NHS Compliance (Wales / Care Package) Updates for 1 April 2026

Updated Care Package Workflows for Wales

Sensei Cloud delivers full compliance for NHS Wales dental claims effective 1 April 2026. For Dental treatment, the banded treatment model is being replaced with care package workflows:

• Urgent and non-urgent care package labels replace the previous banded labels, but the process for creating them is the same.
• Fees and validations are updated for compliance. 
• The software enforces the £384 patient charge cap on claims (excluding laboratory fees).
• Ledger posting reflects the changes. 
• Referral options have been updated in the treatment planning workflow.

All submissions on or after 1 April 2026 must use the new format, including resubmissions, ensuring a smooth transition for practices.

Automated Care Package Creation

Care package treatment plans are created in the same way as existing NHS dental treatment plans. Sensei Cloud automatically computes the correct list of care packages directly from the procedures and categories in the treatment plan, as well as the patient's age and other applicable criteria. 

Details are accessible from the Treatment Plan window:

Click the icon to display the Care Package Breakdown:

This change removes references to UDAs and treatment/activity bands in multiple areas of the software, including Dental Treatment Plans, Claim UIs, and the Dental Chart.

Urgent Care Package

From the Patient tab, select Treatment Plans > Create New Plan, and then select Urgent Treatment.

The Manage Treatment Plan window is displayed. Add procedures and notes as per the usual process. The software provides validations that prevent disallowed procedures, and disallows combining urgent and non-urgent packages. 

Patient Charge Calculation with Cap

Patient charges are computed automatically per the new schedule, including age-based pricing for New/Initial Assessment and Recall, and a claim-level cap of £384 (excluding laboratory items).

Editable Care Packages on the Claim UI

NHS Claim details include a recap of inferred care packages. Authorized users can use the Update NHS Claim window to override, add, or remove packages, and to adjust counts. Select NHS Claims > Claims Management, and then select the claim to display the Update NHS Claim window and associated Care Packages.
Note: You can also access the this feature directly from the Treatment Plan window.

Referral Option Changes 

In Wales, the Treatment on Referral option has been replaced with two more specific options:
- Referral for Advanced Services
- Referral for High Needs

These changes are also reflected in the Other Services section of the Update NHS Claim window.

Note: The Charge for Additional Services option has been removed, as it was only available when Treatment on Referral was selected.

Laboratory Fee Management

Practices can add Regular Laboratory Fees and Lab-Fee Commissioner Approved on applicable care packages. 

Note: Commissioner-approved fees should be used only for exempt or remitted patients.

A warning message is displayed when marking a claim as Ready to Send in the following scenarios, to help users avoid claim rejections: 

• When Commissioner Approved laboratory fees (Procedure Code 8002) are present for a non-exempt, non-remitted patient 
• When a claim contains laboratory fees but none of the included Care Packages permit lab fee submission

Updated Claim Submission and Data Management

All Welsh Dental claims with a Date of Acceptance on or after 1 April 2026 must use the new care package format and codes (including 9201, 9202, 9212–9222, 9206, 9207, 9208), and no dental banding.
Note: Orthodontic claims still use the NHS band system.

The software validates claim data before allowing a claim to be marked Ready to Send. The validated items include:

• Date
• ACORN requirement
• Exam limits
• Single-package rule

The Ready to Send status is blocked when a plan accepted before 1 April 2026 is completed on or after that date without care packages. 

Transition of Legacy Claims and Treatment Plans

Wales courses of treatment accepted before but completed after 1 April 2026 can be claimed using the new Care Package codes and EDI structures while still applying legacy patient charge bandings, with clinical records preserved intact.

To convert to a treatment plan accepted before 1 April 2026 to Care Packages:

1. Open the treatment plan. The Viewing Treatment Plan window is displayed.
2. Click Edit Treatment Plan Details.
   
3. Click Save Changes. The system automatically converts the treatment plan to Care Packages but posts the regular NHS band charges to the patient's Ledger.
   Additionally, the NHS Care Package breakdown is available from the icon, but there is no charge associated with the listed care packages.

Two-Months Rule Discontinuation

Sensei Cloud no longer enforces the "two months" rule between consecutive NHS Dental courses of treatment. When you create/accept a new plan or mark a claim Ready to Send, the system does not or adjust patient charges based on a prior plan completed within the previous two months. 

Regulation 11 Restrictions

Sensei Cloud restricts Regulation 11 to Orthodontic courses of treatment. On orthodontic plans, Replacement Appliance and Two Replacement Appliances options remain available.

Note: Replacement appliance options are no longer available on Dental treatment plans because Regulation 11 items are now restricted to Orthodontic treatment plans only, in accordance with current NHS Wales regulations. Orthodontic workflows remain unchanged.

Treatment Under Warranty

There are three new Warranty Care Packages for:

• Permanent Restorations (9203)
• Root Fillings (9204)
• Crown/Bridge/Inlay/Onlay/Veneer (9205)

From the treatment plan, select the Gear icon next to a procedure, select Treatment Done Under Warranty, and click Save.

Warranty is prepended to the Care Package description in the treatment plan as well as in the NHS Care Package Breakdown window when Under Warranty is selected. 

An Original Treatment Was Urgent option is also available to drive the 12 or 24 month warranty period. From the treatment plan, select the Gear icon next to a procedure and select Original Treatment Was Urgent. 

Note: This option is not available for Crown/Bridge/Inlay/Onlay/Veneer Care Package because that type of treatment cannot be done as urgent. 

When claiming a procedure done under warranty, the NHS performs a history check for the patient. The warranty duration for procedures carried out during urgent treatment is different (12 months), so the NHS will implement different validation rules. Non-urgent treatments and Crown/Bridge/Inlay/Onlay/Veneer warranty care packages use the 24 month history check.

Additionally, the Under Guarantee terminology has been replaced with Under Warranty in the Claims Management screen. There is a checkmark in this column when there is at least one Warranty Care Package included in the claim.

Note: 
-- Only one warranty care package is added to a treatment plan per each of the three warranty package types. The number in Clinical Data Set will always be the true number of the data. For example, if there are three crowns marked as Under Warranty, there will only be one Warranty Crown/Bridge/Inlay/Onlay/Veneer Care Package, but the Clinical Data Set will show the three crowns.  

-- You can not manually add or remove Warranty Care Packages from a claim. 

Incomplete Treatment

There are minor enhancements to the claim transmission for Wales claims with an acceptance date on or after 1 April 2026 that have incomplete treatment.

Recall Procedure Codes

There are two new NHS procedure codes for Recalls that automatically attach the Recall or Recall 18-24 months Care Packages with associated £25 patient charges.

The new procedure codes are:

• 109 - Recall Assessment
• 110 - Recall Assessment (18-24 months)

Note: A warning message is displayed for invalid claim combinations. For example, you cannot combine certain treatments such as a 101 Exam/Report and a 109 Recall Assessment. You also cannot include Recall Care Packages on a FTR plan.

Dental Chart Rework

The Dental Chart Planning Mode is updated for Wales NHS treatment plans from 1 April 2026 to hide Band and UDA information for Care Package treatments. This is to ensure that the displayed information remains consistent with the treatment plan and resulting claim.