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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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(b) application of fluoride varnish where clinically indicated,

(d) monitoring of risk factors.

Moderate risk patients

33

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

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

(b) reinforcement of good oral health behaviours, and

Low risk patients

34

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

(a) application of fluoride varnish,

(b) application of fissure sealants,

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

(e) dietary analysis and counselling,

(f) smoking cessation support and referral, and

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

Specific preventative interventions

35

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

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

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

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

(e) any preventative products recommended or provided,

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

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

(h) the planned preventative strategy for future appointments.

Documentation requirements

36

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

(a) written information on oral hygiene techniques,

(b) dietary advice for oral health,

(d) smoking cessation resources,

(e) oral cancer awareness materials, and

(f) age-specific oral health information.

(2) Patient information materials must be—

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

(b) available in Welsh and English,

(d) culturally appropriate, and

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

Patient information materials

37

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

(a) review of clinical records,

(b) patient feedback and surveys,

(d) audit of preventative interventions provided, and

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

(2) The contractor must—

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

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

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

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

Monitoring and audit

38

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

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

(b) issuing requirements to carry out remedial action,

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

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

Breach of prevention requirements

39

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

Payments

40

(1) The contract must provide that—

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

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

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

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

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

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

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

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

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

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

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

(d) standalone preventative appointments where clinically indicated,

(e) application of fluoride varnish where clinically indicated,

(f) provision of patient information materials,

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

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

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

41

(1) The contract must provide that—

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

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

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

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

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

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

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

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

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

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

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

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

42

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

Preventative intervention during a care package

43

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

(a) updates on evidence-based preventative guidance,

(b) training in behaviour change techniques,

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

(e) other relevant professional development as appropriate.

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

Continuing professional development

44

Upon initiating de-listing, the contractor must—

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

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

De-listing notification – prevention services

45

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

(a) de-list the patient, and

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

De-listing after 36 months

46

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

PART 5 — National priorities

47

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

(a) quality improvement,

(b) quality management

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

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

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

(g) digital delivery of services,

(h) improving infection prevention and control, and

(i) sustainability (greener dentistry).

48

(a) quality improvement,

(b) quality management

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

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

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

(g) digital delivery of services,

(h) improving infection prevention and control, and

(i) sustainability (greener dentistry).

Schedule 2 — CARE PACKAGES

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

1

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

2

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

3

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

Schedule 3 — OTHER CONTRACTUAL TERMS

PART 1 — PATIENTS

Persons to whom mandatory services are to be provided

1

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

(a) the person who requires the services, or

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

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

(a) on behalf of any child by—

(i) either parent,

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

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

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

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

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

(a) any protected characteristics under the Equality Act 2010, social class, appearance or medical or dental condition[^f00029], or

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

(6) Sub-paragraph (1) does not apply—

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

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

Patient preference of dental practitioner

2

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

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

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

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

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

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

(3) This paragraph does not apply—

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

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

Violent patients

3

(1) Where a patient of the contractor has—

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

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

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

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

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

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

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

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

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

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

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

(f) any other person present—

(i) on the practice premises, or

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

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

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

(6) The Local Health Board must—

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

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

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

4

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

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

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

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

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

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

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

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

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

Irrevocable breakdown in relationship between contractor and patient

5

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

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

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

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

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

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

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

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

PART 2 — PROVISION OF SERVICES

Course of treatment

6

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

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

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

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

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

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

(a) ended before it has been completed, or

(b) otherwise not completed within a reasonable time.

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

(a) the contractor—

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

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

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

(b) the patient, or

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

Treatment plans

7

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

(a) the name of the patient,

(b) the name of the contractor,

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

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

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

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

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

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

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

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

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

Completion of courses of treatment

8

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

(2) If the Local Health Board—

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

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

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

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

9

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

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

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

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

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

(ii) a copy of the referral notice, and

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

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

Mixing of services provided under the contract with private dental services

10

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

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

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

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

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

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

Repair or replacement of restorations

11

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

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

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

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

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

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

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

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

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

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

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

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

Premises, facilities and equipment

12

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

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

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

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

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

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

Telephone services

13

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

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

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

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

National Institute for Health and Care Excellence guidance

14

The contractor must provide services under the contract in accordance with any relevant guidance that is issued by the National Institute for Health and Care Excellence[^f00030], in particular the guidance entitled “Dental recall— Recall interval between routine dental examinations”[^f00031].

