The National Health Service (Dental Charges) (Wales) Regulations 2006

JurisdictionUK Non-devolved
CitationSI 2006/491

2006 No. 491 (W.60)

NATIONAL HEALTH SERVICE, WALES

The National Health Service (Dental Charges) (Wales) Regulations 2006

Made 28th February 2006

Coming into force 1st April 2006

The National Assembly for Wales makes the following Regulations in exercise of the powers conferred by sections 79, 83A and 126(4) of, and Schedule 12ZA to, the National Health Service Act 19771;

S-1 Title, commencement and application

Title, commencement and application

1.—(1) The title of these Regulations is the National Health Service (Dental Charges) (Wales) Regulations 2006 which come into force on 1 April 2006.

(2) These Regulations apply in relation to Wales.

S-2 Interpretation

Interpretation

2.—(1) In these Regulations—

the Act” means the National Health Service Act 1977;

“the Assembly” means the National Assembly for Wales;

“bridge” means a fixed or a removable bridge which takes the place of any teeth;

“course of treatment” means—

(a) an examination of a patient, an assessment of his or her oral health, and the planning of any treatment to be provided to that patient as a result of that examination and assessment, and

(b) the provision of any planned treatment (including any treatment planned at a time other than at the time of the initial examination) to that patient up to the date on which—

(i) each and every component of the planned treatment has been provided to the patient, or

(ii) the patient either voluntarily withdraws from, or is withdrawn by the provider from, treatment,

by one or more providers of relevant primary dental services;

“dental appliance” means a denture or bridge and for the purposes of this definition, a denture includes an obturator;

“Dental Charges Regulations 1989” means the National Health Service (Dental Charges) Regulations 19892;

“dental public health services” means services provided under section 16CB(5)(c) of the Act;

“General Dental Services Regulations 1992” means the National Health Service (General Dental Services) Regulations 19923;

“orthodontic appliance” means a device used in the mouth to move or immobilise the teeth in order to correct or prevent malocclusion;

“orthodontic treatment” means treatment of, or treatment to prevent, malocclusion of the teeth and jaws, and irregularities of the teeth;

“patient” includes (where the context requires) a person who pays or undertakes to pay a charge on behalf of a person to whom a dental appliance is supplied or to whom some other relevant primary dental service is provided;

“patient record” means a form supplied by a Local Health Board for the purpose of maintaining a record of treatment, and may include an electronic form;

“prison” includes a young offender institution but not a secure training centre or a naval, military or air force prison, and for the purposes of this definition—

(a) “secure training centre” means a place in which offenders subject to detention and training orders under section 100 of the Powers of Criminal Courts (Sentencing) Act 2000 (offenders under 18: detention and training orders)4may be detained and given training and education and prepared for their release, and

(b) “young offender institution” means a place for the detention of offenders sentenced to detention in a young offender institution or to detention in a young offender institution as part of a longer custodial sentence, including custody for life;

“prisoner” means a person who is detained in a prison in which medical, dental, ophthalmic, pharmaceutical or nursing services are provided under the Act by, or under arrangements made by, a Local Health Board;

“relevant Local Health Board” means in relation to a person providing relevant primary dental services—

(i) where a Local Health Board is a party to a general dental services contract or an agreement under section 28C of the Act (personal medical or dental services) for the provision of relevant primary dental services with that person, that Local Health Board;

(ii) where a Local Health Board is providing relevant primary dental services itself under section 16CA(2) of the Act (dental services provided by a Primary Care Trust or Local Health Board) or pursuant to an agreement under section 28C of the Act (personal medical or dental services), that Local Health Board;

(iii) where an NHS trust is providing relevant primary dental services pursuant to an agreement under section 28C of the Act (personal medical or dental services) for the provision of relevant primary dental services, the Local Health Board in whose area all or most of the hospitals, establishments and facilities of the NHS trust are situated; or

(iv) where a Local Health Board or NHS trust supplies dental appliances under the Act otherwise than as part of relevant primary dental services, that Local Health Board or the Local Health Board in whose area all or most of the hospitals, establishments and facilities of the NHS trust are situated;

“relevant primary dental services” means dental treatment (including urgent treatment and orthodontic treatment) provided and dental appliances and orthodontic appliances supplied—

