NHS Dental Services Completion of form guidance FP17W - Wales 1 April 2020

NHS Dental Services
Completion of form guidance FP17W – Wales 1 April
2020
Summary

Welsh Government has made some changes to the FP17W that will go live from 1 April
2020. The guidance highlights these changes using the format in Compass (Compass
on-line) that allows practices to create forms without having to use a practice management
system and specific software.

1. Patient Information

No change in the required completion of this part for any claim made.

2. Dental Care Professional (New)

New Dental Care Professional (DCP) functionality is available – the list of DCPs is taken
from GDC register and is available when the magnifying glass is selected. Only one box
is required to be ticked by the highest qualified DCP.

Following an ACORN course of treatment, there should be no more than 2 courses of
treatment by a DCP in a 12 month period (excluding urgent).

If the GDC Number of the DCP is entered manually then the system will automatically
insert the mandatory leading zeroes and show the name of the DCP to the right of the box.
No entry will be allowed on a claim if the Date of Acceptance is prior to 1 April 2020.

If a DCP GDC Number is entered on a claim there must also be a DCP Type entered and
vice versa otherwise the claim will reject.

Any DCP entered on a claim must be present on the GDC register and must be registered
as of the Date of Acceptance of the claim, otherwise the claim will reject.

Even if all the work on a course of treatment was carried out by a DCP there must still be a
dental Performer number entered on the claim and some form of “significant” treatment
must also be entered.

SEE TAB FOR TREATMENT CATEGORY completion

3. Treatment Dates/Incomplete (New)

If the ACORN Assessment Due box is ticked then the Date of Acceptance must not be
prior to 1 April 2020.

If the ACORN Assessment Due box is ticked then there must be ACORN values on the
same claim before it can be Saved.

If there are no ACORN values entered on the claim then if Compass cannot find a past
claim within the last 12 months for the same performer, contract or provider that does
include ACORN values then a comment will be generated on the pay statement saying
“No ACORN History Found”

4. Exemption, Remissions & Patient Charge

No change in the required completion of this part for any claim made. There is a new
PRWe/PRWw Practice Record Form - Patient Declaration (completed by the patient and
retained as part of the clinical records for at least two years) valid from 1 April 2020.

Patients or practices can utilise the resources in support of this area by looking at
“Information for patients” which is available on NHSBSA website.

5. Supporting Evidence

There is a new PRWe/PRWw Practice Record Form – Patient Declaration (completed by
the patient and retained as part of the clinical records for at least two years) valid from 1
April 2020.

No change in the required completion of this part for any claim made.

6. Treatment Category

Even if all the work on a course of treatment was carried out by a DCP there must still be a
dental Performer number entered on the claim and some form of “significant” treatment
must also be entered (i.e. a Band, Urgent Treatment, Advice Only, Issue of Prescription,
Repairs to Dentures or Bridges, Arrest of Bleeding, Removal of Sutures, Regulation 11,
Domiciliary Visit or Sedations otherwise the claim will reject).

7. Clinical Data Set (New)

For practices using the Compass on-line claim the new Clinical Data Set (as indicated) will
only be displayed if the Date of Acceptance is 1 April 2020 or later. Otherwise the existing
Clinical Data Set will be shown.

Any of the discontinued Clinical Data Set treatments (Scale and Polish, Upper Metal
Denture, Lower Metal Denture, Inlays, the old Examination code, Antibiotics and Best
Practice Prevention) if used on a claim will cause a rejection if the Date of Acceptance is
not prior to 1 April 2020.

Any of the new items brought in for the Welsh Clinical Data Set changes (GDC DCP
Number, DCP Type, ACORN Assessment Due, Toothbrushing Instruction, Upper and/or
Lower Metal Dentures, Prevention and Stabilisation, Onlays, the new Examination code,
Pre-formed Crowns or Advanced Perio RSD) entered on a claim will cause a rejection if
the Date of Acceptance is prior to 1 April 2020 or if the claim’s contract does not operate
under a Welsh health body. (See more detail on the new clinical data set items further
down in this guidance).

