AIBU to think that dentists are using covid as an excuse to refuse to take on NHS patients while the same practices will happily take on new private patients?

[ohcarolina2001]

I moved house to a new area just after lockdown with a new baby. Obviously I haven't been able to try to register with a new NHS dentist until recently as they have been closed due to covid.

Now that they are opening up again I used the NHS website to identify local NHS dentists who are supposedly taking on new patients and rang up loads of them, only to be told they aren't taking on new NHS patients at the moment but are taking on new private patients! One even said they would only register my baby (who doesn't have teeth yet!) for NHS dentistry if I joined the practice as a private fee paying patient, which I find absolutely outrageous!

I resent paying for private dentistry since NHS dentistry is subsidised (or free for some people like myself with my maternity exemption certificate) and is perfectly good enough in my experience. I mean they all qualified as dentists and I don't need a perfect Hollywood smile, just healthy teeth!

I am concerned about my teeth as they haven't been checked since mid pregnancy and I am now nearly 6 months postpartum, and teeth are more vulnerable during and after pregnancy. I also lost part of a filling last week so would like to be seen soon (I appreciate I may need to join a waiting list while they deal with more urgent cases and the backlog of existing patients not seen during lockdown) but I am loathe to give in to greedy CF dentists who should be providing NHS services to the British public but are using covid as an excuse to take on more private patients and leave those who can't afford private services with nothing. Is this not hugely discriminatory?

Exasperated, I rang up the NHS England number which is meant to help you if you are having trouble finding NHS dentistry and explained my predicament. I think the person on the line revealed too much as she actually told me that I can't get drilling done as an NHS patient now, but only as a private patient. I don't mind paying any additional costs for PPE for drilling due to covid, but don't see how it's fair that I should have to go private to get the treatment I need. I mean, either drilling is safe or unsafe: there shouldn't be drilling for the rich but not for the poor, right?!

YANBU - dentists are being CFs and the poor are getting screwed as usual
YABU - dentists can charge what they like, the NHS can't force them to provide NHS services, and your teeth can rot in hell if you can't afford private.

Yup. We moved in January. Found a surgery taking NHS patients after 2 months of searching, completed the forms and were booked in for our registration appointment when lockdown happened.

The surgery are refusing to see me for an urgent problem because we didn't complete registration and won't allow us to book a registration appointment.

No idea what we're supposed to do and cannot afford to go private.

@MaskingForIt

The government have made this decision, not the dentist. If you don’t like it, vote differently.

I have never voted Tory in my life but sadly too many others did. Our health systems are slowly morphing into something closer to the US and soon our teeth will be an indicator of our income level, just like over there. Utterly depressing.

@ABingThing

Yup. We moved in January. Found a surgery taking NHS patients after 2 months of searching, completed the forms and were booked in for our registration appointment when lockdown happened.

The surgery are refusing to see me for an urgent problem because we didn't complete registration and won't allow us to book a registration appointment.

No idea what we're supposed to do and cannot afford to go private.

It's a nightmare. So sorry you are going through this.

@DottyWott

Ah well don’t worry, there won’t be any NHS dentists soon if this carries on much longer, so it will all be equitable and fair and everyone will pay privately.

Many people will be forced to go without treatment if this happens. Yet another blow to the increasing numbers of people falling below the poverty line in this country.

[quote PinkSparklyPussyCat]@Laffinalltheway I contacted my NHS dentist as I've got a problem with a crown but they won't see me but will be in contact when they can. I have no idea when that will be and they annoying thing is I'll need the work done privately by them anyway.[/quote]
Sorry to hear that, super frustrating.

Have you actually asked at the various dentists you have contacted what the prices are? I think you’ll find it’s not “rich” people who pay for dentistry and many dentists are affordable fir a check up, X-ray and then cleaning with hygienist.

@Bottleup

We got an email from our dentist yesterday sent out to all NHS patients saying we cant see you for the foreseeable future but if you want join our private service (attached the details) we can see you as early as this week. Utterly disgusting. So if you have money, drop by, if you dont, f*ck off.

I can see from other responses that not all dentists are being CFs and many are constrained by the NHS but yours blatantly is. Outrageous not to see EXISTING NHS patients, never mind new ones.

@AdoreTheBeach

Have you actually asked at the various dentists you have contacted what the prices are? I think you’ll find it’s not “rich” people who pay for dentistry and many dentists are affordable fir a check up, X-ray and then cleaning with hygienist.

"Rich" is subjective. Yes I have checked the prices on their websites. They are 3-4x what you would pay on the NHS for the basic check ups (but prices spiral if you need some work done) , which I can stretch to if I have to (although I should be getting completely free care with my maternity exemption certificate) , but I am more raising this as an issue for those who really can't afford to pay. Remember a lot of people are exempt from even the NHS charges.

@Blobby10

My OH is a private dentist but says that the corporates nearby have been told not to do anything other than emergency treatment of NHS patients (so around 20%) but they are still getting their full fees as if they were treating all their NHS patients! No idea if this is true or if its rival dentists slagging each other off!!

ohcarolina all dentists are not the same! I had a filling from an NHS dentist but it never felt 'right' and I had increased sensitivity in that tooth. Went back twice and each time he took an x ray and said nothing was wrong. I could feel the tooth pulling every time I chewed something! One afternoon I had the onset of such sudden and severe pain that I practically begged my dentist OH to have a look - he gently poked the tooth and the filling fell out leaving a massive area of rot underneath - needed a root filling. I have no idea why subsequent xrays didn't pick up the gaping hole under the filling but have now freed up my NHS dental place to someone else.

