Mid-year review and year-end reconciliation

The mid-year review gives providers the opportunity to identify and correct any potential issues before the annual year-end reconciliation.

Providers who have not met their expected contracted activity from the previous year may have activity carried forward into the current financial year. They must complete this carried-forward activity first.  It does not count towards the achievement of the mid-year review for the current financial year. Any activity carried forward is deducted from the current year’s activity to give an adjusted figure. All providers receive their adjusted figure as part of their mid-year review.

Providers whose adjusted activity is more than 30% of their contracted delivery at the mid-year point are encouraged to review their activity. This will help providers to deliver activity for the rest of the year that’s consistent with their contract. No further action is required.

Providers with less than 30% must complete a mid-year review action plan. This should detail their plans on how they expect to deliver the agreed activity to meet their contract obligations.

For a very small number of providers, failure to provide an action plan, or failure to deliver against the agreed action plan, may result in contract sanctions being levied against the contract.  Prior to any contract sanctions being placed on the contract, the commissioner or NHSBSA Provider Assurance will be in open dialogue with the provider.

The completion of a year-end final reconciliation is a requirement for all dental contracts. The following service lines are reconciled at the end of each financial year:

• Units of Dental Activity (UDA).
• Units of Orthodontic Activity (UOA).
• Courses of treatment that involve provision of sedation services.
• Courses of treatment that involve provision of domiciliary services.

We support NHSEI regional commissioning teams to review the annual contracted target against the actual delivered activity. This reconciliation process is completed by September each year.

PDS+ contracts and advanced service providers sit outside the scope of the reconciliation process for the NHSBSA PAD. NHSEI regional dental commissioning teams should contact PDS+ and advanced service providers to explain their contract attainment and the process to follow.

The information and data included in the year-end reconciliation and mid-year review is submitted by providers using:

• FP17
• FP17O

Claims are accepted on the Compass system up to 2 months from the completion date of the course of treatment.

Claims submitted later than this must still be submitted, as per the regulations. However, these claims will not be included in mid and year-end reconciliation. 

Only claims submitted up to and including 30 September are included as part of the mid-year reconciliation. To make sure all claims are included in your reconciliation you should submit all claims by the mid and year-end cut off dates.

Providers should discuss the Compass scheduling dates with their team responsible for submitting claims. The responsibility to submit claims within 2 months remains with the provider.

‘Late claims’ submitted outside of the 2-month window should still be submitted to ensure accurate reporting of patient treatments. These are processed for patient charge revenue but do not count towards delivery figures. This includes when a course of treatment is closed before completion.

You can find out more information about late claims in our Knowledge Base.

All submission information is available to providers by 1 July every year on the year-end statement. Be aware that this is the activity data gathered directly from Compass and is still subject to change following the year-end reconciliation process. This is finalised in the year-end letter before 31 July. Providers also have access to monthly schedules in Compass, as well as the year-end report.

From 2020/21, providers will also be able to view their year-end data in the year-end dashboard on Eden.

NHSBSA PAD will deliver a mid-year review for 2021/22 in line with the contract management arrangements detailed in the NHSEI preparedness letter issue 8.

The mid-year review is communicated to dental contracts, in relation to the following service lines only:

• Units of Dental Activity (UDA)
• Units of Orthodontic Activity (UOA)

All letters will be uploaded into Compass and we will send a communication to all business owner email addresses held in Compass to advise when the letters are available to view.

For contractors to view the letter:

1. Select Reporting
2. View Published Reports
3. Input MYRPR into the Report Type field

For commissioners to view the letters:

1. Select Reporting
2. View Published Reports
3. Input MYRCR into the Report Type field

The 2021/21 year-end reconciliation encompasses the full 2021/22 contractual year, in line with the time periods set out within the NHSEI's Key steps in 2022 to deliver for patients in NHS dentist letter (22 December 2021). 

We have produced a letter template for contractors to communicate their final reconciled year-end position:

Year-end 2021/22 reconciliation letter template (Word:277KB)

All letters will be uploaded into Compass and we will send a communication to all business owner email addresses held in Compass to advise when the letters are available to view.

For contractors to view the letter:

1. Select Reporting.
2. View Published Reports.
3. Input AYRPR into the Report Type field.

For commissioners to view the letters:

1. Select Reporting.
2. View Published Reports.
3. Input AYRCR into the Report Type field.

If you need to update your Business Owner email address in Compass, or have any questions regarding your year-end reconciliation, contact us at nhsbsa.dentalcases@nhs.net. 

Key dates and information for contractors and commissioners for the 2021/22 year-end reconciliation process:

Year-end 2021/22 operational workflow chart (Word:193KB)