Wednesday, October 15, 2008

NHS dentists accused of unnecessary check-ups

Dentists are calling patients back for routine appointments far sooner than they need to, in an effort to maximise profits, according to the Government's chief dental officer. NHS dentists earn significantly more since new contracts were introduced in England two years ago but officials believe this could be because some are “playing the system”.

The National Institute for Health and Clinical Excellence (NICE) suggests that most healthy patients do not need a check-up more than once every two years. But Barry Cockcroft, the Chief Dental Officer, believes that many patients are being called back for unnecessary appointments as often as every six months, or paying extra for repeat visits for fillings, crowns or other treatments that could be given in one go. Evidence compiled by the Department of Health suggests that as many as 800,000 appointments - one in ten - could be freed up for more needy patients.

NHS dentists saw 27 million patients in England during the past two years - 1.1 million fewer than than in the two years before the new contracts. In the first year of the new system dentists' average annual income rose from 87,000 to 96,000 pounds. For dentists who own their practice, earnings jumped 35 per cent to an average of 172,000.

Treatment costs are now divided into three bands: 16.20 for a check-up or minor treatment; 44.60 for fillings, root canal work or if your dentist needs to take out one or more of your teeth; and 198 for crowns, dentures or bridges. Children and some adults are exempt from the charges and patients should have to pay only once, even if they need several appointments during one course of treatment. But dentists could abuse this by postponing additional treatments until after a subsequent check-up.

Recently, officials have compared NHS returns by dentists, which give each individual patient a code, to see how many people are attending repeat appointments. Mr Cockcroft is now discussing with local health authorities how to amend the contract so that patients are not overcharged.

A Department of Health source said: “Many patients have been seeing their dentist at six-month intervals for years, but there is no evidence to support this as clinically necessary.” Abuse of the system is believed to be more prevalent in the South, where access to NHS dentists is more difficult. “These dentists are seeing the same healthy patients a lot. Instead of recalling them every year or two years they are coming back every three or four months.”

There were no plans to prosecute dentists, the source said. “We don't want to get into trying to court martial people. We just want to stop it.” Peter Ward, chief executive of the British Dental Association, which represents dentists, said it had noted no evidence that patients were being seen more regularly than they had to be.

The Department of Health said: “Dentists are required by law to provide the best possible healthcare to their patients. If a patient has reason to believe that this has not happened then they can report them to their local primary care trust.”

Source

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