Standard general dental services contract



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PART 7


LEVEL OF SKILL21





  1. The Contractor shall carry out its obligations under the Contract with reasonable care and skill.


PROVISION OF SERVICES22
Course of treatment


  1.  Except in the case of orthodontic services and dental public health services, the Contractor shall provide mandatory and additional services to a patient by providing to that patient a course of treatment.




  1. The Contractor shall use its best endeavours to ensure that a course of treatment is completed, and that it is so completed within a reasonable time from the date on which—




    1. the treatment plan was written in accordance with clause 47; or




    1. where a treatment plan is not required pursuant to clause 51, the initial examination and assessment of the patient took place.




  1. Where the Contractor provides urgent treatment to a patient, the urgent treatment provided shall constitute a course of treatment and no other services shall be provided during that course of treatment.




  1. If a course of treatment is—




    1. terminated before it has been completed; or




    1. otherwise not completed within a reasonable time,

any further services to be provided to that patient under the Contract must be provided as a new course of treatment.




  1. A course of treatment may only be terminated by—




    1. the Contractor by virtue of—




      1. a notice under clause 33,




      1. clause 38; or




      1. clause 39;




    1. the patient; or




    1. a person specified in clause 27 acting on the patient’s behalf.




  1. If the Contractor is unable to complete the course of treatment which has been commenced for reasons beyond its control, it shall give notice to the PCT of the extent of the treatment so provided and the reason for its inability to complete the remainder.



Treatment plans


  1. Subject to clause 51, where the Contractor agrees to provide a course of treatment to a patient, it shall, 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 PCT which shall specify—




    1. the name of the patient;




    1. the name of the Contractor;




    1. particulars of the places where the patient will receive services;




    1. the telephone number at which the Contractor may be contacted during normal surgery hours;




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




    1. the NHS Charge, if any, in respect of those services if provided pursuant to the Contract; and




    1. any proposals the Contractor may have for private services as an alternative to the services proposed under the Contract, including particulars of the cost to the patient if he were to accept the provision of private services.




  1. If the patient, having considered the treatment plan provided pursuant to clause 47, decides to accept the provision of private services in place of all or part of services under the Contract, the Contractor shall ensure that the patient signs the treatment plan in the appropriate place to indicate that he has understood the nature of the private services to be provided and his acceptance of those services.




  1. Where the services included in the treatment plan need to be varied, the Contractor shall provide the patient with a revised treatment plan in accordance with clause 47.




  1. Subject to clause 45, the Contractor shall provide the services which are detailed in the treatment plan, or where the treatment plan is revised, the revised treatment plan.




  1. The obligation to provide a treatment plan under clauses 47 to 49 shall not apply to a Band 1 course of treatment or a charge exempt course of treatment unless—




    1. the Contractor is providing privately any part of that course of treatment pursuant to clauses 58 to 60; or




    1. the patient has requested that he be provided with written details of the course of treatment to be provided or that has been provided to him, whether or not he specifically requests a treatment plan.




  1. The Contractor shall provide the patient with a summary of the care and treatment provided under the treatment plan where the patient so requests because that patient intends to receive services from another contractor.

52.1 The summary shall be supplied to the patient on a form supplied by the PCT for that purpose within 28 days of the patient’s request.


Completion of courses of treatment


  1. The Contractor shall indicate on the form supplied by the PCT pursuant to clause 222 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.




  1. If the PCT—




    1. determines that the number of courses of treatment provided by the Contractor which have not been completed is excessive; and




    1. does not consider that the reasons given by the Contractor for the failure to complete the courses of treatment are satisfactory,

it shall be entitled to exercise its powers under clause 97 on the grounds that the Contractor is not, pursuant to clause 42, 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


  1. Where a patient requires advanced mandatory services, domiciliary services or sedation services that are not provided under the Contract by the Contractor, it shall, if the patient agrees, refer that patient in accordance with clause 56 for the provision of a referral service by an alternative contractor, a hospital or other relevant service provider under Part 1 of the Act.




  1. In referring a patient pursuant to clause 55, the Contractor shall provide—




    1. to the patient being referred, a referral notice on a form supplied for that purpose by the PCT which shall specify the services detailed on the treatment plan which will be carried out by the alternative contractor, hospital or other relevant service provider; and




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




      1. a copy of the treatment plan provided to the patient pursuant to clauses 47 to 49,




      1. a copy of the referral notice, and




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




  1. Where the patient notifies the Contractor, whether verbally or in writing, that he does not wish to be referred to the alternative contractor, hospital or other relevant service provider selected by the Contractor, the Contractor shall, 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 Act for the provision of the referral service.


