The NHS FP17DC is the treatment plan provided to a patient at the start of their course of dental treatment in England.

The form has recently been amended to include the name of the patient's treating clinician, a change that took effect on 1 April 2026 and which represents a significant step towards protecting practice owners from clinical negligence claims alleging a non-delegable duty of care, even where the practice owner had no personal involvement in the patient's treatment.

The significance of this change cannot be overstated. As this article explains, the previous version of the form played a direct role in exposing practice owners to liability in circumstances where they never treated the patient at all.

What is a non-delegable duty of care?

The leading authority on non-delegable duties is Woodland v Swimming Teachers Association [2014] AC 537, in which Lord Sumption identified five cumulative factors that must be present for such a duty to arise:

1. The claimant is a patient, child, or otherwise especially vulnerable or dependent person.
2. There is an antecedent relationship between the claimant and the defendant that places the claimant in the defendant's actual custody, charge, or care, from which a positive duty to protect the claimant from harm arises.
3. The claimant has no control over how the defendant performs those obligations.
4. The defendant has delegated to a third party a function that is integral to the positive duty assumed by the defendant.
5. That third party has been negligent in performing that very function.

In the dental practice context, each of these factors maps naturally onto the relationship between a patient and their NHS dental practice. Patients register with and attend a specific practice expecting to receive care; they often have no meaningful control over which clinician treats them on any given appointment; and the practice owner routinely delegates direct clinical care to associates or other dental care professionals. Where those clinicians are negligent, the Woodland framework opens the door to a claim against the practice owner personally, even if they played no part in the treatment.

A non-delegable duty of care therefore allows a claimant to pursue a defendant for treatment carried out by their employees or third parties, even when the defendant did not treat the claimant personally.

Hughes v Rattan [2022] EWCA Civ 107

The implications of the non-delegable duty in the dental context were brought into sharp focus by the Court of Appeal's decision in Hughes v Rattan.

In that case, the claimant alleged that Dr Rattan, the practice owner, was liable for negligent treatment provided by self-employed associate dentists working at his practice. Two routes to liability were advanced: vicarious liability and non-delegable duty of care.

On vicarious liability (the principle that an employer may be liable for acts of an employee even if the employer was not personally at fault), Dr Rattan succeeded on appeal. The Court of Appeal held that the relationship between Dr Rattan as the practice owner and the self-employed associates (who were engaged on BDA standard terms and retained significant autonomy) did not satisfy the "akin to employment" test following Barclays Bank plc v Various Claimants [2020] UKSC 13. This part of the first instance decision was reversed.

On non-delegable duty of care, however, the claim was upheld. The Court found that Dr Rattan, as the NHS GDS contract holder, owed a non-delegable duty of care to patients attending his practice, and was therefore liable for the negligent acts of the self-employed associate dentists. Two features were central to this finding:

• The GDS Contract framework: As the contract holder with NHS England, Dr Rattan had undertaken a positive obligation to provide dental services to patients. That obligation could not be discharged simply by delegating clinical delivery to associates.
• The FP17DC treatment form: Critically, the previous version of the form named only Dr Rattan as the practice owner and "provider" of treatment - even though he had never personally treated the patient. This created a documented basis for the court to find that the patient was placed in Dr Rattan's charge, satisfying the second Woodland factor.

It is this second point that makes the form change directly legally significant. The old FP17DC, by naming only the practice owner as provider, was itself contributing to the conditions for non-delegable duty liability.

The previous NHS FP17DC

The previous FP17DC included only a space for the practice owner's name as the clinician providing treatment. It made no provision for recording the identity of the dentist who would be directly delivering care to the patient. As Hughes v Rattan demonstrated, this created vulnerability for practice owners: the form effectively represented to patients, and to the courts, that the practice owner was the provider, regardless of the reality on the ground.

This left practice owners exposed to clinical negligence claims premised on non-delegable duty in respect of treatment they had no involvement in, in circumstances where the form itself lent support to the claimant's case.

