2004 - 2005
the Dental Practice Board for England and Wales
This is the DPB
1946 Created as the Dental Estimates Board by the
NHS Act. Came into existence along with the
NHS in 1948. First NHS arm’s length body.
1952 First NHS joint Consultative Staffs Committee
formed within Whitley Council framework.
1956 MacNair Report states: “the efficiency of the
Board is outstanding”.
1959 Special investigation section established.
1970 Mainframe computing.
1989 Name changed and new powers granted
under the Health and Medicine Act 1988.
1989 Department of Employment Fit for Work
award (for second time).
1990 Management of the Dental Reference
Service transferred to DPB.
1990 Patient registration payments introduced
doubling the number of payment transactions.
1991 Payment of dentists taken over from health
1991 First NHS organisation to make electronic
communications available to professional
1996 Electronic Commerce Association award for
1999 Investors in People award.
2000 First NHS organisation to be recognised by BSI
as having an integrated management system.
2002 First NHS organisation to achieve the
information security standard BS 7799.
2002 Unisys Management Today Service
2003 Registration confirmed to new quality standard
ISO 9001: 2000.
2003 Health and Social Care Act provides for abolition
of the DPB.
2004 Announcement of intention to merge DPB into
the NHS Business Services Authority.
Who we are
• The Dental Practice Board is a statutory body set up
originally under the National Health Service Act 1946 and
now under the National Health Service Act 1977 as
amended by the Health and Medicines Act 1988. Our
procedure is governed by the Dental Practice Board
• We are accountable to the Secretary of State for Health
and to the Welsh Assembly Government for carrying out
such duties as may be prescribed with respect to the
approval of estimates of dental treatment and appliances,
and to the remuneration of dental practitioners providing
general dental services.
• We are a centrally financed service covering England and
Wales. Our accounting officer and budget holder are
officials of the Department of Health.
What we do
• We approve payment applications, calculate and transfer
payments. We pay dentists promptly and accurately.
• In conjunction with the NHS Counter Fraud and Security
Management Service we prevent and detect fraud and
abuse by painstaking financial and quality audit which
protects the interests of patients, dentists and taxpayers.
• We provide dental health information to help create a
greater understanding of primary dental care.
• We use our vast experience to reduce cost and improve
the service we provide. We aim to be the pacesetter in
managed services and the byword for health management
• In relentless pursuit of improvement, we combine public
service ethos with commercial sector efficiency and
traditional values with modern practice. We aim to be the
benchmark for public management.
Key performance indicators
Almost twenty years ago we adopted the world class
market sector as our performance benchmark. For
economy we use that sector’s long run achievement of
2 per cent a year unit cost reduction. For staff efficiency
we use 5 per cent a year productivity improvement
compared with the sector’s 4 per cent. We preferred the
higher figure because we started from a low point and
because it was necessary to achieve our cost reduction
rate while making room for investment in longer-term
We refer to our benchmarks as being applicable over
successive medium terms. For reporting purposes we
define a medium term as each three successive
accounting years. On our definition, as the table below
shows, over the latest decade we continued to outperform
our benchmarks. Unit costs fell at an average rate of 4
per cent a year. Staff productivity increased at an average
rate of 13 per cent a year. All our preparations for the
future include a commitment to match or better our
average total expenditure
over the three accounting
ten year average
years to March
yearly rate of change
2005 1995 DPB benchmark
for each payment claim document cleared* 56p 86p down 4 pc down 2 pc
* after adjusting for inflation using GDP deflator
average number of payment claim documents
cleared by each whole time equivalent employed* 142,503 41,909 up 13 pc up 5 pc
* includes overtime and temporary staff
Inside Front This is the DPB
1 Key performance indicators
2 The accounting year to March
3 Board members
4 Operating environment
6 Activity and output
10 Controls assurance
16 Economy and efficiency
19 Modernising dentistry
21 Strategic management
27 Management team
28 Financial statement
Annual accounts 2004-05 and
supplementary statement by the
Comptroller and Auditor General
Service level agreement
Further information &
The accounting year to March 2005
previous year. Higher employer’s contributions to the
NHS pension scheme and payments following last
year’s two year redundancy programme were the
main factors in the increase. In the accounting year
to March 2006 cash utilisation will be £24.1 million.
We are able to report on yet another successful
year. In an atmosphere of considerable uncertainty
about their future, staff at the Dental Practice Board
met all headline service levels, increased their
productivity and dealt with consequences of
changed timing for introduction of the new payment
scheme for dentists and with the formation of the
proposed NHS Business Services Authority.
Merging the role and functions of the DPB with other
organisations into the BSA adds a new dimension to
uncertainty about jobs and location. The uncertainty
is just as true for dental reference officers even
though presently they work from home. Preparing for
the merger requires time and effort diverted from
other subjects. One consequence of a later start
date for the new payment scheme for dentists has
been an increase in the number of PDS
arrangements to administer alongside the reducing
but still greater number of GDS arrangements. This
makes preparing for the new scheme more difficult.
During the year forty nine staff left and one joined.
Year end headcount at 290 was therefore 48 lower.
On average over the year we employed the full time
equivalent of 307 permanent and temporary staff
down from 338. Unexpected additional work for PDS
schemes and BSA formation was absorbed. Once
again more work of a higher standard was provided
by fewer staff. Their productivity rose by 10 per cent
year on year. Our commitment to the BSA is to
reduce the staff headcount to at the most 230 by
March 2007. This commitment is within the scope of
our medium term benchmark of 5 per cent a year
productivity increase. We propose to continue with
our existing plans. To achieve this we expect, during
the current accounting year, to redeploy staff within
the NHS wherever possible and to call for volunteers
for voluntary severance or early retirement.
Cash utilisation during the year was within allocation
of £24.9 million but £1.2 million more than the
Once again the biggest risk of inappropriate
payments to dentists was associated with patient
charges. Based on 137 thousand checks completed
or in process on cases selected since July 2003 our
projection remains that between 82 and 91 per cent
of all checks started will be confirmed within 96
weeks as eligible for exemption from or remission of
patient charges and between 3 and 9 per cent will
be confirmed as not eligible.
There were no changes in board membership during
the year. We are grateful to our staff and to our
board members for continuing to deliver improved
results in unsettling circumstances. Throughout the
year on which we are reporting the implications of
and the effects of the new scheme for paying
dentists and formation of the NHS Business
Services Authority permeated all aspects of our
work. Uncertainty about timing of their
implementation has been especially difficult. Now
that we expect both dates to be April 2006 we will
make sure of an orderly transition of the new
payment scheme and the new authority.
Financial Statements (Annex One)
The financial statements on pages 10 to 32 of
Annex 1, together with the Foreword and other
statements on pages 1 to 7 of Annex 1, and the
Certificate and Report of the Comptroller and
Auditor General on pages 8 and 9 of Annex 1,
reproduce in full those included in the Accounts for
the Dental Practice Board for 2004-05 laid before
the Houses of Parliament on 19 July 2005 under
reference HC136. Pages 1 to 36 and Annex 2 of
this Annual Report provide additional information, for
which we are responsible, that is not included with
those accounts. The auditor is required by auditing
standards to read other information in documents
containing audited financial statements and to
consider the implications for his audit opinion. A
supplementary statement has accordingly been
provided by the Comptroller and Auditor General at
page 9 of Annex 1 in respect of his reading of the
John Taylor & Mary Wyllie, 27 June 2005
Pictured from the reader’s left: David Ferns, Carol Ferguson, Derek Spratt, Mary Wyllie, Sandeep Lakhanpaul and Ruby Austin
The Dental Practice Board is a statutory body.
It is governed by a board whose only executive
member is the chief executive. The chairman and
a majority of other members must be dentists.
Independent members in office during the year
were all appointed by the Secretary of State for
Health. Executive management is not involved in
the appointment of board members.
Lowestoft, practising almost entirely within the GDS since
graduation in 1982. He has recently trained as a clinical
audit facilitator. Born 1960.
Sandeep Lakhanpaul BDS was appointed a member of the
board in January 2002. Mr. Lakhanpaul is a general dental
practitioner within the GDS in Nottingham. He is also a
member of the Nottingham Emergency Dental Service
management board. Born 1967.
Ruby Austin MBE MGDS RCS (Eng) FFGDP (UK) was
appointed member of the board in April 1996. He is a general
dental practitioner practising almost entirely within the GDS.
He holds several training and advisory positions and is an
elected member of the GDPC. Mr. Austin was appointed vice
chairman of the board in April 2002. Born 1937.
Carol Ferguson MA CA* was appointed member of the
board in May 2000. Following a 25 year career in investment
management and finance, she is now a non-executive
director on a number of boards including Monks Investment
Trust, Gartmore Investment Trust, Merrill Lynch Greater
Europe Investment Trust, Vernalis plc and the Institute of
Chartered Accountants’ Compensation Scheme Ltd. Miss
Ferguson chairs the Audit and Risk Management committee.
David Ferns BDS* was appointed member of the board in
January 2002. Mr. Ferns is a general dental practitioner in
Derek Spratt BA* was appointed a member of the board in
May 2000. Mr. Spratt graduated in 1964 with an honours
degree in philosophy. After a spell at GEC
Telecommunications, he joined John Lewis where he worked
until his retirement in 1998, at which time he held the post of
Director of Computer Services. Born 1942.
John Taylor BA Hons MBA CMgr FCMI was appointed to
the board in April 1991. He has been chief executive since
April 1987. Born 1939.
Mary Wyllie BDS DDPH RCS (Eng)* was appointed
member of the board in July 1999 and chairman from July
2001. After qualifying from Liverpool in 1963, Mrs. Wyllie
spent 10 years in the GDS and 10 years in the CDS. She
became an NHS general manager in 1976, later becoming
Chief Executive of West Essex Health Authority. Mrs. Wyllie
chairs the Remuneration Committee. Born 1939.
* members of the audit and risk management and remuneration committees
At the end of March 2005 there were 21,038
dentists providing NHS primary care in England
GDS principals and PDS
dentists excluding VDPs
GDS and PDS VDPs
This year two developments overshadowed all aspects of our
work: one was the rapid increase in personal dental services,
the other the impending formation of the NHS Business
In England and Wales the number of dentists providing
primary care increased over the year by 724 to 21,038 (see
graph). Including the Isle of Man and non dentists we held at
the year end 21,465 personal numbers for payment purposes
an increase of 806 (see table). There was a sharp reduction
in the number of dentists providing general dental services
and a sharp increase in those providing personal dental
At 31 March 2005 there were in existence 21,465
(up 3.9 per cent) personal numbers eligible for
Year to March
non dentists 330 311
GDS only 16,405 18,808
PDS only 3,395 901
salaried only 44 56
GDS and PDS 1,183 485
GDS and salaried 30 37
PDS and salaried 26 18
GDS and PDS and salaried 15 9
Isle of Man 37 34
total 21,465 20,659
Over the year the number of surgery addresses from which
dentists offered NHS primary care rose by 36 to 9,786. The
average number of dentists operating at each address was
Compared with the previous year the number of patients
registered with a dentist fell by 1 per cent to 25.3 million
At the end of March 2005 there were 0.2 million
fewer patient registrations than a year earlier and
there had been a big switch from GDS to PDS.
GDS PDS combined
million million million
adults 14.1 4.0 18.1 down 0.1
children 5.8 1.4 7.2 down 0.1
19.9 5.4 25.3
down 5.0 up 4.8
Excluding the Isle of Man we received 45.5 million
documents containing applications for payment, item of
service and registration under GDS and activity records
under PDS. This was 1.2 million lower than the previous
year and the second successive yearly decrease.
We approved for payment to dentists £1,815 million. This was
£71 million or 4.1 per cent more than the previous year (see
table). In the same period we paid to dentists net of
calculated patient charges and other adjustments £1,423
‘I would like you and your colleagues to know how much I have appreciated the support and help
received from DPB over the years. In fact, I cannot recall a single occasion when a problem or query
has not been dealt with in a professional and friendly manner. I have genuinely felt supported and I
wish the highest standards set by the DPB were followed by many other organisations’
extract from an unsolicited letter received from a dentist on his retirement
million which was £130 million or 10.1 per cent more than the
previous year. One of possibly many factors explaining the
greater proportion increase in payments made compared
with fees authorised is the increase in GDS payment
applications for which the patient was declared to be exempt
from charges or eligible for their full or part remission (see
We are contributing to the modernisation initiatives aimed at
shifting the balance of power to primary care trusts (PCTs) in
England and the local health boards (LHBs) in Wales. A
revised payment system for dentists is being prepared for
implementation by April 2006.
The density of take
up of PDS in PCTs is
greater in the North
and West than in the
South and East.
over 25% and
up to 25%
no PDS activity
surgeries with PDS activity at 31 March 2005
Personal Dental services
The expansion of PDS contracts to 4,500 dentists in more
than 2,000 practices during the past year has maintained the
high level of interest in this area of dentistry, with schemes
now operating in most PCTs across England. A majority of
new practices joining PDS use familiar rather than new
methods of working and of paying for dental services. The
gradual conversion of Community Dental and Emergency
Dental Services into PDS also continues. Much work has
been carried out on DPB systems to allow for a continuation
in the growth of practices entering PDS contracts.
NHS Business Services Authority
The Health and Social Care (Community Health and
Standards) Act 2003 provides for the DPB to be abolished. It
is expected that a new NHS Business Services Authority
(NHS BSA) will carry out our existing functions. In July 2004
the Department of Health announced its intention to reduce
its number of arm’s length bodies. As a result the Dental
Practice Board, the NHS Pensions Agency and the
Prescription Pricing Authority and possibly another body will
merge to form the NHS BSA. It is assumed the NHS BSA will
take on the issue of relocation of the DPB raised originally in
the review by Sir Michael Lyons.
Gross fees authorised for payment were £71
million up on the previous year. Net payments
transferred to dentists were up £130 million.
Year to March
fees authorised 1,815 1,747
change on previous year 71 78
fees paid 1,423 1,293
change on previous year 130 70
The proportion of GDS courses of treatment for
which the patient was declared to be exempt
from charges or to be eligible for full or partial
remission of charges continued the recent
fees authorised and payments made
Activity and output
Over the year we received 45.6 million payment
claim documents and processed to completion
During the year we authorised 73.1 million
separate GDS payments and completed in all 95.3
million payment transactions.
Year to March
item of service 31.4 34.4
new registrations 13.8 15.4
re-registrations 27.8 28.5
GDS authorisations 73.1 78.4
registrations deletions 18.6 16.1
GDS transactions 91.7 94.5
PDS activity records 3.3 0.8
Isle of Man, Salaried and Emergency 0.3 0.3
all transactions 95.3 95.6
Receipt of new prior approval applications fell
again, this year to 443 thousand.
documents dealt with
Over what is now almost six decades since the introduction
of NHS primary dental care there have been only three
pauses in the steady increase in activity. The first coincided
with the fee cut in 1950, the second with the new contract in
1990 and now with the new payment scheme to be
introduced by April 2006.
During the year we received 45.6 million payment application
documents. We processed to completion 46.1 million thereby
reducing work on hand.
In all we completed 95.3 million payment transactions down by
0.3 million on the previous year (see table). A sharp increase
in PDS activity almost offset the similar fall in GDS activity.
We received 443 thousand new applications for our prior
approval of proposed treatment plans and 172 thousand
resubmissions. We returned to dentists 576 thousand
Dental Reference Service
We received 37,992 reports of patient examinations from our
dental reference officers. Of these 22,303 related to the
standard of proposed treatment plans and 15,689 to the
standard of completed treatment. During the year dental
reference officers began the switch in emphasis of their activity
from inspection to clinical governance in expectation that the
new payment scheme would begin in April 2005.
Patient charge refunds
During the year we checked 32,848 refund claims. The total
value of refunds paid was £1,489,354.36. Of these we
refunded 22,098 applications in full, 6,765 in part and
refused 3,840 in full. The value of the claims rejected was
£680,397.13 or about a third of the total amount claimed.
The most frequent reason for rejecting claims was that the
dentist informed us that the treatment was provided privately.
‘Overall, based on the processes current as of today and on the samples taken, the
Complaints Management System is working effectively.’
BSI Assessment Report: CMSAS 86: 2000 – Complaints Management Standard April 2005
Benefit eligibility checks
Based on 137 thousand checks completed or in process on
cases selected since July 2003 (see chart) our projection
remains that between 82 and 91 per cent of all checks
started will be confirmed within 96 weeks as eligible for
exemption from or remission of patient charges and between
3 and 9 per cent will be confirmed as not eligible. Any
remainder will not be determined within that time. When
considering these projections bear in mind that confirmations
of eligibility are reached sooner than those of ineligibility (see
graph below right). At the accounting year end we had issued
3,171 penalty notices. In total we received £194 thousand
following decisions to recover money where checks
confirmed the claimant to be ineligible for exemption from or
remission of charges.
In the year to March 2005 the number of cases referred by
us to health bodies for consideration of disciplinary
proceedings was 23. This is a sharp reduction from the
previous year’s figure of 130 and continues the trend for
fewer disciplinary referrals that has been seen since the year
to March 2002. These year on year reductions in the number
of referrals have come about for a number of reasons that
relate to: our efforts to provide services that are valued by
our customers, the introduction of the Counter Fraud
Services, changes to the Dental Reference Service (DRS)
and our need to classify and tackle risks to funds more
efficiently because of the reduction in our human resources.
During the year we completed 32 thousand
applications for refund of patient charges. We
made 26 thousand refunds and refused 3
Year to March
opening on hand 4,856 3,298
received 30,131 36,911
completed 32,848 35,306
closing on hand 2,139 4,856
mean period to completion 21 days 38 days
patient charge refunds
During the year we completed 75 thousand
benefit eligibility checks in an average of 55
benefit eligibility checks
refunds made 1,489 1,702
refunds refused 680 566
Year to March
opening on hand 15,135 5,438
started 78,677 82,248
completed 75,645 75,551
closing on hand 18,167 15,135
mean period to completion 55 days 30 days
money received 194 65
From July 2003 to March 2005 we completed 137
thousand benefit eligibility checks.
In response to feedback from health bodies where concerns
are solely clinical we deal with them mostly as clinical
governance matters. PCTs have responded well to this
approach and we have had significant positive feedback
since we introduced the change in October 2001.
after N weeks proportion
• confirmed eligible
• confirmed not eligible
• eligibility unknown
weeks elapsed since selection 94
benefit eligibility checks
During the year we transferred payments to
dentists on average 27.9 days after receiving the
service level agreement
12 month centred moving average
1996 months 2006
During the year we received 45.6 million payment
claim documents and processed them so that
99.3 per cent of those paid were on the next
monthly payment for the claiming dentist.
service level agreement
12 month centred moving average
Over the year the error rate in item of service
payments was 0.02 per cent or about 200 in every
service level agreement
12 month centred moving average
payment conformity to SDR
In conditions of unusually high uncertainty, with many leaving
and many switched to new work associated with Personal
Dental Services and formation of the NHS Business
Services Authority, our staff met and surpassed committed
The number of prior approval applications received during
the year ending March 2005 was 443 thousand. This was
29 thousand fewer than in the previous year however the
number of resubmissions grew from 160 thousand in the
year ending March 2004 to 172 thousand. Applications not
referred for a dental reference officer examination of the
patient were returned to the dentist with a decision in an
average of 4.9 days.
During the year 73 million item of service and registration
claims were approved for payment. Associated payments
were made on average 27.9 days after receipt of the claim.
Our main measure of turnaround time, the twelve month
running average, had been stable at or just below the thirtyday
target for over three years. The reduction in turnround
time was in response to a new service target set by our
sponsors. All payment transfers to dentists were on the dates
prescribed. The proportion of claims approved during the
year in time for authorisation on the first available schedule
was above 99 per cent.
The call profile on the main helpdesk has changed over the
past year reflecting new work for benefit eligibility checks and
patient charge refunds and for rapidly increasing personal
dental services. Main helpdesks are now merged. Additional
work accounts for the increase in call traffic on this desk,
from 192 thousand calls in year ending March 2004, to 205
thousand calls in year ending March 2005. For the fourth
consecutive year, the main helpdesk has met its service level
agreement. This year 93 per cent of calls were answered
within 15 seconds.
‘Seven out of ten respondents say their contact with the DPB has been either excellent
Patient survey, RBA Research Ltd. May to June 2004
We continue to be registered by the British Standards
Institute for CMSAS 86: 2000 Complaints Management. We
received 174 complaints during the year. The most frequent
complaint involved the nonpayment of claims. There were a
variety of reasons why claims were not paid on the same
month’s schedule. Although some were due to processing
delays at the DPB, some cases contained inappropriate
claims for treatment which required written clarification from
the dental practices. Other cases were submitted too late
after completion of treatment and were therefore not in
accordance with the regulations. All complainants are
surveyed after clearance. Of the 75 who responded to our
survey 28 viewed our response as not complete. We use
such feedback in our assessment of current practices and
look for ways of improving them.