Infection control

15

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

Treatment under general anaesthesia: prohibition

16

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

Welsh Language

17

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

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

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

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

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

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

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

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

PART 3 — SUPPLY OF DRUGS AND PRESCRIBING

General

18

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

Supply of drugs

19

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

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

Issue of prescription forms

20

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

(2) A prescription form must be—

(a) signed by the prescriber, and

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

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

Excessive prescribing

21

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

PART 4 — PERSONS WHO PERFORM SERVICES

Dental practitioners

22

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

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

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

Dental care professionals

23

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

(a) a dental hygienist,

(b) a dental therapist, or

(i) they are a dental care professional, and

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

Performers: further requirements

24

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

(2) Where—

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

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

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

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

Conditions for employment and engagement: dental practitioners performing dental services

25

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

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

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

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

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

26

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

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

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

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

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

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

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

Conditions for employment and engagement: all persons performing dental services

27

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

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

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

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

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

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

28

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

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

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

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

(b) their education and training, and

Training

29

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

(a) performing dental services under the contract, or

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

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

Level of skill

30

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

Appraisal and assessment

31

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

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

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

Sub-contracting of clinical services

32

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

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

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

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

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

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

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

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

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

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

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

Patient records

33

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

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

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

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

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

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

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

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

(d) the statement concerning any custom-made devices provided by any person as a consequence of regulation 15 of the Medical Devices Regulations 2002[^f00032] (procedures for custom-made devices) in respect of services being provided to that patient.

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

(a) the date on which—

(i) a course of treatment is ended, or

(ii) a course of treatment is completed, or

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

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

Confidentiality of personal data

34

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

Information to patients

35

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

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

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

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

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

(2) The contractor must—

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

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

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

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

Provision of and access to information: Local Health Board

36

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

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

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

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

(ii) workforce information, and

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

Inquiries about prescriptions and referrals

37

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

(a) any prescription form issued by a prescriber,

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

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

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

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

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

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

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

Notification of a course of treatment etc.

38

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

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

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

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

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

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

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

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

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

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

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

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

Annual report and review

39

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

(2) Once the Local Health Board has provided the report referred to in sub-paragraph (1), the Local Health Board must arrange with the contractor an annual review of its performance in relation to the contract.

(3) The Local Health Board must prepare a draft record of the review referred to in sub-paragraph (2) for comment by the contractor and, having regard to such comments, produce a final written record of the review.

(4) A copy of the final record referred to in sub-paragraph (3) must be sent to the contractor.

Notifications to the Local Health Board

40

(1) In addition to any requirements of notification elsewhere in the Regulations, the contractor must notify the Local Health Board in writing, as soon as reasonably practicable, of—

(a) any serious incident that in the reasonable opinion of the contractor affects or is likely to affect the contractor’s performance of its obligations under the contract, or

(b) any circumstances which give rise to the Local Health Board’s right to terminate the contract under paragraph 65 or 70.

(2) The contractor must, unless it is impracticable for it to do so, notify the Local Health Board in writing within 28 clear days of any occurrence requiring a change in the information about it published by the Local Health Board.

(3) The contractor must give notice in writing to the Local Health Board when a dental practitioner who is performing or is due to perform services under the contract (as the case may be)—

(a) leaves the contractor, and the date upon which they left, or

(b) is employed or engaged by the contractor,

which includes the name of the dental practitioner who has left, or who has been employed or engaged, together with that person’s professional registration number.

