Where the contractor provides a complex care pathway in accordance with regulation 13B, the dental services that must be provided under each complex care pathway, and the duration of each complex care pathway, is specified in the appropriate row of Table C.
Table C
Care to be provided under each complex care pathway
| Type of complex care pathway | Duration of complex care pathway | Dental services that must be provided under complex care pathway |
|---|
| Complex care pathway 1 | 6 months from date of initial examination and assessment | - (i)
Oral health assessment including clinically appropriate radiographs - (ii)
Recording of diagnosis and depth of active carious lesions - (iii)
Identification and recording of modifiable risk factors - (iv)
Development of a treatment plan in line with findings from the oral health assessment, which must be shared with the patient - (v)
Provision of clinically evidenced preventative advice and support for the duration of the complex care pathway - (vi)
Provision of clinically appropriate restorations of all relevant and a minimum of 5 teeth and, if required, endodontic therapy - (vii)
Re-evaluation of the patient prior to completion of the complex care pathway, to include recording how the modifiable risk factors identified have been addressed - (viii)
Assessment to determine the clinically appropriate interval for a risk-based recall after the dental services in (i) to (vii) are complete
|
| Complex care pathway 2 | 12 months from date of initial examination and assessment | - (i)
Oral health assessment including clinically appropriate radiographs - (ii)
Recording of diagnosis and depth of active carious lesions - (iii)
Recording of the diagnosis statement for periodontitis - (iv)
Identification and recording of modifiable risk factors - (v)
Development of a treatment plan in line with findings from the oral health assessment, which must be shared with the patient - (vi)
Provision of clinically evidenced preventative advice and support for the duration of the complex care pathway, to include recording how the modifiable risk factors identified have been addressed - (vii)
Provision of a minimum of 3 cycles of periodontal treatment to address periodontitis, in line with the patient’s treatment plan and clinically evidenced care - (viii)
Provision of clinically appropriate restorations of all relevant and a minimum of 5 teeth and, if required, endodontic therapy - (ix)
Assessment to determine the clinically appropriate interval for a risk-based recall after the dental services in (i) to (viii) are complete
|
| Complex care pathway 3 | 6 months from date of initial examination and assessment | - (i)
Oral health assessment including clinically appropriate radiographs - (ii)
Recording of the diagnosis statement for periodontitis - (iii)
Identification and recording of modifiable risk factors - (iv)
Development of a treatment plan in line with findings from the oral health assessment, which must be shared with the patient - (v)
Provision of clinically evidenced preventative advice and support for the duration of the complex care pathway, to include recording how the modifiable risk factors identified have been addressed - (vi)
Provision of minimum of 2 cycles of periodontal treatment to address periodontitis, in line with the patient’s treatment plan and clinically evidenced care - (vii)
Assessment to determine the clinically appropriate interval for a risk-based recall after the dental services in (i) to (vi) are complete
|
Table D
Units of dental activity provided under the contract in respect of completed complex care pathways
| Type of complex care pathway | Units of dental activity provided |
|---|
| Complex care pathway 1 | the sum specified for payment for complex care pathway 1 divided by the monetary value of a unit of dental activity, rounded up to two decimal places |
| Complex care pathway 2 | the sum specified for payment for complex care pathway 2 divided by the monetary value of a unit of dental activity, rounded up to two decimal places |
| Complex care pathway 3 | the sum specified for payment for complex care pathway 3 divided by the monetary value of a unit of dental activity, rounded up to two decimal places |