With reduced numbers of patient examinations there were
fewer complaints about the Dental Reference Service but as
benefit eligibility checking increased this activity attracted
The British Standards Institute in their Continuing
Assessment Visit Report confirmed continuing certification
for OHSAS 18001, ISO 14001 and ISO 9001: 2000 as part of
an Integrated Management System. In addition we were
recertificated to the complaints management standard and
confirmed continuing certification to the Information Security
Management standard BS7799.
The main survey of patients was completed at the end of
June 2004 and a full report received at the end of July. The
survey found that the DPB is carrying out its duties
professionally and politely. The full summary is available on
our website at www.dpb.nhs.uk.
During the year we received 25 thousand payment
queries involving 79 thousand patients. On
average these were returned in 1.5 days.
work in progress
There were fewer complaints about the DRS and
more about eligibility checks.
2005 2004 2003
complaints received 174 187 219
complaints cleared 171 183 211
responded in more
than 14 days 11 15 21
mean time to clear days 7 7 8
with response 28 19 33
Customer surveys show consistently the
importance attached to our help desks and the
high regard in which their service is held.
Response times are above industry standards
and mystery shopping shows continuing service
incoming calls 204,790 66,720
abandoned 0.4 pc 23.4 pc
average wait 9.5 seconds 24 seconds
within 15 seconds 92.5 pc 79.5 pc
As its accounting officer the Dental Practice Board’s chief
executive is responsible for the propriety and regularity of
public funds and assets vested in the Dental Practice Board.
This responsibility requires maintenance of a sound system
of internal control. The overriding principle involved is that in
all material respects public funds are applied to the purposes
intended by Parliament and that financial transactions
conform to the authorities which govern them.
The Controls assurance management system (the Cams) is
now established as the method by which the DPB identifies
and manages risk. Internal audit have built reviews of the
risks identified within the Cams as part of the audit process.
Responsibility for the oversight of the adequacy of the Cams
falls to the Audit and risk management committee, a sub
committee of our board.
An important part of the Cams system is the service
incidents system. This early detection system is available to
all staff and enables anyone to raise a service incident when
encountering something of concern in their day-to-day
activities. Each service incident is referred to a manager who
is responsible for investigating the cause and reporting on
the action taken to prevent it occurring again. The pattern of
service incidents is used to evidence the likelihood and
impact of an identified risk. These are of particular
importance when monitoring the performance of our two
main suppliers, IBM and Astron. (Astron has since been
bought by RR Donnelley.) The recording process involved is
important as it builds an accurate record of what incidents
occurred and when, rather than relying on individuals’
memories of events.
Service incidents are reviewed through our Process Steering
Group and an assessment made as to whether a new risk
should be recorded or an existing one updated. The risk
registers themselves are reviewed at least once a year by
staff who have responsibility for each of the seven systems
which taken together cover the whole scope of our
responsibility: clinical governance; environmental
management; financial governance; health and safety;
information security; quality assurance; and probity.
The Cams has been designed to meet the requirements of
the NHS controls assurance framework as well as those
international quality standards to which we are registered.
These include Quality Management ISO 9001, Environmental
Management ISO 14001, Occupational Health and Safety
Management, OHSAS 18001, and Information Security
Management BS 7799. BSI Assessors for these standards
are now increasingly using the Cams system to base their
We examine but do not treat patients. Our main areas of
clinical risk are cross infection control and the disposal of low
grade clinical waste. Almost all DRS examinations are held in
comparison of critical and service incidents
‘The internal audits sampled reflect a high level of control and monitoring of the process
BSI Assessment Report: BS EN ISO 9001: 2002 – Quality Management System April 2005
the practitioner’s surgery. Internal procedures are in place to
protect against the risk of cross infection between patients
and dental reference officers. These procedures are regularly
monitored to check compliance. We use disposable sterile
instruments which removes the requirement to sterilise
Our disposal of the low grade clinical waste produced through
DRS activity and current developments in cross infection
control are all monitored and discussed at regular intervals.
Our major impact on the environment lies in our use of
utilities and consumption of paper and general waste to
landfill. To manage these risks we have set organisational
objectives to reduce consumption and generated waste and
we recycle wherever possible. In addition we are putting in
place further controls to ensure that environmental
considerations are included in all procurement decisions so
as to only purchase from sustainable sources where
Our main environmental risks in terms of business continuity
are fire, power failure and unauthorised physical access.
These have a variety of controls in place such as back up
generators, fire detection systems, and access control and
To safeguard our public funds from risk of fraud and other
forms of inappropriate payment we have controls in place
which are approved and monitored at board level, through
our Standing Financial Instructions and Systems of
Financial Control. To ensure compliance our internal audit
department monitors their effectiveness throughout the year
and external auditors audit our systems each year. The
Statement on Internal Control in our Annual Accounts
publicly states our policy and approach. The external
auditors report if this does not meet the requirements
specified by Treasury. We returned a nil fraud return for
2004/05. Administration account losses and special reports
are reported to the board and for 2004/05 administration
losses totalled £20.
Statements on corporate governance have also been
produced and are now reflected in our annual report and
accounts. In accordance with the requirements of the NHS to
safeguard public funds we have appointed a local counter
fraud specialist who is responsible for the promotion of an
antifraud culture and investigating any potential fraud
according to NHS guidelines.
Health & Safety management
Our major health and safety risks are injury due to trips and
falls, driving related risks, workstation related risks and risks
associated with contractors working on site for example
window cleaners, catering staff and building contractors. To
manage risks in all these areas regular risk assessments are
carried out, with any identified potential or actual hazards
addressed where possible. In addition to the statutory
requirements, all contractors are required to comply with our
local health and safety policies and systems.
One of our key health and safety risks is the increasing level
of driving staff are required to undertake to carry out their
duties. To control the risks associated with this, all staff who
drive over a certain number of miles on our business have
undertaken a defensive driving course. The aim of this
course is to highlight any potentially dangerous driving habits
and advise the individual on how to drive more safely.
We continually update our information security procedures to
address increases in risk arising from changes in business
requirements and pervasive technology opportunities. The
increase in mobile working by staff and the increased
general availability of devices, such as memory sticks, PDAs
(Personal Digital Assistants) and wireless broadband, all
need appropriate control and countermeasures to ensure
Our registration to BS7799 has been successfully upgraded
to the latest version of the standard. We were the first NHS
organisation to achieve BS7799 registration, which requires a
continuous risk assessment and improvement cycle. Our
processes and computer systems are designed to satisfy
Controls assurance continued from page 11
NHS requirements for information confidentiality. UK
government eGIF standards are being specified for new
computer systems where there is a requirement to transfer
information to or from other organisations.
This year has seen a massive increase in the number of
attempted virus attacks on our computer systems, in
common with the rest of the world. However DPB systems
have remained secure from disruption by viruses due to
increased vigilance by staff and technical advances in antivirus
Our business continuity plans are regularly reviewed in line
with changing business requirements and are tested in
conjunction with our outsourcing partners. Increasing reliance
on electronic communication with stakeholders is bringing
extra requirements for resilience and availability of
communications links with our computer systems.
the Welsh Assembly Government specified in our service
level agreement (SLA). The specific areas of risk that
contribute to this broad risk category include the resourcing
of business processes in particular human resource and IT,
the accurate and timely delivery of those processes and the
ability to meet the changing needs of our stakeholders. A full
risk assessment has been carried out by the Modernising
Dentistry project team on the risks inherent in moving to a
new system of commissioning NHS dentistry in England and
Wales. Examples of controls in place to reduce these risks
are regular monitoring of our SLA, effective management of
our staff and IT systems and regular meetings with the
Department of Health and the Welsh Assembly Government.
We have adopted a process approach to the quality
management of our business. Top level processes have
been mapped to ensure quality improvements are made and
risks to those processes identified.
Our principal quality risk is not meeting our organisational
objectives as agreed with the Department of Health and
Our probity assurance management system is designed to
reduce the risk that public funds allocated to dental services
May-04 Jun-04 Jul-04 Aug-04 Sep-04 Oct-04 Nov-04 Dec-04 Jan-05 Feb-05 Mar-05 Apr-05
each colour represents a specific virus
E-mail virus detection
‘The risk management system CAMS has progressed dramatically.’
BSI Assessment Report: BS EN ISO 9001: 2002 – Quality Management System April 2005
are used other than as intended by Parliament. Our starting
point is to estimate the risk inherent in any circumstance that
can be identified as giving rise to a possibility for an
inappropriate use of public funds and to evaluate the change
in these risks brought about by any procedure.
Risk assessments cover issues arising from the necessity for
and quality of care and treatment provided by dentists, the
accuracy of information provided by patients and dentists
and the validity and reliability of our systems and procedures
for calculating and making payments. Controls on
inappropriate payments include procedures for checking and
validating information received as part of the claim for
payment, random and targeted monitoring of the standard of
care provided and investigation of abnormal or suspicious
Quantifications of all the separate risks identified at various
stages of processing are brought together in a risk-control
matrix. This matrix sets out the impact of each control on
each risk. This allows us to compare risks and arrange our
activities taking into account their rank order. Risk
assessments are carried out to estimate the parameters
included in the matrix.
Raw risk is the risk assumed in the claims made to us before
taking account of our controls. Residual risk is the risk that is
estimated to remain after all the control measures have had
their full effect.
Risk assessments are generally subject to wide margins of
uncertainty. For example, the latest estimate of the risk of
making inappropriate payments relating to exemption from or
remission of patient charges has an associated uncertainty
ranging from 3 per cent to 18 per cent of all payments of this
kind. This estimate overlaps the range estimated in 1997
which was from 6 per cent to 13 per cent.
Our assessment of patient charge risk is based on checks on
a sample of 137 thousand claims in which there was a
declaration of exemption or of entitlement to remission. A
risk assessment provides evidence rather than fact. As we
have no reason to suspect our checks are invalid or that
claims checked may not be a fair sample of all claims of this
kind we assume that the results would be similar if all claims
were to be checked. We hold to this assumption but the way
we hold to it is not dogmatic or inflexible. Risk assessment is
For the accounting year to March 2005 the top risk
categories with their approximate residual risk ranges are:
£11m to £67m*
radiographs £5m to £15m
fillings £4m to £10m
sealant restorations £2m to £8m
crowns, veneers, inlays £2m to £7m
dentures £1m to £7m
capitation £1m to £7m
orthodontic appliances £1m to £7m
continuing care payments £1m to £7m
non-surgical periodontal treatments £1m to £7m
extractions of special difficulty/
other oral surgery £1m to £7m
* refer to comment and graph on page 7
A previous risk assessment estimated that the raw risk of a
small radiograph being of clinically unacceptable quality
might be as high as one in four. A replication of the
assessment in 2005 has confirmed this finding, so it has now
been incorporated into the matrix as applying to all
In the accounting year to March 2006 we expect a great deal
to change in the way primary care dental services are
provided, in preparation for the new dentist payment
arrangements scheduled for implementation by April 2006.
There are likely to be major changes in the risks arising and
in the data that will be available to monitor those risks. Some
risks, such as those associated with patient refunds and
eligibility for free treatment may remain substantially
unchanged. As details of the new arrangements emerge we
are developing the changes necessary to the probity
assurance management system to ensure that we can
continue to provide relevant and cost effective probity
assurance activities based on patient surveys, record card
checks and agency checks, complementing the new
monitoring arrangements to be adopted by the DRS.
Voluntary early retirement and severance as a
result of redundancy continue to be the main
component in staff reduction.
at 31 March 2005 2004
permanent staff 290 338
full-time 233 274
part-time 57 64
on average during year to March 2005 2004
staff employed* 299 325
permanent 281 315
temporary and overtime 18 10
*full time equivalent
During the year 49 staff left and one joined. Most
leaving in recent years has been through
successive voluntary redundancy schemes.
Year to end
March leavers joiners total
50 25 0 0 25
other redundancy other dental
We continue to enjoy the benefits of a stable and
long serving staff membership.
Year to March
staff at year end 290 338
full time 233 274
female 162 193
average age yrs 49 48
average service yrs 19 17
sickness absence pc 2.2 2.7
level 4 and above pc 41 38
level 3 and above pc 81 75
10 year service index pc 80 81
10 year stability index pc 39 30
productivity index* 1,065 969
* 1965 = 108 1975 = 109 1985 = 142 1995 = 373
Our staff worked throughout the year in the context of
considerable uncertainty about their future jobs and location.
Their response was to complete more work than ever before,
at higher service standards and they increased their
productivity by 10 per cent.
Permanent staff numbers continue to decline principally as a
result of early retirement and severance schemes as an
alternative to redundancy. A total freeze on recruitment is
currently in place. Following the retiming of introduction of
the new dentist payment arrangements more temporary staff
were utilised during the period. This was to ensure essential
services and SLA targets are maintained while the
preparations continue for the introduction of the new scheme.
Our benchmark is to sustain staff productivity increases of
5 per cent a year taking one year with another. That figure
has been exceeded in almost every year since we set the
benchmark in 1987, sometimes by a considerable margin.
This year once again our staff achieved record productivity
levels. Their productivity rose by 10.1 per cent year-on-year
to another record high.
Taking into account all reasons for nonattendance including
holidays, staff availability at the main offices in Eastbourne
rose slightly from 80 to 81 per cent of all half day sessions.
The proportion of staff with one or more incidence of
unplanned absence was 62 per cent. Sickness absence was
down a little at 2.2 per cent. When comparing these figures
with other organisations it should be held in mind that we
have a very reliable recording procedure.
The 2004 employee survey was carried out in-house,
breaking with a tradition of using external consultants. This
year’s response rate was 79 per cent, well above the NHS
average of 60 per cent. The survey identified good results in
terms of employee satisfaction in comparison with NHS
‘The DPB has a rigorous training policy and training procedures.’
BSI Assessment Report: BS EN ISO 9001: 2002 – Quality Management System April 2005
averages with fewer staff considering leaving the
organisation and more employees receiving performance
We exceeded once again our benchmark
productivity increase of 5 per cent year-on-year.
Areas highlighted include:
Work Life Balance We were concerned that almost a
quarter of respondents felt that we are not committed to
helping staff balance their work and outside lives.
We are pursuing actively the Improving Working Lives
Standard and there is set up a joint working party with Staff
Side to ensure that we meet and surpass this standard. A
recent review of flexible working arrangements has increased
access to flexible working for those in management grades.
An action plan is in place to implement the Managers Code
Equal Opportunities Following up on issues in the
previous year’s survey, confidence in the DPB’s policies for
dealing with unfair treatment has improved.
Pay, grading and performance We are making good
progress in the implementation of Agenda for Change and
have conducted a full review of all job descriptions and
personnel specifications. Over a quarter of employees have
already been assimilated onto new pay scales as a result of
the ongoing pay modernisation work. We expect to assimilate
all staff by the deadline of September 2006.
Ratio of GDS dentists to staff
1955 1965 1975 1985 1995 2005
10.5 8.4 7.8 9.1 23.1 69.9
Four in five staff have at least one qualification at
or above level three.
national DPB DPB
target 2005 2004
level 4 and above 30pc 41pc 38pc
level 3 and above 60pc 81pc 75pc
Investors in People yes yes yes
new external qualifications achieved during the year
9 technical and professional
1 higher degree
Over the last 20 years our staff structure has
changed markedly. What was a clerical factory is
now a much smaller professional organisation.
We are committed to giving staff the chance to develop.
Following our reassessment to the Quality Management
Standard ISO9001:2000, British Standard Institute assessors
praised our work to implement the Knowledge and Skills
Framework, commenting that the organisation surpassed the
required standards for training and development to ensure
that all staff are competent.
grade 5 and above
1985 1995 2005
Economy and efficiency
Cash used during the accounting period was
within allocation and expenditure was within the
Cash is the money used to pay for employment and
purchase of goods, services and new assets, adjusted
for change in debtors and creditors and expressed net of
Expenditure is the cost of acquiring short or long lived
benefit by cash payment or by incurring a liability,
expressed net of income.
Expense is the net operating cost to the public of
acquiring our services or using up assets provided
Cash utilisation was below net operating cost.
Year to March 2005
cash expenditure expense
£m £m £m
pay 11.9 11.9 11.9
pensions 1.6 2.6 2.6
employment 13.5 14.5 14.5
goods and services 11.6 11.6 11.6
new assets 0.3 0.3
cost of capital (0.1)
income (0.6) (0.6) (0.6)
working capital 0.1
24.9 25.8 25.9
For nearly twenty years we have maintained downward
pressure on total and unit cost by a combination of market
testing, technology and staff productivity. Spectacular increases
in staff productivity have been taken largely as staff reduction
for which successive rounds of redundancy were necessary.
Our cash allocation for the year was £24.95 million of which
£24.60 million was intended for revenue payments and £0.35
million for the acquisition of capital assets. We utilised
£24.90 million cash.
Pension payments of £1.6 million in respect of retired staff
who left under voluntary early retirement schemes included
£0.3 million to buy out part of our commitment and reduce
costs in future years.
Compared with the accounting year to March 2004
expenditure on employment was higher by £2.5 million. There
were increases to pay rates from national awards and in
addition for dental staff from Agenda for Change but these
were more than offset by the employment of fewer staff
following another successful voluntary leaving scheme.
Three main factors more than account for the total increase.
One was the doubling of employer’s superannuation
contributions (increase of £0.6 million); another was the
increased use of agency staff in response to the retiming of
the new payment scheme for dentists (increase of £0.3
Cash used was below allocation due to timing of
capital expenditure projects.
Year to March
pay 11.9 11.1
pensions 1.6 1.0
employment 13.5 12.1
goods and services 11.6 11.9
new assets 0.3 0.3
income (0.6) (0.4)
working capital 0.1 (0.2)
allocation 24.9 23.9
million); the third was the provision for liabilities arising from
voluntary early retirements and severance on the grounds of
redundancy (increase of £1.7 million). Stripped of these
nonrecurring components employment costs remain on a
firm downward path.
Our benchmark for unit cost is 2 per cent a year reduction
after adjusting for inflation. In any period our performance
underlying cost can be distorted by the level of voluntary
early retirement and severance scheme costs. For the last
three years these costs were £3.7million, £0.9 million and
‘The Information Security System was observed to be well controlled and managed.’
BSI Assessment Report: BS7799: 2002 – Information Security April 2005
Looking ahead upward pressure on cost will come from
inflation. Aside from dental staff Agenda for Change should
apply some downward pressure on wages for at least a few
years. This effect will be in part offset by protection of some
salaries. There should also be some benefit from a fixed date
for introduction of the new dentist pay scheme. Formation of
the BSA may also help although for clarity our forecasts are
for a going concern. At the time of preparation of these
notes there are two items which may or may not appear in
our account for the year to March 2006. One results from the
decision to change the discount rate applied to liabilities from
3.5 per cent to 2.2 per cent. If this is to appear in our
expenditure account it will be as a new provision which we
estimate at £1.4 million. The other is the possibility that we
will raise a provision in respect of redundancy to take place
between April and September 2006. Our estimate is that the
provision will not exceed £1.0 million. This means there are
four possible expenditure accounts for next year (see table).
Net operating cost was £2.1 million higher due
mainly to the provision for redundancy costs.
Year to March 2005 2004
pay 11.9 11.1
pensions 2.6 0.9
employment 14.5 12.0
goods and services 11.6 11.9
capital charges 0.4 0.3
income (0.6) (0.4)
net operating cost 25.9 23.8
Expenditure for the year was £25.8 million.
four possible expenditure accounts for
the accounting year to March 2006
A B C D
£m £m £m £m
pay 11.6 11.6 11.6 11.6
unwind discount 0.4 0.4 0.4 0.4
restate discount 1.4 1.4
redundancy 1.0 1.0
employment 12.0 13.4 13.0 14.4
administration 11.1 11.1 11.1 11.1
Net operating cost for every £ authorised was 1.5p
including the DRS or 1.1p without the DRS.
new capital assets 0.3 0.3 0.3 0.3
less income (0.5) (0.5) (0.5) (0.5)
net expenditure 22.9 24.3 23.9 25.3
expense per £ including DRS
expense per £ excluding DRS
merged with DRS in 1990
unit operating cost
‘It is clear that the DPB is carrying out its duties professionally and politely’
Patient survey, RBA Research Ltd. May to June 2004
We are a component of the wider NHS system for providing primary dental care. One of our functions is to promote the interests of dentistry in
the NHS. We do this in many ways including making ourselves available to all NHS dentistry stakeholders. In the picture above Patricia
Burtenshaw (Customer Liaison Manager) is seen answering the queries of two visitors to our stand at a recent conference.
