Definitions and interpretation



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PART 10

FURTHER SERVICES1
168. [ ]
169. [ ]
170. [ ]
171. [ ]
172. [ ]

PART 11

SUPPLY OF DRUGS AND PRESCRIBING1
General
173. The Contractor shall ensure that any prescription form for listed drugs, medicines or appliances issued by a prescriber complies as appropriate with the requirements in this Part.
Supply of drugs
174. A prescriber may—
174.1. supply to a patient such listed drugs, medicines or appliances as are required for immediate use before a supply can otherwise be obtained under clause 175; or
174.2. personally administer to a patient any drug or medicine required for the treatment of that patient.
175. A prescriber shall order such listed drugs, medicines or appliances (other than those supplied under clause 174) as are needed for the treatment of any patient to whom it is providing services under the Agreement by issuing to the patient a prescription form.
176. The prescription form, which is to be supplied by the Board, shall—
176.1. be signed by the prescriber; and
176.2. only be issued to patients to whom the Contractor is providing services under the Agreement, and a separate prescription form shall be issued for each patient.
Excessive prescribing
177. The Contractor shall not prescribe drugs, medicines or appliances whose cost or quantity, in relation to any patient, is, by reason of the character of the drug, medicine or appliance in question, in excess of that which was reasonably necessary for the proper treatment of that patient.
PART 121

PERSONS WHO PERFORM SERVICES
Qualifications of performers: dental practitioners
178. A dental practitioner may perform dental services under the Agreement provided―
178.1. that dental practitioner is included in the dental performers list held by the Board; and
178.2. that dental practitioner’s inclusion in that list is not subject to a suspension.
179. …
180. Upon the coming into force of the first regulations under section 36A(2) of the Dentists Act
180.1. a dental hygienist;
180.2. a dental therapist; or
180.3. a professional or member of a class as specified in regulations made under section 36A(2) of the Dentists Act,
may perform dental services under the Agreement provided he is—
180.3.1 a dental care professional; and
180.3.2. his registration in the dental care professional register established under section 36B of the Dentists Act is not subject to a suspension.
Performers: further requirements
181. No health care professional or other person other than one to whom clause 178 and 179 applies may perform clinical services under the Agreement unless he is appropriately registered with his relevant professional body and his registration is not subject to a suspension.
182. Where—
182.1. the registration of a dental practitioner, dental care professional or other health care professional; or
182.2. a dental practitioner’s inclusion in the dental performers list held by the Board,
is subject to conditions, the Contractor shall ensure compliance with those conditions in so far as they are relevant to the Agreement.
183. No health care professional or other person may perform any clinical services under the Agreement unless he has such clinical experience and training as are necessary to enable him properly to perform such services.
Conditions for employment and engagement: dental practitioners performing dental services
184. The Contractor must not employ or engage a dental practitioner to perform dental services under the Agreement unless the Contractor has checked that the practitioner meets the requirements in clause 178.
185. Where the employment or engagement of a dental practitioner is urgently needed and it is not possible to check the matters referred to in clause 178 in accordance with clause 184.2 before employing or engaging him he may be employed or engaged on a temporary basis for a single period of up to 7 days whilst such checks are undertaken.
Conditions for employment and engagement: persons performing dental services other than dental practitioners
186. The Contractor shall not employ or engage a person (other than one to whom clauses 184 and 185 apply) to perform dental services unless from the coming into force of the first Regulations under section 36A(2) of the Dentists Act, the Contractor has checked that—
186.1. his name is included in the register of dental care professionals, and
186.2. his registration in the dental care professional register is not subject to a suspension,
if that person is being employed or engaged to practise a profession that has been specified in Regulations made under that section; and
186.3. he has taken reasonable steps to satisfy himself that he has the clinical experience and training necessary to enable him to properly perform dental services.
187. Where the employment or engagement of a person specified in clause 186 is urgently needed and it is not possible to check his registration in accordance with clause 186.1 (where it applies) before employing or engaging him, he may be employed or engaged on a temporary basis for a single period of up to 7 days whilst such checks are undertaken.
188. When considering a person’s experience and training for the purposes of clause 186.3, the Contractor shall have regard in particular to—
188.1. any post-graduate or post-registration qualification held by that person; and
188.2. any relevant training undertaken by him and any relevant clinical experience gained by him.
Conditions for employment and engagement: all persons performing dental services
189. The Contractor shall not employ or engage a person to perform dental services under the Agreement unless—
189.1. that person has provided two clinical references that relate to two recent posts (which may include any current post) exercising the profession in which he seeks employment or engagement with the Contractor which lasted for three months or more without a significant break, or where this is not possible, that person has provided a full explanation and alternative referees; and
189.2. the Contractor has checked and is satisfied with the references.
190. Where the employment or engagement of a person falling within clause 189 is urgently needed and it is not possible for the Contractor to obtain and check the references in accordance with clause 189.2. before employing or engaging him, he may be employed or engaged on a temporary basis for a single period of up to 14 days whilst his references are checked and considered, and for an additional period of a further 7 days if the Contractor believes the person supplying those references is ill, on holiday or otherwise temporarily unavailable.
191. Where the Contractor employs or engages the same person on more than one occasion within a period of three months, it may rely on the references provided on the first occasion, provided that those references are not more than twelve months old.
Conditions for employment or engagement: persons assisting in the provision of services under the Agreement
192. Before employing or engaging any person to assist it in the provision of services under the Agreement, the Contractor shall take reasonable care to satisfy itself that the person in question is both suitably qualified and competent to discharge the duties for which he is to be employed or engaged.
193. The duty imposed by clause 192 is in addition to the duties imposed by clauses 184 to 191…
194. When considering the competence and suitability of any person for the purpose of clause 192, the Contractor shall have regard in particular to:―
194.1. that person’s academic and vocational qualifications;
194.2. his education and training; and
194.3. his previous employment or work experience.
Training
195. The Contractor shall ensure that for any dental practitioner or dental care professional who is—
195.1. performing dental services under the Agreement; or
195.2. employed or engaged to assist in the performance of such services,
arrangements are in place for the purpose of maintaining and updating his skills and knowledge in relation to the services which he is performing or assisting in performing.
196. The Contractor shall afford to each employee reasonable opportunities to undertake appropriate training with a view to maintaining that employee’s competence.
Appraisal and assessment
197. The Contractor shall ensure that any dental practitioner performing services under the Agreement—
197.1. participates in the appraisal system (if any) provided by the Board; and
197.2. co-operates with the Board in relation to patient safety.
Sub-contracting of clinical matters
198. The Contractor shall not sub-contract any of its rights or duties under the Agreement to any person in relation to clinical matters unless—
198.1. it has taken reasonable steps to satisfy itself that—
198.1.1. it is reasonable in all the circumstances, and

