HSCB Health and Social Care Board

Getting Your HSCB Dental Number

and what it means for practitioners

Areas to be covered today

Part 1 HSC structures

Forms- HS48 & HS50

Minimum standards

GDS Regulations

Part 2 Record keeping

Pre treatment monitoring

Prior Approval

Post treatment monitoring

• Probity

• Referral Dental Officer

clinics

Part 3 Individual responsibilities

Part 4 Out Of Hours clinics

Part 5 Adverse Incidents/SAIs

Complaints

Referrals to specialists

Occupational health

Part 6 Prescribing issues

Part 7 Orthodontic Issues

Part 8 Useful websites

Evaluation

Part 1- HSC structures

Minister

PHA

DHSSPS

Reflects direct access by the Minister on issues of performance management

HSCB

LCGs

Trusts

GDPs/GPs/

Independent &

Private Sector/

Voluntary &

Community

NIMDTA

BSO

PCC

RQIA RQIA

Main roles of the players

DHSSPS – Formulates and sets policy, the GDS regulations and

the SDR, negotiates the new contracts and sets the budget for the Board

HSCB – Implements the policy, the GDS regs and the SDR set

by the DHSSPS, commissions services within the budget set by the DHSSPS, monitors performance, takes action if required. In relation to dentistry this is done directly with GDPs, salaried GDPs and Oasis.

Main roles of the players

RQIA

– Registers and inspects all dental practices where ANY

private work is carried out and inspects all practices

that declare themselves wholly health service

Trusts

– Are commissioned (in relation to dentistry) to provide

hospital and community dental services

Patient and Client Council (PCC)

– Advocate for the patient

Michael Donaldson

AD(D)

Judi McGaffin

Regional Lead – GDS

and Governance

Donncha O’Carolan

Regional Lead –CDS and

HDS and Public Health

10 Dental Advisers

Philip Colgan (RQIA)

Peter Jackson (Western LCG)

Jonathan Montgomery (Northern LCG)

Derek Maguire (Belfast LCG)

William Priestley (Belfast LCG)

Joe McGrady (South Eastern LCG)

Catherine McQuillan (Western LCG)

Gerry Cleary (North & West LCG)

Julie Kelly (Northern LCG)

Brid Hendron (Southern LCG)

Contact Numbers:

Directorate of Integrated Care:

Western Office 028 953 61010

Northern Office 028 953 62849

Belfast Office 028 953 63926

South East Office 028 953 63926

Southern Office 028 953 62104

Forms available from BSO

1 HS48 form

Completion and acceptance of the form

gives you entry onto the Board’s dental

list to provide General Dental Services.

Submission is followed by you being

supplied with your DS number to

identify you and pay you

2 HS50 - Block Transfer Form

Part 1 should be completed by the practitioner with whom

the patients are registered

It is very important that arrangements are made for the

patients to be transferred as BSO will cease the suffix “9”

at the end of the VDP/GPT contract and the patients will

therefore be deregistered.

Contact:

Gillian Weir Telephone 028 9536 3769

Business Services Organisation

http://www.hscbusiness.hscni.net/ (Handout)

Transferring or Leaving practice

• Contact Gillian Weir at BSO for advice on withdrawing from the Dental List

• Provide 3 months notice to BSO

• Completion of HS50- Block transfer form

• Make appropriate emergency cover/contact arrangements with the practice principal/other associates

• Inform your local Dental Adviser (DA)

• Contact GDC if withdrawing from register- otherwise you will appear on the next calendar year’s “Removals due to Non Payment list”, which is forwarded to your Dental Adviser

Minimum Standards for Dental

Care and Treatment (DHSSPS) Describe the standards of care to be provided from patient’s perspective.

There are 15 different standards specified.

Applicable to both health service and private care.

The idea is that these will form the basis of the RQIA practice inspections.