Mixing of services provided under the Contract with private services


  1. Subject to clause 60 and the requirements in clauses 47.7, 151 to 154 and 164 to 167, the Contractor may, with the consent of the patient, provide privately any part of a course of treatment or orthodontic course of treatment for that patient, including in circumstances where that patient has been referred to the Contractor for a referral service.




  1. The Contractor shall not, with a view to obtaining the agreement of a patient to undergo services privately




    1. advise a patient that the services which are necessary in his case are not available from the Contractor under the Contract; or




    1. seek to mislead the patient about the quality of the services available under the Contract.




  1. The Contractor when mixing services provided under the Contract with private services—




    1. in respect of an orthodontic course of treatment




      1. shall provide the case assessment wholly privately or wholly under the Contract, and




      1. shall provide the orthodontic treatment wholly privately or wholly under the Contract; and

60.2 may not provide privately or under the Contract treatment that involves the administration of general anaesthesia or the provision of sedation.


Repair or replacement of restorations


  1. Subject to clause 63, where a restoration specified in clause 62 needs to be repaired or replaced, the Contractor shall repair or replace the restoration at no charge to the patient.




  1. The restorations referred to in clause 61 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 and is a banded course of treatment for the purposes of calculating the number of units of dental activity.

62A. The band in which a restoration specified in clause 62 falls shall be determined in accordance with the NHS Charges Regulations.




  1. Clause 61 shall not apply where—




    1. within the relevant period, a person other than the Contractor has provided treatment on the tooth in respect of which the restoration was provided;




    1. the Contractor advised the patient at the time of the restoration and indicated on the patient record that—




      1. the restoration was intended to be temporary in nature, or




      1. in its opinion, a different form of restoration was more appropriate to secure oral health but, notwithstanding that advice, the patient nevertheless requested the restoration which was provided;




    1. 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




    1. the repair or replacement is required as a result of trauma.




  1. In clauses 62 and 63, “the relevant period” means the 12 month period beginning on the date on which the restoration was provided, and ceasing twelve months after that date.


Premises, facilities and equipment


  1. The address of each of the premises to be used by the Contractor or any sub-contractor for the provision of services under the Contract is as follows: [ ]23.

[65A. In the case of a Contractor who is entitled to a contract by virtue of the Transitional Order the following additional provision is required before clause 66 where the PCT is not satisfied that the practice premises are suitable premises for the delivery of services or sufficient to meet the reasonable needs of the Contractor’s patients. The additional clause is as follows –


65A. The Contractor agrees that-
[insert steps to be taken by the Contractor to bring the premises up to the appropriate standard]

[ ]


[ ]

[ ]


[ ]
[insert details if any financial support is to be available]

[insert period in which premises must be brought up to an appropriate standard]

[ ]


  1. 24The Contractor shall ensure [subject to any clause 65A provision] that the practice premises used for the provision of services under the Contract are—




    1. suitable for the delivery of those services; and




    1. sufficient to meet the reasonable needs of the Contractor’s patients.




  1. The obligation in clause 66 includes providing proper and sufficient waiting-room accommodation for patients.




  1. The Contractor shall 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.




  1. In clause 66, “practice premises” includes a mobile surgery.



Telephone services


  1. The Contractor shall not be a party to any contract or other arrangement under which the number for telephone services to be used by—




    1. patients to contact the practice for any purpose related to the Contract; or




    1. any other person to contact the practice in relation to services provided as part of the health service,

starts with the digits 087, 090 or 091 or consists of a personal number, unless the service is provided free to the caller.


National Institute for Clinical Excellence guidance


  1. The Contractor shall provide services under the Contract in accordance with any relevant guidance that is issued by the National Institute for Clinical Excellence, in particular the guidance entitled “Dental recall - Recall interval between routine dental examinations” (available at www.nice.org.uk).


Infection control


  1.  The Contractor shall ensure that it has appropriate arrangements for infection control and decontamination.


Treatment under general anaesthesia: prohibition


  1.  The Contractor shall not provide any services under the Contract that involve the provision of general anaesthesia.



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