198.1.2. that the person is qualified and competent to provide the service; and


198.2. it is satisfied in accordance with clauses 250 to 253 that the sub-contractor holds adequate insurance.
199. Where the Contractor sub-contracts any of its rights or duties under the Agreement in relation to clinical matters, it shall—
199.1. inform the Board of the sub-contract as soon as is reasonably practicable; and
199.2. provide the Board with such information in relation to the sub-contract as it reasonably requests.
200. Where the Contractor sub-contracts clinical services in accordance with clause 198, the parties to the contract shall be deemed to have agreed a variation to the agreement 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 clause 286 shall not apply.
201. 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 13

RECORDS, INFORMATION, NOTIFICATION AND RIGHTS OF ENTRY1
Patient records
202. The Contractor shall 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 Agreement, including treatment given to a patient who is referred to the Contractor.
203. The patient record may be kept in electronic form.
204. The patient record shall include details of any private services (to the extent that they are provided with services under the Agreement) and shall be kept with—
204.1. a copy of any treatment plan or referral treatment plan given to the patient pursuant to clause 47 or clause 164;
204.2. all radiographs, photographs and study casts taken or obtained by it as part of the services provided to that patient;
204.3. where an orthodontic course of treatment has been provided to a patient, a copy of the orthodontic treatment plan;
204.4. where information is required to be notified to the Board in accordance with clause 221, and that information is to be submitted electronically―
204.1.1. the written declaration form in respect of exemption under section 177(1) of the 2006 Act duly made and completed in accordance with regulations made under sections 176 and 177(5) of that Act; and
204.4.2. a note of the evidence in support of that declaration;
204.5. the statement concerning any custom-made device provided by any person as a consequence of regulation 15 of the Medical Devices Regulations 2002 in respect of services being provided to that patient.
205. The patient record and the items referred to in clause 204.1 to 204.5 shall be retained for a period of 2 years beginning with—
205.1. the date on which—
205.1.1. a course of treatment or orthodontic course of treatment is terminated; or
205.1.2. a course of treatment or an orthodontic course of treatment is completed; or
205.1.3. in respect of courses of treatment or orthodontic courses of treatment not falling within clause 205.1.1 or 205.1.2, the date by which no more services can be provided as part of that course of treatment or orthodontic course of treatment by virtue of clause 44.2 or clause 148.2.
206. Nothing in clauses 202 to 205 shall affect any property right which the Contractor may have in relation to the records, radiographs, photographs and study models referred to in those clauses.
Confidentiality of personal data
207. The Contractor shall nominate a person with responsibility for practices and procedures relating to the confidentiality of personal data held by it.
Patient information
208. The Contractor shall ensure that there is displayed in a prominent position in its practice premises, in a part to which patients have access
208.1. in respect of its practice based quality assurance system referred to in clauses 246 to 249, a written statement relating to its commitment to the matters referred to in clause 249;
208.2. such information relating to NHS charges as is supplied by the Board for the purposes of providing information to the patients; and
208.3. information about the complaints procedure which it operates in accordance with Part 20, giving the name and title of the person nominated by the Contractor in accordance with clause 269.
209. The Contractor shall

