According to Public Health Scotland, 94.6% of the Scottish population were registered with an NHS dentist at the end of September 2024. Even if these patients don't attend regularly, the 'lifetime registration' policy in Scotland means they still expect to be able to see 'their dentist' if and when they need to.
Because of this, it's important to be mindful of your ethical obligations and the relevant legislation when deregistering patients, or you could face complaints or criticism.
We've addressed some common questions from DDU members in Scotland to help you navigate this tricky dento-legal area.
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When is a patient registered?
A patient is registered with an individual dentist (rather than a practice) when they have completed and signed the relevant sections of a GP17PR form.
A capitation arrangement begins immediately and remains in place until it is terminated by one of the mechanisms described below.
How is a patient deregistered?
Registration automatically terminates when:
- the patient registers with any other NHS dentist in Scotland, within the practice or externally
- the patient's record on the National Community Health Index (CHI) database shows them as deceased or having moved out of Scotland
- the patient is part of a bulk transfer (see below).
Dentists can also actively terminate a capitation arrangement by applying to withdraw the patient from their list (deregistration). This is done by the dentist submitting a GP200 form to their local health board.
It's usually necessary to give patients three months' notice of their removal from the list, but this notice period can be waived in some circumstances. For example, the NHS Inform website advises patients that, "Registration can be withdrawn immediately by the dentist due to violence, abusive behaviour or repeated non-attendance."
Do I need a specific reason to deregister a patient?
Removing a patient without suitable justification can leave you vulnerable to complaints of unfairness.
We therefore recommend that practices have a clear policy setting out when and how patients can be deregistered. This ensures patients are informed about what behaviour is unacceptable and gives you a consistent process to follow.
The GDC's guidance on ending a professional relationship with a patient (Standards for the Dental Team, paragraph 1.7.8) says, "you must be satisfied that your decision is fair and you must be able to justify your decision." It adds that it would not be acceptable to stop treating someone just because they have made a complaint.
The GDC expects dental professionals to tell patients in writing about the decision to remove them and why. You are also asked to give your reasons when completing the GP200 form.
Am I responsible for the patient's care during the notice period?
In its guidance on De-registration of NHS Patients, the Scottish Dental Clinical Effectiveness Programme (SDCEP) says, "On giving notice you must try to complete any outstanding care to manage the oral health of the patient. You must also notify the Health Board and give details of the outstanding treatment and any arrangements made to try to complete this."
If the reason for deregistering is non-payment of charges, you won't be required to try to complete outstanding treatment.
The GDC says you should, "take steps to ensure that arrangements are made promptly for the continuing care of the patient." For example, it might be possible to transfer them to a willing colleague at the practice or recommend they obtain a list of NHS dental practices from the local health board.
If they register with another dentist before the three-month notice period is up, their registration with you ends - so you do not need to try and complete any outstanding treatment.
Can I immediately deregister a patient who is aggressive or violent?
The three-month notice period doesn't apply if the patient has behaved violently or left staff fearful of their safety. However, the NHS Regulations (as amended) require you to have reported violent incidents to the police and obtain a police incident number when notifying the health board and requesting immediate deregistration though the GP200.
SDCEP says the patient should ideally be notified by phone/e-mail and then in writing within seven days. The health board should then take all reasonable steps to notify the individual concerned of their de-registration.
If the patient has breached your practice's zero tolerance policy but the police have not been involved, the health board may be able to use their discretion to let you deregister them immediately. Otherwise, you may be obliged to offer care for three months.
We advise discussing the situation with the local dental practice adviser before submitting a formal request.
Do I really need to write to the patient?
If you want to deregister an NHS patient and none of your colleagues are willing to take on their care, it's advisable for the practice to write and inform them before you - as the registered dentist - complete and submit the GP200 form to the health board.
As well as following GDC guidance, this approach makes practical sense because the health board will write to the patient after receiving the GP200 form, notifying them the date when their registration will officially end.
You wouldn't want this to be the first the patient knows about it, as that could easily prompt a complaint (patients can also appeal the decision to deregister).
The practice's letter should set out the reason(s) why the patient is being deregistered and the notice period. It's also an opportunity to make an offer of care during the notice period or advise them how they can make their own arrangements, such as obtaining a list of NHS dental practices from the local health board or searching the NHS Inform directory.
Can I deregister several patients at once if I move, sell my practice or retire?
The bulk transfer process is used to transfer a list of patients from one dentist to another on a specific date, usually due to incoming/outgoing associates, retirements, or practice sales.
You can find out more on how to do this on the NSS Practitioner Services website.
What if I want to go private?
If you are converting individual NHS patients to private, or moving them onto an independent practice plan, you should submit a GP200 form for each patient at the time of conversion (otherwise you may be criticised for inappropriately taking NHS capitation payments for private patients).
If you are reducing your list, or completely withdrawing from the NHS, you should write to the affected patients giving them at least three months' notice that you are going to stop providing them with NHS dental treatment and explain the new private arrangements.
You must also complete the necessary paperwork for the NHS to ensure the de-registration happens.
Again, it's important to include an offer NHS of care during the notice period and advise them of how they might find an alternative NHS dentist, if necessary.
To help reduce delays, NSS Practitioner Services has updated its GP200 process when multiple patients are being withdrawn.
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If you're unsure about whether you would be justified in deregistering a patient, our expert team is on hand to guide you through whatever you're facing.
Contact us today if you need support.
This article first appeared in Dentistry Scotland and has been edited for publication.
This page was correct at publication on 02/09/2025. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.
by Simon Kidd Dento-legal adviser
BDS Dip.MJDF MFDS MCGDent LLM DLM
Simon gained his BDS in 2007 at the University of Glasgow and worked as a general dental practitioner in Scotland for 17 years. He attained the MJDF in 2010 and went on to gain a Master's Degree (LLM) in Healthcare Law and Ethics in 2020. Simon was a vocational trainer for many years and represented dentists on advisory groups and committees including the LDC. He now works full-time for the DDU as a dento-legal adviser.