In April, changes were made to the NHS standard form provided to patients that could help practice owners when faced with a solicitor's letter. Bethan Parry and Alice Webb, partner and paralegal at Browne Jacobson LLP, explain why

The NHS FP17DC - the treatment plan provided to a patient at the start of their NHS dental treatment in England - was amended on 1 April 2026 to include the name of the treating clinician. This change is more significant than it might appear. The previous version of the form played a direct role in exposing practice owners to clinical negligence liability in circumstances where they had no personal involvement in the patient's treatment at all.

Why does the form matter legally?

A non-delegable duty of care allows a claimant to pursue a practice owner for treatment carried out by their associates or other dental care professionals, even where the practice owner did not treat the patient personally. In the dental context, this arises naturally from the structure of the relationship between patient and practice - patients register with and attend a specific practice expecting to receive care, often with no meaningful control over which clinician treats them at any given appointment.

The implications of this were brought into sharp focus by the Court of Appeal's decision in Hughes v Rattan [2022] EWCA Civ 107, in which the practice owner was found liable for negligent treatment carried out by self-employed associate dentists working at his practice. The Court found that Dr Rattan, as the NHS GDS contract holder, owed a non-delegable duty of care to patients attending his practice. That obligation could not be discharged simply by delegating clinical delivery to associates.

Critically, the old FP17DC named only Dr Rattan as the practice owner and ‘provider’ of treatment, even though he had never personally treated the patient. This created a documented basis for the Court to find that the patient was placed in his charge. The old form was, in effect, contributing to the conditions for non-delegable duty liability.

What has changed?

The new FP17DC, which took effect from 1 April 2026, requires the name of the clinician responsible for delivering the treatment to be recorded on the form. This change was introduced specifically to reduce the risk of non-delegable duty claims succeeding against practice owners who had no personal involvement in the treatment in question.

By naming the treating clinician on the face of the treatment plan, the new form creates a contemporaneous record attributing clinical responsibility to the dentist who actually delivered care; weakens the evidential basis for arguing that the patient was placed in the practice owner's charge; and provides clearer attribution of liability from an indemnity perspective, supporting the direction of claims to the correct indemnifier.

What the form does not do

Practice owners and their indemnifiers should be careful not to treat the new form as a complete answer to non-delegable duty claims. There are several important limitations to keep in mind:

  • The non-delegable duty is not eliminated. The duty arises from the structure of the relationship between patient and practice, not from the content of a document. A claimant could still argue that the practice owner, as GDS contract holder, retained an overarching non-delegable duty irrespective of who was named on the treatment plan. The form is powerful evidence, but not a complete shield.
  • Mid-treatment changes of clinician. Where the treating dentist changes during a course of treatment, the form may not accurately capture this unless practices implement specific protocols to update the record.
  • Private patients are not covered. The new form applies to NHS treatment only. For private patients, no FP17DC is used, and practice owners remain potentially exposed to non-delegable duty claims under the existing legal position. This is a significant ongoing risk for mixed practices and those providing predominantly private care.
  • Historic claims are unaffected. Claims arising from treatment provided before 1 April 2026 will continue to be assessed against the old form position. The risk profile established by Hughes v Rattan persists in full for that cohort of potential claims.

What should practice owners do now?

The form change is most effective when treated as part of a broader risk management approach rather than a standalone solution. The following practical steps are recommended:

  1. Implement the new form immediately and consistently. Ensure the updated FP17DC is used for every NHS treatment episode from 1 April 2026, with the treating clinician accurately named at the outset. Train reception and clinical staff accordingly.
  2. Establish a protocol for changes of treating clinician. Where a clinician changes mid-course of treatment, document this clearly so that the clinical record always reflects who delivered care at each appointment.
  3. Review associate agreements. The form change does not alter the underlying contractual position with associates. Practice owners should ensure associate agreements clearly allocate clinical responsibility and require associates to maintain adequate, current indemnity cover.
  4. Verify associate indemnity arrangements. Regularly confirm that all treating clinicians hold appropriate cover. The practical benefit of attributing clinical responsibility to an associate is significantly diminished if that associate is unindemnified.
  5. Retain completed forms as part of the clinical record. The evidential value of the form depends on it being properly completed, stored, and retrievable. Practices should ensure their record retention policies treat the FP17DC as a key document.
  6. Do not overlook private patients. Given that the new form does not apply to private treatment, practices should consider what equivalent steps they can take to document clinical responsibility clearly in the private context.

Areas to watch

It is still early days since the form change took effect, and a number of questions are likely to crystallise over time as the new position beds in. Practitioners and practice owners should keep a watching brief on the following:

  • Court scrutiny of the new form. The true legal impact of the updated FP17DC will only become clear when it is tested in litigation. Courts will need to consider whether the form change is sufficient to break the chain of non-delegable duty liability or whether other factors, such as the GDS contract holder's broader obligations, continue to sustain it.
  • Indemnifier and insurer responses. It remains to be seen whether indemnity providers will adjust their approach to associate cover requirements, policy terms or pricing in light of the form change and the clearer attribution of clinical responsibility it provides.
  • Compliance in practice. Consistent and accurate completion of the new form is essential to its evidential value. Where forms are completed incorrectly, inconsistently or not at all, the protection the change was intended to provide will be undermined. This is an area where NHS England and the GDC may take a closer interest over time.
  • Private patient equivalence. Given that the form change offers no protection for private treatment, there may be growing pressure from indemnifiers, representative bodies or through litigation, for an equivalent standard of clinical attribution to be adopted in the private context.

The bottom line

The updated NHS FP17DC represents a meaningful and welcome development for dental practice owners and their indemnifiers. By placing the treating clinician's identity on the face of the treatment plan, it addresses one of the specific evidential factors that contributed to the finding of non-delegable duty liability in Hughes v Rattan and strengthens the basis for attributing clinical responsibility to the treating dentist.

Practice owners should not, however, view the form change in isolation. It reduces, but does not eliminate, the risk of a successful non-delegable duty claim. Combined with robust associate agreements, verified indemnity arrangements, and consistent clinical governance, it forms an important part of a comprehensive approach to risk management. The coming 12-36 months will be telling in terms of how the courts, indemnifiers and regulators respond to the change.

Bethan Parry and Alice Webb are specialist healthcare lawyers at Browne Jacobson LLP, advising dental practice owners, associates and indemnifiers across the full range of clinical negligence and regulatory matters