209.1. compile a document (in this paragraph called a “patient information leaflet”) which shall include the information specified in Schedule 3 to this Agreement;


209.2. review its patient information leaflet at least once in every period of 12 months and make any amendments necessary to maintain its accuracy; and
209.3. make available a copy of the leaflet, and any subsequent updates, to its patients and prospective patients.
210. The requirements in clause 209 do not apply to the Contractor to the extent that it provides services to persons detained in prison.
Provision of and access to information: the Board
211. The Contractor shall, at the request of the Board—
211.1. produce to the Board or to a person authorised in writing by the Board in such format, and at such intervals or within such time period, as the Board specifies; or
211.2. allow the Board, or a person authorised in writing by it to access,
the information specified in clause 212.
212. The information specified for the purposes of clause 211 is—
212.1. any information which is reasonably required by the Board for the purposes of or in connection with the Agreement; and
212.2. any other information which is reasonably required in connection with the Board's functions,
and includes the Contractor’s patient records.
213. …
214. …
215. …
216. …
217….
Inquiries about prescriptions and referrals
218. The Contractor shall, subject to clauses 219 and 220, sufficiently answer any inquiries whether oral or in writing from the Board concerning—
218.1. any prescription form issued by a prescriber;
218.2. the considerations by reference to which prescribers issue such forms;
218.3. the referral by or on behalf of the Contractor of any patient to any other services provided under the 2006 Act; or
218.4. the considerations by which the Contractor makes such referrals or provides for them to be made on its behalf.
219. An inquiry referred to in clause 218 may only be made for the purpose either of obtaining information to assist the Board to discharge its functions or of assisting the Contractor in the discharge of its obligations under the Agreement.
220. The Contractor shall not be obliged to answer any inquiry referred to in clause 218 unless it is made—
220.1. in the case of clause 218.1 or 218.2, by an appropriately qualified health care professional; or
220.2. in the case of clause 218.3 or 218.4, by an appropriately qualified dental practitioner,
appointed in either case by the Board to assist it in the exercise of its functions under paragraph 38 of Schedule 3 of the Regulations and that person produces, on request, written evidence that he is authorised by the Board to make such inquiry on its behalf.
Notification of course of treatment or orthodontic course of treatment
221. The Contractor shall, within 2 months of the date upon which―
221.1. it completes a course of treatment in respect of mandatory or additional services;
221.2. it completes a case assessment in respect of an orthodontic course of treatment that does not lead to a course of treatment;
221.3. it provides an orthodontic appliance following a case assessment in respect of orthodontic treatment;
221.4. it completes a course of treatment in respect of orthodontic treatment;
221.5. a course of treatment in respect of mandatory services or additional services or orthodontic course of treatment is terminated; or
221.6. in respect of a course of treatment not falling within clause 221.4 or 221.5, no more services can be provided by virtue of clause 44.2 or 148.2
send to the Board, on a form supplied by it, the information specified in clause 222.
222. The information referred to in clause 221 is—
222.1. details of the patient to whom it provides services;
222.2. details of the services provided (including any appliances provided) to that patient;
222.3. details of any NHS charge payable and paid by that patient; and
222.4. in the case of a patient exempt from NHS charges and where such information is not submitted electronically, the written declaration form and note of evidence in support of that declaration.
Annual report and review
223. The Board shall provide to the Contractor an annual report relating to the Agreement which shall contain the same categories of information for all persons who hold agreements with the Board.
224. Once the Board has provided the report referred to in clause 223, the Board shall arrange with the Contractor an annual review of its performance in relation to the Agreement.
225. The Board shall prepare a draft record of the review referred to in clause 224 for comment by the Contractor and, having regard to such comments, shall produce a final written record of the review.
226. A copy of the final record referred to in clause 225 shall be sent to the Contractor.
Notifications to the Board
227. In addition to any requirements of notification elsewhere in the Regulations, the Contractor shall notify the Board in writing, as soon as reasonably practicable, of—
227.1. 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 Agreement; or
227.2. any circumstances which give rise to the Board's right to terminate the Agreement under clause 302 or 303.
228. The Contractor shall, unless it is impracticable for it to do so, notify the Board in writing within 28 days of any occurrence requiring a change in the information about it published by the Board in accordance with regulations made under section 99(3) of the 2006 Act.
229. The Contractor shall give notice in writing to the Board when a dental practitioner who is performing or will perform services under the Agreement (as the case may be)—
