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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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Made: 9 February 2026

Coming into force in accordance with regulation 1(2)

The Welsh Ministers make these Regulations in exercise of the powers conferred by sections 2, 56(5) and (6), 57, 58, 59, 60(2), 61, 62, 63(1), 66(1) and (4), 125(1), 126(5) and 203(9) and (10) of the National Health Service (Wales) Act 2006[^f00001].

Part 1 — GENERAL

Title, coming into force and application

1

(1) The title of these Regulations is the National Health Service (General Dental Services Contracts and Patient Charges) (Wales) Regulations 2026.

(2) These Regulations come into force on 11 March 2026, except for regulations 42 and 43 which come into force on the 1 April 2026.

(3) These Regulations apply in relation to Wales.

Interpretation

2

(1) In these Regulations—

“the 1984 Act” (“Deddf 1984”) means the Dentists Act 1984[^f00002];

“the 1986 Act” (“Deddf 1986”) means the Insolvency Act 1986[^f00003];

“the 1989 Act” (“Deddf 1989”) means the Children Act 1989[^f00004];

“the 2006 Act” (“Deddf 2006”) means the National Health Service (Wales) Act 2006;

“the 2005 Order” (“Gorchymyn 2005”)means the Dentists Act 1984 (Amendment) Order 2005[^f00005];

“the 2006 Regulations” (“Rheoliadau 2006”) means the National Health Service (General Dental Services Contracts) (Wales) Regulations 2006[^f00006];

“the 2006 (Charges) Regulations” (“Rheoliadau (Ffioedd) 2006”) means the National Health Service (Dental Charges) (Wales) Regulations 2006[^f00007];

“the 2006 (PDS) Regulations” (“Rheoliadau (GDP) 2006”) means the National Health Service (Personal Dental Services Agreements) (Wales) Regulations 2006[^f00008];

“the 2011 Regulations” (“Rheoliadau 2011”) means the National Health Service (Concerns, Complaints and Redress Arrangements) (Wales) Regulations 2011[^f00009];

“accessibility-enhanced dental services” (“gwasanaethau deintyddol estynedig o ran hygyrchedd”) means services which are designed to accommodate diverse physical and sensory needs, for example bariatric provision due to physical or mobility needs or quiet drills or laser drills;

“ACORN” (“ACORN”) means the Assessment of Clinical Oral Risks and Needs toolkit as defined by the Welsh Ministers and published by Public Health Wales[^f00010];

“active patient” (“claf gweithredol”) means a patient who has received a course of treatment from the contractor in the previous 36 months and that course of treatment was either banded under the 2006 (Charges) Regulations or a care package or a new patient assessment;

“adjudicator” (“dyfarnwr”) means the Welsh Ministers or a person or persons appointed by the Welsh Ministers under section 7(8) of the 2006 Act (NHS contracts) or paragraph 54(4) of Schedule 3 (NHS dispute resolution procedure) to these Regulations;

“advanced mandatory services” (“gwasanaethau gorfodol uwch”) means any primary dental service that would fall within the services described in regulation 14 (mandatory services), but by virtue of the high level of facilities, experience or expertise required in respect of a particular patient, the service is provided as a referral service;

“annual contract value” (“gwerth blynyddol y contract”) means the total annual value in pounds sterling agreed between the Local Health Board and the contractor for the provision of mandatory services under the contract, calculated in accordance with directions made by the Welsh Ministers under section 60 of the 2006 Act, as may be varied from time to time in accordance with the terms of the contract;

“annual delivery report” (“adroddiad cyflenwi blynyddol”) means a report provided by a Local Health Board to a contractor within 20 clear days of the end of the contract year, setting out the percentage of mandatory services delivered by the contractor in each category during that contract year, and where delivery falls below 95% or exceeds 100%, setting out the financial consequences including any financial adjustment or recovery to be applied, or any additional remuneration due to the contractor;

“bridge” (“pont”) means a fixed or removable bridge which takes the place of any teeth;

“care package” (“pecyn gofal”) means a defined bundle of the dental services set out in Schedule 2 which are provided to a patient as a course of treatment based on an assessment of risk and clinical need;

“charity trustee” (“ymddiriedolwr elusen”) means one of the persons having the general control and management of the administration of a charity;

“child” (“plentyn”) means a person who has not attained the age of 18 years;

“clinical examination” (“archwiliad clinigol”) means an appointment that consists of the examination of a patient’s oral health where no treatment is also provided at that appointment;

“clinical services” (“gwasanaethau clinigol”) means services involving a direct clinical examination, a clinical assessment, a clinical diagnosis, clinical treatment, or care of patients which are provided under the contract by dental practitioners, dental care professionals, or other healthcare professionals;

“complete” (“cwblhau”) in relation to a course of treatment and care package, means—where no treatment plan has to be provided in respect of a course of treatment pursuant to paragraph 7 of Schedule 3 (treatment plans), all the treatment recommended to, and agreed with, the patient by the contractor at the initial examination and assessment of that patient has been provided to the patient, orwhere a treatment plan has to be provided to the patient pursuant to paragraph 7 of Schedule 3, all the treatment specified in that plan by the contractor (or that plan as revised in accordance with paragraph 7(3) of that Schedule) has been provided to the patient;

“company secretary” (“ysgrifennydd cwmni”) means the officer of a company who is appointed in accordance with the requirements of the Companies Act 2006, and includes any person authorised by the company to discharge the statutory, administrative or compliance functions ordinarily exercisable by a company secretary, whether alone or jointly with any other person;

“concern” (“pryder”) means any complaint or notification of an incident concerning patient safety but does not include a claim for compensation;

“contract” (“contract”) means, except where the context otherwise requires, a general dental services contract under section 57 of the 2006 Act (general dental services contracts: introductory);

“contractor” (“contractwr”) means any person entering or who has entered into a contract with the Local Health Board;

“course of treatment” (“cwrs o driniaeth”) means—an initial examination of a patient, an assessment of their oral health, and the planning of any treatment to be provided to that patient as a result of that initial examination and assessment as part of a care package and as set out in a treatment plan under paragraph 7 of Schedule 3, andthe provision of any planned treatment under a care package or packages (including any treatment planned at a time other than the time of the initial examination) to that patient;

“de-listing” (“dadrestru”) means a patient who ceases to be an active patient because they have not attended a practice where they are an active patient for a period in excess of 36 months or have been removed from that practice’s list of active patients as a result of the application of paragraph 15 of Schedule 1 or paragraphs 4 and 5 of Schedule 3;

“de-listing process” (“proses ddadrestru”) means the process whereby a patient must be de-listed, and the practice must—notify the patient in writing of the intention to remove them from their list of active patients, including the reasons, andprovide the patient with an opportunity to respond and make representations within 14 clear calendar days;

