National Health Service (General Dental Services) (Scotland) Amendment Regulations 2025: equality impact assessment

Prior Approval

Prior approval is a method of reviewing dentists’ treatment plans, as part of the clinical governance of NHS dentistry. Currently, dentists are required to submit for prior approval to the SDPB any courses of treatment where the cost will exceed £660.

From 1 November 2023, the Scottish Government introduced significant reforms to the NHS dental payment system, moving to a high-trust, low bureaucracy model, which focuses on modernised service provision through clinical discretion and patient-centred care based on need. Within this we made substantial improvements to the fee structure, designed to incentivise dentists to provide more NHS care, and in turn improve patient access to services. As a result of the new payment system, there has been an increased volume of low clinical risk treatment plans being submitted for prior approval, which can result in delays to necessary treatment for patients due to a financial limit rather than for any clinical considerations. Therefore, this SSI will make changes to the prior approval system for dental treatment by changing the basis on which prior approval of treatment is required to ensure that clinical considerations are prioritised in the approval system for dental treatment.

This is largely a technical change which will primarily affect dentists in Scotland that provide NHS general dental services, and NSS Practitioner Services Division as they are responsible for processing prior approval. These changes will have an indirect benefit across the general population in improving treatment times but some people with certain protected characteristics may see more benefit from this change due to their higher level of treatment need.