The DPB modernising dentistry project team was originally
set up in September 2003. This team adopted the principles
of the PRINCE project management methodology with an
experienced senior manager as its project leader. The
project team remain responsible for updating the project risk
register and for monitoring all activities arising from
modernisation that impact upon the DPB and its
stakeholders. Some of the major elements of the project are:
• creation of an appropriate payment system for England,
Wales and Isle of Man;
• production of indicative budgetary information for PCTs
and dentists before new contract implementation;
• production of information for PCTs and dentists after the
new contract implementation;
• implementation and monitoring of field sites in
conjunction with the Modernisation Agency;
• organisation of roadshows for the PCTs on behalf of the
• input to working groups including patient charges review,
clinical pathways, base contract negotiations with the
BDA, professional advisory group and workforce review.
Finance and Operations
In particular we concentrated, in close liaison with the DH,
on building a payment system that will be able to pay
dentists in line with the new arrangements required by the
base contract minimum dataset. This payment system is
based on the existing software systems with some
automation and improvement for dentists and PCTs to the
input of data at the front end and retrieval of information at
the back end of the process. This system will be ready to
make payments in the appropriate way at the time the new
arrangements for dentistry are introduced including those for
the revised patient charge arrangements at any time from
April 2006. It should be noted that the level of manual
processing needed will be greater until April 2006 if the start
date is earlier than April 2006.
The faster take up of PDS schemes before full
implementation of the new contract was dealt with
appropriately by the DPB. We adjusted our existing systems
to cope with a rapid increase in PDS activity instigated by
PCTs. As PCTs need help in understanding existing PDS
and all existing and proposed new aspects of the GDS a
DPB-PCT liaison team has been in place to ensure that
adequate resources are available to support PCTs as they
assume responsibility for commissioning of dentistry locally.
PDS support has been provided to LHBs in Wales in line
with WAG guidelines.
Dental Reference Service
During the year 2004/05 the DRS has continued to support
the aims of the DH framework proposals set out in 2003 and
continues to prepare for the new role envisaged in those
proposals, namely to be in a position to provide clinical
governance and clinical quality support for PCTs and practices
when the proposed new dental contract comes into operation.
The initial project to prepare the DRS for its new role has
been carried to completion and new systems of monitoring
by surgery visits have been devised and piloted. In addition
all DROs have successfully completed the appropriate
training course and have attained the Certificate in Practice
Appraisal awarded by the Faculty of Dental Surgery of the
Royal College of Surgeons. Whilst the exact role which the
DRS will have in clinical governance has yet to be fully
defined, these pilots, together with other training programs
are equipping the clinical staff with the skills and knowledge
to carry our a broad range of tasks to meet future needs.
The increase in PDS activity has provided the opportunity to
scale up the piloting and involve a larger number of practices
in surgery visits. This is providing useful feedback which is
being used to refine the new methods of working.
The DRS continues to support PCTs by making dental
reference officers available to assist them with clinical issues
when setting up new PDS schemes and has also provided
clinicians to assist the Department of Health with work in a
number of areas.
In addition to preparing for the future, normal monitoring
work in the GDS also continues, but it is inevitable that as an
increasing number of practitioners move into PDS and the
number of new style surgery visits increases, so the amount
of traditional GDS monitoring will decrease. The DRS will
however continue to maintain a position which will keep all
options open for the future.
Information and Probity
The Information and Probity Department has provided a
comprehensive service of information and advice in England
to the Department of Health, as policy maker, and to primary
care trusts and others responsible for the implementation of
the new arrangements. Similar support has been provided in
Wales to the Welsh Assembly Government and to local
health boards. This has included input through interorganisational
meetings and response to formal requests for
assistance in modelling the impact of changes to patient
charge regimes, to less formal activities such as the
development of a comprehensive enumeration of the
possible risks inherent in the proposed new arrangements.
information collected and stored in the DPB’s data
warehouse is close to completion. This facility will allow
authorised users to view, analyse and download any activity
data collected under their contracts as part of the new
An illustrative set of reports has been drawn up to reflect the
emphasis and content of the proposed base contract data
set and the likely new reporting style. These reports illustrate
particular choices of reporting level and statistical measures.
Activity summaries will provide a broad indication of activity
in terms of the number of providers, episodes and patients
within a health body and can also summarise salaries paid
and patient charges. It will be possible to demonstrate the
demographic and exemption and remission profile of
patients seen, together with episode length and their patient
charge status. In consultation with the Department of Health
and primary care trusts in England and the Welsh Assembly
Government and local health boards in Wales these reports
will be developed to provide a statistical tool for monitoring
contracts under the new arrangements.
The balance of potential risks to public funds under the new
arrangements are likely to be significantly different from
those under the current arrangements. With the reduction in
the range of information available from the Base Contract
Data Set, it will be more difficult to identify those risks. It is
probable, however, that problems arising from lack of
information about the availability and cost of treatment under
the NHS will feature more prominently when the new
payment arrangements are implemented and we are
planning to increase the number of patient audit
questionnaires and patient record checks in order to
continue to provide assurance to commissioners. The
checks on patient payment status will also be expanded. We
will provide any information gathered on risks to assist the
DRS to maximise the cost effectiveness of that service.
In future it may be possible uniquely to identify patients by
their NHS number or by the data set (surname, forename,
gender, date of birth) and patients seen in a period may be
counted profiled by age, gender, treatment received or
The project that will allow health bodies external access
under secure conditions via the internet to detailed
Although legislation exists which provides for abolition of the
Dental Practice Board and we expect merger into the NHS
Business Services Authority we remain a statutory body and
we continue to manage and to account for the Dental
Practice Board as a going concern.
The Strategic Review we carried out in 2001 highlighted the
recent and ongoing change stemming from the
implementation of the NHS Plan. We stated our aim to be
flexible, innovative and adaptive in our response to these
changes in order to deliver our primary strategic goal:
To contribute to the implementation of dental
and other health strategies of the NHS.
current GDS and PDS requirements. In parallel we are
developing new and amending current systems to deliver the
requirements for payment, quality assurance, probity
monitoring and information services needed for the new
approach to commissioning NHS dentistry within England.
For Wales we are working closely with the Welsh Assembly
Government (WAG) to determine their requirements over the
next few years to ensure we are able to meet them.
Goal 2 We will provide an agreed level of assurance
with respect to the probity of the payment
system in order to prevent and detect
inappropriate payment, unnecessary treatment
or any other abuse within the GDS.
During 2002 three documents were published which
specifically moved forward the Modernising NHS Dentistry
strategy: NHS Dentistry: Options for Change; An Information
Technology Strategy for NHS Dentistry in 21st Century; and
Routes to Reform: A Strategy for Primary Dental Care in
Wales. We are playing an active role in the implementation
of all of these strategies.
We revised our strategic goals in 2003 in the light of these
developments. Our strategic goals are currently as follows:
Goal 1 We will operate any managed services as required
by the Department of Health to world class levels
of efficiency, effectiveness and economy.
One major challenge specifically for the period leading up to
April 2006 and the immediate period following, is to deliver
our current managed services in the area of dentist
payments, patient registration, prior approval and patient
refunds to the levels of quality we know our customers
expect whilst changing our business processes to deliver the
new requirements of the Department of Health for
implementation by April 2006.
Central to our strategy is the need to protect the interests of
patients, whilst also providing impartial and objective
assurance to the taxpayer that funding for NHS dentistry is
not being paid inappropriately. Central to the delivery of this
strategy is our probity assurance operation, which is
underpinned by the activities of the Dental Reference Service.
We have a well-developed ability to manage change and
have been building close working relationships with the
Counter Fraud and Security Management Service (CFSMS)
to enhance probity assurance in dentistry. This work will
continue within the current structure of dentist remuneration
until its replacement by April 2006. Processes relating to the
probity of exemption checks for patient charges will need to
continue post April 2006 and consideration is being given to
what is needed in the future.
Goal 3 We will provide an agreed level of assurance
with respect to the clinical quality of NHS
dentistry contributing towards achieving,
improving and reducing variation in the quality
of NHS dental care.
We will continue to invest where necessary in our current
payment systems to ensure they are able to deliver
Strategic management continued from page 21
We took on the management of the Dental Reference
Service (DRS) in 1991. Over the past seven years, we have
pursued a strategy of expanding this service in order to
provide enhanced levels of assurance on the clinical quality
of the GDS.
Modernising Dentistry and Routes to Reform both proposed
a variety of ways to deliver NHS dentistry in the future,
within England and Wales. Monitoring of all the proposed
options has been highlighted as a key requirement and the
DRS as a nationally based service of independent and
experienced clinicians is ideally placed to play a central role
in monitoring any of the proposed methods of delivery.
In Modernising Dentistry, the encouragement of larger
practices with a mix of dentists and professions
complementary to dentistry (PCDs) opens up the
possibilities of new approaches to clinical governance
reviews. These could take place as part of a practice based
review giving a more detailed picture of the clinical
standards of an entire practice rather than seeing individual
patients throughout the year examining them only on specific
aspects of their treatment.
and the agreed clinical pathways will be required using data
from patients’ dental electronic records.
Goal 4 We will provide open access to high quality,
reliable and relevant information on NHS dentistry
to policy makers at local and national level, dental
practitioners and all other interested parties.
The strategy document ‘An Information Technology Strategy
for NHS Dentistry in 21st Century’ sets out a clear
programme for delivering the IT support vital to the
successful implementation of Modernising Dentistry. We
have over ten years experience in developing and
implementing IT specifications for data transmission in
standardised formats. This has involved the setting up of a
wide area network and enabled the receipt of data from
many different practice management systems. Building on
this experience and combining it with our partnership with
our IT Services provider, IBM, we anticipate playing a major
role in the implementation of this strategy. As part of this
approach we are part of the Department of Health project
team responsible for implementing the Dental IT Strategy
which is now part of Connecting for Health.
We are working closely with the Department of Health,
Welsh Assembly Government and other health bodies to
develop alternative methods of examining patients to provide
more effective clinical governance and improve the patient
experience. We are expanding our service to Personal
Dental Services, according to the requirements of the
Department of Health and the Welsh Assembly Government.
We will also continue to monitor the GDS according to the
requirements of the Department of Health and Welsh
The implementation of electronic data interchange (edi) in
the early 1990s, which enabled dental practices to send us
claim forms electronically, has resulted in the development of
a good working relationship with dental system suppliers. A
move to web enabled transmission of data is being planned
proactively with the suppliers. It is anticipated that these
system suppliers will play a key role over the next few years
in providing the necessary systems within the dental practice
to enable the implementation of the Dental IT strategy. This
will relate particularly to the provision of information for
clinical pathways and the dental electronic health record.
We will contribute to the setting up of clinical pathways and
play a role in the maintenance and control of the
implementation of clinical pathway standards through
practice based systems. To ensure compliance with the
pathways, a comparison between treatments actually given
We will continue to develop our data warehouse to establish
it as one of our core operating systems. This system
enables us to store and analyse data to meet all types of
information needs for both local planning purposes and
national trend analysis and reporting.
The plan to allow PCTs and LHBs direct access using web
technology to their data whenever they require it is near to
completion with the start of the roll out of the system due in
the first half of 2005/06. This will be done in accordance with
data protection legislation to fulfil our role as data custodian.
Goal 6 We will develop further our customer relations
and key partnerships with health organisations
to protect the interests of patients, health
professionals and taxpayers.
We will continue to develop our customer service
Any patient treatment data contained within the proposed
minimum data set will supplement the current patient
treatment data we have as a result of the GDS item of
service remuneration system and the PDS equivalent. The
processing of these data using the data warehouse will
enable us to provide clinical assurance on the new schemes
for the provision of NHS dentistry under Modernising
Dentistry/Routes to Reform. Analysis against the clinical
pathways once agreed and implemented will also be
possible to ensure their effective application.
Goal 5 We will meet our objectives within our agreed
level of funding which takes into account the
need to reduce, in the medium term, our unit
cost by 2 per cent per annum after adjusting for
We will continue to meet our financial objectives principally
through decreasing our permanent staffing levels by
redeployment of staff where possible and running voluntary
early retirement and severance schemes. We will continue
to improve our processes to ensure that our operational
effectiveness is not compromised by this strategy. Where
possible we will seek other more flexible ways of working to
meet the needs of our business. We will also seek other
opportunities to either increase income or decrease
operating costs working in particular with the other
organisations which are to form the NHS BSA.
performance to be the best in the public sector, seeking to
enhance further our customer interactions. We will work
closely with the Department of Health and the Welsh
Assembly Government to help develop and implement a
communications strategy for all stakeholders within dentistry
regarding the changes taking place in 2006.
We have started building effective relationships with PCTs in
England and Local Health Boards in Wales and other dental
related organisations within the NHS to support the effective
delivery of primary care dentistry. Alongside this activity, we
will foster effective and co-operative relationships with other
key stakeholders in dentistry seeking opportunities to work
collaboratively to support the delivery to the patient of
effective dentistry during a period where the delivery models
are changing. We will also seek opportunities to gain new
work in the medical sector, leveraging the scale economies
which our operation provides to the NHS.
Our effective outreach programme highlighted in the
business plan will continue to be developed, including new
ways of engaging with patients, dentists and other key
Goal 7 We will realise fully the potential of and value of
our staff to become a high performing learning
organisation achieving continuous improvement
of its own work.
The development of our IT systems offers the main potential
to reduce our ongoing operating costs. In line with any IT
strategy developed by the BSA we will propose a way
forward for us to migrate our existing and increasingly costly
legacy systems to more flexible and cost effective platforms.
We will meet the objectives in the NHS Plan and targets
contained within related documents including: NHS
Framework for Lifelong Learning ‘Working Together, Learning
Together’; Improving Working Lives (IWL) Standard;
Managing for Excellence in the NHS; Code of Conduct for
Strategic management continued from page 23
NHS Managers; Equalities and Diversity; the NHS
Leadership Quality Framework; and NHS Leaders Career
Development and Planning Scheme. We will implement
Agenda for Change the new NHS pay system on time as
required by the Department of Health. We will create an
organisation in which the leadership is driven by values and
managers develop skills in relation to the needs of their role,
based on feedback from their teams. Staff will be more
involved in management of the organisation and they will
have clear career development paths and pay structures.
To encourage their continuing development we will implement
an e-learning strategy for staff including our management/
leadership development programme, the achievement of
qualifications and implementation of competency frameworks
to support the development of skills and knowledge.
We will identify talent and provide opportunity for staff to
prepare themselves for future senior and specialist posts.
Our staff will learn continuously and develop new skills and
knowledge and they will expand their roles by taking on
In support of their new role in primary care dentistry all dental reference officers were successful in the training course for and were awarded
‘The Certificate in Practice Appraisal’ by the Faculty of General Dental Practice (UK). The photograph of the dental reference officers taken at
the award ceremony includes seated from the readers left: Patricia Langley (certificate programme leader); Clive Gibson (vice-dean of the
FGDPUK); Raman Bedi (chief dental officer for England); Mary Wyllie (chairman of the DPB); Rod Staines (chief dental adviser of the DPB);
Brian Mouatt (chairman of the FDI world dental development committee).
During the year we learned that introduction of the new
payment scheme for dentists and dissolution of the DPB
followed by its merger into the new NHS Business Services
Authority will both happen in the period October 2005 to
April 2006. Setting aside all other considerations we would
not have chosen this coincidence of timing. An interval of up
to a year between the previously expected date for the new
payment scheme and the revised one has provided an
opportunity for widespread introduction of personal dental
services arrangements between dentists and primary care
trusts. Left to our own decisions we would have tried to avoid
administering these arrangements while preparing for the
new scheme and reshaping the DPB for merger into the
BSA. Taken together the implications of these developments
permeate and overshadow all our work.
Personal Dental Services
In line with the Department of Health policy of moving a
significant number of dental practices into PDS by April
2005, during the year we expanded our capability to set up,
implement and run PDS administration, payment and
information systems. This expansion took place alongside
the continuing need to run existing GDS administration,
payment and information systems, whilst at the same time
developing a new payment system to deal with the
forthcoming NHS dentistry arrangements associated with
local commissioning that are currently planned to be
implemented by April 2006. The PDS systems being
expanded are those that were designed for use as part of
the original pilot schemes. They would ideally be subject to
further development to add flexibility to them in terms of a
user friendly front end local data entry facility, a more
sophisticated suite of payment programmes and a better
management information system however the development
skills and resources available to us are also required for the
new payment system. As this remains the priority for the
Department of Health by April 2006, work on improving PDS
systems has been limited. We will keep these conflicting
business issues under review in the coming year and decide,
with the Department of Health and the Welsh Assembly
Government, where to concentrate development activities.
NHS dentistry payments
In 2004 the Department of Health signed off the
specification for the new payment system and certain
assumptions are included in that with regard to, amongst
other issues, patient charges and patient lists. If these
assumptions prove to be incorrect or cannot be confirmed in
detail during the early part of 2005/06 then the risk of the
new system not being ready in full by April 2006 grows
exponentially with time. In support of policy we are keeping
all realistic options open. At the time of writing all main risks
to implementation are set at amber. Monthly meetings are
being held with the Department of Health and regular
meetings with the Welsh Assembly Government to ensure as
much information as possible on policy is available
immediately to us and to our suppliers who are providing the
new system. If the full system is not ready greater manual
processing and more staff will be required and this may
mean a reprioritisation of our work in conjunction with the
Department of Health and the Welsh Assembly Government.
Non confirmation of the final detail of the new NHS dentistry
specification early in 2005/06 will threaten the practice
management system software suppliers’ ability to produce
their systems for dentists in time for April 2006. This might
lead not just to issues for us regarding greater than
anticipated manual processing rather than electronic
processing of the new system payment forms when they are
introduced but also to issues for some dentists in managing
their practices and filling out forms manually for a period of
time whilst the new or updated software is awaited.
NHS Business Services Authority
When we reported on the accounting year to March 2004 we
expected that some time during the following year the DPB
would be abolished and its role and functions taken on by a
new special health authority. In July 2004 the Department of
Health published ‘Reconfiguring the Department of Health’s
Arm’s Length Bodies’. It announced the intended merger of
The NHS Pensions Agency, the Prescription Pricing Authority
and the Dental Practice Board into a new NHS Business
Services Authority. Some functions of the NHS Counter
Fraud and Security Management Services were to be
Developments continued from page 25
included. The driving principles of the merger are for the
new body to be more efficient, effective and economic.
In November 2004 the Department of Health published ‘An
Implementation Framework for Reconfiguring the DH Arm’s
Length Bodies’. Against a baseline of the accounting year to
March 2004 there is required to be across the whole ALB
sector by the accounting year to March 2008 a reduction of
one quarter in staff employed and cost reduction of £250
million. Since then we have produced for the Department of
Health a business and corporate plan that includes our
proposed contribution to that reduction which is by the
accounting year to March 2008 to reduce full time equivalent
employment from 311 to 215 and expenditure from £23.8
million to £22.0 million. We have committed also to meet the
reduced net operating cost target of £23.1 million set for us
by the Department of Health for the accounting year to
At March 2005 our permanent staff was the whole time
equivalent of 267 people. Taking into account those staff
leaving as a result of previous redundancy schemes we
expect to employ on 30 September 2005 the full time
equivalent of 233 staff. On the expectation that the new
payment scheme for dentists will be introduced by April 2006
we estimate that a redundancy scheme of around a dozen
full time equivalent staff, at an approximate cost yet to be
agreed with the Department of Health of up to £1 million,
will be necessary in the Autumn of 2005 to take effect in the
Spring and Summer of 2006 in order to meet our business
plan benchmarks of 2 per cent a year reduction on real unit
cost and 5 per cent a year improvement in staff productivity.
These figures are consistent with satisfying our commitment
to the NHS BSA.
We expect that the NHS BSA will be formed in Autumn 2005
and that the DPB will be dissolved and its role and functions
taken over by the NHS BSA on 1 April 2006. Our
commitment to the NHS BSA is for the accounting year to
March 2008 to employ, on average, no more than 216 whole
time equivalent staff and not to exceed £21.9 million
expenditure for the accounting years to March
2004 2005 2006 2007 2008
actual actual forecast forecast forecast
pay 11.1 11.9 11.6 11.1 11.0
pensions 0.9 2.6 2.8* 0.7 0.7
employment 12.0 14.5 14.4 11.8 11.7
goods and services 11.9 11.6 11.1 10.5 10.3
capital additions 0.3 0.3 0.3 0.3 0.3
before income 24.2 26.4 25.8 22.6 22.3
income 0.4 0.6 0.5 0.4 0.4
after income 23.8 25.8 25.3 22.2 21.9
wte staff at March 311 267 233 217 215
* includes new provisions of £1.0 million for redundancy and £1.4 million for change of discount rate, refer to pages 16 and 17.