Notice provisions specific to a contract with a dental corporation

41

A contractor, which is a dental corporation, must give notice in writing to the Local Health Board immediately when—

(a) it passes a resolution, or a court of competent jurisdiction makes an order that the contractor be wound up,

(b) circumstances arise which might entitle a creditor or a court to appoint a receiver, administrator or administrative receiver for the contractor,

(d) the contractor is unable to pay its debts within the meaning of section 123 of the 1986 Act (definition of inability to pay debts).

Notice provisions specific to a contract with two or more individuals practising in partnership

42

(1) A contractor which is a partnership must give notice in writing to the Local Health Board immediately when—

(a) a partner leaves or informs their partners that they intend to leave the partnership, and the date upon which they left or are due to leave the partnership, or

(b) a new partner joins the partnership.

(2) A notice under sub-paragraph (1)(b) must—

(a) state the date that the new partner joined the partnership,

(b) confirm that the new partner is a dental practitioner,

(c) confirm that the new partner meets the conditions imposed by regulation 4 (general conditions relating to all contracts), and

(d) state whether the new partner is a general or a limited partner.

Notifications to patients following a variation of the contract

43

Where the contract is varied in accordance with Part 8 of this Schedule and, as a result of that variation there are changes in the range of services provided by the contractor, the contractor must ensure that, at least 28 clear days before that change is due to take effect, there is displayed in a prominent position in its practice premises, in a part to which patients have access, written details of that change.

Entry and inspection by the Local Health Board

44

(1) Subject to the conditions in sub-paragraph (2) the contractor must allow persons authorised in writing by the Local Health Board to enter and inspect the practice premises at any reasonable time.

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

(a) reasonable notice of the intended entry has been given,

(b) written evidence of the authority of the person seeking entry is produced to the contractor on request, and

(c) entry is not made to any premises or part of the premises used as residential accommodation without the consent of the resident.

(3) In this paragraph “premises” includes a mobile surgery.

Entry and inspection by the Welsh Ministers

45

The contractor must allow persons authorised by the Welsh Ministers to enter and inspect premises in accordance with section 72 of the Health and Social Care (Community Health and Standards) Act 2003[^f00033] (right of entry).

PART 6 — CONCERNS

Concerns

46

(1) The contractor must establish and operate arrangements which meet the requirements of the 2011 Regulations[^f00034] to deal with any concerns notified about any matter reasonably connected with the provision of services under the contract.

(2) The following matters are excluded from consideration under the arrangement under sub-paragraph (1)—

(a) a concern which is resolved to the satisfaction of the person who notified the concern not later than the next working day after the day on which the concern was notified;

(b) a concern which is being or has been investigated by the Public Services Ombudsman for Wales;

(c) a concern the subject matter of which is, or becomes, the subject of civil proceedings (including the pre-action stage of those proceedings);

(d) a concern the subject matter of which has previously been considered in accordance with arrangements made under the 2011 Regulations or any relevant complaints procedure;

(e) a concern arising out of an alleged failure to comply with a request for information under the Freedom of Information Act 2000[^f00035].

(3) Where the contractor decides that a concern is excluded, it must as soon as reasonably practicable notify in writing the person who notified the concern of its decision and the reason for its decision (except in relation to matters resolved by the next working day).

Notification of concerns

47

(1) A concern may be notified by—

(a) a patient or former patient who is receiving or has received services under the contract,

(b) any person who is affected, or likely to be affected by the action, omission or decision of the contractor, or

(i) has died,

(ii) is a child,

(iii) is unable to notify the concern themselves because they lack capacity within the meaning of the Mental Capacity Act 2005[^f00036], or

(iv) has requested the representative to act on their behalf.

(2) In this Part, reference to a representative where the patient is a child, includes—

(a) a parent,

(b) a person duly authorised by a local authority who is responsible for the child, or

(3) Where a patient has died, a concern may be notified by a relative or other adult person who had an interest in their welfare or, where the patient falls within sub-paragraph (2)(a)(ii) or (iii) by the local authority or voluntary organisation respectively.