“definitive treatment” (“triniaeth ddiffiniol”) means treatment which is intended to provide a long-term or permanent solution to a dental issue, rather than a temporary fix put in place until a long-term or permanent solution can be provided;

“Dental Access Portal” (“Porth Mynediad Deintyddol”) means the online dental appointment allocation system administered by Digital Health and Care Wales;

“dental appliance” (“cyfarpar deintyddol”) means a denture or bridge and for the purposes of this definition, a denture includes an obturator;

“dental care professional” (“proffesiynolyn gofal deintyddol”) means a person whose name is included in the dentists register established in accordance with section 14 the 1984 Act or a person qualified to practise certain aspects of dental care, registered with the General Dental Council under one of the recognised professional titles;

“dental corporation” (“corfforaeth ddeintyddol”) means a body corporate carrying on the business of dentistry in accordance with the 1984 Act;

“dental hygienists” (“hylenyddion deintyddol”) means registered dental professionals whose primary role is to provide preventive oral care, delivered directly or under supervision from a dentist;

“dental nurse” (“nyrs ddeintyddol”) means a registered dental professional who provides clinical and related support to dentists, dental care professionals and patients as recognised by the General Dental Council;

“dental nurses with extended duties in oral health education” (“nyrsys deintyddol â dyletswyddau estynedig mewn addysg iechyd geneuol”) means dental nurses registered with the General Dental Council who, in addition to their core supportive functions, have undertaken approved training enabling them to deliver oral health education, preventive oral health advice, and other extended duties;

“dental performers list” (“rhestr cyflawnwyr deintyddol”) means the list prepared by a Local Health Board in accordance with regulations made under section 63 of the 2006 Act (persons performing primary dental services);

“dental practitioner” (“ymarferydd deintyddol”) means a person who is registered in the dentists register;

“dental public health functions” (“swyddogaethau iechyd deintyddol y cyhoedd”) means functions provided by the contractor by virtue of section 67(3)(c) of the 2006 Act;

“dental therapists” (“therapyddion deintyddol”) means registered dental professionals competent to carry out specified items of dental treatment directly or under the supervision of a dentist;

“dentist” (“deintydd”) means a registered dental professional as recognised by the General Dental Council;

“dentists register” (“cofrestr deintyddion”) means the register referred to in section 14(1) of the 1984 Act[^f00011];

“Digital Health and Care Wales” (“Iechyd a Gofal Digidol Cymru”) means the organisation established under the Digital Health and Care Wales (Establishment and Membership) Order 2020[^f00012];

“direction pending an investigation” (“cyfarwyddyd wrth aros am ymchwiliad”) means a direction issued by a regulator which imposes requirements, restrictions or conditions on a person’s registration, scope of practice, or functions for the purpose of protecting the public, the public interest, or the interests of that person, for the period during which an investigation into that person is being carried out;

“director” (“cyfarwyddwr”) means—a director of a body corporate, ora member of the body of persons controlling a body corporate (whether or not a limited liability partnership);

“director of a body corporate” (“cyfarwyddwr corff corfforedig”) includes a member of the body of persons controlling a body corporate (whether or not a limited liability partnership);

“domiciliary services” (“gwasanaethau cartref”) means a course of treatment, or part of a course of treatment, provided at a place other than—the practice premises of any provider of primary dental services,a mobile surgery of any provider of primary dental services, ora prison;

“exempt person” (“person esempt”) has the same meaning as section 126 of the 2006 Act;

“family member” (“aelod o deulu”) means—a spouse,a civil partner,a person whose relationship with the registered patient has the characteristics of the relationship between spouses or civil partners,a parent or step-parent,a son,a daughter,a child of whom the person is—the guardian,the carer duly authorised by the local authority to whose care the child has been committed under the 1989 Act, ora grandparent;

“financial recovery” (“adenilliad ariannol”) means the recovery by a Local Health Board of amounts already paid to a contractor for mandatory services which the contractor has failed to deliver, being recovery of up to 100% of the value of underperformance where delivery falls below 95%;

“guarantee period” (“cyfnod gwarant”) means—in relation to a standard care package, 24 months beginning with the date the restoration or treatment was provided, orin relation to an urgent care package delivered at an urgent care appointment, 12 months beginning with the date the restoration or treatment was provided;

“health service body” (“corff gwasanaeth iechyd”) means—a Local Health Board, an NHS trust or a Special Health Authority established under the National Health Service (Wales) Act 2006, andany equivalent body exercising functions corresponding to those of a Local Health Board, NHS trust or Special Health Authority and in particular includes bodies known at the relevant time as—a Strategic Health Authority,a Primary Care Trust,a Clinical Commissioning Group, oran Integrated Care System,or any body succeeding or replacing those bodies which performs substantially equivalent functions;

“initial examination and assessment” (“archwiliad ac asesiad cychwynnol”) means an examination and assessment of a patient that includes—a clinical examination comprising completion of an ACORN assessment, a review of the patient's medical, dental, lifestyle and accessibility needs, a clinical oral examination including periodontal assessment, caries detection, soft tissue examination, and inspection of teeth and existing restorations, radiographic examination where clinically indicated, and occlusion and TMJ examination where clinically indicated, andan assessment comprising risk allocation (low, moderate or high), provision of tailored preventative advice and oral health promotion, formulation of a personalised care package or combination of care packages where treatment is necessary, and comprehensive clinical records and outcome measures;

“interim delivery report” (“adroddiad cyflenwi interim”) means a report provided by a Local Health Board to a contractor by the end of the seventh month of the contract year, setting out the percentage of mandatory services delivered by the contractor in each category as at the end of the sixth month of the contract year, and where delivery in any category falls below 40%, identifying the shortfall and any proposed mid-year financial adjustment;

“interim suspension order” (“gorchymyn atal dros dro interim”) means a measure which temporarily removes a registered person from the register pending the completion of an investigation and any subsequent disciplinary hearing;

“level 1 procedure” (“gweithdrefn lefel 1”) means treatment categorised as level 1 in accordance with NHS England’s Commissioning Guide for Oral Surgery[^f00013] or an equivalent document adopted by Welsh Local Health Boards;

“licensing body” (“corff trwyddedu”) means any body that licenses or regulates the health care professions;

“listed” (“rhestredig”) means such drugs, medicines or dental appliances as are included in a list for the time being approved by Welsh Ministers for the purposes of section 80 of the 2006 Act[^f00014] (arrangements for pharmaceutical services);

“Local Health Board” (“Bwrdd Iechyd Lleol”) means, a Local Health Board established under section 11 of the 2006 Act, which is a party, or a prospective party, to the contract;

“mandatory services” (“gwasanaethau gorfodol”) means the services listed in regulation 14 and described in Schedule 1;

“medical performers list” (“rhestr cyflawnwyr meddygol”) means a list of medical performers prepared by a Local Health Board in accordance with regulations made under section 49 of the 2006 Act (persons performing primary medical services);

