models in respect of treatment) taken or obtained by or on behalf of the contractor as part of the care and treatment under ... a capitation arrangement or treatment on referral ....

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

(3) The contractor shall, during the period in which it holds any records, forms, radiographs, photographs and study models referred to in sub-paragraph (1)—

(i) produce them on request to the dental officer, or any authorised officer of the Agency or the Health Board , including, where appropriate and requested by that officer, in electronic form; or

(ii) send them to the SDPB, the dental officer, or any authorised officer of the Agency, or the Health Board within 14 days of being required to do so by one of those persons.

(3A) For the avoidance of doubt, in paragraph (3)(ii) “send” includes, where appropriate, by an electronic communication.

(4) A contractor may keep the records ... referred to in sub-paragraph (1) and the form recording recalled attendance in accordance with paragraph 31 in electronic form.

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

Prior approval of care and treatment

28

(1) Subject to sub-paragraphs (6), (7) and (10), where care and treatment requires prior approval, from the SDPB, the dentist—

(a) shall submit, without unreasonable delay, to the SDPB 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) other than in an emergency, shall not, until the dentist receives approval from the SDPB, 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 an addition to such care and treatment is necessary, and by reason of the variation or addition the care and treatment includes or becomes treatment requiring prior approval, the contractor—

(a) shall submit, without unreasonable delay, to the SDPB 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) other than in an emergency, shall not, until the dentist receives approval from the SDPB, 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 SDPB 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 carrying out the treatment 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 Schedule4,

the dentist shall re-submit, without unreasonable delay, the estimate to the SDPB 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 SDPB 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 carrying out the treatment a variation of or addition to such care and treatment is necessary, the dentist shall re-submit, without unreasonable delay, the estimate to the SDPB for approval together with details of any part of that care and treatment provided or to be provided privately.

(5) Where the SDPB receives an estimate under sub-paragraph (3) or (4) it may withdraw or vary its original approval insofar as the care and treatment has not yet been carried out in accordance with such approval, or add to its original approval, and, other than in an emergency, the dentist shall not, until he receives approval from the SDPB, 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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(7) A 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 aboard for a period in excess of four weeks, and in such event shall submit an estimate to the SDPB for approval within 7 days of the commencement of the care and treatment.

(8) Where, in consequence of any proceeding under the National Health Service (Discipline Committees) (Scotland) Regulations 2006[^f00053] in respect of general dental services provided in the area of any Health Board, a dentist is required for any period to submit all estimates to the SDPB for approval, in respect of all treatment or any specified description of treatment, the contractor or dentist—

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

(b) shall not proceed with such treatment until the dentist receives approval from the SDPB, except that the dentist 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 SDPB under regulation 27(2) a dentist is directed, for any period, to submit all estimates to the SDPB 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 area of any Health Board) to the SDPB for approval; and

(b) shall not proceed with such treatment until the dentist receives approval from the SDPB, except that the dentist 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 or contractor carrying out any care and treatment privately.

Completion of estimate

29

(1) Subject to sub-paragraphs (3) and (5), when submitting an estimate to the SDPB for approval in accordance with paragraphs 28(1), (2), (3), (4), (8) or (9), a dentist shall in all cases, in addition to the information specified in those sub paragraphs, provide to the SDPB the following information—

(a) the dentist’s name and address and the number by which the dentist’s arrangement with the Health Board is identified;

(b) the patient’s name and address 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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(3) Subject to sub-paragraph (4), a dentist must use an electronic communication to submit an estimate to the SDPB for approval as mentioned in sub-paragraph (1), and must—

(a) 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 , either on a form supplied by the Health Board or in electronic form;

(b) use only such computer program as the SDPB has approved as suitable for the purpose; and

(i) all the information specified in sub paragraph (1)(a) to (c) except the dentist’s name and address; and

(ii) the personal identification number allocated to the dentist by the SDPB for that purpose.

(4) Where the proposed care and treatment mentioned in sub-paragraph (1) is orthodontic treatment, a dentist may use an electronic communication to submit an estimate to the SDPB for approval, when that estimate is submitted before 1 January 2020.

(5) A dentist who, in accordance with sub-paragraph (4), uses an electronic communication to submit an estimate to the SDPB, must—

(a) 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, either on a form supplied by the Health Board or in electronic form;

(b) use only such computer program as the SDPB has approved as suitable for the purpose; and

(i) all the information specified in sub-paragraph (1)(a) to (c) except the dentist’s name and address; and

(ii) the personal identification number allocated to the dentist by the SDPB for that purpose.