Cover areas such as;

- Choosing your dental service

-The quality of your care and treatment

- Medical and other emergencies

- Children, young people and vulnerable adults

http://primarycare.hscni.net/pdf/Minimum_Standards_for_Dental_Care_and_Treat

ment.pdf

General Dental Services

Regulations (Terms of Service) Five key areas:

a. Care quality

b. Infection Control standards met

c. Health and Safety Compliance

d. Radiological Regulations Compliance

e. CPD compliance (both clinical audit, and peer

review and GDC requirements)

f. Compliance with QA returns (practice based)

Failure to comply with GDS terms of service

The HSCB can refer the case to RPP (lay and

professional involvement) for a decision on the

way forward

RPP can refer the case for HSCB disciplinary

action, to the Reference Committee or to an

outside body e.g. NCAS or the GDC for further

investigation / action

Overview Part 2

Record Keeping

Monitoring

Importance of Record-Keeping

Information Sharing

Recollection

Evaluation of care e.g. Periodontal

Clarification of disputes

Protection (Peace of mind !)

Positive Assurance

Regulation GDS regs, http://primarycare.hscni.net/3486.htm

GDC Standards for Dental Professionals 2005

Record keeping…..questions

A What should you send to the Board if

you are asked to send a patient's

dental record?

B How long have you got to send the

records to the HSCB?

Patient Record Definition

Everything relating to the patient’s treatment, i.e.

Record card, HS45, HS45PR, HS45DC, DB114(Ortho),

Radiographs, photographs, study models, receipts, lab

documents, Statements of Manufacture(SOM), details of

prescribed drugs, etc.

Medico legal... Referral letters and reports are also

included in the definition above.

Patient records must be retained for 6 years (GDS

Regs).

Claims Forms

A valid HS45PR form requires:

1) A Claim Reference Number

2) The dentist’s name, address and contract number

3) Evidence of exemption/remission seen/not seen

4) The patient’s DOB and CHI

5) Completed exemption/remission status

6) The patient’s signature(s) and dates(s) on parts C or D

and on part E.

RECORDS

what the Terms of Service say paragraph 25 (3) The dentist shall, during the period in which he holds any

records, forms, radiographs, photographs and study

models referred to in sub-paragraph (1) –

(i) Produce them on request to a dental officer of relevant

Board or a referral dental officer for inspection; or

(ii) Produce them to a referral dental officer, the

Committee, the BSO or the Board within 14 days of being

required to do so by a referral dental officer, the

Committee, the Agency or the Board

REQUIRED STANDARDS

Containing Sufficient information:

To satisfy ‘legal’ requirements must be Full, Accurate

and Contemporaneous (the content of records is the

responsibility of the dentist even when dictating to

someone else)

To verify treatment

To assure a third party e.g. HSCB, DHSSPS, GDC

Learning points from record calls

• Time for records to be received

by the HSCB exceeded 14 days

• Incomplete records forwarded

• Radiographic issues

• RCT radiographs

• 2 visit S&P….2nd visit not

recorded

• Item 1C –NB. pocket depths!

• Sedation claims…no “justification” or

consent recorded

• Dentures…. material and how many

teeth are being replaced not recorded

• Details of claim not matching notes

• LA details missing

• Prescription details missing

• See MDS 680 (handout)

FULL , ACCURATE , CONTEMPORANEOUS

and LEGIBLE please

If it isn’t written down –

it didn’t happen!

Prior Approval Process

General Dental Service Regulations (NI) 1993 –

part vi

Treatment > £280 & discretionary items

Changes in SDR now include

• Time barred Scales and Polishes

• Bridgework replacing molar teeth

• Porcelain Veneers

• Cobalt/chrome dentures

Prior Approval ctd

Pre-treatment Examination – Dentist notified

by DB26

BSO Dental Officers on behalf of Dental

Committee

Dental Committee - Appeals Procedure

Current waiting times for approval = 6-8

weeks

Dental Committee

STATUTORY COMMITTEE

Chairman appointed by Minister

Members nominated by 4 Board LDCs, 1 DPC (BDA)

representative, 1 BSO nomination

Experienced GDPs

Meet approx every 3 weeks at BSO

Appeal to DHSSPS - CDO

Issues

Prior approval avoidance – consequences

Clinical necessity

Quality of submission; enclosures

Patient pressure / expectation

If you offer private provision when approval is

turned down….remember clinical necessity!!