Period for notifying concerns

48

(1) A concern must be notified within 12 months after—

(a) the date on which the matter which is the subject of the concern occurred, or

(b) if later, the date on which the matter came to the notice of the person notifying the concern.

(2) The 12 month time limit in sub-paragraph (1) does not apply if the person nominated in accordance with paragraph 49(2)(a), below, is satisfied that—

(a) the person had good reasons for not notifying the concern within that time limit, and

(b) it is still possible to investigate the concern effectively and fairly.

(3) A concern may not be notified 3 or more years after—

(a) the date the matter occurred, or

(b) if later, 3 or more years from the date it came to the notice of the person notifying the concern.

Further requirements for concerns procedures

49

(1) A concerns procedure arranged in accordance with paragraph 46 must also comply with the requirements set out in sub-paragraphs (2) to (6).

(2) The contractor must nominate—

(a) a person (who need not be connected with the contractor and who, in the case of an individual, may be specified by their job title) to be responsible for the operation of the concerns procedure and the investigation of concerns, and

(b) a partner, or other senior person associated with the contractor, to be responsible for the effective management of the concerns procedure and for ensuring that action is taken in the light of the outcome of any investigation.

(3) A concern may be notified—

(a) in writing,

(b) electronically, or

(4) Where a concern is notified verbally, the member of staff to whom the concern has been notified must make a written record of the concern and provide a copy of the written record to the person who notified the concern within 5 working days.

(5) A concern must be—

(a) acknowledged in writing within the period of 5 working days beginning with the day on which the concern was notified in accordance with sub-paragraph (3) or, where that is not possible, as soon as reasonably practicable, and

(b) properly investigated.

(6) Within the period of 30 working days beginning with the day on which the concern was received by the person specified under sub-paragraph (2)(a) or, where that is not possible, as soon as reasonably practicable, the person who notified the concern must be given a written summary of the investigation and its conclusions.

(7) If the contractor is unable to provide a written summary within 30 working days, it must notify the person who notified the concern accordingly and explain the reason why, and send the response as soon as reasonably practicable and within 6 months beginning with the day upon which it received notification of the concern.

(8) At the time it acknowledges notification of a concern, the contractor must offer to discuss with the person who notified the concern—

(a) the way in which the investigation must be handled, including any requirement for consent to use medical records,

(b) the availability of advocacy and support services, and

(9) If the person who notifies the concern does not accept the offer of a discussion under sub-paragraph (8), the contractor must consider and make a decision upon the matters set out in sub-paragraphs (8)(a) to (c) and write to the person accordingly.

(10) Where the investigation of the concern requires consideration of the patient’s dental records, the person specified in sub-paragraph (2)(a) must inform the patient or person acting on their behalf if the investigation involves disclosure of information contained in those records to a person other than the contractor or an employee of the contractor.

(11) The contractor must keep a record of all concerns and copies of all correspondence relating to concerns for a period of at least 7 years from the date on which such concerns were notified, but such records must be kept separate from the patients’ dental records.

Co-operation with investigations

50

(1) The contractor must co-operate with—

(a) any investigation of a concern notified in accordance with the 2011 Regulations in relation to any matter reasonably connected with the provision of services under the contract carried out by—

(i) the Local Health Board,

(ii) the Welsh Ministers, or

(iii) the Public Services Ombudsman for Wales,

(b) any investigation of a concern notified in accordance with the 2011 Regulations by an NHS body or local authority which relates to a patient or former patient of the contractor.

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

(a) answering questions reasonably put to the contractor by the investigator,

(b) providing any information relating to the concern notified in accordance with the 2011 Regulations reasonably required by the investigator, and

(c) attending any meeting to consider the concern notified in accordance with the 2011 Regulations (if held at a reasonably accessible place and at a reasonable hour, and due notice has been given) if the contractor’s presence at the meeting is reasonably required by the investigator.

(3) The contractor must inform the Local Health Board, at such intervals as the Local Health Board requires, of the number of concerns it has received under the procedure established in accordance with this Part.

