Healthcare Services (Outpatient Dental Service) Regulations 2023

No. S 408

Healthcare Services Act 2020

Healthcare Services
(Outpatient Dental Service)
Regulations 2023

In exercise of the powers conferred by section 57 of the Healthcare Services Act 2020, the Minister for Health makes the following Regulations:

PART 1

PRELIMINARY

Citation and commencement

1.  These Regulations are the Healthcare Services (Outpatient Dental Service) Regulations 2023 and come into operation on 26 June 2023.

Definitions

2.—(1)  In these Regulations —

“allied health professional” has the meaning given by section 2 of the Allied Health Professions Act 2011;

“dental x-ray” means either of the following types of x‑ray that is conducted for dental imaging purposes:

(a) periapical x-ray;

(b) orthopantomogram;

“duly qualified allied health professional” has the meaning given by section 3 of the Allied Health Professions Act 2011;

“enrolled nurse” means a person who is an enrolled nurse within the meaning of the Nurses and Midwives Act 1999 and holds a valid practising certificate under that Act;

“essential life-saving measure” means any basic emergency procedure that may be carried out on a person for the purpose of resuscitating the person;

“expiry date” has the meaning given by regulation 2 of the General Regulations;

“General Regulations” means the Healthcare Services (General) Regulations 2021 (G.N. No. S 1035/2021);

“healthcare professional” has the meaning given by regulation 2 of the General Regulations;

“licensee” means a person who holds a licence to provide an outpatient dental service;

“MediShield Life Scheme” means the MediShield Life Scheme established by section 3 of the MediShield Life Scheme Act 2015;

“minor dental surgical procedure” has the meaning given by paragraph 2 of the First Schedule to the Act;

“nurse” means a registered nurse or an enrolled nurse;

“oral health therapist” means a person who is registered as an oral health therapist under section 22 of the Dental Registration Act 1999 and holds a valid practising certificate under that Act;

“outpatient dental service” has the meaning given by paragraph 2 of the First Schedule to the Act;

“patient health record” means a record containing the personal data and medical information of a patient that is maintained by a licensee in relation to the provision of an outpatient dental service to the patient;

“personnel”, in relation to a licensee, means any individual employed or engaged by the licensee to assist the licensee in providing an outpatient dental service;

“pharmacist” means a person who is registered under the Pharmacists Registration Act 2007 and holds a valid practising certificate under that Act;

“radiography procedure” means a dental x‑ray or dental cone beam computed tomography;

“radiological service” has the meaning given by paragraph 2 of the First Schedule to the Act;

“radiological service licensee” means a person who holds a valid licence under the Act to provide a radiological service;

“registered nurse” means a person who is a registered nurse within the meaning of the Nurses and Midwives Act 1999 and holds a valid practising certificate under that Act;

“simple in vitro diagnostic test” has the meaning given by paragraph 2 of the First Schedule to the Act;

“specimen” has the meaning given by regulation 2 of the General Regulations;

“temporary premises” means any premises other than permanent premises;

“testing material” means any test kit, material, device, equipment, instrument or other article that is used to conduct a simple in vitro diagnostic test.

(2)  For the purposes of these Regulations, a licensee is not to be treated as providing any outpatient dental service by remote provision to a patient, merely because —

(a) the licensee provides any information and communication technology to the patient to enable the transmission of data related to the patient’s dental health status between the patient and the licensee and the monitoring of the patient’s dental health by the licensee; or

(b) the licensee communicates with the patient remotely for administrative matters, including (but not limited to) the arrangement of the date of the patient’s next dental appointment.

Application of Regulations

3.  Unless otherwise expressly provided in these Regulations, the provisions of these Regulations —

(a) apply in addition to the provisions of the General Regulations; and

(b) prevail if, and to the extent that, there is any inconsistency between these Regulations and the General Regulations insofar as the matter relates to a licensee.

PART 2

LICENSING MATTERS

Specified service

4.  For the purposes of section 9A(1) of the Act, the conduct of dental cone beam computed tomography is a specified service for an outpatient dental service.

