NHS Dentist; Scale & Polish moved to band 2!

Eastender

Hi Folks,
Many local NHS dentist have been referring their NHS patients for 'scale and polish' which falls under band 1, to either referring them to their Hygienist, which is not covered by the NHS treatment and pay far more than band 1. Or recently in my case, moved to Band 2 treatment under gum disease, where the Dentist just did one session which looked as the normal scale and polish without any gum numbing gel or injections for 'deep scaling' lasting for 10 min. 
How are Dentists getting away with it.

Undervalued

Eastender said:

Hi Folks,
Many local NHS dentist have been referring their NHS patients for 'scale and polish' which falls under band 1, to either referring them to their Hygienist, which is not covered by the NHS treatment and pay far more than band 1. Or recently in my case, moved to Band 2 treatment under gum disease, where the Dentist just did one session which looked as the normal scale and polish without any gum numbing gel or injections for 'deep scaling' lasting for 10 min. 
How are Dentists getting away with it.

What you pay in NHS dental fees is not what the dentist gets paid. They simply collect the fees (from those that are not exempt) on behalf of the NHS, then get paid for their work via a very complex formula. So, it is not the case that your dentist got forty quid extra for "10 min" work. If that were the case and you had needed ten fillings, a root canal and a couple of teeth out over several sessions then the dentist would only have got forty quid for all that work too!

Whether what you had done should have been Band 1 or Band 2 I am not qualified to say. I sure one of the dentists that post here will comment on that.

elsien

Local NHS dentists will do the scale and polish if there is a clinical need. They refer to the hygienist if it's more about how it looks. 

brook2jack2

Undervalued said:

Eastender said:

Hi Folks,
Many local NHS dentist have been referring their NHS patients for 'scale and polish' which falls under band 1, to either referring them to their Hygienist, which is not covered by the NHS treatment and pay far more than band 1. Or recently in my case, moved to Band 2 treatment under gum disease, where the Dentist just did one session which looked as the normal scale and polish without any gum numbing gel or injections for 'deep scaling' lasting for 10 min. 
How are Dentists getting away with it.

What you pay in NHS dental fees is not what the dentist gets paid. They simply collect the fees (from those that are not exempt) on behalf of the NHS, then get paid for their work via a very complex formula. So, it is not the case that your dentist got forty quid extra for "10 min" work. If that were the case and you had needed ten fillings, a root canal and a couple of teeth out over several sessions then the dentist would only have got forty quid for all that work too!

Whether what you had done should have been Band 1 or Band 2 I am not qualified to say. I sure one of the dentists that post here will comment on that.

Almost right , what the dentist gets may be a little bit more , or even less than the band two charge , but ten fillings , a root canal and a couple of teeth out does earn exactly the same as a band two scale and polish ie between £54 and £75 for most dentists.

Considering a room in a dental practice in a cheap area costs £140 or more an hour to run you can see why NHS dental practice is very difficult to keep going. 

Presumably you had two appointments with the dentist , add on the time to decontaminate , write up notes etc and you can see the economics are very difficult. 

Band two is for active gum disease and only someone who can see you and your x rays can comment if that is a valid clinical judgement. The most important part of treatment for gum disease is making sure you are cleaning effectively , using something effectively to clean between your teeth , have given up smoking , if you smoke , and are controlling your diabetes , if you are diabetic. 

Eastender

In my area where I moved to 8 years ago from a London inner city area where some Dentists still do 'scale & polish' themselves without referring you to their 'Hygienist'. It's incorrect to say Dentist will do scale and polish if it's necessary; most NHS Dentist won't do it, they will simply refer the patient to see their Hygienist, not for something fancy and cosmetic but for simple and basic scale and finish, they will not touch it. I don't care that they don't get much money out of it, it's for them to sort it out the with NHS management as they've signed the NHS contract to offer this to the NHS patients. That's another matter and not an excuse to give lesser service to patients and justify for not giving it.

However, this time I went to my old Dentist in the inner city London borough and I just had 1 visit and told her I just wanted the scale and polish only as do not want to come back again and that when she moved my treatment to band 2! The treatment that I had was the exactly the same as a normal scale and polish, i.e. without any injections and numbing gels applied to my gums for specialist gum cleaning and lasted for 10 minutes. 

Undervalued

Eastender said:

In my area where I moved to 8 years ago from a London inner city area where some Dentists still do 'scale & polish' themselves without referring you to their 'Hygienist'. It's incorrect to say Dentist will do scale and polish if it's necessary; most NHS Dentist won't do it, they will simply refer the patient to see their Hygienist, not for something fancy and cosmetic but for simple and basic scale and finish, they will not touch it. I don't care that they don't get much money out of it, it's for them to sort it out the with NHS management as they've signed the NHS contract to offer this to the NHS patients. That's another matter and not an excuse to give lesser service to patients and justify for not giving it.

However, this time I went to my old Dentist in the inner city London borough and I just had 1 visit and told her I just wanted the scale and polish only as do not want to come back again and that when she moved my treatment to band 2! The treatment that I had was the exactly the same as a normal scale and polish, i.e. without any injections and numbing gels applied to my gums for specialist gum cleaning and lasted for 10 minutes. 

I certainly agree with you on the comments I have highlighted. We have debated similar issues on here a number of times. Root canal treatment is another area where this crops up. A NHS dentist is supposed to provide this treatment (Band 2) if it is reasonably straightforward. If he genuinely feels it is beyond his competence and / or facilities, he can refuse but what he cannot do is suddenly be able to do it if the patient pays privately! It is a time consuming procedure and, as I understand it needs expensive materials and sometimes single use tools. So on the NHS, he loses money doing it. As you rightly say, not the patient's problem.

However, even if the dentist is entirely honourable (as I am sure most, but not all, are) there are obviously grey areas in making a judgement about whether it is something he can safely attempt. Even if the patient goes to a specialist for a second opinion (for which he would have to pay) is the specialist really likely to say "Oh come on, your NHS chap should easily have been able to do that he just doesn't want to"! I somehow doubt it. Even if he did would you feel comfortable going back the the NHS dentist and saying "I've had a expert opinion that says you are pulling a fast one, now get on and fix my tooth"!