Weird Behavior From Dentist & "barred"NHS Patient.

Retrogamer

Hello everyone,

Bit of a strange one here.
My father has been using the same dentist surgery the last decade, or more.
This is in Scotland.

Since covid started, they stopped sending letters and booking automatic appointments every 6 months and want customers to do it proactively it seems.

Due to this and my dad being fairly absent minded (he's 74) he hadn't been there in over a year.
When he called them to make an appointment, they informed him that as he didn't make his last appointment he was no longer registered with them and wouldn't be allowed to re-register.

He's since tried to register with other localish dentists within a 5 mile radius, but all have either went private, or are at max capacity.

He phoned the dentist hospital, explained his story and requested an appointment. The dental hospital said this was unusual and they phone  his dentist, on his behalf.
He then received a call from his dentist he had been using for years inviting him to go up to have the toothache resolved.
They done some work on his teeth and resolved the issue. But insisted he still wasn't registered with them and wasn't welcome back.
He asked why and if it was just the one appointment he had missed he would pay the missed appointments fee.
They advised he had missed more than 1 appointment in the decade or more he was there, but i know he hasn't missed one for at least 5+ years, aside from the latest one.

I'm going to submit a subject access request to get all the information but i have a couple of questions.

I suspect although the dentist is NHS registered, they are trying to deregister as many NHS patients as possible, so only private paying patients remain.

1) Is what they are doing against any rules / regulations in Scotland?
2) Why would they agree to see him after a call from the much larger dental hospital, but then tell him afterwards he wasn't welcome there for further treatment?

brook2jack2

You cannot put a subject access request in about clinical matters or another persons dental treatment. 

NHS services are at such a s stretch in Scotland that most/all practices will have a policy that they will not see people after they have missed appointments . https://www.nhstayside.scot.nhs.uk/OurServicesA-Z/Dental/PROD_294339/index.htm

Regular attendance is also needed to maintain registration https://nhsforthvalley.com/health-services/az-of-services/dental-services/

When there is such pressure on NHS dentists and they do not get paid for the time wasted when a patient does not turn up it is perfectly acceptable to health boards to de register a patient who has failed one or more appointments. 

It would seem your father had toothache , which as a good will guesture the practice saw him after speaking to the hospital and did the work . The hospital has no power over individual dentists it would have been one professional asking a favour of another. But as your father had missed appointments  they were not going to re register him , preferring to keep registered patients who do not fail appointments. 

GrumpyDil

 My surgery refuse to see you if you have missed arranging an appointment, so not missing an actual appointment.

My wife had to fight her case as her appointment was cancelled because of Covid lockdown and by the time she could get a new appointment it was more than two years since her previous one. The surgery argued they could remove her because of the gap but eventually backed down. 

Retrogamer

brook2jack2 said:

You cannot put a subject access request in about clinical matters or another persons dental treatment. 

NHS services are at such a s stretch in Scotland that most/all practices will have a policy that they will not see people after they have missed appointments . https://www.nhstayside.scot.nhs.uk/OurServicesA-Z/Dental/PROD_294339/index.htm

Regular attendance is also needed to maintain registration https://nhsforthvalley.com/health-services/az-of-services/dental-services/

When there is such pressure on NHS dentists and they do not get paid for the time wasted when a patient does not turn up it is perfectly acceptable to health boards to de register a patient who has failed one or more appointments. 

It would seem your father had toothache , which as a good will guesture the practice saw him after speaking to the hospital and did the work . The hospital has no power over individual dentists it would have been one professional asking a favour of another. But as your father had missed appointments  they were not going to re register him , preferring to keep registered patients who do not fail appointments. 

I'll be writing it, giving it to him to sanity check it and sign it, then i'll be sending it off on his behalf.

I suspect he has only actually missed one appointment, which they have a fee they charge before they will see you again. Not the more than one, as they have claimed. The SAR will establish the facts.

If they have information about his missing appointments, that's information that pertains to him as a person and thus he will be entitled to that information.
Information kept on individuals must be accurate and relevant.

Strangely enough it's the same dental surgery i use. However i am not using NHS treatment.
The 2nd last time i visited there, they were over 15 minutes late for my appointment, so i told them i wasn't waiting any longer and left.
They apologise profusely as i arranged another appointment, and again when i came back for the new appointment.

I'm not convinced they would have been so apologetic if i wasn't paying for private treatment.

Jonty6262

Some dentist dont care about treating NHS patients anymore. It's all about money being put into their bank account to some of them. There is a few decent compassionate ones left but not many. In a way you can't blame them. If you can get rid of the poor ones on your list and replace them with people lucky enough to be well off then why not. Sadly that's the way it is these days. On the other hand there is some very good top dentist who do still take on NHS patients. Not many though.

brook2jack2

If you read the links your father only has to have missed one appointment for the dentists to de register him . 

NHS practice is in dire financial straits and practices cannot afford what it costs in missed appointments . A room in a dental surgery in a cheap area will cost a minimum of £120 an hour to run. The dentist has all the expenses of practice to pay out of what is paid for treatment. So if a patient doesn't turn up the costs still have to be paid but there is no money coming in. Unfortunately missed appointments are increasing in number and that affects whether a NHS practice can stay open. 

Retrogamer

brook2jack2 said:

If you read the links your father only has to have missed one appointment for the dentists to de register him . 

