The following is a list of enhancements included in R4+ Version 9.0.4. All fixes are cumulative (each new release contains all new fixes as well as all fixes from the previous release).
We have implemented several changes to the Dental Nurse User Role to allow the immediate undertaking of Nurse Applied Fluoride Varnish (Code 711) on Child Patients.
Nurses who have a Performer Number recorded on their User Record will now be able to add their User too or own an NHS Contract. After doing this the user will be automatically assigned a set of Clinic Opening hours to be able to book Appointment Slots, these can then be adjusted in the Planner via View > Default Opening Hours when necessary.
These users will also now be able to enter their PIN number under EDI Management to undertake FP17 Claim Transmissions for completed NHS Courses of Treatment.
Important Note: This is a temporary measure to allow the immediate undertaking of Clinical Treatment & Production of FP17 Claims under NHS Contract by Nurses in the short term. In upcoming releases, we will begin swapping this behaviour into a New unique Clinical User Role as ”Oral Health Providers” which is used in various countries as a level 4 apprenticeship that sits between a Level 1-3 Dental Nurse and Therapist, Hygienist or Dentist Roles.
We will then automatically transfer any Active Dental Nurses operating as an NHS Contract Member into this new user Role when it is introduced so the changeover will be transparent maintaining the same changes made here to allow for applying Fluoride Varnish under NHS Contract. This provides the basis for future enhancements like access to Reports, Role Specific Mail Merges & Reminder Templates for Communications as well as the ability to maintain a separate Recall Cycle so not to affect Dental or Hygienist Recalls.
These future changes will aid this User Role in their Clinical Duties and Correspondence with Patients but will be introduced over time as the NHS Payment Reforms & Other NHS Regulatory changes continue in the R4+ DPMS.
A small adjustment was necessary to all Fissure Sealants and Preformed Crown Treatments so their Activity Banding would start as Band 2a and allow Chart to calculate up through 2b and 2c when needed. This corrects for NHS Courses of Treatments immediately jumping to Band 2b and skipping Band 2a during the Appointment.
New Patient Registration Forms are now available for eSignature Users in England and Wales that support the New Ethnicity Groups and UK-Resident / Not Resident NHS Number Settings as introduced in the April 2026 Payment Reforms.
Important Note: Due to Issues identified in the Print Revisions of these Forms corrections were necessary from the NHSBSA before Full Print and Overprint support could be implemented, these have recently been received so will be implemented in a subsequent R4+ DPMS update.
A new option has been added to the Create Plan form for an NHS Course of Treatment called “Stabilisation” and is meant for patients with unstable dental disease with 7 or more Carious Teeth, and at least 2 of them have Caries extending close to or into the Nerve of the Tooth.
When used a Care Package Charge is generated immediately unlike other Courses of Treatment allowing the course to be completed while empty so the FP17 Claim can be transmitted, this acts like an Urgent Course of Treatment in that only certain Treatments are allowed to be used dependant on the Stabilisation need if deemed necessary, these Treatments are detailed in the R4+ NHS Care Package Code Lookup Document.
In the FP17 Claim the “Clinical Data” Tab must be populated for Risks, Perio Health, Tooth Decay Status, Other Dental Needs & an ACORN Assessment Carried Out to ensure successful Stabilisation Claim Transmission.
Important Note: Recall Assessments & Patient New Examinations are not allowed to take place in the same Course of Treatment as Stabilisation, so if one or more is also necessary, it must be undertaken in a Separate Course as the Payment Reform Regulations expect Stabilisation to be carried out before anything else is provided.
Clinicians will now be able to apply Laboratory Fees to an NHS Course of Treatment. Two new Codes have been introduced to the NHS Code Scheme under the Miscellaneous Category “3001 – Laboratory Fee” & “3002 – Laboratory Fee Commissioner Approved”. When used the User will be immediately prompted to enter the required value. This avoids problems for permission restricted Clinical Users.
One Code can be entered in a patients NHS Course of Treatment to convey all applicable Lab Fees in their Dental Care as a single charge to the Patient, once recorded this information is also supplied as part of the FP17 Claim. If a patients required Lab Fees change as Treatment continues or due to FP17 Claim rejection if an Exempt Patient, re-open the course, delete and re-add the required Code to include any increase or decrease required in the Fees.
Under the 2026 Payment Reforms Laboratory Fees do not contribute towards the £384 Patient Charge Threshold Limit so for Non-Exempt Patients it may seem that an NHS Course of Treatment’s Total Patient Charge has breached in more Expensive or Complex courses of Treatment.
Where a Patient has a HC3 Partial Exemption the maximum the Patient can pay for an NHS Course of Treatment will now be governed by the lower limit between both the £384 legal maximum and the HC3 exemption value that is entered.
