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.
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.
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.
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