“mobile surgery” (“deintyddfa symudol”) except where expressly provided otherwise in these Regulations, means any vehicle in which services under the contract are to be provided;

“national disqualification” (“anghymhwysiad cenedlaethol”) means—a decision made by the First-tier Tribunal under section 159 of the National Health Service Act 2006[^f00015],a decision under provisions in force in Scotland or Northern Ireland corresponding to section 159 of the National Health Service Act 2006, ora decision under regulations made pursuant to section 63 of the 2006 Act (persons performing primary dental services);

“national priorities” (“blaenoriaethau cenedlaethol”) means services provided in accordance with the National Priorities Scheme set out in Part 5 of Schedule 1 and directed by the Welsh Ministers under section 60(3)(b)(i) of the 2006 Act;

“new patient assessment” (“asesiad claf newydd”) means an assessment carried out in accordance with paragraph 10 of Part 2 of Schedule 1;

“NHS Charge” (“Ffi GIG”) means a charge made to the patient for provision of services pursuant to the 2006 (Charges) Regulations or these Regulations;

“NHS contract” (“contract GIG”) has the same meaning as in section 7 of the 2006 Act;

“NHS dispute resolution procedure” (“gweithdrefn datrys anghydfodau’r GIG”) means the procedure for disputes specified in paragraph 54 of Schedule 3;

“other healthcare professionals” (“proffesiynolion gofal iechyd eraill”) means registered healthcare professionals (other than dental practitioners or dental care professionals) who may be involved in providing or supporting services under the contract;

“other relevant service provider” (“darparwr gwasanaeth perthnasol arall”) means a provider of primary dental services under Part 1 of the 2006 Act (other than another contractor or a hospital) to whom a patient might be referred for the provision of advanced mandatory services, domiciliary services or sedation services;

“parent” (“rhiant”), in relation to any child, means a parent or other person who has parental responsibility for that child;

“parental responsibility” (“cyfrifoldeb rhiant”) has the same meaning as in sections 2 and 3 of the 1989 Act;

“patient” (“claf”) means a person to whom the contractor is providing services under the contract;

“patient record” (“cofnod claf”) means a record (whether in paper or electronic form) maintained by the contractor for the purpose of recording treatment provided to a patient;

“practice” (“practis”) means the business operated by the contractor for the purpose of delivering services under the contract;

“Practice Committee” (“Pwyllgor Practis”) means any of the committees listed in section 27A(4)(a) of the 1984 Act;

“practice premises” (“mangre practis”) except where expressly provided otherwise in these Regulations, means an address specified in the contract as one at which services are to be provided under the contract but does not include a mobile surgery;

“premium rate number” (“rhif cyfradd premiwm”) means a telephone number designated as an Unbundled Tariff or premium rate number in the National Telephone Numbering Plan published by the Office of Communications under section 56 of the Communications Act 2003[^f00016];

“prescriber” (“rhagnodydd”) means a dental practitioner who is either engaged or employed by the contractor or is a party to the contract;

“prescription form” (“ffurflen bresgripsiwn”) means a written or electronic document, issued by an authorised prescriber, which records the medicinal product, dental appliance, or other item to be supplied to a patient, and which is completed, signed, or authenticated in accordance with any requirements set by the Local Health Board for the purpose of enabling lawful dispensing;

“prevention services” (“gwasanaethau atal”) means services provided to prevent oral disease and promote oral health, including tailored preventative advice, oral health education, dietary and lifestyle advice, fluoride use, fissure sealants, and other evidence-based preventative interventions as set out in Part 4 of Schedule 1;

“primary carer” (“prif ofalwr”) means the individual who has the main responsibility for providing care or support to another person, whether or not the individual is remunerated for doing so, and irrespective of whether the care is provided on a formal or informal basis; and includes a person who provides such care by reason of family relationship, friendship, or a recognised caring arrangement;

“primary dental services” (“gwasanaethau deintyddol sylfaenol”) has the same meaning as in section 58 of the 2006 Act;

“prison” (“carchar”) means any institution used for the lawful confinement of individuals sentenced or remanded by the courts and includes a young offender institution, a secure training centre, a secure children’s home and a naval, military or air force prison;

“private dental services” (“gwasanaethau deintyddol preifat”) means dental services except for the purposes of the National Health Service (Wales) Act 2006;;

“professional registration number” (“rhif cofrestru proffesiynol”) means the number against a dental practitioner’s name in the dentists register;

“professional regulatory requirements” (“gofynion rheoleiddiol proffesiynol”) means the duties, standards, competencies and obligations placed upon dentists and dental care professionals by the General Dental Council as the statutory regulator, including compliance with the Council’s requirements relating to registration, scope of practice, professional conduct, continuing professional development, fitness to practise, and any other rules or standards issued by the General Dental Council from time to time;

“recall appointment” (“apwyntiad adalw”) means a routine dental examination provided to an active patient at an interval determined by the contractor in accordance with NICE guideline CG19, being an interval of between 3 and 24 months based on the patient's oral health risk category (low, moderate or high risk), for the purpose of monitoring the patient's oral health and providing preventative care;

“recognised professional titles” (“teitlau proffesiynol cydnabyddedig”) means any professional title which—is protected by or conferred under an enactment applicable in England and Wales, andmay lawfully be used only by a person registered, licensed, authorised or otherwise regulated by the body responsible for that profession, this includes (but is not limited to) titles protected under—the Dentists Act 1984,the Medical Act 1983,the Health Professions Order 2001,the Nursing and Midwifery Order 2001, andany enactment replacing or amending those instruments;

“referral notice” (“hysbysiad atgyfeirio”) means the notice referred to in paragraph 9(2)(a) of Schedule 3 (referral to another contractor, a hospital or other relevant service provider for advanced mandatory, domiciliary or sedation services);

“referral service” (“gwasanaeth atgyfeirio”) means one or more of advanced mandatory services, domiciliary services or sedation services provided to a patient who has, during a course of treatment, been referred by the contractor to a provider of primary dental services under Part 1 of the 2006 Act, for the provision of one or more of those services as part of that course of treatment;

“referral treatment plan” (“cynllun triniaeth atgyfeirio”) means a treatment plan provided pursuant to paragraph 7(1) of Schedule 3 or that plan as varied in accordance with paragraph 7(3) of that Schedule;

“register of dental care professionals” (“cofrestr o broffesiynolion gofal deintyddol”) means the register maintained by the General Dental Council under section 36B of the 1984 Act (the dental care professionals register)[^f00017];

“restoration” (“triniaeth adferol”) means any procedure or material used to repair, replace, or reconstruct lost or damaged tooth structure, including the placement of fillings, inlays, onlays, crowns, bridges, prosthetic appliances;

“step-parent” (“llys-riant”) means a person who is married to (or in a civil partnership with) a child’s biological parent, but is not themselves a biological or adoptive parent of the child and has acquired parental responsibility for the child in question in accordance with section 4A of the 1989 Act;

