Overview
From April 2026 practices in Wales will continue to operate under a General Dental Services (GDS) contract, but the details are changing. There will be a structural change meaning that patient lists will be used. This change will result in patients being formally attached to a practice, rather than attending on an episodic basis as they have done previously. This means that there will be a need for practices to have a more stringent and transparent process for managing non-attendance and the delisting of patients.
While your approach, and the underlying principles relating to managing these patients, will remain unchanged (such as the need for fairness, non-discrimination, and clear justification) there are new procedural expectations. You will need to ensure that any decision you make to remove a patient is reasonable, proportional, appropriately documented, and most importantly, in line with the contract. Grounds for delisting a patient include a breakdown in the professional relationship, persistent non-attendance, or violent behaviour.
The contractual changes introduce additional reporting requirements for practices. In some circumstances you will need to notify your local health board (LHB) of the issues that have led you to delist patients. The changes also remove discretion in certain situations, which means that you must delist patients in defined scenarios. This represents a shift from the current position, where you are able to use your discretion in all cases. This means that it is important to ensure that you understand the changes and to update your team and front-of-house staff accordingly.
Whenever processes change within a practice, there is a risk that mistakes may occur, so you should make sure that your whole team is aware of the issues. Your team should gather as much information as they are able to from patients who may meet the criteria for delisting. This will place you in the strongest possible position when it comes to providing information to your LHB about the steps you are taking.