Small dental practice taken over by group

Downthedrain

My wife and I are long-time NHS patients at what was a small, local practice that has now been taken over by a dental group. Our dentist of many years has gone, along with everyone else from the old practice.

Today was our first appointment under the new owners and the first question asked was "Do you pay for treatment?" When we said yes, the receptionist asked if we'd mind registering as independent patients "to free up NHS places". She gave us a leaflet showing three categories; NHS, Independent and Private. The Independent category stated that treatment prices were matched to the NHS and that we would still retain our NHS places (whatever that means) and pay no more than NHS costs. It also said we could go back to the NHS scheme at any time. We said that we were unprepared for this and needed to do some research, and that rather than springing this on us they should have given us advance notice. The look of displeasure on the receptionist's face suggested there was more to this than their leaflet suggested.

To my mind, independent is pretty much private by another word. I'm suspicious of the financial motive behind asking us to sign up as a different patient type. The practice now seems to be geared up around cosmetic treatment.

We usually get a descale as part of our NHS examination but now had to ask for it specifically, as it wasn't offered. We were then directed to an additional service to remove stains "costing between £80 and £100"

It seems to me that by agreeing to re-register as independents would have future financial implications. In particular, I periodically need NHS dental prescriptions due to an underlying health conditions.

In addition, when I asked the 'dentist' whether she would now be our dedicated dentist who we would see each time and she said no, she's a dental therapist and if treatment was needed we would need to book an appointment to see a dentist.

Any advice welcome.

brook2jack2

NHS dental practices have no such thing as registration , they are only obliged to see a patient whilst they are under a course of treatment. 

They have only a set amount of NHS work they can do a year and are financially penalised if they do any more. Some practices will , therefore stop seeing NHS patients for several days of the weeks or months of the year as they run out of funding. Some will see people "independently " for around the same amount of money to get over this . However as you point out they cannot prescribe NHS prescriptions on a private course of treatment so any prescriptions would be private and charged , accordingly, at the chemist. 

NHS dental practice is getting more and more financially difficult for practices to provide. The government is encouraging them to use dental therapists for routine check ups etc with dentists doing the more complicated work that only they can do. In theory this may allow the NHS to get a quart out of a pint pot. 

Scaling has been completely removed from NHS treatment in Wales and cosmetic scaling is no longer allowed anywhere in NHS. If you have gum disease you should have treatment but removing a bit of scale from behind lower teeth etc is cosmetic and paid for privately. 

Many dentists who are older have been continuing in in NHS practice even though  it is increasingly difficult to provide a service and stay afloat financially. When a new dentist or company takes over they have massive loans to buy the practice , update etc and often have to take difficult decisions that the previous owner may have been able to avoid coming up to retirement.

My own view is that NHS dental service is in its death throes , all parties policies are just rearranging the deck chairs on the Titanic. For those who still have a NHS service good but the writing is on the wall , you can't recruit dentists who cannot make a living and repay their massive loans on NHS work and with a room costing £140 an hour to run its very difficult to cover your costs just doing NHS work without the private to subsidise costs. When I qualified £95 out of every £100 spent on dentistry was spent on the NHS . Now it's around £40 out of every £100 and falling . 

p00hsticks

There is a recent thread on a similar topic here
Concerned I am being coerced off of the NHS register. — MoneySavingExpert Forum

Downthedrain

This looks to be increasingly common.

One thing that concerns me is that by agreeing to being treated independently, the practice says we can revert to NHS treatment at any time - what happens if all of the NHS 'slots' are allocated?

I've also found myself in a difficult situation halfway through the course of treatment; I have auxiliary nerves in my lower jaw and a root canal treatment on a molar was undertaken without pain relief (I had received the maximum permitted dose of local anaesthetic without any effect). It had to be abandoned and the suggestion was that I be referred to the NHS  Maxillofacial surgery unit at the local hospital where a different procedure could be undertaken. Would I still be eligible for this as an independent patient?

brook2jack2

Private and independent patients can be referred for treatment , if available, in the NHS. I would check what you have been referred for as maxillofacial facial will only take the tooth out , they cannot root fill teeth. In fact there are virtually no places to refer for endodontics on the NHS and the very , very ,very few places there are are very restricted in who they will treat with very long waiting lists. 

brook2jack2

Even if you were seen as a NHS patient there is no such thing as registration , so you are only guaranteed NHS treatment during a course of treatment after that the practice do not have to offer you another NHS course. In many places with huge deficits of surgeries offering NHS treatment the authorities want them to offer one course of treatment only so that the most people can be seen with the very limited resources. 

In this respect you are no worse off independent or NHS , if funding has run out or there is no space then neither will get you seen on the NHS. 

welshdent

basically what brook said! 
It strikes me that your practice is trying to maintain access for you at lower costs wherever possible when they may have limited or insufficient NHS funding which is entirely possible especially if its spread between a few dentists.

I dont see any suspicious financial motivation at all. If they wanted to make more money then you woyl,d be told private or nothing. 

I see it as a practice trying to maintain access for their patients while sustaining a business financially.