“sedation services” (“gwasanaethau tawelyddu”) means a course of treatment provided to a patient during which the provider administers one or more drugs to a patient, which produce a state of depression of the central nervous system to enable treatment to be carried out, and during and in respect of that period of sedation—the drugs and techniques used to provide the sedation are deployed by the provider in a way that ensures loss of consciousness is rendered unlikely, andverbal contact with the patient is maintained in so far as is reasonably possible;

“sub-contractor” (“is-gontractwr”) means a person with whom the contractor has made an arrangement in accordance with paragraph 32 or 77 of Schedule 3;

“trauma” (“trawma”) means damage to teeth, gingival tissues or alveoli caused by a force arising outside the mouth, resulting in mobility, luxation, subluxation or fracture of the hard tissues or injury to the soft tissues;

“urgent care” (“gofal brys”) means treatment to provide relief from pain and/or to prevent significant deterioration of a particular dental problem, with the aim to provide, where possible, a long-term solution;

“urgent care appointment” (“apwyntiad gofal brys”) means an appointment provided within 72 hours to a patient who requires prompt dental care due to pain, discomfort, trauma or acute infection, or where it is not clinically appropriate to provide treatment within that timescale, as soon as reasonably practicable thereafter;

“urgent treatment” (“triniaeth frys”) means treatment provided during an Urgent Care Appointment arranged under paragraphs 3 and 4 of Schedule 1 or in relation to urgent care of an active patient;

“voluntary organisation” (“sefydliad gwirfoddol”) means a body, except a public authority or a local authority, the activities of which are carried on otherwise than for profit.

(2) In these Regulations—

(a) references to forms supplied by the Local Health Board to contractors includes electronic forms and forms which are generated electronically, but does not include prescription forms, and

(b) references to the delivery of services include the delivery of services by using electronic means such as video conferencing where—

(i) in the dental practitioner’s clinical judgment delivery of the service in this way is appropriate,

(ii) the system to be used is one which has been approved by the Local Health Board, and

(iii) the Local Health Board has provided its permission in writing for the contractor to deliver certain services under the contract in this way.

Part 2 — CONTRACTORS

Conditions: introductory

3

A Local Health Board may only enter into a contract if the conditions can be met which are set out in—

(a) regulation 4, and

(b) in the case of a contract to be entered into with a dental corporation on or after the coming into force for all purposes of article 39 of the Dentists Act 1984 (Amendment) Order 2005[^f00018] (substitution of sections 43 and 44), regulation 5.

Prescribed conditions

4

(1) For the purposes of section 59(1) of the 2006 Act (persons eligible to enter into GDS contracts) the prescribed condition is that a person must not fall within paragraph (3).

(2) The reference to “person” in paragraph (1) includes any director, chief executive or company secretary of a dental corporation.

(3) A person falls within this paragraph if—

(a) they are the subject of a national disqualification,

(b) subject to paragraph (4), they are disqualified or suspended (other than by an interim suspension order or direction pending an investigation) from practising by any licensing body anywhere in the world,

(c) within the period of 5 years before the date the contract started or, if earlier, the date on which the contract is signed—

(i) they have been dismissed (otherwise than by reason of redundancy) from any employment by a health service body, unless they have later been employed by that health service body or another health service body and paragraph (5) applies to them or that dismissal was the subject of a finding of unfair dismissal by any competent tribunal or court, or

(ii) they have been removed from, or refused admission to, a dental or medical performers list by reason of inefficiency, fraud or unsuitability, unless that person’s name has later been included in such a list,

(d) they have been convicted in the United Kingdom of—

(i) murder, or

(ii) a criminal offence other than murder, committed on or after 26 August 2002, and have been sentenced to a term of imprisonment of over 6 months,

(e) subject to paragraph (6), they have been convicted outside the United Kingdom of an offence—

(i) which would, if committed in England and Wales, constitute murder, or

(ii) committed on or after 26 August 2002, which would if committed in England and Wales, constitute a criminal offence other than murder, and been sentenced to a term of imprisonment of over 6 months,

(f) they have been convicted of an offence referred to in Schedule 1 to the Children and Young Persons Act 1933[^f00019] (offences against children and young persons with respect to which special provisions of this Act apply) or Schedule 1 to the Criminal Procedure (Scotland) Act 1995[^f00020] (offences against children under the age of 17 years to which special provisions apply) committed on or after 1 April 2006,

(g) they have—

(i) been made bankrupt or had sequestration of their estate awarded or they are a person in relation to whom a moratorium period under a debt relief order (under Part 7A of the 1986 Act) applies unless they have been discharged from the bankruptcy or sequestration or the bankruptcy order has been annulled,

(ii) been made the subject of a bankruptcy restrictions order or an interim bankruptcy restrictions order under Schedule 4A [^f00021] or a debt relief restrictions order or interim debt relief restrictions order under Schedule 4ZB [^f00022], to the 1986 Act unless that order has ceased to have effect or has been annulled, or

(iii) made a composition agreement or arrangement with, or granted a trust deed for, their creditors unless they have been discharged in respect of it,

(h) an administrator, administrative receiver or receiver is appointed in respect of the person,

(i) they have within the period of 5 years before the date the contract started or, if earlier, the date on which the contract is signed—

(i) been removed from the office of charity trustee or trustee for a charity by an order made by the Charity Commissioners or the High Court on the grounds of any misconduct or mismanagement in the administration of the charity for which they were responsible or to which they were privy, or which they, by their conduct, contributed to or facilitated, or

(ii) been disqualified under section 69B of the Charities and Trustee Investment (Scotland) Act 2005[^f00023] (disqualification from holding office with senior management functions), from being concerned in the management or control of any body, or

(j) they are subject to a disqualification order under the Company Directors Disqualification Act 1986[^f00024].

(3) A person does not fall within paragraph (3)(b) where the Local Health Board is satisfied that the disqualification or suspension from practising is imposed by a licensing body outside the United Kingdom and it does not make the person unsuitable to be—

(a) a contractor, or

(b) a director, chief executive or company secretary of a corporation entering into a contract, in the case of a contract with a dental corporation.

(4) Where a person has been employed as a member of a health care profession any later employment must also be as a member of that profession.

(5) A person does not fall within paragraph (3)(e) where the Local Health Board is satisfied that the conviction does not make the person unsuitable to be—

(a) a contractor;

(b) a director, chief executive or company secretary of a corporation entering into a contract, in the case of a contract with a dental corporation.

Additional prescribed conditions relating to contracts with dental corporations

5

(1) Subject to paragraph (2), it is a condition in the case of a contract to be entered into with a dental corporation on or after the date of the coming into force for all purposes of article 39 of the 2005 Order[^f00025] that no—

(a) offence has been or is being committed under section 43 of the 1984 Act, or

(b) financial penalty has been imposed under section 43B or 44 of the 1984 Act.