Probity Strategy

Risk Management

Prevention

Detection

Deterrence

All governed by a DHSSPS Circular HSC (F) 46/2011 on

Post Payment Verification

See Probity Dental Assurance process and the code

clarification paper (handouts)

Some potential areas of concern

1. Volume of claims - outliers

2. Outliers in terms of treatment provided and not

provided - any patterns may be subject to

review

3. Number of split estimates

4. Average cost per claim.

5. EDI claims

RDS/RDO Remit

Monitor the quality of health service

dental work

Ensure probity of GDS claims

Provide information for policy makers

RDS what the

Terms of Service say paragraph 28 v

(5) Where a dentist –

a) has been notified that a patient has been requested to

submit himself for examination by a dental officer or

referral dental officer; and

b) Has not been notified that the examination has been

carried out or cancelled, he shall not, otherwise than in

an emergency, provide any care and treatment to that

patient and shall take all reasonable steps to facilitate the

examination

Referral Examinations Patients are randomly selected from any calim for

payment

Examination centres across N.I.

Dentist and patient notified

D4Ts/radiographs/models to be forwarded as

requested….Use the D4T for comments!!

Patient has a right to see the report

Never call a patient in to your practice prior to the RDO

examination unless they require to be taken out of pain

or are in need of urgent care…

RDS Codes

Code A = Satisfactory

Code B = RDO wishes to comment or

bring to the notice of the dentist

further treatment required since

HS45/EDI submission.

Code C = RDO does not agree with

the completed HS45/EDI submission

– A reply is required.

Code X = Dentist has claimed a fee for

radiographs which have not been

submitted. Radiographs required (never

call a patient back to take these

retrospectively)

Code D = RDO does not agree to a major

extent with the completed treatment/ or the

dentist has contacted the patient prior to

the exam for non-emergency treatment. A

reply is required

Code E = RDO disagrees fundamentally

with the completed treatment. A reply is

required

Codes D and E

Will always result in more patients/record

cards being called for examination

Notification to Regional Lead for GDS and

other Dental Advisers/Probity Division

Referral To Regional Professional Panel

(RPP)

Overview Part 3

Individual responsibilities

Individual responsibilities

Cross Infection control---HTM-01-05,

IR(ME)R

Data handling and data protection

CPD and Clinical Audit and Peer Review

Mixing HS and Private care

NHS +

IV sedation

“Infection control is everyone’s business and it

is important that all members of staff observe

good infection control practice”

(Teare et al. J Hospital Infection 2001; 48:312-319)

In relation to endodontics remember that

files are single use, NOT single patient

IR(ME)R 2000

As per IR(ME)R 2000, all radiographs must be justified and

quality assured. (see handout) There should always be a

recorded clinical evaluation of the outcome of each

exposure (JRE). NB. Justification may only be

determined by examination of the patient

Poor quality radiographs may lead to fee recovery for that

and associated items. Grade 3 radiographs must always

have a report in the records (even if not making a claim)

IRR99 also applies

See handout “Prescribing radiographs in GD Practice” and

letter from Michael Donaldson of 19 Sept 2011

Data handling and data security

Personal legal obligation to protect and process

patient information in line with the Data

Protection Act 1998

Personal information can only be used for the

purposes that it is collected for and for HSC

monitoring purposes

Sanctions can be financial and there could also

be criminal convictions

See Handouts

CPD/ Peer Review

and Clinical Audit GDC provides annual update to the Board of

all registered practitioners’ compliance with

the GDC requirement i.e. 250 hours of CPD

every 5 years

Practitioners are required to participate in 15

hours of Peer Review or Clinical Audit every

3 years and must submit a report of their

activity to CAPRAP (BSO database)