Prohibited service delivery modes

5.—(1)  A licensee must not provide an outpatient dental service using a conveyance that is not a vehicle.

(2)  A licensee must not conduct a dental cone beam computed tomography at any temporary premises or by remote provision.

PART 3

REQUIREMENTS RELATING TO PERSONNEL

Qualifications, skills and competencies of Clinical Governance Officer

6.—(1)  For the purposes of section 24(3)(b) of the Act, an individual is suitably qualified to be appointed as a Clinical Governance Officer for an outpatient dental service or a specified service for an outpatient dental service if the individual —

(a) is registered under section 14 of the Dental Registration Act 1999 and holds a valid practising certificate under that Act; and

(b) has either of the following:

(i) registration under section 14C(1) of the Dental Registration Act 1999 as a specialist in a particular branch of dentistry and accreditation as such specialist by the Dental Specialists Accreditation Board;

(ii) full-time work experience as a dentist for a continuous period of at least 2 years in treating patients —

(A) in the provision of an outpatient dental service, acute hospital service or ambulatory surgical centre service provided in a private hospital, medical clinic or healthcare establishment (as the case may be) licensed under the repealed Act; or

[S 841/2023 wef 18/12/2023]

(B) in the provision of an outpatient dental service, acute hospital service or ambulatory surgical centre service licensed under the Act.

(2)  In this regulation, “Dental Specialists Accreditation Board” means the board that is established under section 41 of the Dental Registration Act 1999.

General requirements relating to personnel

7.  A licensee must —

(a) establish, implement and regularly review policies and the appropriate processes for the training and competency assessment of the licensee’s personnel to ensure that the personnel are able to perform their work effectively, safely and in compliance with the applicable laws, guidelines, policies, processes, procedures and protocols; and

(b) monitor and regularly review the work performance of the licensee’s personnel to ensure compliance by the personnel with the applicable laws, guidelines, policies, processes, procedures and protocols.

No employment or engagement of unauthorised persons to practise dentistry

8.  A licensee must not employ or engage any person to practise dentistry unless the person is a dentist.

PART 4

PREMISES, CONVEYANCES, EQUIPMENT, ETC.

Standards for approved permanent premises

9.  A licensee must —

(a) ensure that every approved permanent premises is sufficiently spacious and appropriately equipped to enable the outpatient dental service (including any essential life‑saving measure) to be provided to a patient in a proper, effective and safe manner;

(b) ensure that there is sufficient lighting and ventilation at every approved permanent premises;

(c) ensure that every approved permanent premises is designed, built, and equipped to enable and facilitate —

(i) access to and from the approved permanent premises by patients with physical disability; and

(ii) movement within the approved permanent premises by patients with physical disability;

(d) if the licensee designates a separate area (called in this regulation the waiting area), whether inside or outside the approved permanent premises, where a patient may wait to receive the outpatient dental service or for any matter that is related to the provision of the outpatient dental service by the licensee, including making payment or collecting medicine, ensure that the waiting area is —

(i) within the direct line of sight of at least one personnel; and

(ii) sufficiently spacious and adequately equipped to ensure the reasonable comfort of every patient waiting in the waiting area;

(e) ensure that toilet facilities are available in every approved permanent premises, or assistance with toileting needs is provided to patients where needed;

(f) ensure that care or treatment (other than any essential life‑saving measures) is provided to a patient only in an area at the approved permanent premises that is sufficiently spacious, appropriately equipped and, if necessary, partitioned (whether on a permanent or temporary basis) from the other parts of the approved permanent premises to ensure the patient’s comfort, safety and privacy; and

(g) prevent unauthorised access to the approved permanent premises.