Pictured from the reader’s left: Rod Staines, Derrick Stirling and Chris Edmonds
Chris Edmonds BA MBA
Head of Finance and Operations
During the year Chris was responsible for managing the processing of all transactions arising from general and personal dental
services schemes. He leads our modernising dentistry project and is responsible for the DPB Helpdesk, finance, staff
development, quality assurance, internal audit of DPB operations and the development and implementation of improved working
methods. Before joining us in September 1998 Chris managed the Scottish Power clinical waste subsidiary and was with
Southern Water during privatisation. Born 1956.
Rod Staines LDS
Chief Dental Adviser
Rod is responsible for the management of the Dental Reference Service. Before joining the DPB in 1991, he had 25 years’
experience as a general dental practitioner during which time he was an LDC secretary, BDA branch secretary and member of
the Representative Board. Rod was a dental reference officer and senior dental officer prior to his appointment in September
2000 as chief dental adviser. He was for 10 years the vice-chairman of a charitable trust involved in the setting up of a care
home for the elderly in Oxford. Born 1941.
Derrick Stirling JP BSc Hons MSc FSS
Head of Information and Probity
Derrick is responsible for organising the DPB’s probity activities, the dental contracts department and for dental health
information. He has been responsible for the development of the probity assurance management system. Derrick joined us in
1996 after a long successful career with the government statistical service. He is a chairman magistrate on Brighton and Hove
bench. Born 1942.
Before each accounting period we receive an indication from the
Department of Health, made without commitment, of the cash
allocated to us for the period. We must not exceed this amount.
for the year to March
2005 2004 2003
Net of expected receipts from recoverable value added
tax and other income our cash allocation was
£25.0m £23.9m £23.5m
After deducting recovered value added tax and other
income and allowing for movements in pension
provision, debtors, creditors and cash requirements for
agency payments cash used was
£24.9m £23.7m £23.5m
Accountability for public funds requires us to conduct our
operations economically. We must achieve in each accounting
period the lowest total cost consistent with the investment needed
by a going concern for continuous improvement in efficiency and
Cash payments and liabilities incurred for employment,
bought in goods and services and for asset purchase
resulted, after deducting income, in expenditure of
£25.8m £23.8m £26.8m
Deducting asset purchase from expenditure then adding
depreciation on assets, impairments and capital charges
gave a net operating cost of
£25.9m £23.8m £26.6m
Accountability for public funds requires us to conduct our
operations efficiently. We must make continuous reductions in
During the year the number of payment application
documents processed to completion resulted in
documents dealt with of
46.2m 46.9m 46.4m
Dividing net operating cost by the documents dealt with
gave an average unit cost of
56.0p 50.7p 57.2p
The above statement is derived from the statutory accounts of the Dental Practice Board for the year ended 31 March 2005
and from output figures. The statutory accounts can be found at annex 1.
The Dental Practice Board is a body corporate whose
statutory origin is Section 37 of the National Health Service
Act 1977. The current statutory basis for the constitution and
purposes of the DPB is the Dental Practice Board
The DPB has such rights and may do such acts only as are
authorised directly or indirectly by the statute creating it. These
include what is expressly stated in the statute or regulations
made under it and what is necessarily and properly required
for carrying into effect the purposes of its incorporation or
what may fairly be regarded as incidental to or consequential
on those things which are authorised by the legislation.
The process of accountability to Ministers through the
Department of Health and the Welsh Assembly Government
includes an Annual Accountability Review, an Annual Report
and quarterly finance reviews.
At the Annual Accountability Review on 28 July 2004, chaired
by the Senior Departmental Sponsor, we accounted fully for
our activities and financial performance in the year to March
2004. The annual report and accounts were produced for the
year to March 2004 in a timely fashion. The draft of these
documents was seen and approved by the sponsor branch.
In line with the guidance associated with the management of
arms length bodies we sent to our Senior Departmental
Sponsor in December 2004 a corporate plan for the years to
March 2006 to 2009. This document contained the required
financial information and objectives for the period. Included
was a draft service level agreement with the Department of
Health and Welsh Assembly Government for the year to
March 2006. We presented at formal meetings with
representatives of the Senior Departmental Sponsor our
performance against targets during the year.
The board and its committees
The board of the Dental Practice Board conducts its affairs in
accordance with the Guidance on Codes of Practice for
Board Members of Public Bodies published by the Cabinet
Office (OPS) in January 1997.
There are normally eight board members: a chairman who
must be a dentist, a vice chairman and three others who
must be dentists, two other members who must not be or
ever have been dentists and the chief executive for the time
being. During the accounting year to March 2004 one member
who is a dentist resigned and has not been replaced. The
roles of chairman and chief executive are separate. The
chief executive is the only board member who is an employee
of the DPB and is the only executive board member. All other
board members are independent of the organisation.
Members are appointed by the Secretary of State after open
competition. Independent members are appointed for three
years with the possibility of reappointment. The chief
executive’s contract provides for one year’s notice.
The Audit and risk management committee comprises four
independent board members. This year they were Carol
Ferguson, David Ferns, Derek Spratt and Mary Wyllie. The
committee was chaired by Miss Ferguson who reported to
board meetings. Full minutes of the committee meetings are
circulated to all board members. The chief executive and the
head of finance and operations attend meetings. The audit
manager and the controls assurance executive report in
person to the committee. The role, constitution and duties of
the committee are consistent with the Department of Health’s
Audit Committee Handbook April 2001.
Representatives of the Comptroller and Auditor General
(C&AG), as our external auditors, attended committee
meetings to present their audit approach and findings. The
C&AG gave an unqualified opinion on our administration
accounts for the year ended 31 March 2005. Over the year,
the committee received and considered 36 reports from
The Remuneration committee had the same membership as
the Audit and risk management committee. This committee
was chaired by Mrs. Wyllie who reported to board meetings.
Minutes were circulated to all board members. The chief
executive and the head of finance and operations attended all
meetings. The committee advises the board on the remuneration
of senior managers and policy on staff pay where there is
discretion. The committee also advises the board on senior
Governance continued from page 29
management appointments. In 2004/05 the committee
continued to take on the role given it in the senior management
pay (SMP) arrangements set out in the Health Service
Circular HSC 1998/017. During the year the committee
considered matters relating to the Whitley Council Pay awards,
local pay bargaining, senior managers’ contracts and pay and
board members’ remuneration. The committee was kept up
to date on progress to implement Agenda for Change which
supersedes Whitley arrangements with effect from October
2004 and must be implemented in full by September 2005.
The chairman of the board receives a salary in recognition of
2 days per week devoted to the Dental Practice Board. The
chief executive is a full time employee of the Dental Practice
Board. He has a contract providing for one year’s notice and
has agreed to a request to serve until at least 30 September
2005. Non-executive board members other than the chairman
receive daily sessional fees for the duties they perform.
Board members also receive reimbursement of travel and
subsistence expenses which are wholly and necessarily in
the performance of their duties. Where a board member
chooses to use their personal car a mileage allowance is
paid based on NHS national rates. For some categories of
vehicle this is in excess of the current Inland Revenue
mileage rate of 40p. The excess over 40p is treated as a
benefit in kind and taxed accordingly.
Remuneration Pension Benefit
Contribution in kind
£ £ £
Mary Wyllie 31,309 - 1,016
John Taylor 101,881 14,263 -
Ruby Austin 3,058 - 176
Carol Ferguson 1,000 - 75
David Ferns 2,905 - -
Sandeep Lakhanpaul 2,491 - 447
Derek Spratt 1,921 - 165
The chief executive was the highest paid employee.
The Joint consultative staff committee is chaired by the chief
executive. It met four times during the year. The committee is
made up of senior managers and staff representatives. It has
several subcommittees dealing with welfare, health and
safety and training amongst other subjects. Issues discussed
included relocation, creation of the NHS BSA, appointments,
promotion, subcommittee reports, policies and procedures
and strategy issues. In addition a staff suggestion scheme is
Audit manager’s report on corporate
In accordance with the reporting arrangements set out in the
NHS Internal Audit Manual, our internal auditors prepare
quarterly reports for the Audit and Risk Management
Committee in which their activities are summarised. These
reports describe the major audit issues and compare
activities against the audit plan agreed by the committee at
the beginning of the year.
In addition, the Audit and Risk Management Committee
receive an annual report on the audit manager’s findings on
internal control. This report contains a clear statement of
assurance by the audit manager regarding the adequacy and
effectiveness of the risk management, control and
governance processes at the DPB.
Chief executive’s responsibilities
The Secretary of State has directed that the chief executive
should be the accounting officer for the DPB. As such he has
the responsibility for the propriety and regularity of the public
finances and must prepare a set of annual statements to show
that he has properly discharged these duties and
Two statements by the accounting officer can be found in the
Annual accounts at pages 4 to 7 of annex 1 to this report.
• Statement of the board of the dental practice board and
chief executive’s responsibilities
• Statement on internal control 2004-2005.
We have adopted, as a model, the Code of Best Practice for
Board Members of Public Bodies. This Code stipulates that
public bodies and their boards must at all times:
• observe the highest standards of propriety involving
impartiality, integrity and objectivity in relation to the
stewardship of public funds;
• maximise value for money through ensuring that services
are delivered in the most efficient and economical way,
within available resources, and with independent validation
• be accountable to Parliament, users of services, individual
citizens and staff for the activities of the DPB, and the
extent to which key performance targets and objectives
have been met;
• in accordance with Government policy on openness,
comply with all reasonable requests for information from
Parliament, users of services and individual citizens.
External audit’s responsibilities
The Comptroller and Auditor General is our external auditor.
He has a statutory responsibility to express an independent
opinion, based on his audit work, on the DPB's financial
statements. He reports his opinion as to whether the
financial statements give a true and fair view and have been
prepared in accordance with relevant legislation, and whether
in all material respects the expenditure and income have
been applied to the purposes intended by Parliament. He
may also report to Parliament on the economy, efficiency and
effectiveness with which the DPB has used its resources.
Internal audit’s responsibilities
Internal audit have a responsibility to examine objectively,
evaluate and report on the adequacy of internal control as a
contribution to the proper, economic and effective use of
resources. Internal audit fulfil these responsibilities by
adherence to the mandatory NHS Internal Audit Standards.
Adherence to these standards assists the accounting officer
to ensure that internal control systems are being properly
Their work is undertaken in accordance with the reporting
arrangements set out in the NHS Internal Audit Standards.
Detailed plans are agreed annually with the Audit and risk
management committee and quarterly reports are prepared
in which their activities are summarised. These reports
describe the major audit issues and compare activities
against the audit plan agreed by the committee at the
beginning of the year. In addition, the Audit and Risk
Management Committee receive an annual report on the
audit manager’s findings on internal control. This report
contains a clear statement of assurance by our audit
manager regarding the adequacy and effectiveness of
internal financial controls at the DPB.
Fraud and corruption policy
We are committed absolutely to maintaining an honest, open
and well-intentioned atmosphere within the organisation; to
the elimination of fraud and any other form of wrongdoing
and to the rigorous investigation of any such cases. We have
a comprehensive Counter Fraud and Corruption Policy. In
addition we have in place procedures (in the form of
Standing Orders, Standing Financial Instructions and
procedure notes) designed to minimise the likelihood of the
DPB being a victim of fraud; a response plan to be followed
in the event of suspected fraud being reported; and guidance
notes issued by the Audit Commission have been given to all
staff. The audit manager is an Accredited Counter Fraud
Specialist. There were no instances of fraud or corruption
during the year.
In response to HSC 1999/123 - Governance in the new NHS,
we appointed a controls assurance executive from 1 July
1999. Controls assurance is not seen as a purely financeorientated
initiative but one which adds real value to the DPB
by the review of its control environment in an open and
honest manner. The initiative offers the opportunity to
empower staff to become involved in developing and
monitoring the control environment in an efficient and
effective way. The DPB is in its sixth year of self-assessment
against the controls assurance standards. Both the
governance and the risk management standard require the
Governance continued from page 31
organisation to assure itself of the adequacy of its risk
management system which the DPB has implemented
through the Controls Assurance Management System. A
report on the Cams is presented to the Audit and risk
management committee quarterly. The purpose of this report
is to assure the Board that risks have been identified and are
either adequately controlled or risk treatment plans are in
evidence to put in the necessary controls. From 2001/02
onwards all NHS bodies have been required to submit a
Statement on Internal Control as part of their annual financial
statement. This means that the Board of the DPB, as part of
its mandatory Governance responsibilities, needs to conduct
a review of the effectiveness of their systems of internal
control at least annually. Our statement on internal control
can be found on pages 5 to 7 of our annual accounts. The
statement has been recently approved by our board.
Each year the chief executive may ask our audit manager to
undertake a number of special investigations for and on
behalf of the board. These reviews vary enormously and may
include complaints from patients about the way in which
officers of the DPB have treated them; complaints from
dentists about decisions the DPB have made; through to
cases of suspected internal fraud or other wrongdoing.
These cases are particularly complex, difficult or sensitive. A
thorough and detailed analysis of all the relevant
circumstances is required. The purpose of these
investigations is to identify weaknesses in systems operated
by the DPB and to recommend action in order to improve the
efficiency and effectiveness of the service provided to the
Declaration of interest
In accordance with the Code of Best Practice for Board
Members of Public Bodies, the chairman and other board
members are required to declare any personal and other
interests which may conflict with their responsibilities as
board members. A register is maintained by the head of
finance and operations containing details of relationships
with organisations likely to be involved with the DPB or NHS.
This register can be inspected by contacting the Head of
Finance And Operations. Contact details can be found inside
the back cover of this report. We have adopted a policy
which stipulates that no employee will be permitted to
undertake business activities or other work where we
consider that this is incompatible with the public interests.
Key financial measures
All public servants are expected to observe the highest
standards of conduct and act with propriety, particularly in
the care and management of public funds.
Our key financial measures are of total and unit cost. They
are published at pages 16, 17 and 28 of this report.
Total cost is measured as (1) our cash allocation,
(2) cash utilised, (3) expenditure by cash payments and
liabilities incurred, (4) expense or operating cost,
(5) operating cost net of income generated.
Unit cost is measured as net operating cost divided by
counts of activity and output: dentists serviced, payments
made, documents processed, transactions processed and
£ fees authorised.
The Chief Executive is the accounting officer with overall
executive responsibility for systems and financial activities.
His responsibilities are shown on page 4 of the first annex to
this report in the “Statement of the board of the Dental
Practice Board and chief executive’s responsibilities”.
The financial procedures, processes and responsibilities are
set out in the Standing Financial Instructions and Systems of
Financial Control. These documents are reviewed annually.
The Head of Finance and Operations provides financial
information and advice for the Board.
The accounts or financial statements have been prepared in
accordance with the Resource Accounting Manual issued by
Treasury. An operating cost statement has been used which
shows the net cost of operations of the Dental Practice
Board on an accruals basis.
Provision continues to be made for the cost of staff leaving
under the voluntary severance and early retirement scheme
at the time the decision is made and becomes binding on the
board and the employee. This is in advance of the date the
Statement of principles
Statements of the principles on which policies guiding the life
of the DPB are based have been approved by the board and
agreed with staff side representatives. The statements are
published in the staff handbook available on our intranet.
We successfully delivered three roadshows on behalf of the
Department of Health, aimed at PCT staff who will have
responsibility for commissioning NHS dental services.
Roadshows took place in London in May 2004 and in
Manchester and Birmingham during June 2004. In addition
to keynote addresses by Professor Raman Bedi, David
Hewlett, Barry Cockcroft and Tony Jenner, there were four
workshops focussing on specific issues including access,
engaging with dentists, delivering the new contract and
learnings from the GMS contract. Attendance at each
roadshow was over-subscribed and the feedback received
This year we focussed on enhancing our presence at the
key dental exhibitions, and in particularly the British Dental
Association Annual Conference and Exhibition. Here we
worked with the Department of Health, the Modernisation
Agency and the National Primary and Care Trust
Development programme to join us on a combined stand
promoting the Modernising Dentistry Agenda. The stand
was visited by over 300 dentists to find out more about the
new arrangements for NHS dentistry. This was the highest
number of visitors ever to our stand at a BDA conference
exhibition. We also supported Department of Health
colleagues in putting on a presentation about the
‘Countdown to 2005’ as part of the BDA Conference fringe
As this arrangement proved to be so successful we will be
repeating it as this year’s BDA conference and exhibition
Development and implementation of new and improved
methods are overseen by three groups. A policy group of board
members and senior managers acts as a sounding board and
advisory group. A development group of senior and middle
managers identifies evaluates and develops new methods. A
change management board of senior managers controls
expenditure, sanctions implementation and monitors results.
All organisations who were registered to the international
quality management standard ISO9001 (1994) were required
to adapt to the revised standard ISO9001: 2000 by December
2003. We were confirmed for transition in April 2003. This
means that our management system is now process based.
We continue to be registered to ISO14001 (environmental
management), OHSAS 18001 (occupational health and
safety), CMSAS86:2000 (complaints) and BS7799
(information security). We are also considering registration to
BS 15000 (IT service management standard). This promotes
the adoption of an integrated process approach to effectively
delivering managed services to meet the business and
We have a policy of continuing staff development in the
support of lifelong learning. Staff are encouraged to
demonstrate that they are qualified to carry out their work
through independent verification.
In this year, seven staff achieved NVQs and five other
academic qualifications under the DPB training policy
including one PhD. In addition, two members of staff
achieved NVQ unit accreditation and five staff acquired
relevant technical certificates. We are an EDEXCEL/BTEC
and OCR/AAT approved learning centre and are formally
recognised as an Investor in People. An additional Internal
Verifier was qualified during the year. During the year we
introduced the Staff Development and Recognition
Programme, a bespoke Level 3 qualification for DPB staff
validated by the Open College Network.
Governance continued from page 33
In support of developing new systems of quality monitoring,
all 63 members of the Dental Reference Service achieved
the Faculty of General Dental Practice (UK) Certificate in
Appraisal of Dental Practices, with seven distinctions awarded.
Implementation of NHS Pay Modernisation through Agenda
for Change led to extensive development of job evaluators,
analysts and awareness programmes for all staff to help
support assimilation to the new pay system.
Feedback meetings are held for all staff on the outcome of
Accountability reviews and the chief executive meets all staff
in small groups to discuss whatever they wish. This is in
addition to monthly team briefings and written monthly
reports on DPB performance for all staff.
From the 2001 Census 96.6 per cent of Eastbourne travel to
work district residents are white which compares with 98.0
per cent of our staff. We are an equal opportunities employer.
Senior Management Pay
The pay envelope laid down for senior managers in 2004-
2005 was adhered to fully.
The Equal Opportunities policy in our employee handbook
makes clear our position on the employment and
advancement of disabled people clearly establishing the
principle of non-discrimination.
Since the introduction of the Disability Discrimination Act
1995 we have considered our position on the employment of
disabled people. We have made numerous alterations to the
premises to improve access and facilities for disabled people
providing for their full integration into our working
arrangements. We have made reasonable adjustments to our
disabled employees’ work where necessary, in line with the
employer’s duty under the Disability Discrimination Act.
The requirements of the Disability Discrimination Act are
included in the DPB’s staff policies.
The provision of a secure environment for staff, visitors,
information and equipment is considered an essential
requirement for the delivery of high quality services. We
maintain registration to BS7799-2:2002, the British Standard
for Information Security Management, which requires a
continuous cycle of security risk assessment, planning and
The standard is designed to ensure:
confidentiality - access to data is confined to those
with specific authority to access it;
integrity - all system assets are operating according to
specification, with no loss or corruption of data;
availability - information is delivered to the right person,
when it is needed.
Specific staff have responsibility for information security, data
protection, freedom of information and Caldicott
guardianship. As required we have nominated a board
member and member of staff to oversee our security
Better Payment Practice Code
We apply the code to all creditors with a target to pay within
30 days of receipt of goods or a valid invoice (whichever is
the later) unless other payment terms have been agreed with
the supplier. We report performance at note 2.4 on page 22
of our annual accounts.
