NHS Dentist

brook2jack

A new,new contract is being piloted as we speak. However there is widespread pessimism about it that it is not addressing the current problems. As many pcts are in the red and more cuts need to be made nhs dentistry is not seen as a priority. Indeed if you look on most pct/lhb websites you will see the appalling phrase "toothache no matter how severe is not classed as an emergency". The only leverage the public has is to lobby pcts and write when they have problems of access and emergency treatment. Our own health authority has said it will not increase emergency sessions since phone calls to them have dropped. This is because people have given up trying as they know there is only one clinic locally on a sunday with space to see only 20 people not because there is no need for emergency treatment for people not in a course of treatment with a nhs dentist.

LondonDiva

seven-day-weekend wrote: »

Ah, I think this is what my dentist does. He treated my son on the NHS when he was unemployed, but he had to go private once he got a job (he's now on the family Denplan).

I also think that is why I thought NHS people did not have to pay.

Thanks for the clarification.

What your current dentist is doing is a breach of contract. Unless they have a very specialised contract (extremely rare), they are not allowed to pick and choose who they see.

If they are accepting NHS patients, they must see any category of patient.

seven-day-weekend

LondonDiva wrote: »

What your current dentist is doing is a breach of contract. Unless they have a very specialised contract (extremely rare), they are not allowed to pick and choose who they see.

If they are accepting NHS patients, they must see any category of patient.

I may be wrong in saying my son HAD to go private. I think we all assumed that's what happened once he was working.

So could I go to my dentist and tell him I wanted to be treated on the NHS and he would have to accept me? If not, why not? He is a private dentist but came up on the NHS list as accepting NHS patients. If that's the case, what's the criteria for who is private and who is NHS?

brook2jack

London diva is wrong again. Specialised contracts are allowed and in force in large parts of the country. If a dentist had a restricted contract pre 2006 many pcts and lhbs allow restricted contracts eg under 18s only, exempt patients only, over 65s only. If you check on the nhs website there will often be an entry eg new patients under 18 only. This is not my area but is an example of widespread restricted contracts http://www.nottspct.nhs.uk/my-nhs-services/dentists/12-access-to-an-nhs-dentist.html

Only some pcts chose not to allow restricted contracts hence many dentists withdrew entirely from nhs treatment in 2006 and may be part of the reason why the number of children treated on the nhs has dropped. There is a body of evidence to show restricted contracts improve access to dental treatment to deprived groups where otherwise nhs cover would be lost.

brook2jack

seven-day-weekend wrote: »

I may be wrong in saying my son HAD to go private. I think we all assumed that's what happened once he was working.

So could I go to my dentist and tell him I wanted to be treated on the NHS and he would have to accept me? If not, why not? He is a private dentist but came up on the NHS list as accepting NHS patients. If that's the case, what's the criteria for who is private and who is NHS?

Read my comments above. Many areas of the country have restricted contracts. On most nhs websites it will indicate if a dentist is accepting all patients, exempt, under 18s etc but sometimes not, it depends on the area. If your dentist has a restricted contract they cannot and will not offer nhs dentistry to fee paying adults.it is a choice many dentists made to continue to provide some nhs cover to the neediest partially subsidising it from their private patients.

seven-day-weekend

brook2jack wrote: »

Read my comments above. Many areas of the country have restricted contracts. On most nhs websites it will indicate if a dentist is accepting all patients, exempt, under 18s etc but sometimes not, it depends on the area. If your dentist has a restricted contract they cannot and will not offer nhs dentistry to fee paying adults.it is a choice many dentists made to continue to provide some nhs cover to the neediest partially subsidising it from their private patients.

Thanks for your clear explanation. This would explain why our dentist treated my son for free whilst he was unemployed.

LondonDiva

seven-day-weekend wrote: »

I may be wrong in saying my son HAD to go private. I think we all assumed that's what happened once he was working.

So could I go to my dentist and tell him I wanted to be treated on the NHS and he would have to accept me? If not, why not? He is a private dentist but came up on the NHS list as accepting NHS patients. If that's the case, what's the criteria for who is private and who is NHS?

This is the case - it's very unlikely that the PCT would agree to a specialised contract unless there is a specific need for that type (so a need for practice to take patients with learning disabilities etc).

Ask the PALS team whether the practice has a limited contract - if they say no, the practice MUST treat within the contract.

You would be amazed by the number of practices who say that they are on restricted contracts when they are not. Although the whole point of the 2006 contract was to specifically remove the over 65 /under 18 barriers that patients reported facing as practices were creaming the easiest / most profitable cases.

thegirlintheattic

LondonDiva wrote: »

What your current dentist is doing is a breach of contract. Unless they have a very specialised contract (extremely rare), they are not allowed to pick and choose who they see.

If they are accepting NHS patients, they must see any category of patient.

This isn't correct. Even if you go on NHS Choices beside the dentists there is a box with 5 or 6 categories with ticks and crosses showing which types of nhs patients they are currently accepting.

brook2jack

Londondiva, I'm sorry but you are wrong for many ,many parts of the country. Look at the link above for Nottinghamshire, it is a pattern repeated for many parts of the country. Look on the local nhs website for many parts of the country and you will see that in black and White restricted contracts are widespread and the 2006 contracts aims were to increase access and have fewer and simpler courses of treatment.
By the way provision of dental services for disabled people is a specialist service normally provided by community services and put out to seperate tender it never has been covered by the uda system and to my knowledge would not be part of a restricted contract which is part of general dental service contracting.

Also for your information studies show that the over 65 age group is ,because they have kept teeth and then have multiple disabilities medications etc, the group in highest need of dental treatment and as you no doubt know the more treatment a patient needs the more difficult it is for a dentist to break even. The second group with high dental needs are patients on benefits. So restricted contracts actually cater for two of the groups with the highest dental needs (and least profit). You are also probably aware that recently released figures show that less children are being seen on the nhs now than 2006. The biggest single reason for children to be hospitalised is dental problems, so the third group of people seen on restricted contracts are amongst the neediest.

Toothsmith

Have you changed jobs in the past few years Londondiva?

I remember in the early days of the dental new contract you were something to do with PCT and dentistry, but recently, you do seem to be a bit behind what is actually going on in this sphere.

PCTs in different parts of the country have evolved in very different ways, and local contracting has meant a more diverse 'national' health service in dentistry than ever before.

That plus all the job uncertainty within the PCTs themselves means that there can be huge diversities in what one will clamp down on, whilst another allows.