Standards for approved conveyances

10.  A licensee must —

(a) ensure that every approved conveyance is sufficiently spacious and appropriately equipped to enable the outpatient dental service (including any essential life‑saving measure) to be provided to patients in a proper, effective and safe manner;

(b) ensure that there is sufficient lighting and ventilation in every approved conveyance;

(c) ensure that every approved conveyance is sufficiently spacious to enable at least one patient (whether or not disabled) to move into and within the approved conveyance and receive care and treatment from such number of personnel of the licensee that may be necessary, whether the patient is standing up, sitting or lying down;

(d) ensure that every approved conveyance is designed, built, and equipped to enable and facilitate —

(i) access to and from the approved conveyance by patients with physical disability; and

(ii) movement within the approved conveyance by patients with physical disability;

(e) if the licensee designates a separate area (called in this regulation the waiting area), whether inside or outside the approved conveyance, where a patient may wait to receive the outpatient dental service or for any matter that is related to the provision of the outpatient dental service by the licensee, including making payment or collecting medicine, ensure that the waiting area is —

(i) within the direct line of sight of at least one personnel; and

(ii) sufficiently spacious and adequately equipped to ensure the reasonable comfort of every patient waiting in the waiting area;

(f) ensure that assistance with toileting needs is provided to patients where needed;

(g) ensure that there is a fire extinguisher in every approved conveyance;

(h) ensure that care or treatment (other than any essential life‑saving measure) is provided to a patient only in an area within the approved conveyance that is sufficiently spacious, appropriately equipped and, if necessary, partitioned (whether on a permanent or temporary basis) from the other parts of the approved conveyance to ensure the patient’s comfort, safety and privacy;

(i) ensure that every approved conveyance is not used for any purpose other than to provide the outpatient dental service by the licensee;

(j) prevent unauthorised access to every approved conveyance; and

(k) cause to be conspicuously displayed on every approved conveyance the business name by which the licensee provides the outpatient dental service.

Standards for facilities and equipment

11.—(1)  A licensee must ensure that every equipment or facility that is used in the licensee’s provision of the outpatient dental service is safe and effective.

(2)  Without limiting paragraph (1), a licensee must ensure that —

(a) every equipment or facility must be installed, and used or operated properly, in accordance with the instructions of the manufacturer of the equipment or facility;

(b) where the licensee is approved to provide the outpatient dental service using an approved conveyance, every equipment, instrument, appliance, material or facility that is necessary for the provision of the outpatient dental service is —

(i) fit for use at the approved conveyance;

(ii) if necessary, calibrated for use in the approved conveyance; and

(iii) securely fastened or stored in a manner so as not to pose a threat or risk to the safety of any person in the approved conveyance while the approved conveyance is in motion; and

(c) where the possession, use or operation of any equipment or facility requires any certification or licence, at all times when the licensee is in possession of the equipment or facility —

(i) the licensee holds the valid certification or licence for the possession, use or operation of the equipment or facility; and

(ii) the equipment or facility is checked regularly, and maintained properly and according to the manufacturer’s specifications, so as to ensure that it is adequate, functional and effective.

Environment cleaning

12.  A licensee must ensure that every approved permanent premises and every approved conveyance (as the case may be) is kept clean and sanitary by establishing and implementing measures and processes for regular cleaning and additional ad hoc cleaning to minimise the spread of pathogenic organisms.

Infection control

13.  A licensee must prevent the occurrence of, or manage, control and contain the spread of any infection that is, or is suspected to be, connected with the licensee’s provision of an outpatient dental service at any approved permanent premises, temporary premises or using any approved conveyance by ensuring that —

(a) only equipment, material or article that is reprocessed through high-level disinfection or sterilisation in accordance with the specifications by the manufacturer of the equipment, material or article (as the case may be) and is not subsequently contaminated, is used in any dental procedure on a patient;

(b) every equipment, material or article that is used in every dental procedure is —

(i) reprocessed through high-level disinfection or sterilisation in accordance with the specifications by the manufacturer of the equipment, material or article, as the case may be; and

(ii) kept and stored under the appropriate conditions to ensure that the equipment, material or article remains fit for use until it is used in the next endoscopic, operative or invasive procedure; and

(c) every equipment that is used to reprocess or sterilise any other equipment, material or article is checked regularly and maintained properly in accordance with the specifications by the manufacturer of the equipment, so as to ensure its proper and effective operation.

 

Made on 20 June 2023.

CHAN YENG KIT

Permanent Secretary,
Ministry of Health,
Singapore.

[MH 78:44/1; AG/LEGIS/SL/122E/2020/23 Vol. 1]