Specialist Dental Accountants for over 28 years - Call 020 8346 0391 

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This is just a summary of what we consider to be the main points. Full details will be available on www.dpb.nhs.uk and www.doh.gov.uk/dental in the run-up to April 2005.

In April 2005, major changes will be introduced and will apply to all who work in primary dental care, both in general dental practice and the salaried services.

The main change is that the introduction of local commissioning of primary dental care by Primary Care Trusts (PCTs). They will enter into local contracts with dentists, as well as providing some services themselves. The main aim is to allow dentists to manage their workload each day, with more time to concentrate on preventive care and discuss treatments with patients.

General dental practitioners who currently have a GDS contract, whether as a practice owner or associate, will be offered a new contract under the new arrangements. Your most recent gross earnings, increased by any agreed Review Body Uplift, will be paid to you in monthly instalments. (Please not allowances will be made if the practice as carried a vacancy during 2003, for example as a result of maternity leave, and for dentists who are increasing or decreasing the amount of NHS care they provide). These payments will be protected for three years, to enable parties to get used to the new system. If you agree with their local PCT to increase or decrease the amount of NHS care you provide, the payments will change accordingly.

For this money you will have to provide care for a similar number of patients, both registered and occasional, as you do now. The range of treatments will be the same, but it will be up to your clinical judgement what care is provided to meet the patients’ clinical need. It is expected that this will lead to a more preventive approach to patient care.

Your NHS pension scheme arrangements will be the same as before, but with greater flexibility for those who want to change between self-employed and salaried options.

Out of hours services will no longer be your responsibility, but will be arranged by the local PCT, and you can agree to play a part.

Please note you can still continue to do a mix of NHS and private work.

It is called a base contract and will be used to ensure a smooth transition into the new system.

It will run, if you wish, throughout the transitional period (April 2005 – March 2008). However dentists and PCTs who, by common agreement, wish to make the change faster, will not be prevented from doing so.

As it evolves, dentists and PCTs may want to agree different arrangements together, for example to provide care for an agreed group of patients, or section of the community, such as from an area of social deprivation. The provision of additional NHS commitment would attract more payment.

The new Special Health Authority will take on many of the functions, like paying dentists and monitoring activity etc. that was previously undertaken by the DPB.

Yes. PCTs will have a legal obligation to ensure the delivery of high quality dental care to all who live, work in, or visit their area.

PCTs will be able to prioritize local dental services.

They may also look at issues such as better access to services, including improved access to specialist services. They may also wish to introduce programmes to address oral health inequalities, for example for homeless people. Please note that GDPs still have the right to decline to accept a new patient.

PCTs will have to hold such a list, and all dentists will have to be on one list. It is intended that those dentists already on one of the primary care lists or in NHS salaried employment will automatically be transferred to the performers’ list.

-Treatment must be clinically necessary, and for patients accepted as NHS patients, must be available under the NHS.

-Patients must be able to exercise informed choice.

-Cosmetic treatment may not be offered under the NHS, but may be offered privately, although not in the salaried services.

-If a practitioner does not have appropriate facilities/expertise, they should refer the patient to a local colleague who provides care under NHS or to a hospital.

Dentists will still have to follow advice on recall intervals from the NICE (National Institute for clinical excellence) which is expected to report later this year, which means patients with a low risk of disease will be seen less often.

Out of hours provision will be the responsibility of the PCT, and dentists may play a part if they wish.

Yes, contracting relationships are likely to evolve. Practitioners may want to develop special interests such as sedation

Every year the contract will be reviewed and discussed.

A practice based contract means the practice owner holds the contract for the entire practice and delivers the services under that contract through dentist performers in much the same way as using assistants now. An associate can remain self-employed even if there is a practice contract.

Assistants who do not hold their own GDS contract will not be entitled to a new contract.

However, it is also possible for dentists working within a practice to hold their own contract and remain personally responsible for the services they provide as so associates now. If an associate moves to a new practice a new contract will need to be arranged there providing funding is available.

Practice owners and colleagues within the practice will have to decide whether they wish to contract as a practice, or as individuals.

Yes, the base contract will simply include an appendix setting out their orthodontic commitment. Alternatively, they could hold an additional separate PDS contract with the PCT for the orthodontic activity.

As a provider under General Dental Services, you will be entitled to a contract. Rather than a base contract, your contract will be a parallel personal dental services contract, limited to the provision of orthodontics, with the same protections (i.e three years gross earnings guarantee and pension protections)

Yes, and equally the same transitional protection over three years will apply if you remain under a PDS contract.

The body corporate will be able to hold a contract with the PCT, and your contractual arrangements will need to be negotiated with your body corporate.

If you are a provider of GDS in a dental corporate, you will be offered a new contract, but you will need agreement from the body corporate.

You will not have to keep a list of patients but may wish to do so for practice management purposes. You will have to fill in and submit a shortened FP17 form when a course of treatment is completed.

We take great pride in our service, and would be delighted to invite you for a free 1 hour, no obligation meeting at our comfortable offices. Simply call us  on 020 8346 0391 to arrange a mutually convenient time.

This web-site was last updated on 13/06/2008

Specialist Dental Accountants for over 27 years.

Copyright © 2003-2008 Mac Kotecha & Company. All rights Reserved. The information on this site is for general guidance only. It is essential to take professional advice on specific issues about their impact on any individual or entity. No liability can be accepted for any errors or omission or for any person acting or refraining from acting on the information provided on this site.

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