The new NHS FP17DC

The new FP17DC, which took effect from 1 April 2026, requires the name of the clinician responsible for delivering the treatment to be included on the form. This change was introduced in recognition of the need to reduce the risk of non-delegable duty claims succeeding against practice owners who had no personal involvement in the treatment in question.

By naming the treating clinician on the face of the treatment plan, the new form:

• Creates a contemporaneous record attributing clinical responsibility to the dentist who actually delivered care, rather than the practice owner by default.
• Weakens the evidential basis for the second Woodland factor, the argument that the patient was placed in the practice owner's charge, by identifying a specific treating clinician from the outset.
• Provides clearer attribution of liability from an indemnity perspective, supporting the direction of claims to the correct indemnifier.

What the form does not do: Important limitations

Practice owners and their indemnifiers should be careful not to treat the new form as a complete answer to non-delegable duty claims. Several important limitations must be kept in mind:

• The non-delegable duty is not eliminated by the form. The Woodland duty arises from the structure of the relationship between the patient and the practice, not from what any document states. A claimant could still argue that the practice owner, as GDS contract holder, retained an overarching non-delegable duty irrespective of who was named on the treatment plan. The form is powerful evidence but not a complete shield.
• Mid-treatment changes of clinician are common in dental practice. Where the treating dentist changes during a course of treatment, the form may not accurately capture this unless practices implement specific protocols to update the record.
• The form applies to NHS treatment only. For private patients, no FP17DC is used, and practice owners remain potentially exposed to non-delegable duty claims under the existing legal position for private treatment. This is a significant ongoing risk for mixed practices and those providing predominantly private care.
• Historic claims will continue to be assessed against the old form position ( i.e. those arising from treatment provided before 1 April 2026). The risk profile established by Hughes v Rattan persists in full for that cohort of potential claims.

What should practice owners do now?

The form change is most effective when treated as part of a broader risk management approach rather than a standalone solution. Practice owners and their indemnifiers should consider the following steps:

1. Implement the new form immediately and consistently: Ensure the updated FP17DC is used for every NHS treatment episode from 1 April 2026, with the treating clinician accurately named at the outset. Train reception and clinical staff accordingly.
2. Establish a protocol for changes of treating clinician: Where a clinician changes mid-course of treatment, document this clearly so that the clinical record always reflects who delivered care at each appointment.
3. Review associate agreements: The form change does not alter the underlying contractual position with associates. Practice owners should ensure associate agreements clearly allocate clinical responsibility and require associates to maintain adequate, current indemnity cover.
4. Verify associate indemnity arrangements: Practice owners and their indemnifiers should regularly confirm that all treating clinicians hold appropriate cover. The practical benefit of attributing clinical responsibility to an associate is diminished if that associate is not indemnified.
5. Retain completed forms as part of the clinical record: The evidential value of the form depends on it being properly completed, stored, and retrievable. Practices should ensure their record retention policies treat the FP17DC as a key document.
6. Do not overlook private patients: Given that the new form does not apply to private treatment, practices should consider what equivalent steps they can take to document clinical responsibility clearly in the private context.

Conclusion

The updated NHS FP17DC represents a meaningful and welcome development for dental practice owners and their indemnifiers. By placing the treating clinician's identity on the face of the treatment plan, it addresses one of the specific evidential factors that contributed to the finding of non-delegable duty liability in Hughes v Rattan and strengthens the basis for attributing clinical responsibility to the treating dentist.

Practice owners should not, however, view the form change in isolation. It reduces, but does not eliminate, the risk of a successful non-delegable duty claim. Combined with robust associate agreements, verified indemnity arrangements, and consistent clinical governance, it forms an important part of a comprehensive approach to risk management.

Our dedicated dental clinical negligence team has many years' experience advising practice owners, associate dentists, and their indemnifiers on vicarious liability and non-delegable duty of care – the principles at the heart of decisions such as Hughes v Rattan. We advise at every stage, from reviewing associate agreements and indemnity arrangements through to the defence of complex claims. If you have questions about the implications of the FP17DC changes or your indemnity position, please do not hesitate to get in touch.