Mixing HS and Private treatment

NHS/Private treatment in one course of

treatment- permissible with patient

consent

NHS/Private treatment on one tooth in

one course of treatment – not

permissible

Charging additional fees (NHS +)

Levying additional charges out with those

stipulated in the SDR would still constitute a

breach of the GDS regulations, even if the

patient has consented to such an additional

charge. Furthermore, if the patient is unaware

that the charge is additional to Health Service

charges, the practitioner may be open to an

allegation of fraud.

IV sedation main points to consider

• Policies and Protocols

• Skills

• Training and experience

• Low strength midazolam

• Rapid Response Report compliance

• Related Peer Review and Clinical audit

recommended

Other areas of individual responsibility

IRR 99

Health and Safety Legislation e.g.

COSHH, risk assessment/management,

workplace ergonomics

Medical Devices Regulations 2002

Overview Part 4

Out of Hours Arrangements

OUT OF HOURS ARRANGEMENTS

Under GDS regulations dentists are required

to make reasonable arrangements to secure

that a patient requiring prompt care and

treatment will receive such care and treatment

as soon as appropriate either from

him/herself, or from another dentist (HPSS

GDS Regulations NI 1993)

Aim: to provide an out of hours service for the relief of

dental pain, until patients can attend a dental practice

during normal working hours for a assessment and full

treatment of their dental complaint

Conditions treated at OOH Centres: •Bleeding

•Swelling

•Trauma

•Severe pain

NOT routine dental treatment- including recement of crowns, or repair to

dentures etc that does not involve the relief of dental pain

The out of hours payment to the dentists working in

the WLCG rota, in DUC, BHSCT and CAH rotas is

through the SDR

Out of hours care in the Western LCG is provided

by local rotas

Each out of hours site has a clinical lead:

• Belfast Sarah Lochhead

• Craigavon David Reaney

• Dalriada Derek Manson

Failure to attend your allocated session

When a session is allocated to a dentist, it is their responsibility that the

session is filled until another dentist agrees to cover their session for

them through the on-line rota system

If the dentist covering the session fails to attend, it will be classed as the

dentist who bought the session on the rota that failed to attend, not the

dentist who was originally allocated the session and subsequently sold it

through the on-line rota system.

Failure to attend an allocated session, for whatever reason, is taken

very seriously by the Board and will result in a fine of £240, and may

lead to a referral to the Regional Professional Panel

Indemnity

Indemnity NOT provided by Out Of Hours site

Dentists work under their OWN Indemnity

Dentists responsibility to ensure they have correct

and valid indemnity which covers them for working

at the OOH situation

Referrals

Onward referrals for extreme emergency,

beyond the competency of general dental

practice

Ring Ulster Hospital, and speak to on-call

dentist at Maxillo-Facial Department

Dental Charges

It is the dentists responsibility to advise which, if

any, dental charges are applicable and this should

be recorded in the patient’s clinical notes

The Board has developed a charge sheet that is

used at all sites and will be updated by the Board in

line with any changes to the SDR

Overview Part 5

What is an Adverse Incident?

“Any event or circumstance that could have

or did lead to harm, loss or damage to

people, property, environment or

reputation.”

This includes “near misses”

Significant Events, AI & SAI SAI

Adverse Incidents

Significant Events

•Significant Event: - Within Practice, discussed over coffee, specific to practice, solved by practice, no learning outside Practice

•Adverse Incident: - Within/involving Practice, could happen to another Practice, may/may not be solvable by Practice, potential learning for other practices (individual /trend)

•Serious Adverse incident: - As for AI but meets SAI criteria

GDS examples of AI (single event)

Prescription pad goes missing

The same local anaesthetic cartridge is used for 2 Patients

A patient is admitted to hospital with a spreading oral

infection after receiving dental treatment

A dentist finds untreated caries in a patient recently

discharged as orally fit by another dentist in the practice

When should an adverse incident be

reported? And to whom?