(4) In this paragraph—

“investigator” means the bodies set out in sub-paragraph (1) or their authorised representative;

“local authority” means—a county council or county borough council in Wales,any of the bodies listed in section 1 of the Local Authority Social Services Act 1970[^f00037] (local authorities),the Council of the Isles of Scilly, ora council constituted under section 2 of the Local Government etc, (Scotland) Act 1994[^f00038] (constitution of councils);

“NHS body” means a Local Health Board, an NHS trust, an NHS foundation trust, an integrated care board, NHS England or an equivalent body constituted in Scotland or Northern Ireland.

Withdrawal of concerns

51

(1) A concern may be withdrawn at any time by the person who notified it.

(2) A person may notify a withdrawal—

(a) in writing,

(b) electronically, or

(3) The contractor must write to the person who has withdrawn a concern verbally to confirm the verbal withdrawal as soon as practicable.

(4) Where a concern has been withdrawn, the contractor may nevertheless continue to investigate any issues raised if it considers it necessary to do so.

PART 7 — DISPUTE RESOLUTION

Local resolution of contract disputes

52

In the case of any dispute arising out of or in connection with the contract, the contractor and the Local Health Board must make every reasonable effort to communicate and co-operate with each other with a view to resolving the dispute, before referring the dispute for determination in accordance with the NHS dispute resolution procedure set out in paragraph 53 or 54 (or, where applicable, before commencing court proceedings).

Dispute resolution: non-NHS contracts

53

(1) In the case of a contract that is not an NHS contract, any dispute arising out of or in connection with the contract, except matters dealt with under the procedures for notifying concerns pursuant to Parts 6 of this Schedule, may be referred for consideration and determination to the Welsh Ministers—

(a) if it relates to a period when the contractor was a health service body, by the contractor or by the Local Health Board, or

(b) in any other case, by the contractor or, if the contractor agrees in writing, by the Local Health Board.

(2) In the case of a dispute referred to the Welsh Ministers under sub-paragraph (1)—

(a) the procedure to be followed is the NHS dispute resolution procedure, and

(b) the parties agree to be bound by any determination made by the adjudicator.

NHS dispute resolution procedure

54

(1) The procedure specified in the following sub-paragraphs and paragraph 53 applies in the case of any dispute arising out of or in connection with the contract which is referred to the Welsh Ministers—

(a) in accordance with section 7(6) of the 2006 Act (where the contract is an NHS contract), or

(b) in accordance with paragraph 55 (where the contract is not an NHS contract).

(2) Any party wishing to refer a dispute as mentioned in sub-paragraph (1) must send to the Welsh Ministers a written request for dispute resolution which must include or be accompanied by—

(a) the names and addresses of the parties to the dispute,

(b) a copy of the contract, and

(3) Any party wishing to refer a dispute as mentioned in sub-paragraph (1) must send the request under sub-paragraph (2) within a period of 3 years beginning with the date on which the matter giving rise to the dispute happened or should reasonably have come to the attention of the party wishing to refer the dispute.

(4) Where the dispute relates to a contract which is not an NHS contract, the Welsh Ministers may decide the matter itself or, if they consider it appropriate, appoint a person or persons to consider and decide it.

(5) Before reaching a decision as to who should decide the dispute, either under sub-paragraph (4) or under section 7(8) of the 2006 Act, the Welsh Ministers must, within the period of 7 clear days beginning with the date on which a matter was referred to them, send a written request to the parties to make in writing, within a specified period, any representations which they may wish to make about the matter.

(6) The Welsh Ministers must give, with the notice given under sub-paragraph (5), to the party other than the one which referred the matter to dispute resolution a copy of any document by which the matter was referred for dispute resolution.

(7) The Welsh Ministers must give a copy of any representations received from a party to the other party and must in each case request (in writing) a party to whom a copy of the representations is given to make within a specified period any written observations which it wishes to make on those representations.

