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Dental Protection comments on GDC v Williams “top up fees” judgment

Post date: 22/05/2023 | Time to read article: 2 mins

The information within this article was correct at the time of publishing. Last updated 26/05/2023

In the case of GDC v. Williams, the Court of Appeal handed down judgment and held that supplemental fees (described as top-up fees) in addition to the NHS charge were permitted under the NHS Regulations - in this particular case for a more aesthetically pleasing ceramic crown.

Commenting on the case, Dr Raj Rattan, Dental Director at Dental Protection, said:

“This judicial precedent has many implications. Dental professionals work in a complex system and there are many interdependencies.  This complexity is compounded by what the Court noted as ‘unclear Regulations’ which were ‘not at all straightforward.

“There will inevitably be unforeseen and unintended consequences of any policy change, not to mention that the introduction of a top-up fee would in effect create a new hybrid category of care and raises questions about how, for example, the replacement or repair (guarantee) Clause is applied.

“The GDS contract was not drafted with this in mind, and a redrafting of the Regulations is perhaps now inevitable to provide the much-needed clarity. Optimists may argue that this development presents a wider opportunity – a catalyst to drive system reform.

“Pending further clarification, we advocate the precautionary principle and advise members to refrain from offering patients top-up options or accepting top-up fees from patients.

“It is in the interests of the profession and patients to ensure that any changes to the regulations are consistent with the judgment. We are in discussions with stakeholders to represent our members’ interests. We look forward to receiving further guidance and will be keeping members updated as the implications for them become clearer.”


Notes to editors

For further information email [email protected]

About Dental Protection

Dental Protection is a registered trademark and a trading name of The Medical Protection Society Limited (“MPS”). MPS is the world’s leading protection organisation for doctors, dentists and healthcare professionals. We protect and support the professional interests of more than 300,000 members around the world. Membership provides access to expert advice and support and can also provide, depending on the type of membership required, the right to request indemnity for any complaints or claims arising from professional practice.

Our in-house experts assist with the wide range of legal and ethical problems that arise from professional practice. This can include clinical negligence claims, complaints, medical and dental council inquiries, legal and ethical dilemmas, disciplinary procedures, inquests and fatal accident inquiries.

Our philosophy is to support safe practice in medicine and dentistry by helping to avert problems in the first place. We do this by promoting risk management through our workshops, E-learning, clinical risk assessments, publications, conferences, lectures and presentations.

MPS is not an insurance company. All the benefits of membership of MPS are discretionary as set out in the Memorandum and Articles of Association.

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