• It should be an immediate response to the

occurrence…don’t investigate first!

• If the incident is related to the sudden or

unexpected death of a patient then….within

24 hours

• All other adverse incidents should be

reported within 72 hours

Adverse Incident Reporting Summary

Why report?

Learn from incidents

Share knowledge

Prevent reoccurrence

Learning Culture – NOT Blame Culture !

Adverse Incident “Any event or circumstance that

could have or did lead to harm, loss or damage to people, property,

environment or reputation”

Complaints

Definition

“Any expression of dissatisfaction which requires

a response”

What you need to do …. • Have a designated complaints officer

• Develop a Practice-based complaints procedure.

• Develop a complaints leaflet

• Respond in appropriate timescales

• Monitor take cognisance of issues being raised

• Learn from complaints

Referrals

• Each practitioner is responsible for referring

patients for hospital/ specialist care, as

appropriate

• New practitioners should acquaint themselves

with local specialists

• Referral Guidelines for Specialist Hospital

Dental Services -

http://www.hscbusiness.hscni.net/services/2470.

htm

Please note: Criteria for referral : Available on the BSO website

Patients who do not meet the criteria outlined in the

guidelines will be returned to the referring practitioner

Trusts will refuse to see patients who have been referred to

them when the treatment required is available under the

General Dental Services but the patient does not wish to

pay

Guidelines for Oral Maxillofacial Services and Paediatric

Dentistry are almost finalised and will be issued soon

Occupational Health The HSCB provides an occupational health service for all

members of the dental team The contact details are ….

Belfast Trust (Belfast) 028 9504 0401

Southern Trust (Armagh) 028 3741 2473

Northern Trust (Antrim) 028 9442 4403

Western Trust (Derry) 028 7161 1407

Western Trust (Omagh) 028 8283 5395

Western Trust (Enniskillen) 028 6638 2342

South-Eastern Trust (Ulster Hospital) 028 9056 1300

Occupational Health Services

Screening service at the start of employment

This is a one off service and the onus is on the practitioner to inform OH

if their status has changed, eg a sharps injury with a NON sterile

needle, travel to an endemic TB area or high risk behaviour.

Following a sharps injury the clock is ticking so stop work and deal with

it immediately following the HSC flowchart, Management of Sharps

Incidents in Dental Practices & GP Practices

**REPORT TO HSCB AS AN ADVERSE INCIDENT**

Back pain management

Stress management

Dealing with stress

Practice can be stressful for many reasons -

Difficult patients

Regulatory inspections

Payment deadlines

Managing staff

HELP IS AVAILABLE – self referral or OH advice is available to all

dentists and their staff - contact your local OH department on the

numbers given

Other support services are also available locally – Samaritans, NIAMH,

Minding Your Head, Lifeline

DON’T SUFFER IN SILENCE

Overview Part 6

Prescribing

What can dentists prescribe?

For all prescriptions, dentists should only

prescribe medication

• that has uses in dentistry

• to meet the dental needs of the patient

• that he/she is competent in prescribing

NHS and Private patients

NHS patients

• Dentists can prescribe any medication in the DPF on

an NHS Rx

• Dentists can prescribe any medication not in DPF on a

private prescription (or purchase OTC)

Private Patients • Private Rx or purchase OTC

Points to Consider when Prescribing

• Is prescribing necessary: risks v’s benefits

• Check Medical History

• Caution in potential high-risk groups eg

• Pregnancy/Breastfeeding

• Elderly

• Children

• Patients on anticoagulants

Refer to BNF for further details

• Adequate patient information should be provided eg

clear instructions, benefits of medication, potential side-

effects and suitable disposal

Dental Prescribing of High Strength Fluoride Toothpastes

Dental practitioners may prescribe fluoride toothpastes containing

2800ppm or 5000ppm. It is essential that in doing so practitioners realise

they must fulfil the legal requirements for the prescribing of a medicine as

detailed in previous slide

Repeat prescribing

Repeat prescribing should not be undertaken without ensuring that clinical

monitoring of the patient is ongoing and they are complying with clearly

identified and recorded recall intervals

Clinical notes

Clinical records should record

Clinical indication for prescribing medication AND the prescription details

Any repeat prescription issued and reason why before the recall date for

the patient review

Spot the error!

