New Nhs Dental Contracts

[funkymonkey]

ok so weve all heard the horror stories where people are being made to go private or loose there dentists due to the new nhs contract (mainly in the east midlands according to the number of calls we get in nhs direct) but if your local dentist is nhs still like mine it is so much cheaper!

checkup 6 weeks ago (first in 5 years) revealed the need for 5 fillings

5 fillings done today (yes im sore)

total cost including checkup and two of the fillings were at the front so white!

£42.40

a complete bargain!

so the moneysaver in me says if you havnt been to the dentist in a while (which is naughty of you) and you can get into an nhs one its not as expensive as you might think! dont be put off by the thought of impending doom -financially!

[Toothsmith]

Five fillings in how much time?

I would guess a half hour appointment? So real quality workmanship then!

It's only a bargin if it saves you money. Now, of course I expect that it was done completely by the book, and every precaution, and recommended technique was followed.

It must just be that I am very slow in that I couldn't manage anything more than a couple of fillings in the same area of the mouth in a half hour appointment. Or maybe you were in the chair for over an hour?

And what about next time you go and it's only one filling needed. That too will cost you £42.50.

Although if you were in the chair for over an hour, that dentist will be bankrupt by the time you go again!

The new NHS contract is a dogs dinner, and it encourages and rewards poor workmanship. Avoid like the plague.

[funkymonkey]

now i have to disagree - sorry i didnt make myself clear.

my dentist was only meant to do two - on one side but her half hour appointment after mine was cancelled so i asked if i could have them all done to save coming back!. took about an hour and 10 in total! wasnt the best experience.

yes just one filling is the same price as having upto 6 i think. any more and it jumps to the next band which is £180!!!

not all dentists are money grabing people in the same way that not all plastic surgeons do private work and most nurses stick with the nhs through thick and thin because we actually life providing a quality nhs service! im not implying that you are money grabbing because i understand some dentists got a bad deal - it just amases me that some practices are happy with nhs and some arnt. surely you get the same offer all over the country?

although i kow the east midlands doesnt have a lot of dentists.


also ive had private fillings that have fallen out and nhs that have stayed in.

[emilyt]

O Funkymonkey you poor thing. How on earth did you cope with having 5 fillings all at once. I had one today at 12.20. Have only just got the feeling back in my mouth and feel so sore. I can't complain now after reading your post. Couldn't imagine the pain of 5. I do sympathise.

[funkymonkey]

no pain yet! ive got my feeling back! i have what i think is a hole though and i had a big bit of imalgum in my mouth when waling out of the dentist but got it checked out and nothing had fallen out. just feels like there is a hole not but might be where they have built up the filling.

had soup through a straw for dinner lol!

[Toothsmith]

yes just one filling is the same price as having upto 6 i think. any more and it jumps to the next band which is £180!!!



No - Exam, simple cleaning, emergency dressings, x-rays = Band 1 =£15.50

(Dentist gets credited 1 Unit of Dental Activity (UDA))

All & any fillings, root fillings, extractions, extensive cleaning = Band 2 = £42.50 (Or £42.40 - not sure) (Dentist gets 3 UDA however many fillings)

Any treatment involving lab work (EG denture, crown be it single or multiple units, bridges etc) = Band 3 = £189 (Dentist gets 12 UDA)

The dentist will have a 'target' UDA figure to reach to get the same funding as last year.

If he goes over - he gets no more money, but may apply for a greater target (Although no guarentee of more funding to go with it!) for the next year.

If he goes under, he has 6 weeks to make up the shortfall, or funding next year wil lbe cut (And of course, in those 6 weeks he should also be getting well on the way with next years target as well!)

Now lets have a look at those bands.

One filling done in 10 minutes gets the same points as a mouthful of fillings done over several visits.

To root fill an abscessed tooth properly and save it takes about an hour and a half of surgery time. this gets 3 points. To take it out takes 20 mins tops and gets the same points.

To take it out and replace it with a single unit denture will push it up to a band 3 treatment and cost the patient £189, but, more importantly, earn the dentist 12 whole points! Brilliant, especially if it's an exempt patient who doesn't have to pay the charge!

If a patient presents who needs several crowns, the dentist will only get 12 points, and yet be faced with a lab bill of several hundred pounds to get them all made. If he can convince the patient to have them done at a rate of one every 6 months, he will get 12 points a time, although the patient will have to pay £189 each time. Probably easier all round to just refuse to see that patient.

I repeat that this contract is the death of decent dentistry in the public sector in this country - but that is exactly what the government wanted. the only reason 90% of dentists signed it was because at the time, they had no alternative. All the sensible ones who actually care about their work are planning their exit.

Things may seem OK at the moment, but we are only 3 months into it. PCTs are not rocking the boat too much yet.

Lets not forget though that on April 1st, we lost 10% at least of the dentists who had an NHS contract. This was hailed as a success by Rosie Winterton, as obviously we had too many in the first place!