(2) Paragraph (1) does not apply if the Local Health Board is satisfied that any offence under section 43 or penalty imposed under section 43B or 44 of the 1984 Act does not make the dental corporation unsuitable to be a contractor, whether by virtue of the time that has elapsed since any conviction or the penalty which was imposed, or otherwise.

Reasons

6

(1) Where a Local Health Board is of the view that the conditions in regulation 4 or 5 for entering into a contract are not met, it must notify the person or persons intending to enter into the contract of its view in writing and its reasons for that view and of their right of appeal under regulation 7.

(2) The Local Health Board must also notify in writing its view and its reasons for that view to a director, chief executive or company secretary of a dental corporation that is notified under paragraph (1) where its reason for the decision relates to that person or those persons.

Appeal

7

A person who has been served with a notice under regulation 6(1) may appeal to the First-tier Tribunal against the decision of the Local Health Board that the conditions in regulation 4 or 5 are not met.

Part 3 — PRE-CONTRACT DISPUTE RESOLUTION

Pre-contract disputes

8

(1) Subject to paragraphs (2) and (3), if, in the course of negotiations intending to lead to a contract, the prospective contracting parties are unable to agree on a particular term of the contract, either party may refer the dispute to the Welsh Ministers to consider and decide the matter in accordance with the procedure provided for in paragraphs 54(2) and (3) of Schedule 3.

(2) Paragraph (1) does not apply in the case where both parties to the prospective contract are health service bodies (in which case section 7(6) of the 2006 Act (NHS contracts) applies).

(3) Before referring the dispute for consideration and determination under paragraph (1), both parties to the prospective contract must make every reasonable effort to communicate and co-operate with each other with a view to resolving it.

(4) Disputes referred to the Welsh Ministers in accordance with paragraph (1), or section 7(6) of the 2006 Act, must be considered and decided in accordance with the provisions of paragraphs 54(4) to (13) and 55(1) of Schedule 3, and paragraph (5) (where it applies) of this regulation.

(5) In the case of a dispute referred to the Welsh Ministers under paragraph (1), the determination—

(a) may specify terms to be included in the proposed contract,

(b) may require the Local Health Board to proceed with the proposed contract, but may not require the proposed contractor to proceed with the proposed contract, and

Part 4 — HEALTH SERVICE BODY STATUS

Health service body status

9

(1) Where a proposed contractor elects, in a written notice served on the Local Health Board at any time before the contract being entered into, to be regarded as a health service body for the purposes of section 7(4) of the 2006 Act[^f00026], it must be so regarded from the date on which the contract is entered into.

(2) If, in accordance with paragraph (1) or (5), a contractor must be regarded as a health service body, that fact must not affect the nature of, or any rights or liabilities arising under, any other contract with a health service body entered into by that contractor before the date on which the contractor must be so regarded.

(3) Where a contract is made with an individual dental practitioner or two or more persons practising in partnership, and that individual, or that partnership must be regarded as a health service body in accordance with paragraph (1) or (5), the contractor must, subject to paragraph (4), continue to be regarded as a health service body for the purposes of section 7(4) of the 2006 Act for as long as that contract continues and irrespective of any change in—

(a) the partners comprising the partnership,

(b) the status of the contractor from that of an individual dental practitioner to that of a partnership, or

(4) A contractor may at any time request a variation of the contract to include or remove provision from the contract that the contract is an NHS contract, and if it does so—

(a) the Local Health Board must agree to the variation, and

(b) the procedure in paragraph 57(1) of Schedule 3 applies (variation of a contract: general).

(5) Where, pursuant to paragraph (4), the Local Health Board agrees to a variation of the contract, the contractor must be regarded, or subject to paragraph (7), cease to be regarded, as a health service body for the purposes of section 7(4) of the 2006 Act from the date that variation takes effect pursuant to paragraph 57(1) of Schedule 3.

(6) Subject to paragraph (7), a contractor ceases to be regarded as a health service body for the purposes of section 7 of the 2006 Act if the contract is terminated.

(7) Where a contractor ceases to be a health service body—

(a) pursuant to paragraph (5) or (6), it continues to be regarded as a health service body for the purposes of being a party to any other NHS contract entered into after it became a health service body but before the date on which the contractor ceased to be a health service body (for which purposes it ceases to be such a body on the termination of that NHS contract);

(b) pursuant to paragraph (5), the contractor must continue to be treated as a health service body (and accordingly the contract must continue to be regarded as an NHS contract) for the purposes of the consideration and determination of the dispute, where it or the Local Health Board—

(i) has referred any matter to the NHS dispute resolution procedure before it ceases to be a health service body, or

(ii) refers any matter to the NHS dispute resolution procedure, in accordance with paragraph 54(1)(a) of Schedule 3, after it ceases to be a heath service body;

(c) pursuant to paragraph (6), it continues to be regarded as a health service body for the purposes of the NHS dispute resolution procedure where that procedure has been started—

(i) before the termination of the contract, or

(ii) after the termination of the contract, whether in connection with or arising out of the termination of the contract or otherwise.

Part 5 — CONTRACTS: REQUIRED TERMS

Parties to the contract

10

A contract must specify—

(a) the names of the parties,

(b) in the case of a partnership—

(i) whether or not it is a limited partnership, and

(ii) the names of the partners and, in the case of a limited partnership, their status as a general or limited partner, and

NHS contracts

11

In the case of a contractor who must be regarded as a health service body pursuant to regulation 9, the contract must state that it is an NHS contract.

Contracts with individuals practising in partnership

12

(1) Where the contract is with two or more individuals practising in partnership, the contract must be treated as made with the partnership as it is from time to time constituted, and the contract must make specific provision to this effect.

(2) Where the contract is with two or more individuals practising in partnership, the contractor must be required by the terms of the contract to ensure that any person who becomes a member of the partnership after the contract has come into force is bound automatically by the contract whether by virtue of a partnership deed or otherwise.

Duration

13

(1) Except in the circumstances specified in paragraph (2), a contract must provide for it to subsist until it is terminated in accordance with the terms of the contract or the general law.

(2) The circumstances referred to in paragraph (1) are that the Local Health Board has terminated the contract of another provider of primary dental services, and as a result of that termination, it wishes to enter into a temporary contract for a period specified in the contract for the provision of services.

(3) Where a contract is entered into pursuant to paragraph (2)—

(a) paragraph 62 (termination by the contractor) of Schedule 3 does not apply to the contract, and

(b) the parties to the temporary contract may include such terms as to termination by notice as they may agree.

Mandatory services

14

(1) For the purposes of section 58 of the 2006 Act (primary dental services), the services which must be provided under a general dental services contract are described in paragraph (2).