Health, safety and welfare at work
We have implemented comprehensive policies to make
proper provision for the health, safety and welfare at work of
all our employees. These policies have been introduced in
accordance with the Health and Safety at Work Act 1974, the
Management Regulations 1999, the Disability Discrimination
Act 1995, the Display Screen Equipment Regulations 1992
and Improving Working Lives 2000. Promotion of these
policies is accepted as a corporate responsibility and we
employ specialists to advise and assist us. Our procedures
conform to the guidelines set out under OHSAS 18001.
They are covered by our accreditation and monitored by the
British Standards Institute.
We recognise the need to achieve sound environmental
performance. We have adopted and implemented
comprehensive environmental management systems which
conform to the International Standard for Environmental
Management Systems ISO 14001: 1996. They are covered
by our accreditation and monitored by the British Standards
European monetary union
In line with government requirements all new systems
development/enhancements consider the possibility of UK
entry into the single currency. It is now some years since an
initial assessment of the specific steps and timescales the
move to the Euro would involve was carried out.
Considerable IT changes and developments have taken
place in that time and the detail may have changed but the
underlying approach of a change over on a specific date
Freedom of Information Act 2000
The full powers of the Freedom of Information Act came into
effect from 1 January 2005. By the end of March 2005, we
received six requests for information about our processes
and working procedures; two requests were from journalists,
two from members of the public, one from a local primary
care trust and one from the Dental Practitioners’ Association.
The types of information requested included:
• annual amounts paid to dental practices
• the discretionary fees guide
• the number of NHS procedures carried out in Eastbourne
• probity operations information and our unit costs for
• our staff suggestion scheme, and
• our business plans and budgets
In all but one of the requests we were able to release the
information or direct the enquirer to where they could find the
We allow time for public service. Several members of staff sit
as magistrates and a Samaritan volunteer is allowed time
out. In addition there is a charitable give-as-you-earn scheme
and our Sports and Social Club organises charity fund raising
In the first full year of our Welsh Language Scheme we have
successfully continued to produce all correspondence with
Welsh patients bi-lingually.
In April 2005 we took on responsibility for benefit eligibility
checks in Wales, and are working towards ensuring that all
related written and verbal communication with Welsh patients
can be carried out in Welsh as well as English The DPB’s
Welsh language scheme is being amended to reflect this
Agenda for Change
A new pay system for all NHS staff will ensure fair pay and a
clearer system for career progression. Staff will be paid on
the basis of the jobs they are doing and the skills and
knowledge they apply to these jobs. This reform is
underpinned by a job evaluation scheme specifically
designed for the NHS.
Arm’s length bodies (ALBs)
ALBs are stand-alone national organisations sponsored by
the Department of Health. The work they undertake ranges
from back office administrative functions to complex ethical or
clinical-related work. The first ALB to be established formally
was the DPB in 1948.
British Standards Institute (BSI)
BSI Management Systems operates world wide to provide
organisations with independent third-party certification of
their management systems, including ISO 9001:2000
(Quality), ISO 14001 (Environmental Management), OHSAS
18001 (Occupational Health and Safety) and BS 7799
Counter Fraud and Security Management Service
The Counter Fraud and Security Management Service
(CFSMS) is a Special Health Authority, which has
responsibility for all policy and operational matters relating to
the prevention, detection and investigation of fraud and
corruption and the management of security in the National
Data Protection Act 1998
The Data Protection Act gives individuals certain rights
regarding information held about them. It places obligations
on those who process information while giving rights to those
who are the subject of that data.
Dental Reference Service (DRS)
The Dental Reference Service has monitored general
dentistry in England and Wales since 1927. It transferred to
working within the NHS in 1948 and for many years visited
surgeries to examine patients to monitor clinical quality and
confirm the probity of claims made for treatment. In 1990,
the DRS became part of the DPB and is now changing its
role to become more involved in clinical governance and
clinical quality support for health bodies and practices.
Freedom of Information Act 2000
The Freedom of Information Act 2000 gives people a general
right of access to information held by or on behalf of public
authorities, promoting a culture of openness and
accountability across the public sector.
General Dental Services
This is the main service through which NHS dental treatment
Knowledge and Skills Framework
The NHS Knowledge and Skills Framework defines and
describes the knowledge and skills which NHS staff need to
apply in their work in order to deliver quality services.
Local Health Boards (LHBs)
Local Health Boards exist in Wales in order to improve the
health and healthcare of the local population. They were
established in 2003 to take over the responsibilities of the
Health Authorities in Wales and were given three quarters of
the NHS health budget in Wales.
Comptroller and Auditor General (C&AG)
The C&AG is the head of the National Audit Office (NAO),
which scrutinises public spending on behalf of Parliament and
is independent of government. The NAO audit the accounts of
all central government departments and agencies, as well as
a wide range of other public bodies, and report to parliament
on the economy, efficiency and effectiveness with which they
have used public money.
NHS Business Services Authority (NHS BSA)
The Health and Social Care (Community Health and Standards)
Act 2003 provides for the DPB to be abolished. It is expected
that a new NHS BSA will carry out our existing functions.
Personal Dental Services (PDS)
PDS was first piloted in 1998 and provides an opportunity for
dentists and health bodies to work in partnership and provide
dental services that meet local needs. The number of PDS
contracts has expanded to 4,500 dentists in more than 2,000
Primary Care Trusts (PCTs)
PCTs are free-standing statutory bodies in England
responsible for delivering better health and better care to
their local population. They receive budgets directly from the
Department of Health.
DENTAL PRACTICE BOARD
ANNUAL ACCOUNTS 2004–2005
DPB Annual Report and Accounts 2004-2005
The accounts for the year ended 31 March 2005 have been prepared in accordance with a direction given by
the Secretary of State dated 20 December 2000 under section 98(2) of the National Health Service Act 1977
and in a format as instructed by the Department of Health with the approval of Treasury.
The Dental Practice Board was set up under its previous name of the Dental Estimates Board by the National
Health Service Act 1946. It now operates under the National Health Service Act 1977 (as amended) and
regulations made under that Act. The new name for the Board took effect in 1990 as a result of the Health and
Medicines Act 1988. The statutory duties of the Dental Practice Board are set out in the National Health
Service Act 1977 and an extract from S.37 states:
… for constituting a Board, to be called the Dental Estimates Board, of whom the Chairman and a majority of
the members shall be dental practitioners providing general dental services.
On 20 November 2003 the Health and Social Care (Community Health and Standards) Act 2003 which
provides for the Abolition of the Dental Practice Board under section 181 received Royal Assent. The notes
associated with the Act indicate that the assets, liabilities and staff (subject to consultation) will be transferred
under Section 11 of the National Health Service Act 1977 to a new Special Health Authority. However, in
October 2003 the Secretary of State announced the intention to review the Department of Health’s Arms
Length Bodies of which the Dental Practice Board is one. The role of the Dental Practice Board after abolition
is now described in a report published in July 2004 and named Reconfiguring the Department of Health’s Arms
Length Bodies (the review). This report outlined the intention of the Department of Health to reduce its number
of Arms Length Bodies and the Secretary of State announced that by 2007-2008 there will be a 50% reduction
reducing total expenditure by £0.5 billion and staff posts by 25%. As a result the intention is that the Dental
Practice Board, the NHS Pensions Agency and the Prescription Pricing Authority will merge soon to form the
NHS Business Services Authority.
The main purpose of the Dental Practice Board as set out in the 2001 Strategic Review is:
… to contribute to improved dental health services by providing first class, cost effective services in payment
processing, information analysis, clinical monitoring and probity assurance.
The principal functions for the year covering England and Wales are:
approval of the fee claims, and applications for the prior approval of treatment, from dental
practitioners and the calculation and transfer of payments;
provision of dental health information;
monitoring the quality of dental treatment prescribed and provided;
preventing and detecting fraud and abuse.
Review of activities and performance against targets
The accounts report a net operating cost of £25.9 million which is £0.1 million below the resource limit agreed
with the Department of Health. This is an increase in net operating cost of £2.1 million from the previous year.
This increase is principally due to the year on year variance on expenditure on voluntary early retirement and
severance schemes which was £2.2 million in 2004-2005 compared to £0.5 million in 2003-2004.
The scheme run in 2004-2005 and its associated cost of £2.2 million is in respect of 37 (34.2 whole time
equivalents) who will leave in the period April 2005 to September 2005. Provision is made in the accounts for
the costs at the time the scheme is approved and becomes legally binding on the Dental Practice Board and
During the financial year to 31 March 2005 the Dental Practice Board has been consulting with the Department
of Health and Welsh Assembly Government and preparing for the changes it is anticipated the Government’s
agenda for modernising dentistry will bring. The timescale for the implementation of the new National Health
Service arrangements for dentistry is currently stated as being by April 2006. In the interim period temporary
staff are being used to cover short term peak workloads associated with processing General Dental Services
and Personal Dental services claims at the same time as preparing new administrative systems for the new
contract. This incurred a cost in 2004-2005 of £0.3 million.
The expenditure with the IT Services contractor (IBM) of £5.1 million is a decrease of £1.0 million over
2003-2004. This is all within the terms of the contract which commenced on 1 January 2003, the Dental
Practice Board having negotiated reductions in the annual cost of the contract to reflect efficiencies promised at
the time by the supplier. IT projects necessary to support the Department of Health and Welsh Assembly
Government in the Modernising Dentistry initiatives resulted in expenditure of £0.9 million.
The Dental Reference Service is developing new ways of working to support the Modernising Dentistry
agenda. This has resulted in changes to the profile of costs during the year and savings have been achieved
although some of these may be short term as activity in some areas and consequently cost has been lower
during this preparation phase. Examples of savings in 2004-2005 are £0.1 million on postage and £0.2 million
on the dental chaperone service.
Income is increased by £0.1 million due to additional rent received from a local NHS Trust for the use of the
Capital expenditure at £0.3 million was as planned, with £0.1 million being spent on replacement vehicles and
£0.2 million on IT and furniture and fittings.
The Eastbourne property which is the Headquarters of the Dental Practice Board was valued as required every
5 years and the new valuations of land (£1.55 million) and buildings (£4.7 million) have been included in the
accounts giving an unrealised surplus of £2.4 million.
The Dental Practice Board measures its cost effectiveness by expressing its net operating cost as a unit cost,
based on the number of dentist claim form documents dealt with in the financial period. The standard is to
achieve a 2% reduction in cost per annum in real terms after adjusting for inflation, over each medium term.
Documents dealt with of 46.2 million result in a unit cost of 56.0p per document. This compares with 50.7p per
document for 2003-2004 and 57.2p in 2002-2003 the year on year variances principally attributed to the
phasing of expenditure on Voluntary Early Retirement and Severance schemes. The savings arising from
these schemes in the current year and in the past have allowed the Dental Practice Board to always achieve its
medium term targets. The savings that will be delivered in future years mean that the standard remains for
now a realistic target for the Dental Practice Board.
The balance sheet at 31 March 2005 shows net liabilities of £2,197,000 (31 March 2004 £3,785,000). The
figure shown at 31 March 2005 includes liabilities falling due in future years which, to the extent that they are
not to be met from the Dental Practice Board’s other sources of income, may only be met by future direct
funding from the Dental Practice Board’s sponsoring department, the Department of Health. This is because,
under the normal conventions applying to parliamentary control over income and expenditure, payments may
not be made by the Department of Health to the Dental Practice Board in advance of need.
Funding for 2005-2006, taking into account the amounts required to meet the Dental Practice Board’s liabilities
falling due in that year, has already been included in the Department of Health’s Estimates for that year, which
have been approved by Parliament, and there is no reason to believe that the department’s future sponsorship
and future parliamentary approval will not be forthcoming.
As outlined above it is expected that the Dental Practice Board will become part of a new NHS Business
Services Authority. The accounting policy in note 1.1 explains that where transfer of activities is between NHS
bodies they are not considered as ‘discontinued’.
It has accordingly been considered appropriate to adopt a going concern basis for the preparation of the Dental
Practice Board’s financial statements.
The Board of Directors is normally comprised of one executive member, the Chief Executive, John Taylor
BA Hons MBA CMgr FCMI and seven non-executive members including the Chairman.
The six non-executive members who served in the financial year are:
Mary Wyllie BDS DDPH RCS (Eng) - Chairman
Ruby Austin MBE MGDS RCS (UK)
Carol Ferguson MA CA
David Ferns BDS
Sandeep Lakhanpaul BDS
Derek Spratt BA
Foreword continued from page 2
A new non-executive member has not been appointed in view of the changes anticipated as a result of the Arm’s
Length Bodies review.
Details of the remuneration of the non-executive directors together with information in respect of senior executive
managers of the Dental Practice Board’s management team are given in a note to the accounts (Reference 2.3
on page 21).
The policy of the Dental Practice Board is to ensure that ability to do the job is the sole criterion for recruitment or
advancement consistent with the principle of fair and open competition. Disabled employees have equal
opportunities for training to develop new skills and advance their careers.
The Dental Practice Board is an equal opportunities employer. This policy means that all employees have equal
opportunity for employment and advancement. There is no difference in treatment based on colour, race, national
origins, sex, marital status, sexual orientation, religion, politics, age or union affiliation.
Health, Safety and Welfare at Work
The Dental Practice Board recognises and accepts its responsibilities for the health, safety and welfare at work of
The promotion of health, safety and welfare at work is an integral function and responsibility of executive
management and specialists are available to assist and advise them. A regular system of staff consultation is
maintained. Minutes of consultative meetings together with agreed policies and responsibilities are available to all
staff on the Dental Practice Board Intranet. Health, safety and welfare at work are continually assessed as part of
the Dental Practice Board’s Controls Assurance Management System which is outlined in the Statement of
Internal Control (Reference pages 5 to 7).
Major Incident Plan
The Dental Practice Board has a major incident plan in place which is fully compliant with “Handling Major
Incidents: An Operational Doctrine” and accompanying NHS guidance on major incident preparedness and
The Dental Practice Board applies the Better Payment Practice Code and has again exceeded the NHS target of
95% paid within 30 days (Reference 2.4 on page 22).
The Comptroller and Auditor General is the appointed external auditor for the Dental Practice Board.
John Taylor 12 July 2005
Statement of the Board of the Dental Practice
Board and Chief Executive’s responsibilities
Under the National Health Service Act 1977 and directions made thereunder by the Secretary of
State with the approval of Treasury, the Dental Practice Board is required to prepare a statement of
accounts for each financial year in the form and on the basis determined by the Secretary of State,
with the approval of Treasury. The accounts are prepared on an accruals basis and must give a true
and fair view of the Dental Practice Board’s state of affairs at the year end and of its net resource
outturn, recognised gains and losses and cash flows for the financial year.
The Accounting Officer for the Department of Health has appointed the Chief Executive of the Dental
Practice Board as the Accounting Officer, with responsibility for preparing the Dental Practice
Board’s accounts and for transmitting them to the Comptroller and Auditor General.
In preparing the accounts, the Board and Accounting Officer are required to:
observe the accounts direction issued by the Secretary of State, including the relevant
accounting and disclosure requirements, and apply suitable accounting policies on a
make judgements and estimates on a reasonable basis;
state whether applicable accounting standards have been followed and disclose and
explain any material departures in the financial statements; and
prepare the financial statements on a going concern basis, unless it is inappropriate to
presume that the Dental Practice Board will continue in operation.
The Chief Executive's relevant responsibilities as Accounting Officer, including responsibility for the
propriety and regularity of the public funds and assets vested in the Dental Practice Board, and for
the keeping of proper records, are set out in the Accounting Officers' Memorandum issued by the
Department of Health.
To the best of my knowledge and belief, I have properly discharged the responsibilities set out in my
letter of appointment as an Accounting Officer.
John Taylor 12 July 2005
Statement on internal control 2004-2005
1. Scope of responsibility
The Board is accountable for internal control. As Accounting Officer, and Chief Executive of this
Board, I have responsibility for maintaining a sound system of internal control that supports the
achievement of the organisation's policies, aims and objectives. I also have responsibility for
safeguarding the public funds and the organisation's assets for which I am personally responsible as
set out in the Accounting Officer Memorandum.
The Dental Practice Board is also accountable for delivery of services as defined in the Service Level
Agreements with the Department of Health and Welsh Assembly Government.
2. The purpose of the system of internal control
The system of internal control is designed to manage risk to a reasonable level rather than to
eliminate all risk of failure to achieve policies, aims and objectives; it can therefore only provide
reasonable and not absolute assurance of effectiveness. The system of internal control is based on
an ongoing process designed to:
• identify and prioritise the risks to the achievement of the organisation's policies, aims and
• evaluate the likelihood of those risks being realised and the impact should they be realised, and
to manage them efficiently, effectively and economically.
The system of internal control has been in place in the Dental Practice Board for the year ended 31
March 2005 and up to the date of approval of the accounts.
The Board exercises strategic control over the operation of the organisation through a system of
corporate governance which includes standing orders, standing financial instructions and the
establishment of an Audit and Risk Management Committee.
3. Capacity to handle risk
Leadership & Accountability
The Dental Practice Board has an organisational management structure with clearly defined lines of
accountability. The ownership of risk has been defined throughout the management structure. The
accountability for managing risk at the Dental Practice Board is shown in the diagram below.
Audit & Risk
Quality Finance Health & Safety
Environment Probity Clinical
Specific individual responsibilities are as follows:
The Chief Executive is accountable for having in place an effective system of risk management and
The Board of the Dental Practice Board is responsible for monitoring the effectiveness of the
systems within the organisation.
The Audit Manager is the designated person with overall responsibility for auditing the Controls
Assurance Management System and for reporting its effectiveness to the Board.
The Business Development Manager is the designated person with overall responsibility for
implementing and managing the Controls Assurance Management System.
Individual managers have responsibility with regard to specific areas of corporate wide risk.
The Audit and Risk Management Committee have overall responsibility for ensuring that an
appropriate system is in place for the identification, assessment and control of risk.
Senior managers from all areas have attended workshops run by external consultants to ensure an
understanding of risk management. Staff have also received training on specific areas of risk such
as Health and Safety and Information Security. All staff are trained to identify and manage risk in a
way appropriate to their authority and duties.
4. The risk and control framework
The Dental Practice Board has designed and implemented a web based Controls Assurance
Management System . The rationale of the Controls Assurance Management System is to create a
system that interlinks throughout the organisation highlighting all risks both at a local and corporate
level within seven interconnecting systems:
information security management,
health and safety management.
There have been clear responsibilities assigned for managing risk throughout the Dental Practice
Board and the creation of an intranet based Controls Assurance Management System has made risk
management a very open and accessible system for all members of staff.
Risk management is embedded in the activity of the organisation by virtue of robust organisational
and committee structures. The Dental Practice Board is committed to a strategy, which minimises
risks to all its stakeholders through a comprehensive system of internal controls, whilst maximising
potential for flexibility, innovation and best practice in the delivery of its strategic objectives. The
Dental Practice Board recognises it is impossible to eliminate all risks and that systems of controls
should not be so rigid that they stifle innovation and imaginative use of limited resources in order to
achieve its objectives.
The controls the Dental Practice Board has in place are designed to safeguard our principal functions
in supporting the Dental Services of the NHS within England and Wales, namely: the approval of
payment applications; calculating and transferring payments; preventing and detecting fraud and
abuse; providing dental health information.
Statement on internal control 2004-2005
continued from page 6
In addition, the Dental Practice Board will seek to eliminate and control all risks that have the
harm its staff, visitors and other stakeholders including any harmful impact on the environment,
result in a loss of public confidence in the Dental Practice Board and/or its partner agencies,
result in the Dental Practice Board failing to meet its statutory duties,
have severe financial consequences preventing the Dental Practice Board from carrying out its
5. Review of effectiveness
As Accounting Officer, I have responsibility for reviewing the effectiveness of the system of internal
control. My review is informed in a number of ways. The head of internal audit provides me with an
opinion on the overall arrangements for gaining assurance through the Assurance Framework and
on the controls reviewed as part of the internal audit work. Senior managers within the organisation
who have responsibility for the development and maintenance of the system of internal control
provide me with assurance. The Controls Assurance Management System itself provides me with
evidence that the effectiveness of controls that manage the risks to the organisation achieving its
principal objectives has been reviewed. My review is also informed by the work of the external
I have been advised on the implications of the result of my review of the effectiveness of the system
of internal control by the relevant internal mechanisms, including the Audit and Risk Management
Committee. A plan to address weaknesses and ensure continuous improvement of the system is in
Ongoing assurance will be provided by the comprehensive mechanisms already referred to in this
Statement. These include:
Regular reports to the Board on the risks faced by the organisation and the controls in place to
Reports on the annual assessment against the NHS Controls Assurance Standards.
Regular reports on the work of internal audit.
