NHS dentist treatment charges

Exodi

brook2jack2 said:

Undervalued said:

brook2jack2 said:

You should have been given an estimate form detailing what treatment you are having and the costs associated with it. Treatment of gum disease is an ongoing process and if you have gum disease there are several stages to treatment , normally involving visits every three months or so , all of which are normally charged at band two charges . 

If you have not already got a fp17dc (presuming you are in England or Wales) ask for an estimate form and take things from there. 

NHS practice is difficult enough but increasing numbers of patients fail their appointments so most practices will ask for a deposit or payment up front. 

Whilst I sympathised with dentists on that point, as I understand it (unless anything has changed recently) a NHS dentist is not allowed to charge for a missed appointment (wrongly in my view). So would they not have to refund any prepayment if the patient fails to show up but demands their money back?

In England and Wales they are not allowed to charge for missed NHS appointments , but they are in Scotland and NI. 

Up to 40% of all new patient dental appointments are failed . It’s a reason why most NHS dentists cannot hit their targets, are hit by massive clawbacks and have to go private to stay afloat. 

The much publicised dental practice in Bristol ,that had patients queuing around the block for NHS appointments when it reopened,  had 11 patients not turn up on the first day ! 

This infuriates me.

Do we know what the reasons are for missed appointments? While I'm sure some a minority could be a genuine issue like a vehicle breaking down, up to 40% suggests that a least for a significant number of patients the reason for missing the appointment was within their control.

Similarly there is a sign up in my local GP surgery stating that around 25% of appointments are missed.

Considering there is mass coverage on how hard it is to get an NHS dentist/GP appointment, I'm amazed at how casually people seemingly approach actually turning up to it.

brook2jack2

The the majority of missed appointments are men aged 18 to 30 , the other large group is those who recieve free dental treatment . Children also make up a greater proportion of missed appointments. 

For a while , in England and Wales , it was allowed to charge for missed appointments. This brought the rate down , which then rocketed up when dentists were no longer allowed to charge. 

The follow on is around 70% of NHS dentists cannot hit their targets and are subjected to clawback of money at the end of the year . They get no money for missed, cancelled appointments and this has been a major factor in the financial viability of a practice doing NHS work. To put into context one room , in a cheap area, in a dental practice doing mostly NHS work costs upwards of £140 an hour to run. The only money they get for all the running expenses , wages, training , equipment , consumables etc is what is earned by seeing patients. 

Rocco85

It took me long enough to be seen after the previous practice ceased trading and closed a few years ago. I’m lucky that another company have taken on the previous patients. 

However, I will not be hoodwinked into paying more than I should and I have an uneasy feeling that’s exactly  what’s happening. 

I received a call from the practice today, rather than send me the fp17dc form I requested, or discuss over the phone, I have been booked in for a review of the costs/treatment plan with the clinician - at my inconvenience, but it’s something. 

Hoenir

Exodi said:

brook2jack2 said:

Undervalued said:

brook2jack2 said:

You should have been given an estimate form detailing what treatment you are having and the costs associated with it. Treatment of gum disease is an ongoing process and if you have gum disease there are several stages to treatment , normally involving visits every three months or so , all of which are normally charged at band two charges . 

If you have not already got a fp17dc (presuming you are in England or Wales) ask for an estimate form and take things from there. 

NHS practice is difficult enough but increasing numbers of patients fail their appointments so most practices will ask for a deposit or payment up front. 

Whilst I sympathised with dentists on that point, as I understand it (unless anything has changed recently) a NHS dentist is not allowed to charge for a missed appointment (wrongly in my view). So would they not have to refund any prepayment if the patient fails to show up but demands their money back?

In England and Wales they are not allowed to charge for missed NHS appointments , but they are in Scotland and NI. 

Up to 40% of all new patient dental appointments are failed . It’s a reason why most NHS dentists cannot hit their targets, are hit by massive clawbacks and have to go private to stay afloat. 

The much publicised dental practice in Bristol ,that had patients queuing around the block for NHS appointments when it reopened,  had 11 patients not turn up on the first day ! 

This infuriates me.

Do we know what the reasons are for missed appointments? While I'm sure some a minority could be a genuine issue like a vehicle breaking down, up to 40% suggests that a least for a significant number of patients the reason for missing the appointment was within their control.

Similarly there is a sign up in my local GP surgery stating that around 25% of appointments are missed.

Considering there is mass coverage on how hard it is to get an NHS dentist/GP appointment, I'm amazed at how casually people seemingly approach actually turning up to it.

Our local hospital has a rate of 18%. 

No amount of reorganisation or funding can make up for the waste of valuable resources. About time individuals were made to suffer the consequences. 