Completion of claim forms

30

(1) Subject to sub-paragraph (2), where a person declares that that person or a person for whom that person is responsible does not have to pay the charges prescribed by the National Health Service (Dental Charges) (Scotland) Regulations 2003[^f00054] by virtue of either—

(a) entitlement to exemption under paragraph 2(4) or 3(4) of Schedule 11 to the Act; or

(b) entitlement to remission of such charges under regulation 3 or 5 of the National Health Service (Travelling Expenses and Remission of Charges) (Scotland) (No.2) Regulations 2003[^f00055],

the contractor shall ask that person to produce satisfactory evidence in support of that declaration and where that person does not produce such evidence the contractor shall record that fact in the form claiming remuneration for the treatment of that person or the person for whom that person is responsible.

(2) Where, at the time of the declaration there is already available to the contractor satisfactory evidence of an entitlement to exemption from the charges on the grounds that the person in respect of whom the declaration is made is under 26 years of age, the obligations on the contractor specified in sub-paragraph (1) shall not apply.

(3) The contractor may appoint a member of the contractor’s staff to undertake the task set out in sub‑paragraph(1) on the contractor’s behalf, and where the contractor does so the contractor shall ensure that that staff member is given sufficient instruction to perform that task.

Recalled attendance

31

Where a dentist is recalled to the practice premises at a time when the dentist does not normally provide or assist in the provision of general dental services, in order to provide treatment in an emergency, the dentist shall, on each occasion the dentist does so, at the time of that recalled attendance—

(a) complete a form supplied by the Health Board for the purpose of supporting the dentist’s claim to an allowance for that recalled attendance; and

(b) obtain the signature on that form of the patient who the dentist has been recalled to treat, or of a person acting on behalf of that patient.

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

32

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

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

(3) Insofar 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 contractor shall not be regarded as having failed to comply with sub‑paragraphs(1) or (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 contractor, or a dentist assisting in the provision of general dental services—

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

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

the contractor or dentist (as the case may be) shall not, otherwise than in an emergency, provide or assist with the provision of any care and treatment to that patient and shall take all reasonable steps to facilitate the examination.

(6) Where a contractor, or a dentist assisting in the provision of general dental services—

(a) has been notified that a dental discipline committee will investigate a reference relating to the provision of general dental services by the dentist or contractor (as the case may be) to a patient; and

(b) has not been notified—

(i) that the investigation has been completed; or

(ii) that such committee has no objection,

the contractor or dentist (as the case may be) shall not, other than in an emergency, provide or assist with the provision of 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 or contractor carrying out any care and treatment privately.

Dental care professionals

33

A dentist may in the provision of general dental services arrange for care and treatment to be given by dental care professionals in accordance with the provisions of the Dentists Act 1984, and any regulations made under it and shall ensure that such care and treatment is properly completed.

Postgraduate education

34

A dentist shall in the provision or assistance with 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

35

A contractor shall display in a prominent position at the practice premises such information as the Health Board or the Agency may issue.

Complaints

36

A contractor must have arrangements in place which operate in accordance with section 15 of the Patient Rights (Scotland) Act 2011, and any regulations or directions made under that Act.

Co-operation and investigation

37

(1) A contractor or any dentist who assists the contractor in the provision of general dental services shall cooperate with any investigation of a complaint by the Health Board in accordance with the procedures which it operates in accordance with section 15 of the Patient Rights (Scotland) Act 2011, whether the investigation follows one under the practice based complaints procedure or not.

(2) The cooperation required by sub-paragraph (1) includes—

(a) answering questions reasonably put to the contractor or dentist by the Health Board;

(b) providing any information relating to the complaint reasonably required by the Health Board; and

(c) attending any meeting to consider the complaint (if held at a reasonably accessible place and at a reasonable hour, and due notice has been given), if the presence of a contractor or any dentist who assists the contractor in the provision of general dental services at the meeting is reasonably required by the Health Board.

Returns re complaints

38

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Professional indemnity

39

A contractor shall, if asked in writing to do so by the Health Board on whose dental list the contractor’s name is included—

(a) state whether the contractor is indemnified against claims relating to the business of dentistry carried out by the contractor, and relating to the practise of dentistry by any dentist, assistant, deputy and other dental care professional whose work the contractor directs or who is employed or engaged by the contractor;

(b) if the contractor is so indemnified, provide documentary evidence to that effect.

Clinical audit activities

40

(1) Subject to the remainder of this paragraph, in the relevant period a dentist on sub-part A of the first part or the second part of the dental list shall—

(a) undertake at least 15 hours of quality improvement activities; and,

(b) where that dentist is of a type described in subparagraph (7), undertake at least 5 hours of quality improvement activities within the first year of the relevant period.

(2) Subject to sub-paragraph (8), a contractor must take reasonable steps to ensure that any dentist employed or engaged by the contractor in the provision of general dental services shall—

(a) undertake at least 15 hours of quality improvement activities during the relevant period; and,

(b) where that dentist is of a type described in paragraph (7) undertake at least 5 hours of quality improvement activities within the first year of that relevant period.