Compass on-line process - if entries are made on this tab but then the Date of
Acceptance is changed from post 1 April 2020 to pre 1 April 2020 then any of the new
entries highlighted will be lost.

Similarly if entries are made on the existing Clinical Data Set tab but the Date of
Acceptance is changed from pre 1 April 2020 to post 1 April 2020 then any of the
discontinued treatments (e.g. Scale and Polish, Inlays, Best Practice Prevention etc.) will
be lost.

Guidance for the new Clinical Data Set items

Tooth brushing instruction, including demonstration as required. Interdental Cleaning
demonstration (and observation of patient using ID brushes in relevant areas in the
mouth). This also includes the removal of plaque retentive factors e.g. calculus,
overhangs etc.

The application of a licenced fluoride varnish product including pre and post-operative
instructions.

Fluoride varnish should be applied on all children that do not have any contraindications
for such application and who have parental consent in place. Fluoride varnish should also
be applied on all adult patients who have been classified as ‘Red’ and ‘Amber’ for tooth
decay on ACORN.

Fluoride varnish should be delivered in combination with other relevant prevention items
individualised for each patient following a risk and needs assessment (ACORN) e.g. Brief
Intervention in smoking cessation & referral to Help Me Quit, TBI/ID, Behaviour change
conversations etc.

Prevention and stabilisation - Band 2 - If a patient is suffering from high tooth decay
rate and has 4 or more teeth with active tooth decay that extend to dentine and beyond,
practices can work with the patient to stabilise the teeth with active tooth decay first, with a
view of controlling risk factors, before carrying out definitive restorative treatments.
Prevention including the application of fluoride varnish (when not contraindicated) and the
prescription of appropriate high strength fluoride toothpaste is expected on these patients.

Stabilisation, advice and review can be provided over several repeat visits in the first
course of treatment. A definitive treatment plan will be agreed with the patient dependent
on their ability and willingness to make the necessary changes to their behaviour – any
non-compliance needs to be recorded. Following the first course of treatment, advice may
need to be repeated to secure engagement. Each course of treatment may have 2 or more
visits and in general will be a Band 1, 3 months apart. Band 2 stabilisation should not
normally be required more than once per year per patient.

Pre formed crowns are a Band 2 treatment for children e.g. preformed crown on D’s and
E’s using Hall Technique.

Examination not possible is defined as when a clinical examination is not possible and
should be a rare event e.g. Special Care Dentistry patients and pre-cooperative children
i.e. 1 year old attending with a parent for preventive visit. A full assessment of risk factors
and appropriate prevention is still expected for these patients.

Onlay with cusp coverage - Band 3. This is to be used for reporting lab fabricated
restorations i.e. indirect restoration on teeth that require one or more cusp coverages and
teeth that cannot be satisfactorily restored using direct restoration techniques and
materials.

Advanced Periodontitis and Root Surface Debridement which is also known as
comprehensive sub-gingival debridement. It is usually required to stabilise active
periodontitis (categorised as Red on ACORN) once patients risks factors have been
controlled including patients maintaining good plaque control (please refer to All Wales
GDS Periodontal Care Pathway for details/guidance).

This will involve an ACORN and a first course of treatment will include a number of visits,
an offer of an advice plan and a review of changes in plaque scores. The FP17W should
be submitted and a 3 month review course of treatment undertaken before treatment starts
including a full radiographic assessment and root surface debridement. This would be a
Band 2 for engaging patients. Non-engaging patients may have a further course of
treatment, advice and review in any given year.

8. Other (New)

Only change is the revised Wording for Recall Interval (claim creation and amendment)

9. Ethnic Origin

This part of claim remains as optional – “What is your ethnic group?” remains as part of
the form and continues to be included on the revised “Practice Record Form – Patient
Declaration” that should be retained by a practice transmitting or by completing the
Compass on-line form.

10. Dentist Declaration (New)

Your attention drawn to the slightly amended wording of the first two declarations.