Overview
Dentists providing HSC dentistry have clear responsibilities for patients registered under continuing care, capitation, or referral arrangements. Understanding how these systems operate, and how they can be started, managed and ended appropriately, is essential to maintaining compliance and avoiding complaints or contractual issues.
Adult patients register for continuing care by signing an HS45 form, usually followed by an examination and the issue of a treatment plan. This plan must set out the care required to maintain oral health, any agreed private treatment, estimated costs and recall intervals, and should be updated whenever treatment needs to change. Continuing care registration lasts 24 months and includes entitlement to emergency cover and, in many cases, free repair or replacement of certain restorations within 12 months.
Capitation applies to patients under 18 and begins at the time of examination. Dentists receive regular payments, with enhanced rates for children with special needs or from areas of social deprivation, alongside item‑of‑service fees for certain treatments. Capitation also runs for a 24‑month period and automatically converts to continuing care when a patient turns 18.
Registered patients are entitled to prompt emergency care, either from their own dentist or through suitable arrangements with others. Practices must have accessible systems for urgent care.
Once a continuing care or capitation arrangement is in place, you remain responsible for the patient until it ends. Arrangements usually require three months’ written notice to terminate, unless they lapse automatically or the patient agrees to transfer to private care. Ending patient relationships must be handled carefully, with clear documentation and, where appropriate, advice from indemnity providers.
This guidance also sets out rules for referrals, mixing HSC and private care, record keeping, prescriptions, domiciliary visits, patient information, and the use of deputies or assistants. Adhering to terms of service, maintaining accurate records, and communicating transparently with patients are central to providing safe, compliant care and protecting both patients and the practice.