(2) A contractor must provide—

(a) urgent access for new patients, as set out in Part 1 of Schedule 1,

(b) recall appointments for patients who require recall appointments between 18 and 24 months later than their most recent appointment,

(d) care packages, as set out in Part 3 of Schedule 1,

(e) prevention services as set out in Part 4 of Schedule 1, and

(f) urgent care for active patients.

(3) For the purposes of section 61 of the 2006 Act (GDS contracts: other required terms) a contractor must also provide a selection of the National Priorities, as set out in Part 5 of Schedule 1 in accordance with directions made by the Welsh Ministers under section 60(3)(b)(i) of the 2006 Act.

Advanced mandatory services

15

(1) Any level 1 procedure must be provided by the contractor unless the contractor, or any dental practitioner employed by the contractor, does not have the relevant experience or expertise, in which case the level 1 procedure can be referred as an advanced mandatory service.

(2) Advanced mandatory services which are the subject of a referral under paragraph (1) are to be arranged through a Personal Dental Services Agreement under the 2006 (PDS) Regulations.

Services: general

16

(1) A contract must specify—

(a) the services to be provided by the contractor,

(b) the address of each of the premises to be used by the contractor or any sub-contractor for the provision of such services, or, if the contractor provides services from a mobile surgery, that fact,

(d) the date it is effective from.

(2) The reference to premises in sub-paragraph (b) does not include any place in which a patient is residing.

Proportion of mandatory services

17

(1) The standard proportions of mandatory services (other than urgent care for active patients) are as follows—

(a) 7% for urgent treatment for new patients,

(b) 3% recall appointments between 18 and 24 months since the most recent appointment,

(d) 70% to provide care packages,

(e) 5% for prevention services, and

(f) 5% for national priorities.

(2) A Local Health Board may depart from the standard proportions within the overall total of 100% if it is satisfied that there are different levels of need in its area which require the proportions to be adjusted in order to ensure that patients in its area are properly provided for.

(3) The departure from the standard proportions may be on a whole area basis, part of an area basis or, subject to paragraph (4), in relation to a single practice.

(4) Unless paragraph (7) applies, before altering the proportions for a single practice, the Local Health Board must consult the contractor for that practice and give at least 28 clear days’ notice.

(5) The Local Health Board must have regard to any representations the affected contractor makes within the 28 day period set out in paragraph (4) when determining the proportions which apply to that single practice but need not have regard to any representations made outside that period.

(6) If the contractor for a single practice who has been consulted in accordance with paragraph (4) does not agree with the amended proportions imposed by the Local Health Board the contractor may refer the dispute to the Welsh Ministers to consider and decide the matter in accordance with the procedure provided for in paragraphs 54 to 55 of Schedule 3.

(7) Where a Local Health Board determines that the 5% allocation for national priorities referred to in sub-paragraph (1)(f) is not required, either in whole or in part, for a specified period, the Local Health Board may—

(a) reallocate any unused proportion from sub-paragraph (1)(f) to the provision of care packages under sub-paragraph (1)(d) for a specified period,

(b) make such reallocation for the whole of its area, part of its area, or in relation to one or more individual practices, and

(8) Where a reallocation is made under sub-paragraph (7), the Local Health Board must notify the affected contractor or contractors in writing of—

(a) the revised proportion allocated to care packages under sub-paragraph (1)(d),

(b) the period for which the reallocation applies, and

(c) the date from which the reallocation takes effect, which must be at least 14 clear days after the date of notification.

(9) Urgent care for active patients must be delivered notwithstanding that the proportions set out in paragraph (1) have been achieved and is not included in the overall percentage.

Period over which the proportion of mandatory services must be delivered

18

The proportion of each mandatory service, expressed as a percentage, to be provided by the contractor whilst the contract is in effect relates to—

(a) where the contract begins on 1 April, each financial year, or

(b) subject to regulation 36(1), where the contract begins on a date except 1 April, the remainder of the financial year in which the contract begins, and then in each financial year thereafter.

Underprovision of proportions of mandatory services

19

(1) The contract must provide that the Local Health Board must not, pursuant to Part 8 of Schedule 3 (variation and termination of contracts), be entitled to take any action for breach of a term of the contract giving effect to regulation 17 (including termination of the contract) where paragraph (2) applies.

(2) This paragraph applies where the contractor has failed to provide the required proportion of mandatory services over a period of a year and—

(a) that failure amounts to a variation of 5 per cent or less of the mandatory service, and

(b) the contractor agrees to provide the mandatory services it has failed to provide within such time period as the Local Health Board specifies in writing, such period to consist of not less than 60 clear days.

(3) Paragraphs (1) and (2) do not prevent the Local Health Board from taking action under Part 8 of Schedule 3 for breach of contract (including terminating the contract) on other grounds.

(4) In a case where the contractor does not agree to provide the relevant mandatory service it has failed to provide within such time period as the Local Health Board specifies the Local Health Board may, if it deems such a step appropriate, apply financial recovery up to 100% of the value of the underperformance.

Mid-year delivery report

20

The contract must require that a Local Health Board produces and provides to each contractor a mid-year delivery report.

Mid-year delivery report requirements

21

(1) Subject to regulation 37, a mid-year delivery report must be provided, in a form which is prescribed by the Local Health Board, not before the last day of the sixth month of the contract and no later than the last day of the seventh month of the contract and at corresponding annual intervals thereafter and must set out—

(a) the sum total percentage of the services specified in regulation 17(1) delivered over the relevant preceding 6 calendar month period, and

(b) the percentage achieved against each of the individual services specified in regulation 17(1), delivered over the relevant preceding 6 calendar month period.

(2) In this regulation “relevant preceding 6 calendar month period” means the 6 month period preceding the last day of the sixth month of the contract referred to in paragraph (1).

Mid-year financial adjustments

22

Where the sum total of the percentages reported under regulation 21(1) is below 40%, the Local Health Board may, if it deems it appropriate, implement a mid-year financial adjustment, and reduce payments to the contractor for the remainder of that financial year to reflect the percentage which had been delivered when the report was produced and must notify the contractor that it has taken this step and its reasons for doing so within 14 clear days.

Appeals against mid-year financial adjustments

23

A contractor who is subject to a mid-year financial adjustment in accordance with regulation 22 may appeal that decision to the Welsh Ministers in accordance with the procedure provided for in paragraph 53 or 54, as the case may be, of Schedule 3.

Annual delivery reports

24

(1) The contract must require that the Local Health Board provides an annual delivery report to the contractor.

(2) An annual delivery report must set out both the overall percentage of the services specified in regulation 17(1) as a whole and the percentage achieved against each of the individual services specified in that regulation, during the previous year of the contract.

(3) An annual delivery report must be provided in a form which is prescribed by the Local health Board,

(a) in the case of a contract under regulation 13(1) not before the last day of the twelfth month of the contract and not after the twentieth day of the thirteenth month of the contract and at corresponding annual intervals thereafter;

(b) in the case of a contract under regulation 13(2), no more than 20 clear days after the end of the period specified in the contract.