HillStreetBlues

I've been to quite a few hospital appoints and never had one on time, my friend had one at 10am and was seen at 4pm (I never had to wait that long).
To me that seems they factor in the non attendance and allow for it, but when everyone does turn up then it causes a even longer delay.
I know a dentist would be different as less room for manoeuvre, but I've always waited past my app time for those as well.

brook2jack2

The things in a dental practice that make you run late will be the same as hospital

people turning up late , even a couple of minutes

people turning up with problems and wanting them sorted without forwarning 

human beings are variable so proceedures not going exactly as planned so taking longer , you can’t just stop because time has run out 

in winter waiting for all the outer clothing to be removed then put back on again 

people being nervous , or having physical difficulties that means it takes longer to do anything 

emergencies slotted in , impossible to know how long you will need before you start 


In a dental practice any time you don’t have a person in the chair you are losing money so there is no way to book out empty slots to allow time to catch up later. 

Running late is one of the biggest stressors on practitioners , it has real physical effects on blood pressure , heart rate etc and no dentist or doctor wants to run late but human beings are not cars , you cannot always predict how long something will take. I’ve lost count of the times I have not had a lunch break , or have had to stay later because of the unexpected . The abuse we got for running late is unbelievable , the worst I had was when a patient had a heart attack in the waiting room and I was resuscitating them . The patients were kept in another waiting room and one kicked off because I was running late for his check up and demanded to know how much longer I would be. He had been told it was a medical emergency , he had seen staff and equipment going through and knew we were waiting for paramedics/ambulance to arrive. 
The patient with the heart attack lived. 

Undervalued

HillStreetBlues said:

I've been to quite a few hospital appoints and never had one on time, my friend had one at 10am and was seen at 4pm (I never had to wait that long).
To me that seems they factor in the non attendance and allow for it, but when everyone does turn up then it causes a even longer delay.
I know a dentist would be different as less room for manoeuvre, but I've always waited past my app time for those as well.

Likewise!

Ten or more years ago I needed to see my GP regularly and usually booked the first appointment in the morning. Invariably, even then, I was seen 10 to 15 mins late and was usually with the doctor for longer than the 10 min slot. So patient two was seen at least 25 mins late and so on. In a way the occasional missed appointment must have been welcomed by the GP to catch up but no doubt the non arrivals were seldom conveniently spaced out.

My current NHS dentist "employs" / rents a chair to dentists that change all too often. One at least was driving 50 miles to work and it transpired that their child care arrangements meant that they were going to be 20 mins late even with favourable traffic. Frequently the first patient could wait the better part of an hour. That could have been at least mitigated by booking the first patient say half an hour later. But no! So it is not all one sided.

Rocco85

So I have just been to see the dentist for a consultation on the treatment plan and costings that were proposed initially. 

I am being charged x 2 band 2 price because….in his words “your appointment will take 60 minutes which is the length of two appointments, because we have to do an intensive clean that may require numbing, then I will measure the level of gum disease you have”, I then proceeded to say but this is all part of the same treatment? I understand I will be billed further for progress appointments but…then the hygienist says “you’re not having a standard scale and polish so it’s a separate cost for the deep clean”.

is that not all part of the treatment? 

I then explained when I had a composite inlay fitted it took 4 appointments and I was billed for it as one treatment. 

I was not getting anywhere so I said fine, thank you for your time and left. 

Toothsmith

Did they specifically say you were being treated as an NHS patient, as those are not NHS rules. 

There are private practices who base their fees on the NHS fees, but if they're not operating on the NHS, would be free to charge things in multiples like this - but they should be very very clear that you're NOT an NHS patient. 

If you ARE an NHS patient with them - then this is wrong 

Undervalued

Rocco85 said:

So I have just been to see the dentist for a consultation on the treatment plan and costings that were proposed initially. 

I am being charged x 2 band 2 price because….in his words “your appointment will take 60 minutes which is the length of two appointments, because we have to do an intensive clean that may require numbing, then I will measure the level of gum disease you have”, I then proceeded to say but this is all part of the same treatment? I understand I will be billed further for progress appointments but…then the hygienist says “you’re not having a standard scale and polish so it’s a separate cost for the deep clean”.

is that not all part of the treatment? 

I then explained when I had a composite inlay fitted it took 4 appointments and I was billed for it as one treatment. 

I was not getting anywhere so I said fine, thank you for your time and left. 

Were you given an NHS treatment plan?

If the NHS treatment is clinically necessary then it doesn't matter how long the appointment takes or how many visits are necessary, only one NHS band 2 charge is payable.

They can offer private treatment that is not covered by the NHS as an optional extra but they cannot refuse to carry out clinically necessary NHS treatment because it is time consuming.

They may well lose money on this treatment but that is not your problem. 

If that is what they are doing, they should be struck off! Check the facts then report them!