(8) Following receipt of any representations from the parties or, if earlier, at the end of the period for making such representations specified in the request sent under sub-paragraph (5) or (7), the Welsh Ministers must, if they decide to appoint a person or persons to hear the dispute—

(a) inform the parties in writing of the name of the person or persons whom it has appointed, and

(b) pass to the person or persons so appointed any documents received from the parties under or pursuant to paragraph (2), (5) or (7).

(9) For the purpose of assisting the adjudicator in the consideration of the matter, the adjudicator may—

(a) invite representatives of the parties to appear before the adjudicator to make oral representations either together or, with the agreement of the parties, separately, and may in advance provide the parties with a list of matters or questions to which the adjudicator wishes them to give special consideration, or

(b) consult other persons whose expertise the adjudicator considers would assist in the consideration of the matter.

(10) Where the adjudicator consults another person under sub-paragraph (9)(b), the adjudicator must notify the parties accordingly in writing and, where the adjudicator considers that the interests of any party might be substantially affected by the result of the consultation, the adjudicator must give to the parties such opportunity as the adjudicator considers reasonable in the circumstances to make observations on those results.

(11) In considering the matter, the adjudicator must consider—

(a) any written representations made in response to a request under sub-paragraph (5), but only if they are made within the specified period,

(b) any written observations made in response to a request under sub-paragraph (7), but only if they are made within the specified period,

(d) the results of any consultation under sub-paragraph (9)(b), and

(e) any observations made in accordance with an opportunity given under sub-paragraph (10).

(12) In this paragraph, “specified period” means such period as the Welsh Ministers specify in the request, being not less than 2, nor more than 4, weeks beginning with the date on which the notice referred to is given, but the Welsh Ministers may, if they consider that there is good reason for doing so, extend any such period (even after it has expired) and, where they do so, a reference in this paragraph to the specified period is the period as so extended.

(13) Subject to the other provisions of this paragraph and paragraph 57, the adjudicator has wide discretion in determining the procedure of the dispute resolution to ensure the just, expeditious, economical and final determination of the dispute.

Determination of dispute

55

(1) The adjudicator must record the determination and the reasons for it, in writing and give notice of the determination (including the record of the reasons) to the parties.

(2) In the case of a contract referred for determination in accordance with paragraph 54(1), section 7(12) of the 2006 Act applies as that subsection applies in the case of a contract referred for determination in accordance with section 7(6) of the 2006 Act.

Interpretation of Part 7

56

(1) In this Part, reference to any dispute arising out of or in connection with the contract includes any dispute arising out of or in connection with the termination of the contract.

(2) Any term of the contract that makes provision in respect of the requirements in this Part survive even where the contract has ended.

PART 8 — VARIATION AND TERMINATION OF CONTRACTS

Variation of a contract: general

57

(1) Subject to sub-paragraph (2) and paragraphs 58(6), 59(6) and 71, no amendment or variation has effect unless it is in writing and signed by or on behalf of the Local Health Board and the contractor.

(2) In addition to the specific provision made in paragraphs 58(6), 59(6) and 71, the Local Health Board may vary the contract without the contractor’s consent where it—

(a) is reasonably satisfied that it is necessary to vary the contract so as to comply with the 2006 Act, any regulations made pursuant to that Act, or any direction given by the Welsh Ministers pursuant to that Act, and

(b) notifies the contractor in writing of the wording of the proposed variation and the date upon which that variation takes effect.

(3) Where it is reasonably practicable to do so, the date that the proposed variation takes effect must be not less than 14 clear days after the date on which the notice under sub-paragraph (2)(b) is served on the contractor.

Variation provisions specific to a contract with an individual dental practitioner

58

(1) If a contractor which is an individual dental practitioner proposes to practise in partnership with one or more persons during the existence of the contract, the contractor must notify the Local Health Board in writing of—

(a) the name of the person or persons with whom it proposes to practise in partnership, and

(b) the date on which the contractor wishes to change its status as a contractor from that of an individual dental practitioner to that of a partnership, which must be not less than 28 clear days after the date upon which it has served the notice on the Local Health Board pursuant to this sub-paragraph.