(i) under section 16CA(2) of the Act (dental services provided by a Primary Care Trust or Local Health Board);

(ii) under a general dental services contract; or

(iii) in accordance with arrangements under section 28C of the Act (personal medical and dental services);

“restoration” means a filling, root filling, inlay, porcelain veneer or crown;

“trauma” means damage to teeth, gingival tissues or alveoli caused by a force arising outside the mouth, resulting in mobility, luxation, subluxation or fracture of the hard tissues or injury to the soft tissues;

“treatment” means all proper and necessary dental treatment which a provider of relevant primary dental services usually undertakes for a patient and which the patient is willing to undergo, including examination, diagnosis, advice on and planning of treatment, preventive care and treatment, periodontal treatment, conservative treatment, surgical treatment, the supply and repair of dental appliances and orthodontic appliances, orthodontic treatment, the taking of radiographs, the provision of sedation in connection with such treatment, the supply of listed drugs and the issue of prescriptions whether or not provided on referral to the provider of relevant primary dental services;

“urgent treatment” means one or more of the treatments listed in Schedule 4 that are provided to a person in circumstances where—

(a) prompt care and treatment is provided because, in the opinion of the dental practitioner, that person’s oral health is likely to deteriorate significantly, or the person is in severe pain by reason of his or her oral condition; and

(b) care and treatment is provided only to the extent that is necessary to prevent that significant deterioration or address that severe pain,

and “urgent course of treatment” will be construed accordingly;

(2) A reference to the Assembly includes a reference to a Special Health Authority or Local Health Board exercising functions on its behalf.

S-3 Charges for the provision of dental services

Charges for the provision of dental services

3.—(1) Subject to paragraph (2) below, a charge of the amount provided for in, and calculated in accordance with, regulation 4 may be made and recovered in respect of—

(a)

(a) the provision of relevant primary dental services; and

(b)

(b) the supply of dental appliances under the Act otherwise than as part of relevant primary dental services.

(2) No charge will be made and recovered under paragraph (1) in respect of—

(a)

(a) a supply under the Act, otherwise than as part of relevant primary dental services, of dental appliances to a person who has undergone operative procedures affecting the mandible, the maxilla or the soft tissues of the mouth as part of treatment for invasive tumours;

(b)

(b) a prisoner;

(c)

(c) the provision of dental public health services;

(d)

(d) the removal of sutures;

(e)

(e) subject to paragraph (3) below, the clinical examination and any report on that examination and the provision of an assessment and advice where, on the day upon which the examination is being performed or the assessment is made, the patient—

(i) is under the age of 25 years; or

(ii) has attained the age of 60 years; or

(f)

(f) the examination and assessment of a patient leading to—

(i) the issue of a prescription,

(ii) the repair of a dental appliance,

(iii) the arrest of bleeding, or

(iv) the removal of sutures,

if, at the same time, no other treatment listed in Schedules 1, 2 or 4 is provided and no dental appliances listed in Schedule 3 are supplied.

(a)

(a) (3) it is a condition of entitlement under regulation 3(2)(e) that—

(i) a written declaration, on a form provided for that purpose by the Local Health Board will be made to the effect that the patient is, on the day upon which the examination takes place, within one of the categories specified in regulation 3(2)(e); and

(ii) where the Local Health Board so requires evidence of entitlement will be supplied by or on behalf of the patient;

(b)

(b) the declaration referred to in paragraph (3) (a)(i) will be made by the patient for whom the examination will be provided, except where the application is made by another person on the patient’s behalf, it will be made instead by that person;

(c)

(c) in this Regulation “evidence of entitlement” means the patient’s birth certificate;

(d)

(d) nothing in paragraphs (3) (a)(ii) or (c) prevents the Local Health Board from accepting evidence other than that referred to in paragraph (3) as a means of establishing that a patient is within one of the categories referred to in regulation 3(2)(e).

S-4 Calculation of charges

Calculation of charges

4.—(1) Subject to paragraph (6), a Band 1 charge, that is to say a charge of £12.00 may be made and recovered in respect of any course of treatment, the entirety of the components of which are set out in Schedule 1, provided as part...

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