For NHS dental practices — commissioner guidance on mixed NHS and private treatment
Mixed NHS and private dental treatment documentation
NHS commissioners across England — including the South West — have reminded contractors that patients must receive full, clear information when NHS and private treatment are combined in one course of treatment. Consent must be free and informed, with costs that are clear and unambiguous before treatment starts.
This page is general information, not legal advice. For your own situation, take professional legal, indemnity, and commissioner guidance.
What commissioners are asking for
When both NHS and private options have been discussed and treatment is not available under NHS regulations, clinicians may provide a mix of NHS and private dental treatment. The patient must be issued with an FP17DC form or equivalent documenting the NHS and private elements planned under the course of treatment (CoT).
- Keep clear, accurate, contemporaneous notes of conversations about mixing NHS and private treatment.
- Never mislead patients about what is available on the NHS — a course of treatment includes necessary treatment to secure oral health.
- Discuss NHS and private options with outcomes, differences, and costs explained clearly. Patients are not obliged to accept private treatment.
- Provide a treatment plan the patient has agreed to — signed, and preferably documented on FP17DC or equivalent.
Smile Consent supports patient-facing consent and cost documentation aligned with these principles. It does not replace official BSA Compass FP17DC submission processes.
Orthodontic treatment
Commissioner guidance is explicit: orthodontic provision must be entirely private or entirely NHS — not mixed within the same plan. Practices should treat orthodontics as a separate pathway when documenting consent and costs.
GDC Standard 2.2 — communicating with patients
The General Dental Council expects registrants to recognise and promote patients' rights to make decisions about their care. Before treatment starts you must:
- Explain the options — including delaying treatment or doing nothing — with the risks and benefits of each.
- Give full information on the treatment you propose and the possible costs.
- Encourage patients to ask questions and give full and honest answers about their options or treatment.
Reference: GDC Standards — Principle 2.2
FP17DC and equivalent documentation
The FP17DC records which elements of a planned course of treatment are NHS and which are private, together with the patient's agreement. Commissioners accept equivalent documentation that clearly separates NHS band charges from private item fees and shows the patient has agreed before treatment.
For mixed plans, documentation should show the NHS band (one charge covering NHS elements in that CoT), each private item and fee, and a total that is clear and unambiguous — not a single blended figure with no breakdown.
How Smile Consent helps today
Smile Consent is built for UK dental practices documenting mixed NHS private dental treatment consent. Clinicians review and approve every draft before it is sent — the platform supports your workflow; it does not replace clinical judgment.
- Mixed NHS + Private payment type with NHS band selection and per-item private fees.
- Cost section that separates NHS band charge from private line items and shows a combined total — aligned with FP17DC documentation principles.
- AI-assisted consent wording covering risks, alternatives, and options — edited and signed off by the treating clinician before send.
- Digital patient signing with timestamped records (sent, opened, signed) for audit and complaint defence.
- PDF archive of signed consent for your records alongside clinical notes in your practice software.
See mixed treatment documentation in action
Book a short demo and we'll walk through mixed NHS and private consent — cost breakdown, patient signing, and the records your team keeps.
Related reading: dental consent law in the UK · compliance software for practices · free CPD on legal consent.