Dentist Fraud

brook2jack

Do you mean by writing to people to check what treatment they had and by getting in a selection of patients from each dentist every year and checking the treatment they had claimed for was done and to a good standard? Also by statistically analysing all claims and investigating any dentist who seemed to be claiming for too many or too few fillings etc?

It was done by the dental reference service for every dentist in the country for decades.

As to signing blank fp17 forms and not giving itemised receipts, just receipts for the whole amount paid, every dentist in the country did that for the very good reason that they took ages to work out and fill out in the days before computers and for this reason it was never a NHS requirement to give an itemised receipt, indeed the official NHS receipts didn't have space to be itemised they just had a small box for amount. This is the Scottish form but the old English form was similar with a similar number of boxes to be filled out http://www.psd.scot.nhs.uk/professionals/dental/gp17-form-completion-guidance.pdf

Of course with computerising giving itemised bills and form filling is a click of a button .

The fp17 form took a long time to fill out, sign and check ditto receipts particularly when there were over 400 different treatment codes that had to be filled in. Older dentists will remember the hours spent after work with a calculator checking and signing the forms in the days before computerised systems made it so much easier

akkers

I think there were computers around back in the 90s.

So now that they have super-duper computers why dont they give itemised receipts.

brook2jack

Yes there were computers in the 90s, however the dental software was rudimentary and as there were over 400 different charges it was too complex and time consuming to produce an itemised receipt particularly when the official NHS receipt forms only had a box for total paid and no room to put each individual item.

In England there are only three bands of treatment and only three bands of treatment payable. If you need treatment you will have signed a fp17dc treatment form detailing all the treatment necessary . The individual treatments do attract attract individual charges only the entire course of treatment.

In Scotland and NI there are still the 400 odd different charges so again you should get a costed treatment plan .

akkers

No, thats not the case with my dentist. They are all computerised, send sms reminders etc but when it comes to receipts they just give you a simple one and there are no details.
Mind you its not the same issue anymore. Nowadays they have the dentist has to give you a form detailing the impeding treatment and costs; whereas in the 90s they were getting you sign a blank NHS form and who knows what treatment they put on there after the event.

akkers

It is a damn state of affairs. The problem is that if you dont agree with your dentist or his methods you dont have much choice; you are stuck with him/her. In my city there are plenty of dental practices but none that are taking NHS patients.

Did you see the news in the papers the other day? They did a snap survey and they could not find any dentist in Huddersfield willing to take on new NHS patients.

When there is no competition, they can do whatever they like.

Undervalued

akkers wrote: »

It is a damn state of affairs. The problem is that if you dont agree with your dentist or his methods you dont have much choice; you are stuck with him/her. In my city there are plenty of dental practices but none that are taking NHS patients.

Did you see the news in the papers the other day? They did a snap survey and they could not find any dentist in Huddersfield willing to take on new NHS patients.

When there is no competition, they can do whatever they like.

I wonder why? I live about 150 miles from Huddersfield and there is no problem getting an NHS dentist here.

brook2jack

NHS dentistry budgets are capped and dentists are only allowed to do a certain amount of treatment each year.

In many areas there is no more money to do any more NHS treatment so dentists may be "willing" to see patients but the commissioning groups are not willing to pay them to see more patients.

Hence some areas there is no "shortage" and in others there is a shortage particularly as if commissioning groups see there is capacity in others villages , towns , areas they will not expend more money in allowing existing dentists to do more work.

Also where ever a dentist works they get the same amount of money. So a practice in a city centre will be much more expensive to run than one in eg a suburb so there are often fewer dentists in big city centres as it is impossible to keep a dental surgery running on the NHS there.

Proxima_Centauri

akkers wrote: »

It is a damn state of affairs. The problem is that if you dont agree with your dentist or his methods you dont have much choice; you are stuck with him/her. In my city there are plenty of dental practices but none that are taking NHS patients.

Did you see the news in the papers the other day? They did a snap survey and they could not find any dentist in Huddersfield willing to take on new NHS patients.

When there is no competition, they can do whatever they like.

That can be said for the NHS in general..

I do notice, though, that NHS dentists tend not to stay NHS for long. They start in the NHS and then move on to private work.

brook2jack

Probably for the same reason 90% of dentists would not advise their children to go into the profession.

The pressure and rate of work a dentist needs to do in the NHS is crushing and takes its toll mentally and physically.

Each year more and more is expected. Regulation , paperwork and litigation increases.

The government promises a "world class service" but the budget cannot deliver.

Young colleagues are graduating with £80,000 debts and just to practice each year (registration £890, insurance £4500, cqc , , DBS etc ) costs what they earn from their first 700 NHS patients each year.

They earn the same amount as doing NHS work but spending a lot more time on patients and using better materials etc

mohawk

I’m having real difficulty understanding the explanations about costs from you dentists posting here. Mentioning UDA’s in an apparently random manner provides me with precisely zero understanding.