Come the end of the year when UDA reviews are due and we will see things get interesting.

Come 2009 when dental funding is no longer ring fenced, but open to the other demands of the NHS as well, and things will get even more interesting.

If I was a member of the public who cared about the work done on my teeth, I would find a dentist I was happy with be it private or NHS, and stick with them whatever. Certainly not jump ship in search of the last NHS dental place when each one steadily goes private.

[allycat999]

I have a NHS dentist who I think is brilliant. He takes his time and my kids love going to the dentist. When he goes private as I am sure he will eventually I will stay with him.

[Turning_into_scrooge]

But do private dentist do work for those on Income Support?

[Robert Sterling]

After a long time with NHS dentistd I am now with private dentists.
Dental Hygeneist charges £140 per hour.

[funkymonkey]

so in away its like the new agenda for change pay package - we get a percentage of our salary for doing a percentage of unsociable hours. if we go over we get no more money. we have to re apply three months later to up our percentage band.

surely if it was that apauling - why would there be any NHS dentists? im intrigued now! i cant believe they get such bad treatment! bloody government. hope its not patricia hewtill lol - BI*CH

[Kinnairdy]

Slight deviation off topic, to help/prevent dental pain take Calendula and Hypericum Tinctures (BioForce Herbals) and Arnica 6c (Homeopathic Tablets)for 7 day's before & 5 day's after treatment. Excellent for relieving post op pain and speeding the healing process, especially wounds/extractions/general aches & pains. Amounts on bottles. No known side effects but if on medication, ie Warfarin (thins blood) or unsure about any tablets check with GP first.
Works for me everytime, no pain at all and wounds heal in less then a week.

[Mrs Wobbly]

Our dentist was one of those 10% who refused to sign the contract, after reading the reasons behind their decision, I fully understand why. Thanks ToothSmith
Denise

[Toothsmith]

But do private dentist do work for those on Income Support?

Private dentists will do work for anybody.

I have several patients on income support on my books.

But they pay the charges like everybody else.

People pay for what they value. The problem with people who don't value good dentistry is that they look at their own income, and because it's not a priority for them, think that the only people who can afford private dentistry must be earning a whole load more money than them. This isn't true.

I remember reading in Car magazine, years ago, about a postman who had really scrimped and saved and gone without loads of things others would call 'necessities' in order to own and run a Lamborghini Countach. (Very nice expensive sports car).

Different people have different priorities.

[Toothsmith]

Slight deviation off topic, to help/prevent dental pain take Calendula and Hypericum Tinctures (BioForce Herbals) and Arnica 6c (Homeopathic Tablets)

Just remind me.

Is 6c the dilution that's the equilavent of one active atom in a swimming pool, or one atom in the Pacific Ocean? ;)

[Toothsmith]

surely if it was that apauling - why would there be any NHS dentists? im intrigued now! i cant believe they get such bad treatment! bloody government. hope its not patricia hewtill lol - BI*CH

It can be very hard to shift the balance of your practice towards the private sector.

Plus, there are an awful lot of dentists out there who have been really committed to the NHS, despite all the kicks in the head (I avoid using teeth). I myself was very pro NHS until about 8 years ago, when it was either stick to my principals and go bankrupt, throwing several nurses out of work and leaving a couple of thousand people without a dentist, or provide crap treatment, or go private.

I am not anti NHS now. I am just anti THIS NHS.

Dentistry is the tip of the iceberg, and because dentistry is made up of sub-contracted independant practitioners, it doesn't hide the cracks as well as the fully nationalised, state owned system of the rest of healthcare.

In short, dentists, unlike doctors, with a bit of planning can walk away.

Many, despite the history, didn't think the new contract would really be this bad. They thought they would 'suck it and see'.

Now they find it is, there will be an awful lot of planning going on!

But of course, there are also the practices who have worked out how to make this system pay, and aren't really that fussed about the standard of dentistry they provide.

They will be the last ones remaining.

[esthomizzy]

Last month I had a gold crown in the back of my mouth. I have an NHS dentist and she's really good but she said that under the previous NHS charges the cost of the crown would have been a lot less than the 189 I just paid. Though from the perspective of getting a check up or a filling it would probably be cheaper. I hope not to need to go to the dentist for yonks now though.

[Toothsmith]

By yonks, I hope you only mean 6-12 months!

Check ups and fillings are also more expensive now if you only need single items.

If you need multiple fillings it's the same charge.

So you have a choice (This Government LOVES it's choices!)

Wait until things have really fallen to pieces and go and get it all fixed at once

(Cheap in money terms, but will knacker your teeth over time)

Or go and get things checked regularly, and fixed whilst the problem is minor.

(Probably as dear as paying privately on the NHS now, but you will have healthier teeth with much less trouble).

Plus, if your dentist is still on the NHS, you will probably have to endure long waits for appointments as now registration has ended, everybody has equal access to any NHS dentist. (In theory!)