General Dental Services Regulations (Northern Ireland) 1993

Prior approval of treatment

26.—(1) Subject to sub-paragraphs (6), (7) and (10), where care and treatment is or includes prior approval treatment, the dentist—

(a) shall submit, without unreasonable delay, to the Committee for approval an estimate of the whole of the care and treatment, including details of any part of that care and treatment to be provided privately; and

(b) otherwise than in an emergency, shall not, until he receives approval from the Committee, proceed—

(i) where prior approval is required by virtue of Part I of Schedule 5, with any item of treatment referred to in that Part, or

(ii) where prior approval is required by virtue of Part II of Schedule 5, with any care and treatment mentioned in the estimate.

(2) Subject to sub-paragraphs (6), (7) and (10), where in the course of providing any care and treatment to which, at its outset, sub-paragraph (1) does not apply, a dentist is of the opinion that a variation of or addition to such care and treatment is necessary, and by reason of the variation or addition the care and treatment includes or becomes prior approval treatment, the dentist—

(a) shall submit, without unreasonable delay, to the Committee for approval an estimate of the whole of the care and treatment (including that which the dentist has commenced) together with details of any part of that care and treatment provided or to be provided privately; and

(b) otherwise than in an emergency, shall not, until he receives approval from the Committee, proceed—

(i) where prior approval is required by virtue of Part I of Schedule 5, with any item of treatment referred to in that Part, or

(ii) where prior approval is required by virtue of Part II of Schedule 5, with any care and treatment mentioned in the estimate.

(3) Subject to sub-paragraphs (6), (7) and (10), where a dentist has obtained approval from the Committee required by sub-paragraph (1) because the care and treatment is or includes an item of treatment referred to in Part I of Schedule 5, and in the opinion of the dentist a variation of or addition to such care and treatment is necessary, which variation or addition—

(a) is or includes an item of treatment referred to in Part I of Schedule 5; or

(b) has the effect that the care and treatment then falls within Part II of Schedule 5,

the dentist shall re-submit, without unreasonable delay, the estimate to the Committee for approval, including details of any part of that care and treatment provided or to be provided privately.

(4) Subject to sub-paragraphs (6), (7) and (10), where a dentist has obtained approval from the Committee in accordance with sub-paragraph (1) because prior approval is required by virtue of Part II of Schedule 5 and in the opinion of the dentist a variation of or addition to such care and treatment is necessary, the dentist shall re-submit, without unreasonable delay, the estimate to the Committee for approval together with details of any part of that care and treatment provided or to be provided privately.

(5) Where the Committee receives an estimate under sub-paragraphs (3) or (4) it may withdraw or vary its original approval in so far as the care and treatment has not yet been carried out in accordance with such approval, or add to its original approval, and, otherwise than in an emergency, the dentist shall not, until he receives approval from the Committee, proceed—

(a) in any case falling within sub-paragraph (3)(a), with any item of treatment referred to in Part I of Schedule 5; or

(b) in any other case, with any of the care and treatment mentioned in the estimate.

(6) Sub-paragraphs (1), (2), (3) and (4) shall not apply where the care and treatment to be provided under a capitation arrangement is care and treatment for which the dentist is remunerated in accordance with Section X (treatment under capitation) of Determination I of the Statement of Dental Remuneration for which he receives no remuneration other than a capitation payment.

(7) The dentist may proceed immediately with the care and treatment of merchant seamen, deep sea fishermen, or oil rig workers, about to go to sea for a period in excess of 4 weeks, or persons about to go abroad for a period in excess of 4 weeks, and in such event shall send an estimate to the Committee for approval within 7 days of the commencement of the care and treatment.

(8) Where, in consequence of any proceedings under the Services Committee Regulations in respect of general dental services provided in the area of any Board, a dentist is required for any period to submit all estimates to the Committee for approval, in respect of all treatment or any specified description of treatment, the dentist—

(a) shall submit, without unreasonable delay, all such estimates (whether relating to treatment to be provided in that or any other area) to the Committee for approval; and

(b) shall not proceed with such treatment until he receives approval from the Committee, except that he may in the course of any single consultation, proceed with treatment consisting of one examination and the taking of no more than 2 small radiographs, each of a size not exceeding 16 square centimetres, or treatment in an emergency.

(9) Where in consequence of a direction given by the Committee under regulation 32 a dentist is directed, for any period, to submit all estimates to the Committee for approval in respect of treatment or a description of treatment specified in the direction, the dentist—

(a) shall submit, without unreasonable delay, all such estimates (relating to treatment in the area of any Board) to the Committee for approval; and

(b) shall not proceed with such treatment until he receives approval from the Committee, except that he may in the course of any single consultation, proceed with treatment consisting of one examination and the taking of no more than 2 small radiographs, each of a size not exceeding 16 square centimetres, or treatment following trauma or in an emergency.

(10) Nothing in this paragraph shall prevent a dentist carrying out any care and treatment privately.