NHS Dentistry 2 month rule

AP3

Hi All,

I broke a tooth back in March, and started treatment for a crown on the 21st March when the preparation for the crown was done.

On the 24th April, the temporary was removed, and the crown was fitted.

On the 3rd May I broke another tooth. They put in a temporary, and told me to come back for a crown.

I booked an appointment for the 13th June for the crown prep, and then the crown was installed today (4th July).

I've paid the band 3 charge twice as a result, although my dentist isn't sure (?!) if I should have.

Given that the first course of treatment finished on the 24th April, and the second course started on the 13th June, which is within 2 calendar months, should I be refunded the second band 3 charge?

If I'm right and the dentist puts up a fight (I hope they won't), what should be my approach to get refunded if due?

Cheers,
Andy

brook2jack

If it is the same dentist (not just the same practice) and you didn't have an urgent course of treatment in between to fit the temporary crown then yes it is a continuation of treatment and you should only pay a band one payment https://contactcentreservices.nhsbsa.nhs.uk/selfnhsukokb/AskUs_Dental/en-gb/9731/general-treatment/41694/what-is-continuation-treatment-further-treatment-within-two-months-and-when-would-it-apply

The NHS contract rules are really complex and even after 13 years after it began it is difficult for a dentist to know all the ins and outs.

You could print out the above link and take it in to the dentist if none of the above exclusions applies.

AP3

Thanks for the quick reply brook2jack.

It was at the same practice, but a different dentist for each course of treatment, as "my" dentist only works at that practice on Thursdays, and was booked solid, so the second one was another dentist.

The first course of treatment wasn't urgent, and was complete.

Looking at the link you sent, I don't see anything about the dentist being different as mattering?

Cheers,
Andy

brook2jack

If it was a different dentist, even though it's the same practice , then you will have to pay two charges, the continuation (and for that matter guarantees) of treatment only applies where both courses of treatment are carried out by the same dentist.

This is because even though dentists work at the same practice , they are independent practitioners, they pay for the use of the practice , materials , expenses and are not employed by the practice .

brook2jack

This is from the 2005 regulations , to clarify

Para 6 NHS (Dental Charges) Regulations 2005
“Where a provider of relevant primary dental services has completed a course of treatment
other than an urgent course of treatment
but, within 2 months of that course of treatment being completed, the same provider determines that the patient requires further treatment which falls within the same or lower charging band as the previous treatment
and that further treatment is provided (whether or not within 2 months of that course of treatment being completed) by the same provider,
no charge may be made or recovered in respect of that further treatment”

AP3

Thanks! I think the key here is "provider", rather than "performer".

Wouldn't the actual dentist be the performer, rather then the provider?

There's a bit that tries to explain (but I don't fully understand) here: https://app.croneri.co.uk/topics/nhs-dental-contracts-england-and-wales/indepth#DCAM-4054826

brook2jack

In the quote from the dental charges regulations above provider means the person who actually performed the dental treatment. Confusingly performer and provider have another meaning in relation to dental contracts but in this context it means the clinician who provided the treatment.

One of the checks the NHS makes on dentists is to check how many continuation courses they do per year. Too many and it will be investigated.

Both courses of treatment have to be done by the same clinician in order to be a continuation. Each dentist , even though they are in the same practice, are independent clinicians and analysis is done every year on their individual treatments.

You will have to pay two charges.

AP3

Ok, not what I was hoping to hear, but thanks for your comprehensive explanation!

Next time I'll hold on for "my" dentist!

AP3

Well I'd given up hope, and didn't chase the dentists at all, but they rang today to tell me they've decided I am due a refund for the second course of treatment!