Asked for Dental NHS Scale and Polish.Told "Go to Hygienist at £25 extra"

brook2jack

BC you were wondering what the dentists cut of the hygienists £30 is ...... In a corporate it is ...... £0. Over the last few years the corporates have removed the referral fee for hygienists.

If it is an NHS practice and referral , then the hygienist will probably end up costing the dentist £10, in other words they will make a loss on the treatment.

In a family run practice it's probably around £0 to £8 depending on area and whether dentist owns practice or not.

brook2jack

Pennylane you say that you can't understand why dentists don't do a quick scale and polish whilst she's in there as your daughters check up only took 3 minutes?

Add on the time that cleaning down the surgery and preparing for the next patient. Then add on the time taken for the 3 year old in pain who has to be persuaded to open their mouth.

Now add on the costs in time (a surgery costs £120 an hour to run and every minute has to be accounted for), materials (handpiece,ultrasonic scaler,handscaler,prophy brush,suction tube,cup,mouthwash,scaler tip,3 in 1 tip,gauze) half of which is thrown away as it is single use, the other half has to be scrubbed, ultrasonically cleaned, the handpieces oiled , the whole lot autoclaved , then bagged and dated.

If you,your daughter etc want a scale and polish but don't NEED it why should the dentist do it for free to you but at quite a cost to them?

brook2jack

There are many things that were available on the old contract that aren't now. The government itself said it wanted fewer and simpler courses of treatment.

For instance alot of children who used to be eligible for NHS bracework are no longer as guidelines were put in to restrict orthodontic work to worst cases only.

At the same time apart from a few special cases all adult brace work was also stopped.

You will not get the same NHS service now as you did pre 2006 because the contract was designed so that "by freeing up time by having fewer and less complicated courses of treatment dentists will be free to take on more patients". Not my words but the words of the government. In other words in order that "everyone will have a NHS dentist" each dentist will take on more people but do less on them.

jugglebug

One little comment.
Under the old contract the exam held a fee. Which was iirc less than a fiver.
The scale and polish held an extra fee. However they were often presented together.
There were also a whole range of more advanced gum disease treatments that had their own extra fees.
All the above comments that imply that in the old days people had their scales routinely at no extra charge are wrong, they were charged extra.
However there were no rules as to when a scale was done.it was enough for one to be wanted. The nhs now specifies one to be needed.

Of course this thread may become redundant soon as the government has recently began releasing info on some new pilots for their new contact. Piloting being something the last didn't bother with.
Time will tell.

welshdent

A lot of people on the old contract treated gum disease on the scale and polish code because it was a lot easier. To claim for periodontal disease treatment was a nightmare involving stipulated recall times And other hoops to jump through or you were unable to complete. For the extra few quid it was barely worth the hassle so it was treated under the simple scale and polish code. Now it's a lot easier ad it's a band 2 for perio. The problem for the patient is they were used to a cheaper cost and probably assumed that was the standard - it wasn't.

boozercruiser

jugglebug wrote: »

One little comment.
Under the old contract the exam held a fee. Which was iirc less than a fiver.
The scale and polish held an extra fee. However they were often presented together.
There were also a whole range of more advanced gum disease treatments that had their own extra fees.
All the above comments that imply that in the old days people had their scales routinely at no extra charge are wrong, they were charged extra.
However there were no rules as to when a scale was done.it was enough for one to be wanted. The nhs now specifies one to be needed.

Of course this thread may become redundant soon as the government has recently began releasing info on some new pilots for their new contact. Piloting being something the last didn't bother with.
Time will tell.

AAAUUU Come on.....I don't want the thread to become redundant, I am enjoying myself!:D

In any case, don't hold your breath in respect of changes being made anytime soon. AND, even if there are any changes to the Dentists NHS Contract, I won't hold my breath that NHS Dental care and cost of will improve.:D

My guess is that they will spend a few hundred million pounds on the Bureaucrocratic set up running the Pilot Schemes, and then the results will be ignored and end up in the bin!

And this attitude coming from an optimist would you believe!;)

Welsh Dental Pilot Programme

Background

In November 2007 the Minister for Health and Social Services requested that a Task and Finish Group was convened to review the new dental contract and look at a range of issues to improve the way in which the contract works.

A number of sub groups were set up, one of which - the Units of Dental Activity (UDA) sub group - was convened in May 2008, with representatives from the British Dental Association (BDA), Welsh Assembly Government, Local Health Boards and Dental Services Division (DSD). The UDA sub group was chaired by David Thomas.

One of the main purposes of the sub group was to review the contract currency. After several meetings where issues relating to UDAs were analysed, the group concluded there was a need to pilot a number of new models of payment relating to the General Dental Service contract.

A report was provided for the Minister. It highlighted many of the complexities in NHS dentistry and recommended any proposed changes to contracts should be piloted thoroughly, and that the recommended changes to the patient pathway should be evaluated carefully.

The Minister accepted all of the recommendations but she was also aware of the impact that the Steele Review in England may have on policy development in Wales and asked the sub group to take account of his findings as well.
UDA Sub Group

The Welsh Assembly Government website contains agendas, minutes and papers from the UDA Sub Group. Pilots

Two pilots have been developed which are unique to Wales.