Don’t misunderstand me. I am on the side of the dentists. I didn’t used to be until I learned a little bit about the completely fraudulent nature of the NHS provision of dental ‘care’. Dentists get all the blame when it is a problem generated entirely by the evil bureaucracy of the NHS.

I would say though, it is the dentist’s fault insomuch as they have been completely unable to explain to the public how this poisonous system works; and that is demonstrated on this thread when some posters have tried explaining, but still leave me completely flummoxed.

I know a UDA is something weirdly varying from practice to practice and in different parts of the country - & I have also been told dental practices are asked to bid against each other with this UDA figure to the NHS.

I also understand there are three bands of NHS treatment, each being paid in different amounts of UDAs. So far that is about all I do understand.

What I cannot possibly understand is a comment like ‘it costs a dentist more to do a root filling than the NHS pays him to do’. I would be really grateful if the dentists could be a bit more coherent & communicative in explaining exactly what is going on. How much time and materials are needed to do the average root filling & how much does the NHS actually pay ?

That could be simply done by explaining that an average/standard root filling, for example, takes 30 minutes, say, and costs £x in costs of materials. But the NHS pays only 3 UDAs (3 x £18 = £54) and the dentist’s time of 30 minutes has to be charged at, say £75, and there is the extra cost of materials used of £25, say, making a total of the dentist spending £100 of time & materials but only being paid £54 by the NHS, thereby making the dental practice a loss.


Any dentist, NHS or the most expensive private ones have to achieve a certain average charge per hour to enable all the costs of running the practice to be paid and then leave an amount to pay a salary to the dentist doing the work. So what is the average number of UDAs that can be crammed into one hour ? It looks to me like it cannot be more than about four UDAs earned per hour - correct me if I’m wrong.

If a dentist does nothing but NHS paid for work and works 48 weeks in a year at 35 working hours per week, that would be 1680 working hours a year. This would roughly indicate to me that if a dentist charged £100 for each of those hours worked, (excluding materials costs) he would be generating a total income for the practice of £168 000 per year.

A standard rule of thumb used by other professionals selling time, like lawyers etc, to calculate how much is needed to charge for each hour is to earn in fees about three times the salary paid to the fee earner. One third of the fees earned are needed to pay the office overheads, including the dental nurse and secretarial staff, and the remaining third is gross profit to the practice for investing in improvements, expansion and keeping for a rainy day and distributing any remaining profits if any, maybe.

So this example of charging £100 an hour would appear to be at about break even with a salary between a low of £56 000 pa, £56 000 to pay for practice overheads and £56 000 gross profit to the practice. If the practice was super-efficient some or all of that third slice of £56 000 could be added to the fee earner’s salary of £56 000 making a possible and entirely theoretical and unlikely to be achieveable £112000 maximum salary though I would guess a more realistic maximum might be no more than about £75 000 ish.

My particular example outlined above is based on the idea of it being appropriate for a junior, not long qualified dentist who should in my opinion earn a low end salary of about £56k per year varying upwards towards the £80k figure for a stellar junior/middle ranking dentist employed/self employed at a practice.

A very experienced dentist might expect to charge two, three four times this hourly rate in the very high end dental practices. But what hourly rate do run of the mill everyday dentists expect to be able to charge ? Nobody seems to have a clue as far as I can tell.

In simple terms a dentist is someone who is selling their expertise and skill by the hour to his patients, who will also have to pay for any materials used as a separate cost. So why can’t dentists explain this to the public to enable the public to understand just what a confidence trick is being engineered by the NHS ?

It would also be helpful if the dentists explained my time costs you £x per hour and the materials used for the procedure have cost me £y and then two figures combined is the total cost to you. Then we would all know where we stand and the patients and dentists would all be a lot happier. It would also mean both the patients and the dentists could challenge the utter nonsense the NHS spews out from its demented bureaucrats.

But what is quite clear to me from describing this theoretical business template above, is that the NHS paying dentists by means of things called UDAs which have a strange and arbitrary value which magically changes in entirely moronic ways depending in which part of the country you happen to be is insane, fraudulent and a downright criminal confidence trick played out by the incompetent and ignorant NHS and Government on both patients and dentists.

I’m just a patient obliged to depend on NHS based treatment. I find it appalling and a nightmare as dentists cannot and do not provide the most appropriate treatment. Just to make it quite plain - I have been receiving very, very bad dental treatment over a long period of time. A lot of harm has been inflicted on my teeth as a result.

But my relationship is with the dentist who treats me, not directly with the government, and I can’t help feeling that dentists in general have let all us patients down by allowing themselves to be browbeaten by a corrupt government into being party to this fraud. The dentists all complain about how wrong this NHS dental system is, but they have allowed themselves to be part of it. All of them should refuse to be part of such a rotten system and then all patients should force the government to honour their legal obligations. Neither patients nor dentists should every have allowed this disgustingly dishonest NHS dentistry system to develop.

So who is going to do something about this ?