John Taylor 12 July 2005
The Certificate and Report of the Comptroller
and Auditor General to the Houses of Parliament
I certify that I have audited the financial statements on pages 10 to 32 under the National Health
Service Act 1977. These financial statements have been prepared under the historical cost
convention as modified by the revaluation of certain fixed assets and the accounting policies set out
on pages 13 to 18.
Respective responsibilities of the Board of the Dental Practice Board, Chief Executive and
As described on page 4, the Board of the Dental Practice Board and the Chief Executive are
responsible for the preparation of the financial statements in accordance with the National Health
Service Act 1977 and directions made thereunder by the Secretary of State with the approval of the
Treasury and for ensuring the regularity of financial transactions. The Chief Executive is also
responsible for the preparation of the Foreword. My responsibilities, as independent auditor, are
established by statute and I have regard to the standards and guidance issued by the Auditing
Practices Board and the ethical guidance applicable to the auditing profession.
I report my opinion as to whether the financial statements give a true and fair view and are properly
prepared in accordance with the National Health Service Act 1977 and directions made thereunder
by the Secretary of State with the approval of the Treasury, and whether in all material respects the
expenditure and income have been applied to the purposes intended by Parliament and the financial
transactions conform to the authorities which govern them. I also report if, in my opinion, the
Foreword is not consistent with the financial statements, if the Dental Practice Board has not kept
proper accounting records, or if I have not received all the information and explanations I require for
I review whether the statement on pages 5 to 7 reflects the Dental Practice Board's compliance with
Treasury’s guidance on the Statement on Internal Control. I report if it does not meet the
requirements specified by Treasury, or if the statement is misleading or inconsistent with other
information I am aware of from my audit of the financial statements. I am not required to consider,
nor have I considered whether the Accounting Officer’s Statement on Internal Control covers all risks
and controls. I am also not required to form an opinion on the effectiveness of the Dental Practice
Board's corporate governance procedures or its risk and control procedures.
Basis of audit opinion
I conducted my audit in accordance with United Kingdom Auditing Standards issued by the Auditing
Practices Board. An audit includes examination, on a test basis, of evidence relevant to the
amounts, disclosures and regularity of financial transactions included in the financial statements. It
also includes an assessment of the significant estimates and judgements made by the Chief
Executive in the preparation of the financial statements, and of whether the accounting policies are
appropriate to the Dental Practice Board's circumstances, consistently applied and adequately
I planned and performed my audit so as to obtain all the information and explanations which I
considered necessary in order to provide me with sufficient evidence to give reasonable assurance
that the financial statements are free from material misstatement, whether caused by error, or by
fraud or other irregularity and that, in all material respects, the expenditure and income have been
applied to the purposes intended by Parliament and the financial transactions conform to the
authorities which govern them. In forming my opinion I have also evaluated the overall adequacy of
the presentation of information in the financial statements.
The Certificate and Report of the Comptroller
and Auditor General to the Houses of Parliament
continued from page 8
In forming my opinion, I have considered the adequacy of the disclosures made in Note 1.1 of the
financial statements concerning the uncertainty of the future arrangements for the Dental Practice
Board’s assets, liabilities, contractual obligations and staff. In view of the significance of this
uncertainty to the financial statements I consider that it should be drawn to your attention, but my
opinion is not qualified in this respect.
In my opinion:
the financial statements give a true and fair view of the state of affairs of the Dental Practice
Board at 31 March 2005 and of the net resource outturn, recognised gains and losses and cash
flows for the year then ended and have been properly prepared in accordance with the National
Health Service Act 1977 and directions made thereunder by the Secretary of State with the
approval of the Treasury; and
in all material respects the expenditure and income have been applied to the purposes intended
by Parliament and the financial transactions conform to the authorities which govern them.
I have no observations to make on these financial statements.
National Audit Office
Comptroller and Auditor General
157-197 Buckingham Palace Road
14 July 2005 Victoria
London SW1W 9SP
Supplementary statement by the Comptroller and Auditor General in respect of material
included at pages 1 to 36 of this Annual Report, not included with the financial statements to
which the audit opinion above relates
In respect alone of my responsibility under United Kingdom auditing standards to read the other
information included with financial statements on which I express an audit opinion, I have read the
additional information on pages 1 to 36, which was not included with the financial statements on
which I reached the audit opinion set out in my Certificate above, and considered whether it is
consistent with the audited financial statements. I have considered the implications for my audit
opinion if I have thereby become aware of any apparent misstatement or material inconsistencies
with the financial statements. I have not considered the effects of any events since the date of my
In this regard, my audit opinion on the financial statements is unchanged
National Audit Office
Comptroller and Auditor General
157 -197 Buckingham Palace Road
14 October 2005 Victoria,
London SW1W 9SP
Operating Cost Statement for the year ended 31 March 2005
Notes £000 £000
Programme costs 2.1 26,443 24,227
Operating income 4 (568) (437)
Net operating cost 25,875 23,790
Net Resource Outturn 3.1 25,875 23,790
Statement of Recognised Gains and Losses for the year ended 31 Marc
Notes £000 £000
Unrealised surplus on the indexation of fixed assets 11.2 294 309
Unrealised surplus on the valuation of fixed assets 11.2 2,394 -
Recognised gains for the financial year 2,688 309
The notes on pages 13 to 32 form part of this account.
Balance Sheet as at 31 March 2005
Notes £000 £000
Intangible assets 5.1 317 425
Tangible assets 5.2 7,183 4,587
Debtors 6 1,139 822
Cash at bank and in hand 7 15 19
Creditors: amounts falling due within one year 8 (1,408) (1,199)
Net current liabilities (254) (358)
Total assets less current liabilities 7,246 4,654
Provisions for liabilities and charges 9 (9,443) (8,439)
Net liabilities (2,197) (3,785)
General fund 11.1 (6,299) (5,240)
Revaluation reserve 11.2 4,102 1,455
The notes on pages 13 to 32 form part of this account.
John Taylor 12 July 2005
Cash Flow Statement for the year ended 31 March 2005
Notes £000 £000
Net cash (outflow) from operating activities 12 (24,599) (23,385)
Capital expenditure and financial investment
(Payments) to acquire intangible fixed assets (18) (135)
(Payments) to acquire tangible fixed assets (325) (214)
Receipts from disposal of tangible assets 16 40
Net cash outflow from investing activities (327) (309)
Net cash outflow before financing (24,926) (23,694)
Net Parliamentary funding 11.1 24,922 23,695
(Decrease)/Increase in cash in the year 7 (4) 1
The notes on pages 13 to 32 form part of this account.
Notes to the Accounts
1 Accounting Policies
The financial statements have been prepared in accordance with the accounts direction
issued by the Secretary of State for Health with the approval of Treasury. The
particular accounting policies adopted by the Dental Practice Board are described
below. They have been consistently applied in dealing with items considered material
in relation to the accounts.
1.1 Accounting Convention and accounts
This account is prepared under the historical cost convention, modified to account for
the revaluation of tangible fixed assets and stock where material, at their value to the
business by reference to their current costs. This is in accordance with directions
issued by the Secretary of State for Health and approved by HM Treasury.
The Dental Practice Board makes payments to dentists on behalf of the General Dental
Services and Personal Dental Services for both England and Wales. The financial
statements for this expenditure for England are not separately published, as the
expenditure is incorporated into the summarised accounts of the Primary Care Trusts.
The General Dental Service expenditure for Wales is published separately and the
Personal Dental Services expenditure for Wales is included in the accounts of the Local
These accounts deal with the operational and administrative costs of the Dental
Practice Board in providing services for General Dental Services and Personal Dental
Services in England and Wales.
Acquisitions and Discontinued Operations
Activities are considered to be 'acquired' only if they are acquired from outside the
public sector. Activities are considered to be ‘discontinued’ only if they cease entirely.
They are not considered to be ‘discontinued’ if they transfer from one NHS body to
As discussed in the Foreword the Dental Practice Board is part of the Arm’s Length
Bodies review announced by the Secretary of State for Health. In the event that the
assets, liabilities, contractual obligations and staff of the Dental Practice Board are
transferred to another NHS body the activities would not be considered as
‘discontinued’. The Accounting Officer of the Dental Practice Board therefore considers
it appropriate to prepare the 2004-2005 financial statements on a going concern basis.
Income is accounted for applying the accruals convention. The main source of funding
for the Dental Practice Board is Parliamentary grant from the Department of Health
from Request for Resources 1 within an approved cash limit, which is credited to the
general fund. Parliamentary funding is recognised in the financial period in which it is
Operating income is income which relates directly to the operating activities of the
Dental Practice Board. It principally comprises fees and charges for services provided
on a full-cost basis to external customers, as well as public repayment work, but it also
includes other income such as that from investments. It includes both income
appropriated-in-aid and income to the Consolidated Fund which HM Treasury has
agreed should be treated as miscellaneous income. Where income is received for a
specific activity which is to be delivered in the following financial year, that income is
The Dental Practice Board is not liable to pay corporation tax. Expenditure is shown
net of recoverable VAT. Irrecoverable VAT is charged to the most appropriate
expenditure heading or capitalised if it relates to an asset.
1.4 Capital Charges
The treatment of fixed assets in the account is in accordance with the principal capital
charges objective to ensure that such charges are fully reflected in the cost of capital.
The interest rate applied to capital charges in the financial year 2004-2005 was 3.5%
(2003-2004 3.5%) on all assets less liabilities, except for cash balances with the Office
of the Paymaster General , where the charge is nil.
1.5 Fixed Assets
All assets falling into the following categories are capitalised:
Intangible assets where they are capable of being used for more than one year and
have a cost, individually or as a group, equal to or greater than £5,000.
Purchased computer software licences are capitalised as intangible fixed assets
where expenditure of at least £5,000 is incurred.
Tangible assets which are capable of being used for more than one year, and they:
- individually have a cost equal to or greater than £5,000;
- collectively have a cost of at least £5,000 and an individual cost of more than
£250, where the assets are functionally interdependent, they had broadly
simultaneous purchase dates, are anticipated to have simultaneous disposal
dates and are under single managerial control; or
- form part of the initial equipping and setting-up cost of a new building, ward or unit
irrespective of their individual or collective cost.
Intangible fixed assets
Intangible fixed assets held for operational use are valued at historical cost. Surplus
intangible assets are valued at the net recoverable amount.
The carrying value of intangible assets is reviewed for impairment at the end of the first
full year following acquisition and in other periods if events or changes in circumstances
indicate the carrying value may not be recoverable.
Tangible fixed assets
Tangible fixed assets are stated at the lower of replacement cost and recoverable
amount. On initial recognition they are measured at cost (for leased assets, fair value)
including any costs such as installation directly attributable to bringing them into
working condition. They are restated to current value each year. The carrying values
of tangible fixed assets are reviewed for impairment in periods if events or changes in
circumstances indicate the carrying value may not be recoverable.
Land and buildings excluding dwellings
Valuations are carried out by the District Valuer of the Valuation Office Agency at
five yearly intervals in accordance with FRS 15. Between valuations price indices
appropriate to the category of asset are applied to arrive at the current value. The
buildings indexation is based on the All in Tender Price Index published by the
Building Cost Information Service (BCIS). The land index is based on the
residential building land values reported in the Property Market Report published
by the Valuation Office. The valuations were carried out in accordance with the
Royal Institute of Chartered Surveyors (RICS) Appraisal and Valuation Manual
insofar as these terms are consistent with the agreed requirements of the
Department of Health and HM Treasury. In accordance with the requirements of
the Department of Health, the asset valuations were undertaken in 2004 as at the
prospective valuation date of 1 April 2005 and have been included in these
accounts at 31 March 2005.
The valuations have been carried out primarily on the basis of Depreciated
Replacement Cost for specialised operational property and Existing Use Value for
non-specialised operational property. In respect of non-operational properties,
including surplus land, the valuations have been carried out at Open Market Value.
The value of land for existing use purposes is assessed to Existing Use Value.
The valuations do not include notional directly attributable acquisition costs nor
have selling costs been deducted, since they are regarded as not material.
To meet the underlying objectives established by the Department of Health the
following accepted variations of the RICS Appraisal and Valuation Manual have
- specialised operational assets have been valued on a replacement rather than
a modern substitute basis;
- no adjustment has been made to the cost figures of operational assets in
respect of dilapidations; and
- additional alternative Open Market Value figures have only been supplied for
operational assets scheduled for imminent closure and subsequent disposal.
Operational equipment is valued at net current replacement costs through annual
uplift by the change in the value of the Gross Domestic Product (GDP) deflator.
Equipment surplus to requirements is valued at net recoverable amount.
Assets in the course of construction are valued at current cost, using the index as
for land and buildings. These assets include any existing land or buildings under
the control of a contractor.
All adjustments arising from indexation and five-yearly revaluations are taken to the
Revaluation Reserve. All impairments resulting from price changes are charged to
the Statement of Recognised Gains and Losses. Falls in value when newly
constructed assets are brought into use are also charged there. These falls in
value result from the adoption of ideal conditions as the basis for depreciated
replacement cost valuations.
Depreciation and Amortisation
Depreciation is charged on each individual fixed asset as follows:
Intangible assets are amortised, on a straight line basis, over the estimated lives of
Purchased computer software licences are amortised over the shorter of the term
of the licence and their useful economic lives.
Land and assets in the course of construction are not depreciated.
Buildings are depreciated evenly on their revalued amount over the assessed
remaining life of the asset as advised by the District Valuer. Leaseholds are
depreciated over the primary lease term.
Each equipment asset is depreciated evenly over the expected useful life:
Furniture and fittings:
Soft furnishings 7
Transport Equipment 7
Mainframe information technology installations 8
Office information technology 5
1.6 Donated Fixed Assets
The Dental Practice Board does not have any Donated Fixed Assets.
1.7 Stocks and work in progress
The Dental Practice Board does not normally recognise stocks.
1.8 Losses and special payments
Losses and special payments are charged to the relevant functional headings, including
losses which would have been made good through insurance cover had the Dental
Practice Board not been bearing their own risks (with insurance premiums then being
included as normal revenue expenditure).
1.9 Pension costs
Past and present employees are covered by the provisions of the NHS Pension
Scheme. The Scheme is an unfunded, defined benefit scheme that covers NHS
employers, General Practices and other bodies, allowed under the direction of the
Secretary of State, in England and Wales. As a consequence it is not possible for the
Dental Practice Board to identify its share of the underlying scheme liabilities.
Therefore, the scheme is accounted for as a defined contribution scheme and the cost
of the scheme is equal to the contributions payable to the scheme for the accounting
period. The total employer contributions payable in 2004-2005 were £1,243,000
The Scheme is subject to a full valuation by the Government Actuary every four years
which is followed by a review of the employer contribution rates. The last valuation took
place as at 31 March 2003 and has yet to be finalised. The last published valuation
covered the period 1 April 1994 to 31 March 1999. Between valuations the
Government Actuary provides an update of the scheme liabilities on an annual basis.
The latest assessment of the liabilities of the Scheme is contained in the Scheme
Actuary report, which forms part of the NHS Pension Scheme (England and Wales)
Resource Account, published annually. These accounts can be viewed on the NHS
Pensions Agency website at www.nhspa.gov.uk. Copies can also be obtained from
The Stationery Office.
The conclusion of the 1999 valuation was that the scheme continues to operate on a
sound financial basis and the notional surplus of the scheme is £1.1 billion. It was
recommended that employers’ contributions remain at 7% of pensionable pay until 31
March 2003 and then be increased to 14% of pensionable pay with effect from 1 April
2003. On advice from the actuary the contribution may be varied from time to time to
reflect changes in the scheme’s liabilities. Employees pay contributions of 6% (manual
staff 5%) of their pensionable pay.
NHS bodies are directed by the Secretary of State to charge employers pension costs
contributions to operating expenses as and when they become due. Until 2002-03 HM
Treasury paid the Retail Price Indexation costs of the NHS Pension scheme direct but
as part of the Spending Review Settlement, these costs have been devolved in full. For
2003-04 the additional funding was retained as a Central Budget by the Department of
Health and was paid direct to the NHS Pensions Agency and the employers’
contribution remained at 7%. From 2004-05 this funding was devolved in full to NHS
Pension Scheme employers and the employer’s contribution rate rose to 14%.
The Scheme is a "final salary" scheme. Annual pensions are normally based on 1/80th
of the best of the last 3 years pensionable pay for each year of service. A lump sum
normally equivalent to 3 years pension is payable on retirement. Annual increases are
applied to pension payments at rates defined by the Pensions (Increase) Act 1971, and
are based on changes in retail prices in the twelve months ending 30 September in the
previous calendar year. On death, a pension of 50% of the member's pension is
normally payable to the surviving spouse.
Early payment of a pension, with enhancement, is available to members of the Scheme
who are permanently incapable of fulfilling their duties effectively through illness or
infirmity. Additional pension liabilities arising from early retirement are not funded by
the scheme except where the retirement is due to ill-health. For early retirements not
funded by the scheme, the full amount of the liability for the additional costs is charged
to the Operating Cost Statement at the time the Dental Practice Board commits itself to
the retirement, regardless of the method of payment.
A death gratuity of twice final years pensionable pay for death in service, and up to five
times their annual pension for death after retirement, less pensions already paid,
subject to a maximum amount equal to twice the member’s final years pensionable pay
less their retirement lump sum for those who die after retirement, is payable.
The Scheme provides the opportunity to members to increase their benefits through
money purchase Additional Voluntary Contributions (AVCs) provided by an approved
panel of life companies. Under the arrangement the employee can make contributions
to enhance their pension benefits. The benefits payable relate directly to the value of
the investments made.
1.10 Research and Development
The Dental Practice Board does not incur Research and Development expenditure.
1.11 Foreign exchange
Transactions which are denominated in a foreign currency are translated into sterling at
the exchange rate ruling on the date of each transaction, except where rates do not
fluctuate significantly, in which case an average rate for a period is used.
Assets held under finance leases and hire purchase contracts are capitalised in the
balance sheet and are depreciated over their useful lives or primary lease term.
Rentals under operating leases are charged on a straight line basis over the terms of
The Dental Practice Board provides for legal or constructive obligations that are of
uncertain timing or amount at the balance sheet date on the basis of the best estimate
of the expenditure required to settle the obligation. Where the effect of the time value
of money is significant, the estimated risk-adjusted cash flows are discounted using the
Treasury’s discount rate of 3.5% in real terms.
2.1 Programme costs
Notes £000 £000 £000
Non-executive remuneration 43 42
Salaries 2.2 11,811 11,056
Early retirement and severance scheme
New scheme 9 2,180 546
Provision no longer required 9 (68) (81)
Unwinding of discount 9 466 410
IT services contractors 5,100 6,074
Bureau keying 1,402 1,243
Reference Service Support
Postage, stationery and
5 486 465
Impairments 5 10 -
Capital charges interest (147) (135)
Loss on disposal 5.4 10 1
Maintenance of equipment and
Transport, travel and
Rent and rates 407 96
Furniture and equipment 423 446
Professional fees and outsourced
Heat, light and power 100 72
Hire and leasing 17 18
Auditor's remuneration: audit fees* 97 99
Auditor's remuneration: other fees - 5
Training 84 103
Other administration costs 491 603
* The audit fee represents the cost for the audit of the underlying financial
statements carried out by the Comptroller and Auditor General. The audit fee also
covers work in respect of General Dental Services and Personal Dental Services
payments made by the Dental Practice Board where the expenditure is
incorporated into the summarised accounts of the Primary Care Trusts.
2.2 Staff numbers and related
employed 2004-2005 2003-2004
staff Other Total Total
£000 £000 £000 £000
Salaries and wages 9,291 455 9,746 9,601
Social security costs 812 10 822 829
Employer contributions to NHSPA 1,243 - 1,243 626
11,346 465 11,811 11,056
The average number of employees during the year was:
employed 2004-2005 2003-2004
staff Other Total Total
Number Number Number Number
Total 281 18 299 325
Expenditure on staff benefits
The Dental Practice Board provides Dental Reference Officers with cars for the
performance of their jobs which involves clinical duties throughout England and Wales.
Where an officer elects to have personal use of the car they make a monthly payment for
this privilege. Under current Inland Revenue rules this results in a taxable benefit of
£74,000 (2003-2004 £70,000).
Retirements due to ill-health
During 2004-2005 there were no early retirements from the Dental Practice Board on the
grounds of ill-health (2003-2004 Nil).
