NHS Dentist

LondonDiva

brook2jack wrote: »

Londondiva is wrong. There is no legal obligation to have a waiting list or to accept nhs patients. If a surgery is at capacity then unless a pct has a policy of managing appointments and waiting lists and have a clause in the dentists contracts saying so then it is perfectly acceptable legally for a surgery to say it has no more capacity. Indeed if you search on websites many surgeries will have on the NHS website they cannot take on new NHS patients.

Indeed the pcts state dentists have to manage their udas so they do not run out of them on their contract so are quite entitled to not take on any new patients. Pcts cannot force a dentist to see anyone let alone a doubtless overrun and overworked dentist in a rural area who is doubtless struggling with the patients they already have.

However pcts have a legal obligation to provide relief for people with dental emergencies. Often these clinics will be at weekends or evenings but will provide emergency treatment only. Nhs direct normally will give details/ book appointments. Then you can look at getting your husband regular care.

LondonDiva is correct - if a practice is an NHS one and believe that they are about to overrun their UDAs and have no current capacity, they MUST advise patients of how long that is likely to be so that a patient can make an informed choice of whether to wait or go elsewhere. I suggest that your practice review all the terms of the contract, it is quite specific.

One of the main reasons for this is that a number of practices were seen to be deliberately mismanaging their UDAs and advising patients that there was no capacity where there was more than enough.

Also, at this time of the year, it is highly unlikely that the practice has used up all their UDAs. In which case, if this was an immediately neccessary / emmergency treatment and the practice still had UDAs left for the whole year, the expectation from the PCT would be that the patient was seen as an emmergency (Band 1), whether the practice felt overworked or not.

OP - if the practice is not an NHS one, not much you can do about it. However, the first step is PALS so that if there is a problem the PCT is alerted and if not, they can help you out.

brook2jack

Sorry but you are wrong. The dentist has to apportion their udas during the year so they are not in the situation of running out at the end of the year and turning patients away.The pct cannot force them to see an emergency patient (band 4 not band 1), which is why most pcts commission emergency and drop in clinics as the only legal obligation is the pcts to provide emergency treatment. Otherwise as you say " no matter how overworked" the surgery is a dentist could be working 24 hours a day and use up their udas or drop dead in weeks.

There are many different dental contracts with many different clauses and I have seen quite a few. In a very few the pct manages the waiting list and the practice has a target of new patients/emergency treatments that have to be seen. These contracts have universally been in large metropolitan areas or for new post 2006 practices. The vast vast vast majority of practices that I know of do not have these arrangements. If they are not taking on new nhs patients it is because they are overun with patients . There is a clause in all dentists contracts that treatment has to be completed within 2 calendar months and if taking on extra patients uses up appointments then this target is not achievable.

This is why most pcts have set up emergency clinics as there is in many pcts/lhbs no spare capacity and this us especially true in rural areas where often dental treatment needs are very high and number of dentists away from population centres very very low.

LondonDiva

brook2jack wrote: »

Sorry but you are wrong. The dentist has to apportion their udas during the year so they are not in the situation of running out at the end of the year.

Their are many different dental contracts and I have seen quite a few. In a very few the pct manages the waiting list and the practice has a target of new patients/emergency treatments that have to be seen. These contracts have universally been in large metropolitan areas or for new post 2006 practices. The vast vast vast majority of practices that I know of do not have these arrangements. If they are not taking on new nhs patients it us because they are overun with patients . There is a clause in all dentists contracts that treatment has to be completed within 2 calendar months and if taking on extra patients uses up appointments then this target is not achievable.
This is why most pcts have set up emergency clinics as there is in many pcts/lhbs no spare capacity and this us especially true in rural areas where often dental treatment needs are very high and number of dentists away from population centres very very low.

I'm going step out of this debate, but will state that I know what I'm talking about and practices that don't advise patients of this are in breach of contract - they just haven't been caught or the PCTs can't be @rsed to deal with them.

Spendless

Have you worked out the cost of private vs taking unpaid time off to see which is the financially cheaper option? My sister's employers allow her to spend a day of her next year's AL if it is close to their holiday year starting.

brook2jack

In rural areas there are often very high dental needs and very few dentists. The pcts/ lhbs are all too well aware of the lack of dental provision. Most of them are also in the red and have policies of not commisioning new dental services and moreover not continuing contracts when practices are sold or dentists die/retire. They cannot also offer contracts to post training dentists. They know where there are only a few dentists running a waiting list is of no use to someone like the ops husband who needs emergency treatment now is not of any use in the short term to them. Many rural practices are small, not big multi clinics, and in the majority of the country completely running at capacity. That doesn't mean they use up their udas (80% of practices can't) but the dentists cant work any more hours in the day to reach these ridiculous targets. If the average nhs dentist sees 35 to 40 patients a day would most people think it reasonable that a pct "expects" them to see even more people when they already feel overworked?

I've read alot of contracts, in alot of areas for many different types of practice. The pct has the responsibilty here not some dental practice which has on the nhs website it's not taking on patients and has told the op it's not taking on nhs patients.

thegirlintheattic

Thanks everyone.

After waying up all the costs and the urgency of care we are going to go private so he can get treated quickly, this means taking out a short-term loan but is the cheapest option. OH called PCT earlier and they were not that helpful apparently, gave him names and numbers of dentists and said call for an emergency appointment, if no luck call back. Not sure what else they said OH and telephone manners don't mix well, am going to call them up tomorrow to see about a more long term solution.

rach

surely if it's that painful he can just take sick leave?

thegirlintheattic

rach wrote: »

surely if it's that painful he can just take sick leave?

He is on codeine so most of the time it is fine thankfully. The pain when there is bad when anything is in his mouth but fine otherwise and certainly not enough to justify a sick day. This is the man that went into work with a broken wrist *facepalm* for two days before I dragged him to to A&E.

shelleyg222

I would certainly keep trying with your pct. My local PCT has arrangements with local dentists that they provide an hour a week to allow emergency treatment for non-registered patients. However, the PCT only refer severe toothaches and swellings which could be life threatening.
In addition to this, (i currently work in a dentist), if I were you I would keep trying your local dentists on a week to week basis. In our practice, we only take on new patients when the dentists feel their work load is lightening (they generally run at being booked up 2 months in advance for treatments). The opening of the books may be for days only, the amount of people wanting a dentist is frightening.
You also mention difficulty towards the cost of treatment, if you havent done so already you could complete a HC1 form, which assesses you for any help which you may receive towards the cost of dental treatment. This could be a full or partial exemption.
In terms of paying for a dental plan such as denplan, be warned as even though you pay an amount each month, you are still eligable for any lab work costs, such as dentures etc on top of this, and this is one of the most expensive parts of dentistry. Dental plans may seem a good idea, but the winner is not always the patient. None of the dentists at the practice I work use this plan.
Good luck, and dont give up on getting this sorted.

brook2jack

The other problem with denplan is you have to be dentally fit to join ie get any problems sorted out first.

The important thing is with your husbands preexisting condition is once his toothache is sorted out it is vital that he gets regular check ups to stop himself getting into trouble again.