In addition to these pilots, providers may also be given the opportunity to join two pilots selected from the English system. Once they have been agreed by the Steele programme board more information will be made available.

The closing date for expressions of interest was Friday 20 August and we are no longer accepting any new submissions.
Downloads

• Quality and Outcome Pilot [Word, 230KB]
• Preventative Dental Care for Children and Young People [Word, 185KB]
• Timeline [Word, 479KB]
• Briefing pack for Providers [Word, 884KB]
• Briefing pack for LHBs [Word, 808KB]
• Expression of interest proforma [the deadline for submissions has now passed]

Links and useful contacts

• A full copy of the Steele review can be found on the Department of Health website: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAnd Guidance/DH_101137

• Prevention and management of Dental Caries in Children’, published by the Scottish Dental Clinical Effectiveness Programme (SDCEP): http://www.sdcep.org.uk/index.aspx?o=2332

• Designed to Smile is a national child oral health improvement programme announced by the Minister for Health and Social Services in March 2008: http://new.wales.gov.uk/topics/health/ocmo/professionals/ dental/publication /information/smile/?lang=en

• Feedback from consultation events held across Wales (March – April 2010) [Word, 44KB]

• Public Health Wales Dental Public Health Team

• Pilot coordinator Raylene Roper is available to discuss any questions you may have regarding the pilots - [EMAIL="raylene.roper@wales.nhs.uk"]raylene.roper@wales.nhs.uk[/EMAIL]

Last updated: 01 September 2010

boozercruiser

Implementing the Steele Review recommendations: Improving dental health, access and care

1 day event - 08 Jul 2010 from 10:00
Professor Jimmy?s Steele review of NHS dental services made important recommendations on improving health, increasing access and ensuring high quality dental care for patients. In taking the recommendations forward, an implementation board has been set up with new approaches being applied by dentists and PCTs in delivering better outcomes for patients.
The Issues
Delegates at this Policy and Practice Briefing will review the recommendations one year on, examine their implementation and assess their implications for local dental provision. Throughout the day delegates will have the chance to engage with the panel, investigating key issues such as:
* Taking the review forward: the roll out timetable and establishing priorities for service providers
* Improving access to and awareness of NHS dentistry treatment
* Patient registration and reward bonuses: new approaches to funding
* Commissioning universal quality and continuity of care standards
* Setting national data requirements: monitoring progress, rewarding quality & learning the right lessons
* Tackling the postcode lottery of care
* The way ahead in dentistry provision
Objectives & outcomes
The morning of this Policy and Practice Briefing will provide delegates with a forum to examine the Steele review one year on and how its recommendations are being implemented locally. The afternoon will be highly interactive, investigating successful examples of dentistry best practice and what practical mechanisms are being put into place to ensure improvements to service provision as outlined by Professor Steele.
Who should Attend?
Delegates will be from a wide range of stakeholders, dental service practitioners and professionals in the NHS; local authorities; central government departments and relevant bodies; representatives from the dentistry industry; academia; the voluntary sector; NGOs and community groups; and all those that have an interest in changes to dentistry service provision.

http://www.westminster-briefing.com/?p=11949 | Westminster, London

jugglebug

The proposal document is here bc.
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_122660

All sounds very promising but the spin from the previous monkeys before the disastrous changes they dumped on us in 2006 sounded good too. Then they started adding extra stuff in such as the nonsense that is the uda

jugglebug

Out of interest you may like to look the old regs regarding fees.
Bit dry and long winded but shows how the old and the new are 2 very different beasts.
http://www.dh.gov.uk/en/Publicationsandstatistics/Lettersandcirculars/Dearcolleagueletters/DH_4106927
you want the document described as the sdr

brook2jack

The elephant in the room here is the treatment that is necessary to secure dental health that is "provided" by the LHB/PCT and not general dentists.

Take a look BC at how long the waiting lists are in your area for a child with abcesses who needs a general anaesthetic for extractions.

Take a look at what your local LHB thinks is appropriate for emergency dental cover on evenings and weekends ... clue "dental pain ,no matter how severe is not an emergency".

Take a look at the waiting lists for wisdom teeth extraction etc

Take a look at the provision of specialist referral services to provide treatment out of the remit of general dentists.

Take a look at the virtual disappearence of domicillary visits ie dental visits to people in their own homes who cannot get to a surgery.

Now look up the local LDC (local dental committee),general practice committee,etc,etc which consists of local dentists who sit on numerous NHS committees, spend hours of their time fighting for what any rational human being would call essential services that at the moment are non existent or have massive waiting lists.

Both you with your complaint about scaling and polishing , and local dentists trying to get the LHB to fund essential services are vying for media attention. Which one will succeed " grasping dentists conning patients" or "health board rationing dental care"?


Finally.... for goodness sake BC, why why why why continue to see a dentist you don't trust wait a few months and then say after treatment ends you will go to the media. It's not a trusting relationship and are you not intending to return for a few years? If so all the fuss about your scale and polish is somewhat negated. If you are intending to return why wait for your expose? You must know the biggest factor in your dental health is not whether you have a scale and polish but whether you have a dentist you trust and whose advice you follow. Treatment must be harrowing both for you and your dentist at the moment.