2.3 Salary and pension entitlement of senior managers
2004 - 2005 2003 – 2004
Other in kind Other in kind
Salary remuner. (rounded to Salary remuner. (rounded to
in £5,000 in £5,000 nearest in £5,000 in £5,000 nearest
bands bands £hundred) bands bands £hundred)
Name and title £000 £000 £00 £000 £000 £00
M Wyllie 30 - 35 Nil 10 30 – 35 Nil 10
J Taylor 100 - 105 Nil Nil 90 – 95 Nil Nil
R Austin Nil 0 – 5 2 Nil 0 – 5 2
N Entwistle* N/A N/A N/A Nil 0 – 5 Nil
C Ferguson Nil 0 – 5 1 Nil 0 – 5 1
D Ferns Nil 0 – 5 Nil Nil 0 – 5 4
S Lakhanpaul Nil 0 – 5 4 Nil 0 – 5 4
D Spratt Nil 0 – 5 2 Nil 0 – 5 1
* Resigned 29 April 2003
Real increase at age 60 at contribution to
in pension and 31 Mar 2005
Cash Real increase stakeholder
Equivalent in Cash pension
sum at age related lump Transfer Transfer Equivalent (rounded to
60 (bands sum (bands Value at Value at Transfer nearest
of £2,500) of £5,000) 31 Mar 2005 31 Mar 2004 Value £hundred)
Name and title £000 £000 £000 £000 £000 £00
J. Taylor 12.5-15 150-160 N/A** N/A* N/A* 9.4
* *Over age 60
As Non-Executive members do not receive pensionable remuneration, there are no entries in
respect of pensions for Non-Executive members.
Benefits in kind paid to the Chairman and Non-Executive members are mileage allowances paid in
excess of the Inland Revenue's approved mileage rates.
Non-executive members who are also Dentists may receive General Dental Services payments in
line with the Statement of Dental Remuneration or Personal Dental Services under contracts with
Primary Care Trusts for England or Local Health Boards for Wales. The Department of Health and
Welsh Assembly Government set the policy for these payments.
Cash Equivalent Transfer Value
A Cash Equivalent Transfer Value (CETV) is the actuarially assessed capital value of the pension
scheme benefits accrued by a member at a particular point in time. The benefits valued are the
members’ accrued benefits and any contingent spouse’s pension payable from the scheme.
A CETV is a payment made by a pension scheme or arrangement to secure pension benefits in
another pension scheme or arrangement when the member leaves a scheme and chooses to
transfer the benefit accrued in the former scheme. The pension figures shown relate to the benefits
that the individual has accrued as a consequence of their total membership of the pension scheme,
not just their service in a senior capacity to which disclosure applies.
The CETV figure, and from 2004-2005 the other pension details, include the value of any pension
benefits in another scheme or arrangement which the individual has transferred to the NHS pension
scheme. They also include any additional pension benefit accrued to the member as a result of their
purchasing additional years of pension service in the scheme at their own cost. CETV are
calculated within the guidelines and framework prescribed by the Institute and Faculty of Actuaries.
Real Increase in CETV
This reflects the increase in CETV effectively funded by the employer. It takes account of the
increase in accrued pension to inflation, contributions paid by the employee (including the value of
any benefits transferred from another scheme or arrangement) and uses common market
valuation factors for the start and end of period.
2.4 Better Payment Practice Code - measure of compliance
Total bills paid 2004-2005 3,022 14,257
Total bills paid within target 3,016 14,236
Percentage of bills paid within target 99.8% 99.9%
The Late Payment of Commercial Debts (Interest) Act 1998
No interest or compensation for debt recovery costs was paid under the legislation (2003-2004 Nil).
3.1 Reconciliation of net operating cost to net resource outturn
Net operating cost 25,875 23,790
outturn 25,875 23,790
limit 25,994 23,800
Under spend against limit 119 er 10
3.2 Reconciliation of gross capital expenditure to capital resource limit
Gross capital expenditure 322 349
Net Book Value of assets disposed (26) (41)
Net capital resource outturn 296 308
Capital resource limit 350 500
Under/(Over) spend against limit Ur 54 192
4 Operating Income
Operating income analysed by classification and activity, is as follows:
in aid 2004-2005 2003-2004
£000 £000 £000
Fees & charges to external customers 568 568 386
Interest received - - 51
Total 568 568 437
Interest was received during 2003-2004 on a rates rebate, in respect of the property at
Eastbourne, covering a number of years
5.1 Intangible Fixed Assets Software
Gross cost at 31 March 2004 623
Additions - purchased 18
Gross cost at 31 March 2005 622
Accumulated amortisation at 31 March 2004 198
Provided during the year 126
Accumulated amortisation at 31 March 2005 305
Net book value as at 31 March 2004 425
Net book value as at 31 March 2005 317
5.2 Tangible Fixed Assets
excl. Transport Information Furniture
Land dwellings Equipment Technology & fittings Total
£000 £000 £000 £000 £000 £000
Cost or Valuation at 31 March 2004 1,110 2,876 1,079 482 597 6,144
Additions - purchased - - 139 90 75 304
Impairments - - - - - -
Indexation 82 228 23 - 11 344
National revaluation exercise* 358 1,596 - - - 1,954
Disposals - - (171) (85) (6) (262)
Gross cost at 31 March 2005 1,550 4,700 1,070 487 677 8,484
Accumulated depreciation at 31 March 2004 - 325 524 169 539 1,557
Provided during the year - 88 157 87 28 360
Impairments - - 10 - - 10
Indexation - 27 12 - 11 50
National revaluation exercise* - (440) - - - (440)
Disposals - - (150) (80) (6) (236)
Accumulated depreciation at 31 March 2005 - - 553 176 572 1,301
Net book value as at 31 March 2004 1,110 2,551 555 313 58 4,587
Net book value as at 31 March 2005 1,550 4,700 517 311 105 7,183
*Accounting instructions issued by the Department of Health require accumulated depreciation to be Nil at
31 March 2005.
The Dental Practice Board does not hold any assets under finance leases nor donated fixed assets.
5.3 Net Book Value of land and buildings
The net book value of land and buildings at 31 March 2005 of £6,250,000 (31 March 2004
£3,661,000) is all freehold. This is the Eastbourne property which is the headquarters of the Dental
Practice Board. The property was revalued during the year in accordance with the guidance detailed
in note 1.5 (b)(i) on page 15.
5.4 Profit / loss on disposal of fixed assets
Loss on disposal of computer assets (5) -
Loss on disposal of motor vehicles (5) (1)
Amounts falling due within one year £000 £000
NHS Pensions Agency 2 -
Department of Health 250 -
Dental Vocational Training Authority 34 17
Welsh Assembly Government 51 14
Prepayments 317 362
Other debtors 485 429
The Dental Practice Board makes payments on an ongoing basis on behalf of the Department of
Health and the Welsh Assembly Government in respect of Electronic Data Interchange grants to
dentists and Continuing Professional Education for dentists, the NHS Pensions Agency in respect
of Widows’/Widowers’ Pension and the Dental Vocational Training Authority. These payments
are either funded in advance or subsequently reimbursed. These paying agency activities result
in debtor or creditor balances. Amounts due to the Dental Practice Board at 31 March 2005 in
respect of these activities totalled £80,000 (2003-2004 £31,000). Amounts due from the Dental
Practice Board are shown in Note 8 Creditors.
Additionally in 2004-2005 the Dental Practice Board made payments on behalf of the Department
of Health principally in relation to the recruitment of dentists from overseas which gave rise to a
debtor of £250,000 at 31 March 2005.
7 Analysis of changes in cash
At 31 Change At 31
March during March
2004 the year 2005
£000 £000 £000
Cash at Office of the Paymaster General - 2 2
Cash at commercial banks and in hand 19 (6) 13
19 (4) 15
8 Creditors 2004-2005 2003-2004
Amounts falling due within one year £000 £000
NHS Pensions Agency 379 257
Department of Health 1 21
Capital creditors - 21
Tax and social security 309 269
Other creditors 293 173
Accruals 423 455
Deferred income 3 3
As described in Note 6 Debtors, the Dental Practice Board acts as a paying agent and these
activities result in debtor and creditor balances. At 31 March 2005 creditors in respect of paying
agency activities totalled £1,000 (2003-2004 £21,000).
9 Provisions for liabilities and charges
Agenda Pensions for
Change staff Total
£’000 £’000 £000
At 31 March 2004 - 8,439 8,439
Arising during the year 43 2,180 2,223
Utilised during the year - (1,617) (1,617)
Provision no longer required - (68) (68)
Unwinding of discount - 466 466
At 31 March 2005 43 9,400 9,443
Expected timing of cash flows: £000 £000 £000
Within 1 year 43 1,417 1,460
1-5 years - 3,844 3,844
Over 5 years - 4,139 4,139
43 9,400 9,443
The Agenda for Change provision relates to back pay due to staff for the period from 1 October
2004 arising from the NHS job evaluation programme. Job evaluations for all posts are due to be
completed by 30 September 2005.
The pension provision relates to all staff who left the Dental Practice Board under voluntary
severance and early retirement schemes where the cost has not been capitalised, i.e. a payment
made to the NHS Pension Agency in respect of the liability. The provision is in respect of all early
retirements where the decision has been made in the year to 31 March 2005 or earlier years and
includes retirements planned for 2005-2006 of £2,153,000 (2003-2004 – retirements planned for
2004-2005 of £2,972,000).
There were no provisions for legal claims or clinical negligence.
10 Movements in working capital other than cash
(Increase)/Decrease in debtors (Decrease) (317) 5
Increase/(Decrease) in creditors (excluding capital creditors) Increase) 230 161
(Decrease) (87) 166
11 Movements on reserves
11.1 General Fund £000 £000
Balance at 31 March 2004 (5,240) (5,049)
Net operating costs for the year (25,875) (23,790)
Net Parliamentary funding 24,922 23,695
Transfer of realised profits/losses from revaluation reserve 41 39
Non-cash items: capital charges interest (147) (135)
Balance at 31 March 2005 (6,299) (5,240)
11.2 Revaluation Reserve £000 £000
Balance at 31 March 2004 1,455 1,185
Indexation of fixed assets 294 309
Revaluation of fixed assets 2,394 -
Transfer to General Fund: realised revaluation (41) (39)
Balance at 31 March 2005 4,102 1,455
12 Reconciliation of operating cost to operating cash flows
Notes £000 £000
Net operating cost before interest for the year (25,875) (23,790)
Adjust for non-cash transactions 2.1 359 331
Adjust for movements in working capital other than cash 10 (87) 166
(Increase)/Decrease in provisions ) 1,004 (92)
Net cash (outflow) from operating activities (24,599) (23,385)
13 Contingent liabilities
At 31 March 2005, there were no known contingent liabilities. (2003-2004 Nil).
14 Capital commitments
At 31 March 2005, the value of capital commitments was Nil (2003-2004 £21,000).
15 Commitments under operating leases
Expenses of the Dental Practice Board include the following in respect of hire and operating lease
Hire of plant and machinery 16 18
Other operating leases 128 130
Commitments under non-cancellable operating leases:
2003 - 04 03
Other leases £000 £000
Operating leases which expire:
within 1 year 77 27
between 1 and 5 years 16 98
after 5 years 24 23
Operating lease commitments include rentals in respect of 24 properties used for dental examination
of patients. Prior to 31 March 2005, notice was given on 19 of these properties, where government
lease arrangements exist, effective from 1 April 2005. Under the government leases the Dental
Practice Board remains liable for the ongoing cost until an alternative tenant is found. Notice has
also been given on 5 properties where there are commercial leases where exit strategies are in the
course of being finalised. Operating lease commitment figures are shown to the end of the lease or,
where earlier, the lease termination date if this has been formally agreed with the landlord.
16 Other Commitments
On 1 January 2003 the Dental Practice Board entered into two seven year contracts, one with IBM
UK Ltd for computing services and one with Astron Document Management Ltd. (formerly Hays
Commercial Services Ltd) for data capture services. The computing services contract involves
payments of £31.9 million over the seven years and is subject to increases in line with inflation. The
data capture contract involves payments of £7.8 million over seven years and adjustments are
dependent on the volumes processed. Both contracts have arrangements within them whereby after
4 years or more, on giving formal notice, the Dental Practice Board can make termination payments
to terminate the contracts.
17 Losses and special payments
Losses or special payments approved during 2004-2005 amounted to £20 (2003-2003 £15).
18 Related Parties
The Dental Practice Board is a body corporate established by order of the Secretary of State
The Department of Health and Welsh Assembly Government are regarded as controlling
related parties. During the year the Dental Practice Board has had a significant number of
material transactions with the Department of Health and Welsh Assembly Government, and
with other entities for which they are regarded as the parent including:
- Strategic Health Authorities, NHS Hospital Trusts and Primary Care Trusts for the use of their
facilities for dental clinics;
- The NHS Pensions Agency;
- The Dental Vocational Training Authority where the Dental Practice Board provides paying
agency services; and
- The NHS Counter Fraud and Security Management Service who carry out checks to ensure
patients are exempt from paying NHS charges.
During the year none of the Dental Practice Board members or members of the key
management staff or other related parties has undertaken any material transactions with the
parties listed above.
The Dental Practice Board Chairman and a majority of non-executive members are required to
be dental practitioners and may receive payments in respect of General Dental Services or
Personal Dental Services. The officers have the same influence over the amount of these
payments as any other dental practitioner and do not gain additional influence as a result of
The Chairman Mary Wyllie and non-executive members Ruby Austin, David Ferns,
Sandeep Lakhanpaul are dental practitioners. The gross payments from General Dental
Services and Personal Dental Services for these officers were all in the band of below
19 Post balance sheet events
From 1 April 2005 HM Treasury changed the discount rate used in calculating provisions from
3.5% to 2.2%. This change will result in an increase in our provisions of approximately
£1,400,000, which will be charged to the Operating Cost Statement in 2005-2006. National
funding of NHS commissioners will be increased by the total estimated effect to offset this
The Dental Practice Board is part of the Department of Health’s Arms Length Bodies review
and details of proposed future changes are given in the Foreword.
20 Financial Instruments
FRS 13, Derivatives and Other Financial Instruments, requires disclosure of the role that financial
instruments have had during the period in creating or changing the risks an entity faces in
undertaking its activities. Because of the way the Dental Practice Board is financed, the Dental
Practice Board is not exposed to the degree of financial risk faced by business entities. Also
financial instruments play a much more limited role in creating or changing risk than would be
typical of the listed companies to which FRS 13 mainly applies. The Dental Practice Board has
no powers to borrow or invest surplus funds and financial assets and liabilities are generated by
day-to-day operational activities rather than being held to change the risks facing the Dental
Practice Board in undertaking its activities.
As allowed by FRS 13, debtors and creditors that are due to mature or become payable within
12 months from the balance sheet date have been omitted from all disclosures other than from
the currency profile.
The Dental Practice Board's net operating costs and capital expenditure are financed from
resources voted annually by Parliament and it is not, therefore, exposed to significant liquidity
All the Dental Practice Board's financial assets and financial liabilities carry nil rates of interest and it
is not, therefore, exposed to interest-rate risk.
Foreign currency risk
The Dental Practice Board has no foreign currency income or expenditure and it is not, therefore,
exposed to foreign currency risk.
A comparison, by category, of book values and fair values of the Dental Practice Board's financial
assets and liabilities as at 31 March 2005 is as follows:
value Fair value
£000 £000 valuation
Cash 15 15
Total 15 15
Creditors over 1 year:
Voluntary severance and early retirements 7,983 7,983
Total 7,983 7,983
21 Intra-government balances
falling due falling due
within one within one
Balances with other central
Balances with NHS Trusts - 2
Balances with bodies external to government 457 1,007
At 31 March 2005 1,139 1,451
falling due falling due
within one within one
Balances with other central
Balances with NHS Trusts - 19
Balances with bodies external to government 464 602
At 31 March 2004 822 1,199
DENTAL PRACTICE BOARD
SERVICE LEVEL AGREEMENT
For the year to March 2006
The Department of Health and the
Welsh Assembly Government
The Dental Practice Board
This document will be subject to change by DH/WAG/DPB/BSA
during the year when plans for implementation of the new
arrangements for NHS dentistry and for the creation of the new
Business Services Authority are finalised
THE DEPARTMENT OF HEALTH
133 – 155 WATERLOO ROAD, LONDON SE1 8UG
DPB Annual Report and Accounts 2004-2005
SERVICE LEVEL AGREEMENT BETWEEN
THE HEALTH DEPARTMENT FOR ENGLAND
AND THE WELSH ASSEMBLY GOVERNMENT
THE DENTAL PRACTICE BOARD
FOR THE ACCOUNTING YEAR TO MARCH 2006
For the agreed allocation for expenditure as defined by the ALB review team for the accounting
year to March 2006 of £23062k with provision for capital expenditure of £340k and a cash limit
of £24100k the Dental Practice Board undertakes to deliver the services set out in this
agreement within the framework of the current business plan with separate figures for England
and Wales, where appropriate. In 2005/06 additional revenue resource cover of £1400k may
be required for an accounting adjustment necessary as a result of the revaluation of the DPB
pension provision and £1000k as a transition cost for a leaving scheme which will help to ensure
the DPB meets its financial targets set by the ALB review team for 2008/09.
For each service, the standards of accuracy and timeliness the DPB undertakes to meet are
defined and the DPB commits to achieve these cost effectively, pursuing a continuing
programme of cost reduction, with the target that costs reduce in line with the targets set by
the ALB review team.
To achieve the standards of service defined in this service level agreement the DPB applies the
following risk and quality frameworks: Controls Assurance Management System (the CAMS)
which incorporates the requirements of NHS Controls Assurance, Quality Management ISO
9001, Environmental Management ISO 14001, Occupational Health and Safety Management
OHSAS 18001, Complaints Management CMSAS 86:2000 and Information Security Management
BS 7799. All the British and International standards listed are externally audited on a regular
basis by the British Standards Institute.
Throughout this document, average is to be understood as arithmetic mean. Unless otherwise
qualified, average refers to the twelve-month period to March 2006; days are calendar days.
Unless specified otherwise, standards involving amounts of work mean that one seventeenth of
the amount will be for Wales.
Section 1: Form of Agreement and Associations
Part 1 Form of Agreement 3
Part 2 Period of Agreement, Review and Renewal 3
Part 3 Monitoring and Reporting 4
Data Protection Act 1998, Freedom of Information
Act 2000 and the Computer Misuse Act 1990 4
Part 5 Instructions and Variations 4
Section 2: Service Specification
Part 1 Prior Approval 5
Part 2 Authorisation 6
Part 3 Registration 7
Part 4 Payment 8
Part 5 Personal Dental Services 9
Part 6 Probity 10, 11
Part 7 Dental Reference Service 12
Part 8 Data Services 13
Part 9 Customer Relations 14
Part 10 Financial Data 15
Part 11 Accountability 16
Part 12 Staff 17
Section 3: Protocol
Part 1 Fraud Definition 18
Part 2 Responsibilities 18, 19
Part 3 Dental Case Profile 20
Section 4: Signatures 21
SECTION 1 - FORM OF AGREEMENT AND ASSOCIATIONS
1 Form of Agreement
1.1 This agreement is made between the Secretary of State 1 and the Dental Practice
Board ["the DPB"] 2 .
1.2 Bodies with an interest in the DPB include the Department of Health, Welsh
Assembly Government, Primary Care Trusts, Local Health Groups, Local Health
Boards, NHS Counter Fraud & Security Management Services, NHS dentists
providing General Dental Services or performing Personal Dental Services.
1.3 This document forms the framework required of the Department of Health as a
means of monitoring the delivery of the functions of its Arms Length Body (ALB),
the Dental Practice Board 3 . It has been prepared with reference to the
Department's "Guide to Managing the Relationship between the Department and
its Arm's Length Bodies.”
1.4 It is agreed that the DPB will undertake the work specified in Part 2 in
accordance with the Conditions specified in Part 1 and shall provide all
information as required in accordance with Parts 2 and 3.
2 Period of Agreement, Review and Renewal
2.1 The Agreement shall take effect on the Commencement Date, being 1st April
2005 and shall terminate on the Completion Date, being 31st March 2006.
2.2 The Agreement shall be valid for a period of 12 months, shall be subject to annual
review and subject to the agreement of all Parties, may be amended, terminated
and / or renewed following the completion of the Agreement and prior to the
commencement of any further Agreement.
For Health; the relevant Directorate of the Department of Health is the Specialist Health Services Directorate of the
Department of Health, of Wellington House, 133-155 Waterloo Road, London SE1 8UG.
Compton Place Road, Eastbourne, East Sussex BN20 8AD.
The DPB is established under section 37 of the NHS Act 1977.
3 Monitoring and Reporting
3.1 The DPB shall send quarterly reports to DH and the WAG, in accordance with
the requirements laid out in this SLA.
3.2 DH or the WAG may call upon the DPB for further reports from time-to-time
on any aspect of the Service Specification and the DPB shall furnish them within
an agreed timescale.
