Regulatory differences between Scotland and England
The work of the Primary Care Trust or NHS Trust (familiar in England) is performed by the Health Boards and Dentistry under the NHS and is managed by the Practitioner Services Division (PSD).
NHS Dentistry in Scotland still operates under the ‘old' system where patients are registered under a capitation or continuing care arrangement with the dentist, who is then paid a fee per item of service. The various fees are set out in the Statement of Dental Remuneration (SDR) which differs slightly from the Northern Ireland SDR and the former English version. Payments under the NHS are made to dentists by the PSD on behalf of the Health Boards which is also responsible for running the Dental Reference Service (DRS). Dental Reference Officers (DRO) in Scotland are responsible for examining patients both in respect of dentists seeking prior approval for treatment, and for assessing the standard of the completed treatment, as well as verifying the claims. The present DRS system for case assessment is currently being reviewed.
The PSD has a Clinical Governance function and may ask dentists to send in records cards which are then checked against the claim forms to corroborate the claims which have been made for these patients. This check may also be performed in conjunction with a DRO patient examination.
There still exists an NHS Disciplinary System in Scotland where a dentist's Health Board may refer a matter for investigation to a neighbouring Health Board if they believe a dentist may be in breach of their NHS Terms of Service.
Scotland has produced their own guidance on Infection Control for healthcare settings, including dental practices. As a result of this, the Scottish Executive Health Dept established the Glennie Group that drew up a framework for improvements in decontamination processes. Download the Decontamination Into Practice guidance.
The guidance for dentists is produced by the Scottish Dental Clinical Effectiveness Programme and can be accessed at www.scottishdental.org/cep. Health Protection Scotland (HPS) is the main body which advises on all aspects of decontamination in healthcare. Click here to visit their website www.hps.scot.nhs.uk.
The NHS complaints system in Scotland is currently being evaluated, but the existing NHS complaints procedure has two stages:
- Local resolution, including conciliation
- Scottish Public Services Ombudsman (SPSO).
Civil law in Scotland is not subject to the Woolf reforms as in England. Most of the Clinical Negligence work in Scotland is funded by Legal Aid although solicitors can also deal with a case on a ‘no win no fee basis'. Dental Protection retains solicitors in Scotland who are instructed to act on behalf of a member if the allegations being made may be investigated in a Court or in a forum such as the GDC.