Provision below 95%

25

(1) Where the sum total of the percentage reported under regulation 24 is below 95% the Local Health Board may—

(a) reduce payments to the contractor for the next financial year and the following financial years to reflect the percentage of services set out in the delivery report, and

(b) apply financial recovery up to 100% of the value of the underperformance.

(2) A Local Health Board who takes either of the steps set out in sub-paragraph (1)(a) or (1)(b) must notify the contractor of its intention and its reasons for doing so 14 clear days before it makes the adjustment or the recovery, as the case may be.

Appeal against application of regulation 25

26

A contractor who is subject to a financial adjustment or to whom financial recovery has been applied in accordance with regulation 25, may appeal the Local Health Board’s decision to the Welsh Ministers in accordance with the procedure provided for in paragraph 53 or 54, as the case may be, of Schedule 3.

Provision over 100%

27

Where the sum total of the percentage reported under regulation 24 is between 100% and 105%, the Local Health Board must either—

(a) reduce the required quantity of the services set out in regulation 17(1) for the next financial year to reflect the work carried out over 100% and bring the overall performance requirements back to 100%, or

(b) remunerate the practice for the value of the extra work carried out.

Provision over 105%

28

In a case where the percentage reported under regulation 24 is over 105% the Local Health Board must not—

(a) increase the required quantity of the services set out in regulation 17(1) to reflect the work carried out over 105% and bring the overall performance requirements to 100%, or

(b) remunerate the practice for the value of the extra work carried out, unless there was a prior written agreement, dated at least 60 clear days before the end of the financial year, between the Local Health Board and the contractor, that performance of over 105% could be delivered in that financial year.

Appeal against application of regulation 27

29

A contractor who has their overall contract proportions reduced in accordance with regulation 27(1)(a) may appeal the Local Health Board’s decision to the Welsh Ministers in accordance with the procedure provided for in paragraph 53 or 54, as the case may be, of Schedule 3.

Finance

30

(1) The contract must contain a term which has the effect of requiring—

(a) the Local Health Board to make payments to the contractor under the contract promptly and in accordance with both the terms of the contract and any other conditions relating to the payment contained in directions issued by the Welsh Ministers under section 60 of the 2006 Act (GDS contracts: payments), and

(b) the contractor to make payments promptly to the Local Health Board and in accordance with both the terms of the contract and any other conditions relating to payment contained in directions issued by the Welsh Ministers under section 60 of the 2006 Act.

(2) The obligation referred to in paragraph (1) is subject to any right the Local Health Board has to set off against an amount payable to the contractor an amount that—

(a) is owed by the contractor to the Local Health Board under the contract,

(b) has been paid to the contractor owing to an error or in circumstances when it was not due, or

(c) the Local Health Board may withhold from the contractor in accordance with the terms of the contract or any other applicable provisions contained in directions issued by the Welsh Ministers under section 60 of the 2006 Act.

(3) The contract must contain a term to the effect that where, pursuant to directions under section 12 or 60 of the 2006 Act, a Local Health Board is required to make a payment to a contractor under a contract but subject to conditions, those conditions are to be a term of the contract.

(4) The contract must contain terms relating to laboratory charge reimbursement for exempt persons in accordance with directions issued by the Welsh Ministers under section 60 of the 2006 Act.

(5) The contract must contain terms relating to central collection of NHS Charges in accordance with directions issued by the Welsh Ministers under section 60 of the 2006 Act.

Payments, charges and financial interests of the contractor

31

(1) The contract must contain terms relating to payments, charges and financial interests which have the same effect as those set out in paragraphs (2) to (4).

(2) The contractor must not, either itself or through any other person, demand or accept any kind of remuneration for its own or another’s benefit from—

(a) any of its active patients for the provision of any treatment under the contract, except as otherwise provided in Schedule 5, or

(b) any person who has requested services under the contract for themselves or a family member, as a prerequisite to providing services under the contract to that person or their family member.

(3) The contract must contain a term that—

(a) only permits the contractor to collect from any active patient any charge that that patient is required to pay by virtue of Schedule 5, in accordance with the requirements of that Schedule, and

(b) provides for obligations imposed on the contractor by virtue of Schedule 5 to be terms of the contract.

(4) The contract must contain a term that requires the contractor to put aside its own financial interests in making a decision—

(a) as to what services to recommend or provide to an active patient who has sought services under the contract, or

(b) to refer an active patient for other services by another contractor, hospital or other relevant service provider under Part 1 of the 2006 Act.

(5) The term “active patient” in this regulation includes a person who pays or agrees to pay a charge on behalf of a person to whom dental services are provided.

Arrangements on termination of a contract

32

A contract must make provision for the arrangements which are to apply on the termination of the contract, including—

(a) the transfer of patient records,

(b) the transfer of responsibility for ongoing courses of treatment,

(d) financial consequences of termination of a contract, including—

(i) payment for services provided up to the date of termination of the contract;

(ii) recovery of any overpayments;

(iii) any financial penalties arising from the termination of the contract,

(e) the contractor’s continuing obligations in respect of confidentiality and data protection, and

(f) dispute resolution in relation to any matter arising from the termination of the contract.

Other contractual terms

33

(1) A contract must contain terms which have the same effect as those specified in Schedule 3, except for paragraphs 54(4) to (13) and 55, unless—

(a) the contract is of a type or nature to which a particular provision in Schedule 3 does not apply,

(b) there has been an agreement between the contractor and Local Health Board, or

(c) the Local health Board has determined, where this is authorised by these Regulations, that the term should not apply,

(3) Where a provision in Schedule 3 applies to a contract, the terms of the contract must give effect to the matters set out in that provision.

(4) A contract must contain a term which requires the contractor to be a member of a cluster.

Part 6 — TRANSITIONAL PROVISION

Interpretation of Part 6

34

In this Part—

“existing contract” (“contract presennol”) means a contract entered into under the 2006 Regulations which is in force immediately before 11 March 2026;

“existing contractor” (“contractwr presennol”) means a contractor who is a party to an existing contract.

Continuity of existing contracts

35

(1) An existing contract has effect on and after 1 April 2026 as if it were a contract entered into under these Regulations.

(2) Paragraph (1) is subject to regulations 36 and 39 to 41.

(3) The Local Health Board and the contractor may agree to vary an existing contract to bring it into conformity with these Regulations.

Mandatory services proportions

36

(1) Where an existing contract does not specify proportions of mandatory services in accordance with regulation 16, the standard proportions in regulation 17(1) apply from 1 April 2026.

(2) A Local Health Board may, before 16 March 2026, give notice to an existing contractor that different proportions apply in accordance with regulation 16(2) and (3).

(3) Where notice is given under paragraph (2), the contractor may make representations within 14 clear days of receipt of the notice.

(4) The Local Health Board must have regard to any representations made under paragraph (3) before determining the proportions to apply from 1 April 2026.

