A complex speciality with major primary and secondary care services, as well as more trainees than any other discipline the orthodontic commissioning guide encompasses the provision of these services within NHS England. You can read the document here.
Like all the guides, there are established levels of care provision:
Level 1: Treatment and care undertaken in NHS primary dental care mandatory contracts and NHS England commissioning expectations of care provided.
Level 2: Treatment undertaken by practitioners, under specialist supervision and with a formal link to a consultant-led MCN. This includes dentists who have enhanced skills and/ or experience; non-specialists who have demonstrated the competencies detailed in the Curriculum for the Primary Care Dentist with a Special Interest in Orthodontics, either by obtaining the Diploma in Primary Care Orthodontics or by demonstrating equivalence.
Level 3a: Treatment undertaken by practitioners who are on the Specialist List for Orthodontics with a formal link to a consultant-led MCN. This is predominantly primary care treatment which could be delivered in either a primary care or secondary care setting.
Level 3b: Treatment undertaken by practitioners who are on the Specialist List for Orthodontics and have undergone an approved period of further post-specialist training or who can demonstrate equivalence. Level 3b Orthodontic treatment is generally delivered within a secondary care setting.
The guide recommends a referral management approach to ensuring that the case complexity is assessed and that care is directed to capacity.