NHS practice is in dire financial straits and practices cannot afford what it costs in missed appointments . A room in a dental surgery in a cheap area will cost a minimum of £120 an hour to run. The dentist has all the expenses of practice to pay out of what is paid for treatment. So if a patient doesn't turn up the costs still have to be paid but there is no money coming in. Unfortunately missed appointments are increasing in number and that affects whether a NHS practice can stay open. 

If that's the case i'd be curious to why they have a missed appointment charge for people who miss appointments, if they just de-register them after the first one.
And why would they (i'm assuming) lie about multiple missed ones. I'm fairly confident there's only one been missed. 

Also, if my dentist is  late for my appointments, and i refuse to wait and re-schedule then leave do you think they will be as accommodating to NHS patients who do the same?

Undervalued

Retrogamer said:

brook2jack2 said:

If you read the links your father only has to have missed one appointment for the dentists to de register him . 

NHS practice is in dire financial straits and practices cannot afford what it costs in missed appointments . A room in a dental surgery in a cheap area will cost a minimum of £120 an hour to run. The dentist has all the expenses of practice to pay out of what is paid for treatment. So if a patient doesn't turn up the costs still have to be paid but there is no money coming in. Unfortunately missed appointments are increasing in number and that affects whether a NHS practice can stay open. 

If that's the case i'd be curious to why they have a missed appointment charge for people who miss appointments, if they just de-register them after the first one.
And why would they (i'm assuming) lie about multiple missed ones. I'm fairly confident there's only one been missed. 

Also, if my dentist is  late for my appointments, and i refuse to wait and re-schedule then leave do you think they will be as accommodating to NHS patients who do the same?

My NHS dentist (in England so sightly different rules) has a warning about making a charge for missed NHS appointments on their appointment slips. I have never heard them make the warning verbally when booking appointments over the phone. However, legally it is a "try on" as it is unenforcible under the NHS rules in England.

As has been said repeatedly on here, in England and Wales there is no such thing as registration, just an obligation to complete a course of treatment once started.

brook2jack2

Op father is in Scotland where there is registration and a surgery can make a charge, if it chooses , for failing a NHS appointment , or can de register a patient for failing an appointment. 

Exodi

Retrogamer said:

Strangely enough it's the same dental surgery i use. However i am not using NHS treatment.
The 2nd last time i visited there, they were over 15 minutes late for my appointment, so i told them i wasn't waiting any longer and left.

To be honest, I was coming round to your point of view up until the point I read this.

Appointments can overrun for numerous reasons, such as complications during procedures.

I'm sure you would also take issue if after an extraction the dentist said "looking at the extraction site now, really you should have some stitches to make sure the gums heal correctly... but I didn't anticipate the extra 15 minutes to do that, and the person after you in the waiting room might throw a tantrum and storm out".

I wouldn't vilify the dentist, under-funding is a nationwide issue, all practices are suffering with it.

The army of people on the waiting list for an NHS slot at that practice would expect patients to be kicked out who miss appointments.

It's inconsistent that you describe your dad as "being fairly absent minded (he's 74)" but simultaneously can not believe that he could have missed appointments.

I'm sorry for the situation he finds himself in.

Retrogamer

Exodi said:

Retrogamer said:

Strangely enough it's the same dental surgery i use. However i am not using NHS treatment.
The 2nd last time i visited there, they were over 15 minutes late for my appointment, so i told them i wasn't waiting any longer and left.

To be honest, I was coming round to your point of view up until the point I read this.

Appointments can overrun for numerous reasons, such as complications during procedures.

I'm sure you would also take issue if after an extraction the dentist said "looking at the extraction site now, really you should have some stitches to make sure the gums heal correctly... but I didn't anticipate the extra 15 minutes to do that, and the person after you in the waiting room might throw a tantrum and storm out".

I wouldn't vilify the dentist, under-funding is a nationwide issue, all practices are suffering with it.

The army of people on the waiting list for an NHS slot at that practice would expect patients to be kicked out who miss appointments.

It's inconsistent that you describe your dad as "being fairly absent minded (he's 74)" but simultaneously can not believe that he could have missed appointments.

I'm sorry for the situation he finds himself in.

I was quite annoyed but never had a tantrum. I was booked in for a check up which doesn't normally take long as work is never done on the initial 6 month appointments there, and i also had a hospital appointment shortly after. So if i remained there on that particular occasion to get my check up completed i'd have missed my hospital appointment and potentially had to wait several weeks / months for another.

My particular gripe with them is they seem to treat private paying patients like me completely different from their NHS patients.

If an NHS patient misses their appointment by 15 minutes, due to road works, bus being delayed etc then i'd be likely marked as a missed appointment and either pay or potentially be removed. But if Dentists run late with their work you'd expected to put any other responsibilities or commitments on hold and just tolerate it.

I said i don't believe he's missed an appointment because he's old school and marks his appointments on a paper calendar in the kitchen, or else sticks the sticker with the appointment time that surgery provides to the fridge or similar.
I also handle almost all of his affairs with these matters and i personally believe that no appointment was made and the surgery is looking to get rid of it's NHS patients so it can have more privately paying ones instead.
Pre covid, appointments were automatically booked every 6 months and texts / letters were sent out to remind people
Post covid, texts are still sent out but appointments are not booked automatically and customers have to be proactive with booking. No letters are sent either.

It's possible i'm wrong, hence the SAR to clarify.
As it seems his only course of action just now is approx 2 hours travel / 25 miles travel to the nearest dental hospital should he need any treatment.