There's a right way and a wrong way to do just about everything and the de-registration of patients in Northern Ireland is no different. Hence, SPPG (formerly the Health and Social Care Board) has contacted all practices to make sure they follow the correct process if de-registering patients.
It's important to be fully versed on any potential consequences of deregistering patients before you do it. Particularly in respect to the impact on continuing care and capitation payments and potential consequences for those who recently benefitted from the £5m Revenue Grant Scheme (RGS).
How to deregister patients
The Strategic Planning and Performance Group (formerly HSCB) at the Department of Health (DoH) has laid out your rights as follows:
Dental practitioners have the right to withdraw from continuing care and capitation arrangements with a patient, under Schedule 2, paragraph 11 and 11A of the General Dental Services Regulations (NI) 1993. However, this must be carried out at an individual patient level as there is no facility for the block deregistration of dental patients.
In practice, the first step is to complete the WCA 966 form for each patient and submit by post to the Business Services Organisation. This must be done in hardcopy. I understand that work is underway to allow for an electronic option, but this is currently not available.
Consequences
Actions have consequences and de-registration of patients is no different. Terminating Continuing Care or Capitation arrangements will impact on the Practice Allowance.
Practitioners are reminded that under the Conditions of Entitlement for Practice Allowance (SDR Determination X) it states that the practice "gives an undertaking to make available all proper and necessary care and treatment under general dental services (except for specialist services on referral) to the full range of health service patients for the following 2 years''.
If this condition is not met due to the deregistration of health service patients, the DoH may recover the relevant practice allowance payments.
Revenue Grant Scheme
Almost £5 million was paid under the recent Revenue Grant Scheme (RGS). The conditions stated that the practice commits to maintaining (or increasing) current patient registration numbers until 31 March 2024 within a 5% tolerance level; and that a practice cannot make a claim against this RGS1 if they proactively deregister patients or switch HSC patients to private/independent care during the remainder of 2021/22, other than for the reasons set out in the GDS Regulations.
Where there is evidence of the deregistration of patients or switching HSC patients to private/independent care, other than for the reasons set out in the GDS Regulations, then the grant allocation will be recovered by the HSCB (SPPG). Queries should be sent to [email protected].
Advice and information
Before taking any steps to de-register patients, practitioners would be advised to check out the information on the BDA website, or if Expert or Extra members, taking advice from the BDA Advice Team before making any major decisions on their direction of travel.
BDA Members on the Extra or Expert tiers of membership have access to one-to-one advice. They may access that advice by contacting the Practice Support team on 020 7563 4574 or emailing [email protected]
Members on the Essential membership tier, requiring one-to-one advice, may upgrade their memberships, at any time, by contacting the Membership team on 020 7563 4550.