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The GDS and PDS Transitional Order
14th Feb 2006
Michael Watson explains the GDS and PDS Transitional Order This order was laid before Parliament in December and came into force on 3 January. It makes arrangements for GDS contracts to be negotiated and signed. It also deals with the abolition of PDS pilot schemes and their replacement with permanent arrangements. It is divided into three parts dealing with GDS contracts, PDS agreements and other requirements such as treatment plans. General Dental Services The PCT must offer you a GDS contract if you are an individual on their dental list, provided your practice is not restricted to orthodontics. There are special provisions if you are on maternity or long term sickness leave. If you cannot agree on a particular aspect of the contract, such as the UDA requirement, and appeal against it, you can still sign, pending the outcome of the appeal. There are similar provisions for two or more dentists acting in partnership and for those who were in pilot PDS schemes who are entitled to transfer to GDS. UDAs - The number of units of dental activity you have to provide under a GDS contract have been calculated by the DPB for most dentists. They have taken the work you did in the test year, Oct 2004 to Sept 2005, categorised the treatment into the four bands in the new charges and assigned UDAs to them. They have then added in UDAs for ‘free’ treatments such as denture repairs to give a total, which they have then reduced by 5%. If you did not work a full year or indeed didn’t work in the test year at all, then you must agree a figure with the PCT, although in the end the PCT can impose one. If you worked in PDS during the test year and want to transfer into GDS then the treatment you did in PDS is the benchmark for your UDA total. It is important that your figures agree with the DPBs, but many have complained that their UDA total has increased, rather than decreased by 5%. Errors may have been made by either side, but there are two factors that may have caused the discrepancy. The DPB has made an assumption that each registered child has been seen twice during the test year and this may not be the case; patients with low caries rates may be seen less frequently. This requirement to count two exams is in the Order and there is not much you can do about it. The DPB has counted as urgent treatments (1.2UDAs) only those courses of treatment claimed for as occasional treatments and a single extraction or a replacement filling will have been counted as a Band 2 treatment ( three UDAs). If you do a lot of such treatments you may need to discuss this with the PCT as, if you have to claim the single extraction as a Band 2 course of treatment, you will have to charge the patient accordingly and the PCT will have to field any complaints. Similar provisions are made for Units of Orthodontic Activity. The Order also allows the PCT to ensure that the practice premises and equipment are fit for purpose, although it is unlikely that this will be done in may cases, time constraints being what they are. Personal Dental Services You are entitled to a PDS agreement if: • You are in PDS as a pilot site • You are in the GDS but want a PDS agreement • You are only going to provide orthodontic treatment • You are part of a partnership only providing orthodontic treatment • You are transferring from a pilot PDS agreement to a permanent one - the duration of the agreement must be not less than the unexpired portion of your agreement • You are transferring from doing orthodontics only in the GDS to a PDS agreement the duration of the agreement must be not less than five years. UDAs - The number of units of dental activity you have to provide under a PDS agreement have been calculated by the DPB but sent to the PCT rather than direct to the dentist as in GDS. But similarly they have taken the work you did under PDS in the test year categorised the treatment into the four bands in the new charges and assigned UDAs to them. They have then added in UDAs for ‘free’ treatments such as denture repairs to give a total which should be reduced by 5%. As with GDS it is assumed that a child has made two visits in the test year whether they have or not. Conclusion The PCT does not however have to abide by DPB figures. It may be that the practice only started PDS in the middle of the test year or it may be that output and activity dropped dramatically. Where possible the PCT and practice should discuss and agree a reasonable number of UDAs to be achieved. They should do this by looking at what treatmnent was provided under the PDS pilot. If they cannot the agreement must state this to be the case and specify the number of UDAs decided by the PCT. Similar provisions are made for Units of Orthodontic Activity. As with GDS the Order also allows the PCT to ensure that the practice premises and equipment are fit for purpose. Although it has not had the publicity of the GDS and PDS regulations, it does lay out in rather legalese terms what the PCT can and cannot ask of you. Its full title is The General Dental Services and Personal Dental Services Transitional Provisions Order 2005: Statutory Instrument 2005 No. 3435 and is published on the Stationery Office’s website. This is only a brief summary of a 28-page Order but it gives some idea of where dentists stand in relation to their PCTs. Michael Watson and Raj Rattan have set up a website www.newcontracthelp.co.uk to help dentists understand the contract. Please visit it for further information.
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