Dental Reform - An Overview

As you will be aware, Scottish Government is implementing NHS dental payment reform. Items and codes within Determination I of the Statement of Dental Remuneration (SDR) have been revised, with the exception of Orthodontic (Item 32) items which remain unchanged. The changes and associated fees have been detailed in PCA(D)(2023)5.

The aim of the reform is to make the treatments available under NHS GDS easier for patients to understand and to simplify remuneration for dentists, with Determination I being reduced from over 700 items to 45.

All items can now be claimed for both adults and children, where clinically appropriate, unless stated otherwise. There will be no longer be a distinction between the treatments available to registered and unregistered patients. All patients will be able to access the same range of treatments. Therefore, all occasional items have been removed. Discretionary items have also been removed, with the exception of one general item 39 code and those required for Orthodontics.

The new item codes will also have a new format. Historically all item codes have been numeric only, i.e., 1401, 1703, etc. But the item codes for the new items start with a letter followed by 3 digits, for example: A003, D001, etc.

Capitation and removal of Continuing Care

• The capitation and continuing care arrangements are being combined into a single unified NHS capitation arrangement, resulting in all references to continuing care arrangements being removed from the regulations.
• Whilst the term continuing care has been withdrawn, registration payments for both adult and child patients will continue to be paid in the same manner, tiered into age-related bands as detailed in section X of the new SDR.
• The new capitation arrangement means that all care and treatment items, where appropriate, will be available for both child and adult patients and there will no longer be separate items for children.
• Reports in eSchedules will continue to display age banded breakdowns in the usual sections and also still refer to Capitation and Continuing Care.

Open courses of treatment

• Active courses of treatment opened before 1 November 2023, but not yet completed, must remain open until the course of treatment is complete. The claim will be paid according to the SDR that applied on the acceptance date of the treatment.
• Any claims/courses of treatment opened on or after 1 November 2023 will be paid on the new Determination I rate.

Patient charges

Patients will continue to pay 80% of the cost of treatment up to a maximum of £384 per course of treatment other than patients who are:

• under 26 years age
• pregnant or have a child under 12 months or
• in receipt of a passported benefit