(3) A dentist shall produce such evidence which demonstrates compliance with that dentist’s duties under subparagraph (1) as the Health Board or NHS Education for Scotland (as the case may be) requires.

(4) In this paragraph—

“joins a dental list” excludes a dentist who is listed provisionally;

“quality improvement activities” means activities (approved by NHS Education for Scotland or the Health Board) which: involve the systematic, critical and reflective analysis of the quality of dental care provided by the dentist, and of any changes made by the dentist to bring about improvement in quality of care, patient experience, patient safety and clinical effectiveness, (including the processes used by that dentist for diagnosis, intervention and treatment and use of resources); and have a defined start and end date, no more than 6 months apart (or such other period as may be agreed with NHS Education for Scotland or, as the case may be, the Health Board);

“the relevant period” means the three year period from 1st August 2010 until 31st July 2013 (inclusive) and each successive period of three years thereafter.

(5) Notwithstanding subparagraph (1) where a dentist joins a dental list after the first day of a relevant period, that dentist shall, from 1st August of the calendar year immediately after that dentist joins, undertake such number of hours of quality improvement activities as are proportionate (which may be zero) to the proportion of the relevant period that remains from that 1st August to the end of that relevant period.

(6) In the operation of subparagraph (5) where that dentist is of a type described in subparagraph(7), that dentist shall, when undertaking such number of hours of quality improvement activities as are proportionate to the remainder of the relevant period, ensure that at least 5 hours of quality improvement activity are undertaken within a year from 1st August of the calendar year immediately after that dentist joins.

(7) The type of dentist described is a dentist who has never been included in sub-part A of a dental list kept under these regulations, or any earlier form of such a list kept under any earlier similar enactment.

(8) Notwithstanding sub-paragraph (1), a dentist who is listed provisionally is not required to undertake quality improvement activities.

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

Patient information leaflets

41

(1) ... a contractor shall compile and make available, to the Health Board (if it requires one) and to any person who may reasonably require one, a document providing information about the provision of general dental services at the contractor’s practice premises (in this paragraph called “a patient information leaflet”) which shall include the information specified in Schedule 5.

(2) A contractor shall make any amendments to the contractor’s patient information leaflet which the contractor 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 first part of the dental list shall satisfy the requirements of this paragraph if the dentist makes available a patient information leaflet, compiled and, where appropriate, revised in accordance with sub-paragraphs (1) and (2), which relates to the partnership or associateship as a whole.

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

Premises and Equipment

42

(1) Unless the contractor provides general dental services only at the place where a patient normally resides or from a mobile surgery, a contractor shall provide proper, sufficient and safe premises, equipment, instruments and procedures.

(2) A contractor who provides general dental services at the place where a patient normally resides or at a mobile surgery shall provide proper, sufficient and safe mobile surgery equipment, instruments and procedures.

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

(4) A contractor shall at all reasonable times, on receipt of reasonable notice in writing, admit a dental officer or a person authorised by the Health Board for the purpose of inspecting any equipment or practice premises, dental surgery, mobile surgery or waiting-room under the contractor’s control and reviewing the procedures and staff training , so as to enable the Health Board to assure itself that the contractor meets the standards set out in sub-paragraphs (1) to (3).

(5) A contractor shall at all reasonable times admit a dental officer or a person authorised by the Health Board for the purpose of inspecting any equipment or practice premises, dental surgery, mobile surgery or waiting-room under the contractor’s control and reviewing the procedures and staff training where—

(a) concerns about patient safety were raised during an inspection under sub-paragraph (4) and further investigation by the Health Board of those concerns is necessary; or

(b) information has come to the attention of the Health Board which necessitates immediate further investigation by it using powers under this sub-paragraph.

(6) A dental officer or a person authorised by the Health Board shall not require to give notice of an inspection under sub-paragraph (5).

Remuneration

43

The provisions of paragraph 20 shall not have effect in relation to any claim made by a contractor in respect of loss of remuneration resulting from the failure of a patient to keep an appointment for general dental services.

Deputies and assistants

44

(1) Subject to the provisions of this paragraph, a contractor may arrange for care and treatment to be provided by a deputy or assistant.

(1A) A contractor who is a domiciliary care dentist may not arrange for the care and treatment of care home residents to be provided on their behalf by a deputy or assistant other than in accordance with paragraph 51.

(1B) A contractor who is listed provisionally may not arrange for care and treatment to be provided by an assistant.

(2) In the case of two or more dentists practising in partnership or as a contractor 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 treatment, if reasonable steps are taken to secure continuity of care and treatment.

(3) A contractor shall—

(a) prior to employing any assistant, see evidence that that assistant is included on the second part of the dental list of the appropriate Health Board;

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