(2) A notice under sub-paragraph (1) must, in respect of the person or each of the persons with whom the contractor is proposing to practise in partnership, and also in respect of itself as regards the matters specified in sub-paragraph (c)—

(a) confirm that they are either—

(i) a dental practitioner, or

(ii) a person who satisfies the conditions specified in section 59 of the 2006 Act,

(b) confirm that they are a person who satisfies the conditions imposed by regulation 4, and

and the notice must be signed by the individual dental practitioner and by the person, or each of the persons (as the case may be), with whom they are proposing to practise in partnership.

(3) The contractor must ensure that any person who practises in partnership with it is bound by the contract, whether by virtue of a partnership deed or otherwise.

(4) If the Local Health Board is satisfied as to the accuracy of the matters specified in sub-paragraph (2) that are included in the notice, the Local Health Board must give notice in writing within 14 clear days to the contractor confirming that the contract continues with the partnership entered into by the contractor and its partners, from a date that the Local Health Board specifies in that notice.

(5) Where it is reasonably practicable, the date specified by the Local Health Board pursuant to sub-paragraph (4) must be the date requested in the notice served by the contractor pursuant to sub-paragraph (1), or, where that date is not reasonably practicable, the date specified must be a date after the requested date that is as close to the requested date as is reasonably practicable.

(6) Where a contractor has given notice to the Local Health Board pursuant to sub-paragraph (1), the Local Health Board—

(a) may vary the contract but only to the extent that it is satisfied is necessary to reflect the change in status of the contractor from an individual dental practitioner to a partnership, and

(b) if it does propose to so vary the contract, it must include in the notice served on the contractor pursuant to sub-paragraph (4) the wording of the proposed variation and the date upon which that variation takes effect.

Variation provisions specific to a contract with two or more individuals practising in partnership

59

(1) Subject to sub-paragraph (4) and in accordance with sub-paragraph (2), where a contractor consists of two or more individuals practising in partnership in the event that the partnership is ended or dissolved, the contract may only continue with one of the former partners if that partner is—

(a) nominated in accordance with sub-paragraph (3), and

(b) a dental practitioner.

(2) A contractor must notify the Local Health Board in writing at least 28 clear days in advance of the date on which the contractor proposes to change its status from that of a partnership to that of an individual dental practitioner pursuant to sub-paragraph (1).

(3) A notice under sub-paragraph (2) must—

(a) specify the date on which the contractor proposes to change its status from that of a partnership to that of an individual dental practitioner,

(b) nominate the dental practitioner with whom the contract continues, who must be one of the existing partners, and

(4) If a partnership is ended or dissolved because, in a partnership consisting of two individuals practising in partnership, one of the partners has died, sub-paragraphs (1) to (3) do not apply and—

(a) the contract continues with the individual who has not died only if that individual is a dental practitioner, and

(b) that individual must in any event notify the Local Health Board in writing as soon as is reasonably practicable of the death of their partner.

(5) When the Local Health Board receives a notice pursuant to sub-paragraph (2) or (4)(b), it must acknowledge receipt of the notice in writing, and in relation to a notice served pursuant to sub-paragraph (2), the Local Health Board must do so before the date specified pursuant to sub-paragraph (3)(a).

(6) Where a contractor gives notice to the Local Health Board pursuant to sub-paragraph (2) or (4)(b), the Local Health Board may vary the contract but only to the extent that it is satisfied is necessary to reflect the change in status of the contractor from a partnership to an individual dental practitioner.

(7) If the Local Health Board varies the contract pursuant to sub-paragraph (6), it must notify the contractor in writing of the wording of the proposed variation and the date upon which that variation takes effect.

Termination by agreement

60

The Local Health Board and the contractor may agree in writing to terminate the contract, and if the parties so agree, they must agree the date upon which that termination should take effect and any further terms upon which the contract should be terminated.

Termination on the death of an individual dental practitioner

61

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