Mid-year and annual delivery reports

37

(1) The first mid-year delivery report under regulation 20 must be provided—

(a) for a contract which started before 1 October 2025, not before 30 September 2026 and not after 31 October 2026;

(b) for a contract which started on or after 1 October 2025, in accordance with regulation 21.

(2) The first annual delivery reports under regulation 24 must be provided—

(a) for a contract which started before 1 April 2026, not before 31 March 2027 and not after 30 April 2027;

(b) for a contract which started on or after 1 April 2026, in accordance with regulation 26.

Health service body status

38

(1) Where, immediately before 11 March 2026, a contractor was regarded as a health service body for the purposes of section 7(4) of the 2006 Act, the contractor continues to be so regarded on and after that date.

(2) Regulation 9 applies to such a contractor as if the election had been made under these Regulations.

Disqualification provisions

39

(1) Regulations 4 and 5 apply to—

(a) contracts entered into on or after 11 March 2026;

(b) variations to existing contracts agreed on or after 11 March 2026 which involve a change of contractor or the addition of a new partner or director.

(2) The conditions in regulations 4 and 5 do not apply to existing contracts unless and until a variation of the type described in paragraph (1)(b) is made.

Disputes and appeals

40

(1) Where, before 11 March 2026—

(a) a dispute has been referred for resolution under the 2006 Regulations, or

(b) an appeal has been made under the 2006 Regulations,

the dispute or appeal continues to be dealt with in accordance with the 2006 Regulations as if they had not been revoked.

(2) Where a dispute or appeal arises on or after 11 March 2026 in relation to a matter which occurred before that date, the dispute or appeal must be dealt with in accordance with these Regulations.

Charges

41

Where a course of treatment is started before 1 April 2026 and continues after that date—

(a) the charge applicable is the charge set out in the treatment plan provided to the patient under paragraph 7 of Schedule 3 to the 2006 Regulations calculated in accordance with the 2006 (Charges) Regulations as they applied at the time the treatment plan was accepted by the patient;

(b) any guarantee period is calculated in accordance with the 2006 (Charges) Regulations as they were in force when the restoration was provided.

Revocation

42

The 2006 Regulations are revoked.

Amendments

43

The 2006 (Charges) Regulations and the 2006 (PDS) Regulations are amended in accordance with Schedule 6.

Schedule 1 — MANDATORY SERVICES

PART 1 — Urgent Access For New Patients

1

Each Local Health Board is required to secure the provision of urgent access appointments within its area in accordance with this Schedule and Schedule 3.

2

The purpose of urgent access appointments is the provision to patients who require urgent care with an appointment within 72 hours of the time they first make contact with the Local Health Board.

Urgent Access Appointments Programme

3

In order to ensure that urgent access appointments are available each Local Health Board must establish an urgent access appointment programme which must—

(a) provide a central team for the Local Health Board area whom people with urgent dental needs can contact for urgent appointments,

(b) provide for that team to make a telephone based assessment of whether the person requires urgent care and if they do, provide them with an appointment,

(c) provide that the team refers any person who is not deemed to require urgent care to the Dental Access Portal and, if needs be, provides the person with assistance to register on the Dental Access Portal,

(d) make arrangements with all contractors within the Local Health Board’s area for an urgent care appointment rota to be in place which provides urgent appointments as required, and

(e) administer the urgent care appointment rota so as to ensure that urgent care appointments are available each working day between 9am and 5pm within a reasonable geographical distance for patients within the Local Health Board’s area.

Urgent care appointments for new patients

4

The contract must specify requirements as to the provision of urgent care including—

(a) that each contractor in the Local Health Board’s area must agree to provide a certain number of urgent care appointments for new patients annually at a time and on dates that are agreed with the Local Health Board,

(b) that each contractor must inform the Local Health Board of what, if any, types of accessibility-enhanced dental services for urgent care appointments they are able to provide,

(c) that urgent care appointments should prioritise relief from pain and the prevention of significant deterioration of the particular problem,

(d) that treatment administered during urgent care appointments, where appropriate, and with the patient’s consent, should, where possible, be permanent definitive treatment including restorations,

(e) that when any necessary treatment cannot be completed during the urgent care appointment, justification for any treatment or care provided must be recorded in the patient’s clinical record and, unless the most appropriate course is an onward referral to an alternative contractor, a hospital or other relevant service provider, the contractor should seek permission from the Local Health Board to take on the patient as a new active patient before providing a further appointment,

(f) that urgent care appointments should, where possible, include a global oral health assessment (including soft tissue) and onward referral to an alternative contractor, a hospital or other relevant service provider, where appropriate, or if not possible, the reason this could not be provided must be recorded in the patient’s clinical record, and

(g) that any patient seen at an urgent care appointment whose treatment is completed at the urgent care appointment or for whom permission sought under sub-paragraph (e) is refused, who is not already registered on the Dental Access Portal should be advised to do so and assistance in registering must be provided by the contractor or their staff if requested by the patient.

Payments

5

The Local Health Board must arrange for each contractor to be remunerated for its participation in the Urgent Access Appointments Programme, established under paragraph 3, in accordance with directions issued by the Welsh Ministers under section 60 of the 2006 Act.

6

The contract must include provision for—

(a) the contractor to be paid for any missed urgent care appointments as long as the contractor can demonstrate that they made adequate efforts, having regard to any guidance given by the Welsh Ministers, to ensure the prospective patient’s attendance and have written to the prospective patient to explain that the urgent care appointment cannot be re-arranged and that the prospective patient needs to re-apply through the Urgent Access Appointments Programme established under paragraph 3,

(b) ensuring that evidence of the efforts made must be retained by the contractor for a period of 24 months from the date of the letter referred to in sub-paragraph (a) and made available to the Local Health Board, on request, for audit purposes,

(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 that patient has been provided to the Local Health Board, or

(bb) 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, and

(d) the contractor to be paid for any unfilled urgent care appointments in accordance with directions issued by the Welsh Ministers under section 60 of the 2006 Act.

Part 2 — New Patient Assessments Arising From The Dental Access Portal

New patient assessments

7

Each Local Health Board is required to secure access to new patient assessments for patients in its area who have applied through the Dental Access Portal.

8

An assessment for a new patient allows a contractor to make an assessment of the oral health needs of a patient and arrange for further treatment if necessary.

Provision of new patient assessments

9

The contract must include the following requirements as to the provision of assessments for new patients by the contractor—

(a) subject to sub-paragraphs (d) and (e), a requirement that contractors acquire all new patients through the Dental Access Portal,

(b) a requirement that contractors provide enough appointments for the assessment of new patients to allow them to fulfil the proportion of that service that has been decided to apply to the practice by the Local Health Board under regulation 17,

(c) a requirement that contractors consider returning the patient to the Dental Access Portal if that patient fails to attend the new patient assessment on two occasions,

(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,

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