Every Contract a Dental Practice Needs in the UK (2025)
Last updated: February 2025
Legal Requirements for a Dental Practice
UK dental practices must be registered with the Care Quality Commission (CQC) in England under the Health and Social Care Act 2008. Dentists must be registered with the General Dental Council (GDC). NHS dental services require a contract with NHS England under the National Health Service (General Dental Services) Regulations 2005. The Dentists Act 1984 governs who can perform dentistry. UK GDPR and the NHS Code of Confidentiality apply to patient records. The Health and Safety (Sharp Instruments in Healthcare) Regulations 2013 address specific workplace hazards. The Ionising Radiation Regulations 2017 apply to dental X-rays.
Essential Contracts
Governs the self-employed associate relationship — must genuinely reflect self-employment to avoid HMRC reclassification, covering UDA allocation, fees, and indemnity
Contract with NHS England for providing NHS dental services, specifying UDA (Units of Dental Activity) targets, funding, and performance requirements
Informed consent documentation for all treatments, meeting GDC Standards requirements — particularly important for invasive procedures and cosmetic treatments
For dental nurses, hygienists, therapists, receptionists, and practice managers — must address GDC registration maintenance and indemnity requirements
Evidence of meeting CQC's five key questions (safe, effective, caring, responsive, well-led) and the fundamental standards
Recommended Contracts
Contract for buying or selling a dental practice, covering goodwill valuation, NHS contract assignment, restrictive covenants, and CQC transfer
Documents referral arrangements with specialist dentists, ensuring compliance with GDC standards on referrals and patient consent
Terms for private dental plans (monthly payment schemes), covering treatment included, exclusions, and cancellation terms
Common Legal Risks for a Dental Practice
- CQC enforcement action including conditions, suspension, or cancellation of registration for failing fundamental standards
- GDC fitness to practise proceedings against individual dentists for clinical or professional failures
- HMRC reclassification of dental associates as employees, triggering backdated PAYE and NIC liability
- NHS contract clawback for under-delivery of UDA targets or breach of contract conditions
- Clinical negligence claims without proper consent documentation and clinical records
Industry-Specific Notes
The dental associate employment status issue is one of the most significant in the profession. HMRC has increasingly challenged the self-employed status of associates, with several cases reaching the tax tribunal. The associate agreement must genuinely reflect self-employment — the associate should bear financial risk, have freedom in clinical decisions, and not be subject to control over how they work. The BDA (British Dental Association) provides template associate agreements. CQC inspection ratings directly affect patient choice and practice value.
FAQ
Is a dental associate an employee or self-employed?
This is the most contentious contractual issue in UK dentistry. Traditionally, associates have been treated as self-employed, but HMRC has challenged this in several cases. The key factors are: does the associate bear financial risk (materials, lab fees, indemnity)?; can they hire a locum as substitute?; does the practice control clinical methods?; do they have their own patient base? A well-drafted associate agreement supporting self-employment is essential, but HMRC will look at actual working practices. The BDA and NASDAL provide guidance and template agreements.
What CQC requirements must a dental practice meet?
Dental practices must meet the CQC's fundamental standards under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These cover: person-centred care, dignity and respect, consent, safety, safeguarding, cleanliness and infection control, safe use of medicines, staffing, complaints handling, good governance, and duty of candour. CQC inspections assess whether the practice is safe, effective, caring, responsive, and well-led. Ratings range from Outstanding to Inadequate. An Inadequate rating can lead to enforcement action or closure.
What happens to the NHS contract when a dental practice is sold?
NHS dental contracts are not automatically transferable. When a dental practice is sold, the NHS contract must be novated (transferred) with the agreement of NHS England. This requires an application process and the buyer must demonstrate they meet the requirements for holding an NHS contract. If NHS England does not agree to the transfer, the contract terminates. The purchase price of a dental practice is heavily influenced by the NHS contract value and UDA rate, so contract assignability is a critical issue in practice sales.
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