Key Changes to the Policy Book for Dental Services in 2023: What You Need to Know
Authors: David Williams and Kerly Chacon
Key Contact: Jon Lawley
This year has seen some major revisions to The Policy Book for Dental Services (first published in 2018), which provides essential guidance on how to manage NHS dental contracts to NHS England and Integrated Care Boards.
Our Acuity Law Corporate Healthcare Team has reviewed and summarised the most noteworthy changes.
Key Performance Indicators (KPIs)
General dental services (GDS) contracts may now include KPIs. As it currently stands, the policy book lacks detailed information on how KPIs will differ from the current UDA or UOA targets in practice, but as Personal Dental Services (PDS) contracts already contain KPIs for NHS service delivery, KPIs may function similarly in GDS contracts.
We will provide further updates as more information is released.
Procurement of Contracts
NHS Provider Selection Regime for PDF contracts: from 1 January 2024, the NHS Provider Selection Regime will take effect for PDS contracts. This aims to streamline the procurement process for PDS contracts with existing contractors or those where the most suitable contractor has been identified.
Changes to management of NHS contracts: if an NHS Contract is novated to a corporate dental body, the contract must now contain a change of control clause. This will require the consent of the NHS where there a change in ownership, with such consent not to be unreasonably withheld or delayed. This was previously recommended but only haphazardly followed. This will be particularly important for buyers who are purchasing shares in other dental companies.
Note: A novation of the NHS contract is different to a variation and has the effect of ending the contractual relationship between the original contractor and the NHS and creating a new contractual relationship between the new contractor and the NHS. From a procurement perspective, this counts as awarding a new contract.
Occupational Health (OH) Services
Commissioners now have a degree of responsibility for the occupational health of the employees of contractors. The updated policy book requires commissioners to consider the impact of work on staff health and make sure staff are fit to undertake the role they are employed to do (both physically and emotionally). Although contract holders, as employers, are responsible for funding this, commissioners should provide a degree of oversight and potentially take a more proactive approach. OH assessments required for all staff include:
- specialist support for managing staff with Blood Borne Viruses;
- urgent and longer-term advice to all staff working in primary care settings on exposure to potential Blood Borne Viruses; and
- consistent and efficient access to OH services for primary care staff.
24-Hour Retirement
Contractors can now opt for “partial retirement” if they are part of the 2008 or 2015 Schemes, allowing a 10% reduction in commitment to the NHS without retiring from the entire NHS Contract.
If you are a “single handler” practitioner (you have only one NHS Contract), you will no longer be required to give up the whole NHS Contract. Previously, this could have led to loss of some NHS benefits.
The scheme applies to dental practitioners with both GDS and PDS contracts.
24-hour retirement can be a complex and confusing area for practitioners. We offer a 24-hour retirement service – please contact our Acuity Corporate Healthcare team for more information.
Partial Sub-Contracting of NHS Contracts
Sub-contracting is usually permitted by NHS Contracts, provided that certain conditions are satisfied (for example, the sub-contractor having suitable insurance and that contracted activity is maintained). Clarification on this means that a contractor can now also sub-contract just part of their NHS contract. This will allow contractors to sub-contract a certain percentage of their UDAs to another party. Further clarification sets out that although NHS services may be sub-contracted, the contractual relationship remains between the contractor and the NHS. The NHS will consider whether sub-contracting is reasonable in all relevant circumstances and, if it considers it is not, will open a dialogue with the contract holder.
Updating the Practice’s NHS.UK Website
As a dental contractor, practice owners must ensure to either update or verify the practice’s NHS.UK prolife at least once every 90 days to avoid a potential contractual breach. This includes information about whether you are accepting new patients. As a dental contractor you must update your profile routinely, as a the NHS.UK website is a first point of call for patients seeking an NHS dental practice in their area.
Contract Re-Basing
Contract holders are now clearly entitled to request a change to either their annual NHS contract value or their required activity. Where a contract holder achieves 96% or less of their contracted UDAs over the previous three financial years, the NHS and the contract holder will work together to agree a mutual reduction – this has been named “recurrent re-basing”. The updated policy book outlines the considerations that the NHS will consider as part of this re-basing.
These are just some (but certainly not all) of the key updates brought about by the new policy book. If you have any questions or want to discuss further with a member of the Acuity Healthcare Team, please contact us.
