Orthodontics is the dental specialty concerned with facial growth, development of the dentition and occlusion, and the assessment, diagnosis, interception and treatment of malocclusions and facial deformity. Orthodontic treatment should only be undertaken where it is believed to be in the patient's best interests in terms of their oral health and/ or psychosocial wellbeing. The clinical advantages and long-term benefits of Orthodontic treatment should justify and outweigh any detrimental effects. Patient factors to consider include co-operation, motivation and their ability to maintain good oral hygiene. It is not generally in the patient's best interest to deliver orthodontic treatment in the absence of a stable oral environment or where there is evidence of active dental disease. There are several factors used to define orthodontic treatment complexity which can be classified as level 1, 2, 3a or 3b. Factors include the type of malocclusion, technical difficulty in improving function and aesthetics, together with any patient modifying factors.

Primary care orthodontic services for children and young people aged 12 -18 years. Patients are referred into the pathway via their general dental practice. All services take place within a primary care setting. 10 year PDS Agreement contract terms for primary care orthodontic services are motivated by the need to support service stability, workforce sustainability and long term planning, in line with the findings of the Orthodontic Needs Assessment (2026) and wider system pressures. Orthodontic service delivery is dependent on a specialist workforce, with recruitment and retention recognised nationally and locally as challenging. Longer term contract arrangements provide greater certainty for providers, enabling workforce planning and retention of specialist orthodontic clinicians and reduced disruption linked with shorter contract terms. In addition, this will support estates and service investment, particularly where providers are delivering specialist orthodontic care from dedicated premises. A 10‑year term offers providers sufficient assurance to invest in infrastructure and incentivises support for service redesign aligned to population need. The length of the contract will be 10 years to start 1 April 2027 and end 31 March 2037. Providers will be paid annually for the period of 10 years. NHS Norfolk and Suffolk Integrated Care Board are awarding the contract named within this notice under the Direct Award C process which is outlined within the Health Care Services (Provider Selection Regime) Regulations 2023. The provider named in this notice is an existing provider and has been reviewed through a Key Criteria assessment to ensure the awarding body is satisfied with current performance and reasonably expects the provider to be able to satisfy the contract which is the subject of this notice. The contract which is the subject of this notice has not changed considerably when compared with the existing contract delivered by the named provider. The ICB may wish to introduce additional services during the lifetime of the contract ("Contract modifications"). Such contract modifications will be contemplated where additional requirements are similar and or complementary to the services already included