Listing of Non Principal General Dental Practitioners, Optometrists and Opthalmic Medical Practitioners

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Consultation

This consultation paper is being sent to NHS Boards, Primary Care Trusts and other interested parties. Copies are being sent to all practices in Scotland providing general dental and ophthalmic services. Dental and ophthalmic contractors are asked to draw it to the attention of all non principals who work in the practice.

CONSULTATION: YOUR VIEWS

1. This consultation paper seeks your views on a proposal by the Scottish Executive to develop the arrangements for quality assurance in general dental services and general ophthalmic services. The proposal is that those dentists who treat patients under NHS general dental services and those optometrists and ophthalmic medical practitioners who test the sight of patients under NHS general ophthalmic services but whose names do not currently appear on the dental or ophthalmic lists held by NHS Boards and Primary Care NHS Trusts should now be listed for the first time. Legislative measures will be required and will be introduced once a suitable legislative vehicle becomes available. The views of those with an interest are a key part of the consultation process, which is an essential part of the Executive's preparations for developing legislation.

2. This paper sets out the proposal in detail and your responses to the points made will be very helpful to us in considering the way forward. However, if you have views which you feel are not covered by the paper, please do not hesitate to put them forward as all comments on any aspect of the paper are welcome. Details of how to contact us and where to send your comments are given at the end of the paper.

3. Views are sought by 10 May. In addition to this consultation, we will seek meetings with bodies which have a key interest in putting the proposed changes into practice: the Scottish Dental Practice Committee and Optometry Scotland, the Common Services Agency, Primary Care Trusts and NHS Boards.

BACKGROUND

4. The development of primary care is a key part of the modernisation of the National Health Service. This consultation paper concerns development of the arrangements for quality assurance: it discusses issues around the first time listing of non principal dentists, optometrists and ophthalmic medical practitioners. The purpose of listing these groups is to strengthen quality assurance.

5. In the context of this consultation paper, non principal dentists may include dentists undertaking vocational training, assistant dentists, locum dentists working in general dental services who do not act as principals, and dentists who perform personal dental services.

Non principal optometrists and ophthalmic medical practitioners may comprise employed assistant, deputy and locum optometrists and ophthalmic medical practitioners working in general ophthalmic services but not on a regular basis for a principal and optometrists in pre registration training.

6. The listing of non principal dentists, optometrists and ophthalmic medical practitioners will require amendments to the NHS (Scotland) Act 1978. The intention is to make these changes when a suitable legislative vehicle is available. Thereafter it would be necessary to prepare secondary legislation by Statutory Instrument.

• Statutory requirements as to NHS Discipline Committees should cover non principals. Reference of a principal to a Discipline Committee arises from a potential breach of the National Health Service (General Dental Services) (Scotland) Regulations 1996 or the National Health Service (General Ophthalmic Services) (Scotland) Regulations 1986, including a potential breach of the terms of service set out in Schedule 1 of these. Those terms of service and those other parts of the Regulations which concern performance should attract to non principals and those which relate to the performance of a principal as a contractor to the Board or Trusts (for example registering and de-registering dental patients) should not attract to non principals.
• The NHS Tribunal should have the same jurisdiction in relation to listed non principals as it has to listed principals.

7. NHS Boards and Primary Care Trusts are currently required to maintain lists of:

• all dental contractors who provide general dental services (GDS) in their area under the National Health Service (General Dental Services) (Scotland) Regulations 1996; and
• all ophthalmic contractors who provide general ophthalmic services (GOS) in their area under the National Health Service (General Ophthalmic Services) (Scotland) Regulations 1986.

8. General ophthalmic services comprise the testing of sight of eligible patients, informing GPs of the results of certain tests, the completion of prescriptions (a written order giving details of lenses intended to be made up into glasses or contact lenses) and the issuing of NHS optical vouchers to eligible patients. General dental services are the range of NHS dental care provided by family dentists to patients.

9. The relevant lists in a given area are known as the dental list and the ophthalmic list and dentists, optometrists and ophthalmic medical practitioners on these lists are commonly known as "principals".

10. To join a dental or ophthalmic list, a principal has to satisfy rules on suitability, including registration with the professional regulatory body and appropriate experience. Once on a list, a principal is subject to discipline procedures relating to statutory Discipline Committees and the NHS Tribunal.

11. The list system does not currently extend to non principals.

12. As an important aspect of the development and strengthening of primary care, the Scottish Executive intends to amend the legislation so that all non principal dentists, optometrists and ophthalmic medical practitioners must join a list in order to practice in an area.

KEY PRINCIPLE

13. Listing for non principal dentists, optometrists and ophthalmic medical practitioners should be introduced to provide the opportunity to bring non principals into the framework for the administration and management of family health services in Scotland. From the date of introduction, a principal would not be able to employ a non principal unless that non principal was listed. This is already the case in general medical practice.

ENTRY TO, CONTROL OF AND OPERATION OF THE LISTS

14. The following principles are proposed.

• The entry and control arrangements for non principals and principals working in family health services should be uniform i.e. for non principals they should mirror as far as practicable those for principals, including any requirements as to suitability.
• Principals should be required to ensure that any organisation providing non principals provide only listed non principals and organisations providing non principals should be required to provide only listed non principals
• The "fast track" application procedure already developed for listing of non-principal GPs should be replicated, thus ensuring that bureaucracy will be kept to a minimum. (The practitioner indicates on the application the area or areas where he or she wishes to work, a "host" Board or Trust checks the information supplied on the application and, where this is found to be satisfactory, the practitioner is then granted entry to the list held by the host Board/Trust and the other relevant Boards/Trusts also grant him/her entry without undertaking further checks.)

FINANCIAL IMPLICATIONS

15. Boards and Trusts will incur limited costs as a result of listing these groups of non principals. These will be subsumed within their overall resources.

CONCLUSION

16. This consultation paper seeks your views on important proposals which will further develop and improve general dental and ophthalmic services in Scotland. Your views are important to us and will help us shape the draft legislation to be brought before Parliament in due course.

22. We invite individuals and organisations to respond to the issues in this consultation paper by 10 May. Copies of the responses will be made available in the Scottish Executive library. We will assume that the responses to this paper may be made publicly available unless you request confidentiality.

23. Responses should be sent to Sheila S Taylor, Primary Care Division, Scottish Executive, 1 East Rear, St Andrew's House, Regent Road, Edinburgh EH1 3DG (0131 244 2469) e-mail sheila.s.taylor@scotland.gsi.gov.uk from whom further copies are available.

Primary Care Division
February 2004