Additionally, any entered Laboratory Fee will be contributed against the Patient up to the Charge Limit with the remainder being covered in the FP17 Claim under NHS Contract.
In Clinical Chart a new option has been added to the Right Click Mouse Menu on the Treatment Item Grid to allow Clinicians to Mark any Treatments that stem from “Trauma Related Injury”.
As Trauma Related Injury could be recorded from the Exam, Advice or Treatment, it is not derived from any specific item so providing this as a Flag option gives flexibility as to when and what it is required against.
A Miscellaneous Trauma Care Package will be automatically applied to the Course’s Care Package List & the Treatment item Description appended with the “– Trauma Related Injury” Text.
Only one Care Package Charge can be claimed per Course of Treatment even if more than one Trauma Related Injury is recorded.
A Package Charge is generated immediately unlike normal Courses of Treatment and can be completed while empty to allow the FP17 Claim to be generated and transmitted.
This course type is like an Urgent Course of Treatment in that only certain Treatments are allowed to take place, where necessary. These are detailed in the R4+ NHS Care Package Code Lookup Document.
Defects Fixed in R4+ v9.0.4
Where Activity Band based Courses and Claims were replaced with Care Package based Courses and Claims the NHS Overview and Activity Reports no longer Counted Courses and Claims Correctly. This has now been fixed in R4+ v9.0.4.
Important Note: This fix is primarily to help correct General Claim and Course Counts under the 2026/27 Contract Period specifically to aid Practices which only undertake Urgent Care in the short term so to be able to accurately monitor progressive totals. Both Reports will continue to report no UDA’s & no courses for Activity Banded & Charge Exempt course types for the moment as these reports are still planned to be fully reworked in an upcoming R4+ DPMS Release to better report the new Payment Reform Contract.
An issue was identified where any Transitional Claims which were already rejected and in the process of being resubmitted were presenting errors when viewed due to not having any Care Package CDS Data Recorded, likewise any attempts to further Submit them would reject by COMPASS for similar reasons. This has now been fixed in R4+ v9.0.4.
An issue was identified where if an Extraction takes place on an adjoining Bridge position the Extraction is not being counted correctly and failed to produce a Caries Care Package Charge. This has now been fixed in R4+ v9.0.4.
An issue was identified where The Recall Assessment Charge was not being recalculated to split between the Patient and NHS if other NHS Treatment is added to the Course of Treatment for Patients in the applicable Age Groups. This has now been fixed in R4+ v9.0.4.
An issue was identified where any FP17 Claims transmitted for Patients applicable for a Free Exam due to the Under 25 and Over 60 Age Groups where the Patient did not Pay any Exam Charge the FP17 Claim transmitted did not contain the Exemption to inform COMPASS the Free Examination was present. This would result in the Claim being Settled without the NHS Covering the Cost of the Examination. This has now been fixed in R4+ v9.0.4.
The following additional Treatments have been identified and are now counted under the Miscellaneous Care Package:
1101 – Gingivectomy – Upper
1102 – Gingivectomy – Lower
1131 – Excision of Soft Tissue
These are also included in the latest version of the R4+ NHS Care Package Code Lookup Document. This has now been fixed in R4+ v9.0.4.
An issue was identified where if a Clinician viewed the FP17 before Completing an NHS Course of Treatment they would be shown the old Activity Banding based form and not the Care Package based form. This has now been fixed in R4+ v9.0.4.
An issue was identified where the Scheduled NHS Charge Value was showing a Negative value after receiving a settled SCHEDL Response for the Claim. This has now been fixed in R4+ v9.0.4.
An issue was identified where an invalid CDS value was being Transmitted informing COMPASS Dentist FP17 Claims were done by a Nurse providing Fluoride Varnish causing an invalid Rejection. This has now been fixed in R4+ v9.0.4.
An issue was identified where updating an older claim would cause a Patient's ethnicity to reset to an older retired ID, which then persist into new FP17 Claims as Courses of Treatment are undertaken, resulting in FP17 Claims with an unsupported Ethnicity recorded. This has now been fixed in R4+ v9.0.4.
Important Note: As some Patients and FP17 Claims may already have been affected, these records will have their Ethnicity Reset, meaning users may find some Patients unexpectedly prompting for Ethnicity Capture when accessed, and likewise prompted to reselect Ethnicity when submitting some FP17 Claims. Once set to a valid Ethnicity in both cases it should now remain correct.
An issue was identified where two queries used to populate the User Selection dropdowns was using a function not supported on older SQL Versions. This has now been fixed in R4+ v9.0.4.