4 Data Protection Act 1998, Freedom of Information Act 2000 and the Computer
Misuse Act 1990
4.1 The DPB shall ensure that the handling and security of the policies relating to
data and information controlled or possessed by it conform with the law, in
particular the Data Protection Act 1998, Freedom of Information Act 2000 and
the Computer Misuse Act 1990.
5 Instructions and Variations
5.1 Except in a case of urgency, all instructions shall be made in writing.
5.2 When the matter is urgent, an instruction may be made orally, but shall be
confirmed in writing as soon as practicable after the event and in any event as
quickly as is reasonably possible.
5.3 Any variations to the agreement of association shall be agreed with the
Department of Health.
SECTION 2 - SERVICE SPECIFICATION
1 Prior Approval
1.1 To receive, examine and give or withhold approval to proposed treatment plans.
1.2 Prior Approval requests not chosen for dental officer reference will be examined
and a response dispatched on average within 6 days of receipt by the DPB [daily
sample of returns].
1.3 Maintain the overall proportion of cases (1 in 25 cases) examined by a dentist,
identify any undesirable trends in dentists’ prescribing patterns and report to
1.4 On average prior approval requests chosen for dental officer reference shall be
dispatched to dentists within 75 days of receipt by the DPB [analysis of returns].
1.5 A system of monitoring prior approval will be used to provide alerts if dentists’
work patterns are varying significantly. This will be reviewed and reported on at the
2.1 To receive, examine and give or withhold approval to payment claims from
dentists under item of service, capitation and continuing care provisions.
2.2 Over the year 990 in every 1,000 or more processed approved payments are to
be authorised for payment on the first available schedule and not more than 1 in
2000 shall miss the second schedule [analysis of approved claims].
2.3 No fewer than 9,985 in 10,000 approved payments shall be authorised at the
correct amount and no fewer than 9,985 in 10,000 shall be correctly recorded
[sample of verified payments].
2.4 Written payment queries shall be cleared or where necessary returned with an
enquiry on average within 2.75 days of receipt by the DPB. All queries shall be
cleared within 10 days [monthly sample of returns].
3.1 To maintain a registration system for patients under the age of 18 and for adults
under the terms of the capitation and continuing care arrangements.
3.2 A ratio of the number of active patient registrations to the number of active patient
identities shall not exceed 1.023 [quarterly survey of all registrations].
4.1 To make transfer payments by BACS or, where agreed payable orders, to each
dentist contract each month and similarly to make associated payments to
primary care trusts, local health boards and local dental committees.
4.2 Payment claims received by the DPB shall, on average over the year be not less
than 27.5 or more than 28.5 days from day of receipt to day of payment. In any
calendar month, the average age shall not be more than 1 day outside those limits
[analysis of approved claims].
4.3 All payment transfers shall be in accordance with the prescribed schedule of
payment dates agreed between the Department of Health and the Welsh
Assembly Government and the General Dental Services Committee.
4.4 The DPB provided the Department of Health and the Welsh Assembly
Government, for sign off by the DH by the end of September 2004, a full
specification of the new payment system needed by April 2006 to pay dentists
under the new arrangements. The specification reflected the policy decisions
that have been made up to that point in time. From 1 st October 2004 to 30 th
September 2005 to build, test and implement that system ready for live running
by April 2006 as specified advising the Department of Health and the Welsh
Assembly Government through a strict change control system of the implications
on the payment system of any changes to policy that they want to make.
5 Personal Dental Services
5.1 To carry out the activities specified in the Secretary of State's "Directions to the
Dental Practice Board concerning functions relating to Personal Dental Services Pilot
Schemes". To summarise:
1) To collect and check information from all Personal Dental Services (PDS)
pilots and produce statistics and reports for
a) the lead officer for each pilot scheme
b) the lead PCT for the pilot scheme
c) the Department of Health, Dental Statistics branch
as specified in the directions. Monthly activity reports to be provided within
10 days of the end of each calendar month.
2) Where requested to do so and as may be specified by the pilot scheme's
lead PCT in an individual Service Level Agreement (SLA) between the DPB
and that PCT:
a) to monitor the provision of PDS (involving previous GDS
b) to carry out probity monitoring, subject to any necessary
collaboration from the lead PCT
c) to provide advice and support to pilots experiencing difficulty in the
electronic submission of activity reports
d) to make payments to providers of PDS
e) to recover overpayments
f) to operate a prior approval system
g) to report on the operation of these services to the lead PCT.
Dental Reference Officer examination of patients may be included in such a
The same provisions will be afforded to any scheme approved by the WAG.
5.2 To develop the new PCT/LHB Liaison Team, as appropriate, to meet the needs of
the expansion of PDS and to evolve the team ready to support PCTs/LHBs under
the new contract.
5.3 To work with the Department of Health and the Welsh Assembly Government, in
particular to keep the effectiveness of these services under review and to develop
new systems in order to support changes in policy.
6.1 To provide an agreed level of assurance with respect to probity of the payment
system and to monitor activity in the General Dental Services and the Personal
Dental Services in order to prevent and detect potential fraud, unnecessary
treatment or any other abuse. To provide such information as may be requested
by the NHS Counter Fraud and Security Management Service (CFSMS) for Risk
Measurement, and the Dental Fraud Team (DFT) in specific cases of suspected or
6.2 Where an allegation of fraud by a dentist is made to the DPB, from any source,
the allegation to be passed immediately to the DFT, in accordance with agreed
6.3 Where the DPB have doubts, in respect of a dentist, about the correctness of
any claim and payment under the SDR they may clarify, amend or disallow the
claim in accordance with paragraph 2.1 of section 2 of this SLA and commence
enquiries by one or more of the following methods:
a) obtaining samples of patient records from the dentist to do comparison
checks between recorded information and claim information
b) issuing questionnaires to patients to seek confirmation of treatment
c) using the Dental Reference Service to make clinical examinations
6.4 Where the DPB enquiries, made under paragraph 6.3, raise a suspicion of
incorrect claiming, to refer the matter to the DFT in writing, within 14 days.
6.5 To refer to the appropriate authorities, in accordance with agreed procedures,
any information that raises a question of abuse that is not fraud related.
6.6 Practitioners will be assessed in accordance with the principles of the risk
management system and those deemed of higher risk, including individual high
earning dentists, shall be subject to enhanced monitoring by the DPB according
to the level of risk. Any suspected fraud or abuse uncovered will be reported to
6.7 Treatment patterns and earnings will be analysed and over the year at least 18
risk assessments shall be carried out, covering various GDS activities to refine
and develop the risk management system or identify areas of concern. Areas of
concern and trends identified by risk assessment projects will be reported to the
CFSMS and in the quarterly report to the Department of Health and the Welsh
6.8 To select, process and check the eligibility of 70,000 claims per year for
exemption or remission of dental charges as agreed with CFSMS. CFSMS will
determine the categories of exemption and numbers to be selected for eligibility
check from time to time after consultation with the DPB. To administer penalty
charges in line with current guidance provided by CFSMS.
6.9 To scrutinise one per cent of all Continuing Professional Development (CPD)
claims authorised in the financial year to 31st March 2006 and seek confirmation
a) the proportion of NHS earnings in relation to total earnings and
b) the qualifying activities and courses attended in respect of verifiable CPD
6.10 To advise the Department of Health and the Welsh Assembly Government on
emerging probity trends in general dental matters.
6.11 Without agreement with the DFT the DPB should not:
a) enter into negotiations regarding repayment of fees or remuneration that
may have been made incorrectly
b) visit, or otherwise contact, dentists except to clarify clinical issues and/or
for educational purposes, service providers or patients to verify claim
details outside normal dental reference procedures unless part of a postpayment
monitoring programme which has been agreed with the DFT
c) undertake targeted dental reference examinations for dentists who are
under investigation by the DFT.
6.12 The DPB will be notified by CFSMS where referrals for fraud, that involve the
GDS and PDS, are made directly to the DFT.
7 Dental Reference Service
7.1 To provide professional dental examination and related services throughout the
GDS and to carry on continuous surveillance so as to provide an agreed level of
assurance in respect of clinical quality.
7.2 The Dental Reference Service (DRS) will undertake to develop and implement a
framework to meet the requirements for clinical assurance by April 2006. The
aim shall be to provide a similar level of assurance in respect of dental activity in
England and Wales.
7.3 The precise mix of work delivered will depend upon monitoring needs as the
year progresses. Quarterly meetings will be held with the Sponsor Branch, the
Chief Dental Advisor and the Head of Information and Probity.
8 Data Services
8.1 To provide dental information to the Secretary for State for Health for England and
the Minister for Health and Social Services in the Welsh Assembly Government and
for policy makers, primary care trusts and practitioners as may be required. The
data services department to establish a proactive role in identifying and alerting the
Department of Health and the Welsh Assembly Government to emerging trends in
dentistry and remuneration patterns.
8.2 To provide information on a regular basis which shall as a minimum include:
a) manpower and workforce information by PCT/LHB, region, age, sex, status
and country of qualification
b) earnings and registration information by PCT/LHB and summarised at
c) treatment information showing the number and associated expense of each
treatment item by country and age of patient
d) information derived from the DRSG population for workforce, treatment,
earning and registration data
e) data on registrations, treatment types, number of dentists and gross fees to
be updated on a quarterly basis on the DPB website within 1 month of the
end of the quarter
f) a digest of statistics and orthodontic summaries to be published annually
within 2 months of the end of the reference period.
The above information, where required monthly, to be provided within 7 days of the
end of the month and, where required quarterly, to be provided within 2 months of
the end of the quarter.
8.3 To meet ad hoc requests from the Department of Health and the Welsh Assembly
Government within agreed timescales. To collaborate on information services for
regions, strategic health authorities, PCTs, LHBs, dental research or commercial
enquiries whilst continuing to meet the requirements of the Department of Health
and Welsh Assembly Government.
8.4 Information requests to the dental data e-mail address to be acknowledged within 2
days of receipt and acted upon within 7 days of receipt.
8.5 To work with the Department of Health, the Welsh Assembly Government, primary
care trusts and local health boards to clarify information needs.
8.6 To provide dental information for policy makers, primary care trusts and
8.7 To support and, where required, contribute to the implementation of the Dental IT
strategy within Modernising Dentistry and provide by the end of June 2005 to all
Primary Care Trusts, Local Health Boards and dentists as specified by the
Department of Health and the Welsh Assembly Government the prescribing profile
information for the financial year 2004/05.
9 Customer Relations
9.1 To contribute to dental health services by providing information about GDS and
its administration to stakeholders.
9.2 To provide an annual report for the Senior Departmental Sponsor, in accordance
with DH central finance guidance and guidance on managing Arm’s Length Bodies,
and in addition translated into the Welsh language for the Welsh Assembly
Government. Distribution to be agreed with the departmental sponsor.
9.3 To make available an induction course on administration of the GDS for parties
of vocational dental practitioners, by arrangement.
9.4 To provide speakers and other contributors for appropriate events, whenever it
is reasonable, to further the interests of the General Dental Services and
Personal Dental Services.
9.5 19 in every 20 complaints received to be acknowledged in writing within 24
hours of receipt and all within 72 hours. A final response to be made, in writing,
within 14 days of receipt of the complaint or an explanation given for the delay.
In the absence of a full response an indication to be given of when a response can
9.6 To distribute the Statement of Dental Remuneration to all GDS practitioners.
9.7 During the year to undertake a survey on customer satisfaction of Primary Care
Trusts, Local Health Boards, dentists and patients on a rotating three-year cycle.
To consider what action to take in response to the findings and to implement an
appropriate improvement programme.
9.8 To undertake to answer at least 90 in every hundred incoming calls, to its main
helpdesk, within 15 seconds. To monitor call-handling quality through regular
quality monitoring programmes, achieving a score of 75 per cent or higher.
9.9 To provide a quarterly magazine (Dental Profile) which will be distributed free to
GDS & PDS dentists. A monthly bulletin on the changes planned for dentistry
(Countdown) shall also be distributed free to GDS dentists. The cost of
distribution of Countdown shall lie with the Dental Practice Board but this may
be renegotiated at their instigation with the Department of Health and the Welsh
Assembly Government during the term of this Service Level Agreement.
9.10 To organise workshops, roadshows and events for dentists, PCTs, LHBs and
patients, in partnership with other organisations as appropriate.
9.11 To distribute copies of the Dental Practitioners Formulary on request.
10 Financial Data
10.1 To provide valid and reliable information for in-year monitoring, periodic accounts
and public expenditure surveys.
10.2 To prepare on request such financial data and forward projections relating to the
DPB administration costs as the Department of Health and the Welsh Assembly
Government may require.
10.3 To prepare regular cash flow reports for GDS expenditure in terms of gross fees
authorised and payment transfers, including monthly reports on funding
requirements, to be submitted to the Department of Health and Welsh Assembly
Government by the 22nd day of the previous month and reports of payments made
to dentists by the 8th working day of the following month.
10.4 To submit year-end accounts for DPB administration and the GDS to the
Department of Health and the Welsh Assembly Government in accordance with the
format and timetable determined between the two.
10.5 To provide forecast out-turns as requested. To provide on request, or at least
quarterly, in-year reports of administration expenditure against agreed budget plans.
10.6* To provide "paying agency" services to the Dental Vocational Training Authority, the
Department of Health and the National Centre for Continuing Professional
Education of Dentists (NCCPED)
10.7* To provide management information as required by the Department of Health and
NCCPED and to manage cash funds received for their account: payments to be
made within 5 working days.
10.8 To assist with financial management aspects of delegation of Department of Health
10.9 To provide "paying agency" services to the Department of Health and Welsh
Assembly Government for EDI grants to dentists.
*Consideration may need to be given to charging at cost for these items.
11.1 To stand prepared to provide an adequate and timely account of management of
the DPB in response to any request from the Department of Health, the Welsh
Assembly Government, the National Audit Office or any Parliamentary body.
11.2 As soon as is reasonably practicable after the end of the financial year, but no
later than 3 months, to prepare and submit a draft full stewardship manifesto and
business planning account for the Secretary of State for Health for England and
the Minister for Health and Social Services in the Welsh Assembly Government,
drawing attention to any matter of which the other parties should be aware, to
be considered at an Annual Accountability Review.
11.3 Papers for the Annual Accountability Review, which have been approved by the
Board, to be submitted to the sponsoring departments at least 4 weeks before
the agreed date of the Annual Accountability Review.
11.4 The final Report to be submitted to the Department of Health by 30 September
11.5 The Service Level Agreement to be formally discussed at the January 2005
12.1 To undertake a staff survey annually.
12.2 To consult staff on issues of concern identified by the staff satisfaction survey and
consider what action to take in response.
12.3 To adhere to equal opportunity policies in recruitment procedures and in the
development and management of staff.
SECTION 3 - PROTOCOL
1 Fraud Definition
1.1 It is not possible to form an opinion as to whether fraud has occurred until such
time as apparent anomalies have been tested and investigated to consider what
independent evidence there is about the matters under issue.
1.2 Deciding when an individual piece of information, or a combination of different
pieces of information, raises a suspicion of fraud is a matter of judgement.
1.3 For example, a dental practice manager leaves a practice and immediately reports
and suggests details of why it is believed that a dentist may be committing a
particular fraud. If the facts of the dentist’s claims seem to support the
information given, then it may be reasonable to say that the allegation that has
been made should be considered as a potential fraud.
1.4 If, on the other hand, the claims submitted by the dentist do not indicate the
characteristics suggested as being part of the fraud then it may not be reasonable
to consider the matter as a potential fraud. It may be that the practice manager
has been sacked and is seeking to “make mischief”.
1.5 One or all of the following factors may be an indicator of fraud in their own right,
or in any combination:
a) anomalies within the types, frequencies or number of claims made under
b) patient questionnaire replies indicate treatment that may be at variance
with what has been claimed
c) dental reference service examinations indicate treatment that may be at
variance with what has been claimed
d) patient questionnaire replies to point of service checks where evidence
indicates that the patient paid a fee although the FP17 or EDI information
indicates that exemption had been claimed
e) a higher than normal rate of patients who cannot be traced or who fail to
f) concerns raised by omissions or anomalies within dental records
submitted to the DPB.
2.1 The DPB has a responsibility to consider all the information available that may
give rise to a suspicion of fraud and will consider:
a) whether anomalies are isolated and infrequent, or many and frequent
b) the risk (previously) associated to particular types of claim under the SDR
c) whether patterns or amounts of claiming fall outside normal claim
patterns without known reason.
and to refer all cases giving rise to a suspicion of fraud to the DFT within 14 days.
2.2 The DPB should not seek explanations from dentists about past claims other than
as part of a post payment-monitoring programme, which has been agreed in
accordance with this SLA.
2.3 When the information has been received as a result of these enquiries the DPB
may conclude that:
a) there is no reason to suspect there is any remaining fraud, error or
clinical issue - the DPB to take no further action, or
b) there are only clinical issues involved. DPB to instigate appropriate action
under disciplinary or other procedures.
2.4 All formal referrals to the DFT to be by letter and authorised by the DPB's head
of information and probity. The letter to set out the matter(s) of concern, giving
notice of the dental profile and analytical data to follow. The information to be
provided within 14 days of the referral letter.
2.5 Referrals to health bodies, relating to the contractors under enquiry, will be
copied to the DFT at the same time as the referral. The DPB to provide advice
on consequences for patient detriment or loss of public funds and to keep this
scope under review.
2.6 Allow the DFT direct access to files in relation to activities carried out on
contractors in question.
3 The Dental Case Profile
3.1 The dental case profile will contain the following information:
a) full contractor personal information, such as full names, date of birth,
country of qualifications and GDC number and registered home address
b) all contractual information relating to the contractor/s in question (both live
and terminated contracts) – i.e. contract numbers, practice addresses and
contact telephone numbers
c) details of primary concern(s) giving rise to the referral to the DFT, including
all linked contractors
d) summary of all alerts received in respect of the dentist in question (from
whatever source) and of the probity enquiry history and a list of documents
retained in the probity file
e) summary of dental reference history reports including numbers of patients
selected and results where examinations were achieved
f) summary of previous referral to HA/PCTs/LHBs, GDC or police and
outcomes, where known, and including any recorded periods of suspension
g) associates, partners, assistants' details as above, where applicable.
3.2 Additional information to be provided on request and to a timetable agreed on a
case by case between the DFT manager and the DPB:
a) copies of enquiry evidence obtained from checks (patient record cards,
questionnaires, DRO reports that form part of the case referred)
b) copies of required documents from the probity file
c) subject to availability, the names and addresses of patients selected for DRO
examination where appointments were not kept by patients
d) relevant claims data from April 1998
e) copies of the contractor's annual prescribing profiles
f) copies of monthly payment schedules
g) fee assignment details, such as bank account details (including number and
sort code) and copies of all signed agreements held on file at the DPB for all
linked and related contractors, as appropriate
h) details of all earnings for all contracts relating to the practices concerned for
all linked dentists for a five-year period, where applicable
i) name/s of software used by contractors transmitting claims by EDI and
names of suppliers if known
j) list of all contracting health body details (addresses and telephone numbers)
for all contracts concerned
k) archived dental reference officer reports including contemporaneous notes
for adverse-coded results, where available.
3.3 Information to be provided on a case by case basis:
a) where agreed between DFT and DPB, the DPB to arrange an immediate
hold on destruction of all claims forms (paper, scanned/ imaged or EDI).
DPB to provide original documents as requested.
b) a list of patient registration details (both live and lapsed registrations).
SECTION 4 - SIGNATURES
for the Department of Health for England
for the Welsh Assembly Government
for the Dental Practice Board
Further information & contact points
Annual Report and Accounts
Head of Finance and Operations 01323 433463
Dental Profile magazine
Public Relations 01323 433395
NHS General Dental Services and
Dental Reference Service
Helpdesk 01323 433550
open Monday to Friday 8.00 am – 6.00 pm
Helpdesk 01323 433553
open Monday to Friday 8.00 am – 6.00 pm
Declaration of interest register
Head of Finance and Operations 01323 433463
Helpdesk for NHS General Dental Services 01323 433222
Other enquiries 01323 433517
A copy of this report is available in Welsh
Mae copïau o’r adolygiad hwn ar gael yn Saesneg
DPB Helpdesk 01323 433550
GDS statistical data
Data Services Branch 01323 433218
Dental Practice Board
Compton Place Road
DPB Research Unit
External Projects department 01323 433512
Complaints about the services provided by
the Dental Practice Board
DPB Helpdesk 01323 433550
Dental Practice Board Eastbourne BN20 8AD
Telephone 01323 433550 Fax 01323 433517