229.1. leaves the Contractor, and the date upon which he left; or
229.2. is employed or engaged by the Contractor,
which shall include the name of the dental practitioner who has left, or who has been employed or engaged, together with his professional registration number.
Notice provisions specific to an agreement with a dental corporation1
230. The Contractor shall give notice in writing to the Board forthwith when—
230.1. it passes a resolution or a court of competent jurisdiction makes an order that the Contractor be wound up;
230.2. circumstances arise which might entitle a creditor or a court to appoint a receiver, administrator or administrative receiver for the Contractor;
230.3. circumstances arise which would enable the court to make a winding up order in respect of the Contractor; or
230.4. the Contractor is unable to pay its debts within the meaning of section 123 of the Insolvency Act 1986.
Notice provisions specific to an agreement with a company limited by shares1
230A. The Contractor shall give notice in writing to the Board forthwith when—
230A.1. it passes a resolution or a court of competent jurisdiction makes an order that the Contractor be wound up;
230A.2. circumstances arise which might entitle a creditor or a court to appoint a receiver, administrator or administrative receiver for the Contractor;
230A.3. circumstances arise which would enable the court to make a winding up order in respect of the Contractor;
230A.4. the Contractor is unable to pay its debts within the meaning of section 123 of the Insolvency Act 1986; or
230A.5. changes take place in relation to the ownership of shares in the company.
230B. A notice under clause 230A.5 must—
230B.1. provide the name of any person ceasing to own a share in the company;
230B.2. provide the name of any new person acquiring a share in the company; and
230B.3. confirm that following any changes in share ownership, that the company continues to meet the conditions in section 108(1A) of the 2006 Act.
Notice provisions specific to an agreement with a limited liability partnership1
230C. The Contractor shall give notice to the Board forthwith when—
230C.1. it passes a resolution or a court of competent jurisdiction makes an order that the Contractor be wound up;
230C.2. circumstances arise which might entitle a creditor or a court to appoint a receiver, administrator or administrative receiver for the Contractor;
230C.3. circumstances arise which would enable the court to make a winding up order in respect of the Contractor;
230C.4. the Contractor is unable to pay its debts within the meaning of section 123 of the Insolvency Act 1986; or
230C.5. any membership changes are notified in accordance with section 9 of the Limited Liability Partnership Act 2000 to the registrar (within the meaning of that Act) in relation to a person who becomes or ceases to be a member or designated member (within the meaning of that Act) and the notice must specify the date on which that person becomes or ceases to be a member or designated member (as the case may be).
230D. A notice under clause 230C.5 must confirm—
230D.1. that any new member joining the partnership meets the conditions imposed by regulation 4 of the Regulations; and
230D.2. following the membership changes, that subsections 108(1B) or 108(1C) of the 2006 Act continue to apply to the partnership.
Notifications to patients following variation of the Agreement
231. Where the Agreement is varied in accordance with Part 22 of this Agreement and, as a result of that variation there is to be a change in the range of services provided by the Contractor, the Contractor shall ensure that 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 Board
232. Subject to—
232.1. the conditions in clause 233; and
232.2. clause 234, the Contractor shall allow persons authorised in writing by the Board to enter and inspect the practice premises at any reasonable time.
233. The conditions referred to in clause 232.1 are that—
233.1. reasonable notice of the intended entry has been given;
233.2. written evidence of the authority of the person seeking entry is produced to the Contractor on request; and
233.3. entry is not made to any premises or part of the premises used as residential accommodation without the consent of the resident.
234. Where the Contractor is providing services under the Agreement in a prison, the Contractor shall not be obliged to comply with clause 232, or clauses 235 or 236, if—
234.1. the Contractor has used its best endeavours to allow the Board or the Care Quality Commission to enter and inspect the practice premises; but
234.2. entry and inspection has been prevented by the prison authorities despite the Contractor’s best endeavours.
Entry and viewing by Local Healthwatch organisations
235.  Subject to clause 234, the contractor must comply with the requirement to allow an authorised representative to enter and view premises and observe the carrying-on of activities on those premises in accordance with regulations made under section 225 of the Local Government and Public Involvement Health Act 2007.
Entry and inspection by the Care Quality Commission
236. Subject to clause 234, the Contractor shall allow persons authorised by the Care Quality Commission to enter and inspect premises in accordance with section 66 of the Health and Social Care (Community Health and Standards) Act 2003 (right of entry).
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