Writing Prescriptions For all NHS and private prescriptions, including for

CDs, the prescription must:

•be written (or printed) in indelible ink

•be signed in ink by the prescriber (ensure legible)

•be dated

•specify the prescriber’s address and profession

•include the name and address of the patient

•For POMs, include the age / date of birth for children

under 12 years

•Include details of the medication including

appropriate quantity and clear dosage instructions

Safe Prescribing • Avoid the unnecessary use of decimal points. Quantities of 1 gram or

more should be written as 1g etc quantities of less than 1 gram

should be written in milligrams eg 500mg, not 0.5g

• When decimals are unavoidable, a zero should be written in front of

the decimal point where there is no other figure eg 0.5ml, not .5ml

• Dose and frequency should be stated; for preparations to be taken

‘as required’ a minimum dose interval should be specified

• The names of medicines and preparations should be written clearly

and not abbreviated, using approved titles only

• The quantity to be supplied should be clear. The number of days

treatment should be indicated in the box provided on the NHS forms

Safety measures with prescriptions

A How do you ensure the prescription you write is correctly

managed

B How do you ensure that the prescriptions in the practice are

kept safely?

Prescription Security

When writing prescriptions: • Prescribe appropriate amounts for the clinical indication;

avoid ‘excessive prescribing’

• Draw a diagonal line across the blank part of the form

• For medication prone to abuse, write the quantity in

words and figures

• Ensure alterations are clear and initialled

• Make sure to familiarise yourself with and adhere to

the individual practice protocol

Prescription Security • Keep stocks of blank forms to the minimum necessary

• Store blank forms/pads in a locked cupboard at all times

• Do not leave blank forms/pads unattended

• Ensure prescriptions are collected by an authorised

representative

• Stolen or missing prescriptions should be

notified to the Local Medicines Management

Office, HSCB AND CFPS Fraud Hotline phone

number 08000963396

Which CDs can dentists prescribe?

-NHS prescriptions: CDs listed in the DPF only (See BNF) ie:

• Schedule 3: temazepam tablets and oral solution,

•Schedule 4: diazepam tablets and 2mg/5ml oral solution

•Schedule 5: dihydrocodeine 30mg tablets

-Private prescriptions: Any CD (Schedule 2-5)

Note: for all CDs, dentists should be able to justify clinical need

and quantities prescribed

Private Prescriptions for Schedules 2 and 3 CDs

•PCD1 Forms (obtained from BSO) must be used

•Prescribers must have a unique prescriber identification number

CD Monitoring

• Following dispensing, community

pharmacists forward private and NHS

prescription forms to the BSO

The HSCB is responsible for monitoring

CD prescribing (BSO data used)

Summary Drug Quantity to be queried

Diazepam 2mg / 5mg tablets > 10 tabs per script

Diazepam 10mg tablets Any quantity per script

Diazepam liquid 2mg/5ml Quantity > 50ml

Nitrazepam tablets Any quantity per script

Temazepam 10mg/20mg > 5 tabs per script

Temazepam liquid 10mg/5ml > 20mls per script

Dihydrocodiene 30mg tablets > 16 tabs or if routinely prescribed i.e. more than 2 prescriptions /

month for quantity > 16 tabs

Midazolam injection/oral Any quantity per script

The following should also be queried

All scripts for children

Prescribing of any CD not included in BNF dental formulary e.g. co-codamol, co-dydramol

Any prescription that does not have adequate dose and / or directions indicated

FRAUDULENT MEDICATION REPORT

WHAT IS A

FRAUDULENT

MEDICATION REPORT

(FMR)? The term Fraudulent Medication

Report is used by the Business

Services Organisation’s Counter Fraud

and Probity Services (CFPS)

department to describe incidents

involving a person(s) practicing some

form of deception or forgery or a

combination of both, in order to obtain

medication in greater quantities than

originally prescribed or to obtain

medication that was not prescribed to

them at all.

WHAT IS A FRAUDULENT MEDICATION

REPORT (FMR)?

The term Fraudulent Medication

Report is used by the Business

Services Organisation’s Counter

Fraud and Probity Services

(CFPS) department to describe

incidents involving a person(s)

practicing some form of

deception or forgery or a

combination of both, in order to

obtain medication in greater

quantities than originally

prescribed or to obtain

medication that was not

prescribed to them at all.

WHAT IS A FRAUDULENT MEDICATION REPORT

(FMR)?

The term Fraudulent Medication Report is used by

the Business Services Organisation’s Counter

Fraud and Probity Services (CFPS) department to

describe incidents involving a person(s) practicing

some form of deception or forgery or a combination

of both, in order to obtain medication in greater

quantities than originally prescribed or to obtain

medication that was not prescribed to them at all

The individual may be attempting to obtain the

medication for personal consumption or to sell

onto others

Counter Fraud and Probity Services investigate all

received reports of fraudulent medication activity.

The most common offence committed is Fraud by

False Representation which is a criminal office

against Section 2 of the Fraud Act 2006. If a

person is found guilty of fraud, depending on the

seriousness of the offence, they are liable to a fine

or imprisonment for up to ten years

FRAUDULENT MEDICATION REPORTS

TYPES OF INCIDENTS A Dental Practice/Practitioner may be contacted by a Pharmacy or BSO/HSCB

employee or the PSNI to inform them that one of their prescriptions has been

used in a potential fraud. Examples of incidents which might be reported or

queried are:

•Prescription item(s) which appear to have been altered, normally to increase

quantity and/or strength

•Drug items which appear to have been added to a prescription in different

handwriting

•Drug items poorly spelt, incorrect dosage or other prescribing abbreviations that

are not in keeping with the rest of the prescription

For further advice and guidance please refer to www.cfps.hscni.net/reportfmr/ or telephone the Fraud Hotline on 0800 096 33 96

Orthodontic Monitoring - Item 32

As with all practitioners working within the GDS,

specialist practitioners providing orthodontic

services may expect to have both Probity and

Quality of care reviews within their first year of

practice and on an ongoing cyclical basis: in

order to provide assurance to the HSCB and

also when requested to the DHSSPS

Retention

Item 3231/3232- note time requirements

Items 3233/34 – lab sheets form part of patient

record (also fulfil Statement of Manufacture

Directive march 2010)

Item 3237/3238 – Note Wenvac/Essix retainers

do not command higher fee

Incomplete Cases

• HS45s/EDI submission with comments should be

returned for re-approval, with details of all

treatment provided including appliances fitted,

number of visits/DNAs, objectives achieved/not

achieved, reason for discontinuation/transfer

• BSO Dental Advisers will make a decision on

partial fees, based on information received, and

payment will be issued in next schedule

Websites Forms including HS48 and HS50 forms

www.hscbusiness.hscni.net/services/2371.htm

Minimum Standards for Dental Care and Treatment http://www.dhsspsni.gov.uk/min_stds_dental_candt.pdf

Statement of Dental Remuneration http://www.hscbusiness.hscni.net/services/2069.htm

Other websites that may be of use

www.dhsspsni.gov.uk/pgroups/dental/dental.asp

www.hscboard.hscni.net

www.hscbusiness.hscni.net

http://www.hse.gov.uk/risk/index.htm

www.rqia.org.uk

www.gdc-uk.org

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