NHS dentists are (IMO) stuck between a rock and a hard place - they are often very time restrained, often have to use the cheapest composite for fillings etc and get paid a miniscule amount for procedures therefore whilst they will do the job, they sometimes just can't do a proper job without it costing them loads of money.

Of course some dentists will be better than others but I am just expecting pretty basic NHS care which has always been good enough IME. There is always the option for those who can afford it to pay for private but this is a luxury for many.

@Bellevu

If the dentist can take on your daughter, then they can take you on instead. They are breaching their nhs contract and as a potential fraud could be reported to the CCG and the GDC.

Go back and say that since they have space for your daughter, they have space for you. They can't choose children over an adult if there's space, which they have confirmed they have.

Ask how many UDAs they have left and where you are in their waiting list if they can't take you. Insist they tell you about the daughter/private thing by email as you want to check it out with the GDC and ccg.

They are deliberately picking and choosing the profitable and easy bits of the contract rather than pushing back.

This is really useful intel, thanks. I think I will go back to them and/or report them. I do have their response in writing already about only taking my daughter if I go with them as a private patient. I had to Google the acronyms you mention and found them all except for UDAs - what does this stand for? Thanks

Too right!

“don’t children only NHS contracts exist anymore then?
They certainly used to be a thing
Not for at least a decade, probably closer to 2000. Only very few exist and they would likely be specific to a speciality e.g. disabilities, HIV etc“

This is definitely not true in my area. There have been in recent years, and I thought still were contracts for children only and exempt patients only. To improve access. You sound very certain and very angry but you may be wrong here.

Sorry, my post addresses @Bellevu

I signed up as an NHS patient in the last couple of weeks so this is not true across the board.

I only needed a check up and a clean but I can see why this situation you are outlining, is the case. Firstly, they were all decked out in full PPE, secondly for the first time ever, the hygienist had a nurse assisting (Covid related) and thirdly, any room where there had been some kind of drilling had to go out of service for a period of time, for cleaning or whatever. So they had increased staffing and equipment costs plus the ability to see less patients.

@arethereanyleftatall

Yabu op. Simply because you've decided this is 'greedy dentists' whilst simultaneously having fuck all understanding of how their contracts with the government work.

I thought the point of AIBU was to indeed find if I am being unreasonable or not? I am learning more about the system in the process and now have SOME sympathy for some dentists but clearly there are also many CF dentists out there who need to be reported going on the stories others have sharef. @Bellevu seems to know lots about it land agrees with me so I will definitely be using this intel to explore my options and hopefully pave the way for a fairer system so people on low incomes don't have to go without care.

Dentists in England do not ‘register’ in the same way as GPs do.

UDA is a unit of dental activity - dental practices are contracted for a certain number of those per financial year. Once they are used up, they don’t get more. Each band of treatment is worth a certain number of UDAs.

And no, child only contracts are very rare these days - they sort of go against the dental regulations. They were put in place long long time ago to improve access.

@Bellevu

If the dentist can take on your daughter, then they can take you on instead. They are breaching their nhs contract and as a potential fraud could be reported to the CCG and the GDC.

Go back and say that since they have space for your daughter, they have space for you. They can't choose children over an adult if there's space, which they have confirmed they have.

Ask how many UDAs they have left and where you are in their waiting list if they can't take you. Insist they tell you about the daughter/private thing by email as you want to check it out with the GDC and ccg.

They are deliberately picking and choosing the profitable and easy bits of the contract rather than pushing back.

CCGs do not commission dentistry, NHS England does. GDC will bounce this back to NHSE.

They don’t have to tell anybody how many UDAs they have left, it is commercially sensitive.
But you are right, they are picking and choosing and that’s against their Regs.

I work for the NHS and have close contact with lots of dentists/ oral surgeons (I do tonnes of dental anaesthesia).

I needed a new dentist and asked around.

All my colleagues many of whom have split job plans so work part of the week in the hospital and part in practice (some NHS/ some private) said don't go NHS.

They explained that the funding for NHS dentistry is now so inadequate that the care NHS dentists can deliver is far below the standard a reasonable dentist would aspire to.

So for the first time ever I have a private dentist.

The AGP (aerosol generating procedure) rules for dentistry have been a bit chaotic since the beginning and are a major part in the slow ramp up of dental services. This might get better as more is understood about aerosolisation and risk of covid spread via it.

The costs of PPE must be pretty burdensome though for practices - each contact needs mutiple pairs of gloves, a gown, visor (this can be reusable, and a mask - reusable, or sessional) for both the dentist and his assistant.

There are also heightened cleaning requirements and they are being told to give "air clearance time" between patients of up to 60mins which obv. reduces the work they can do each day.

There have been differences in localities about how much non AGP work could be done eg. friends son had dental trauma in Scotland during lockdown and got no treatment, whereas I know if he had been seen where I work his tooth would have at least been dressed.

YABU - haven’t RTFT but dentists get paid a set amount under their contract with the NHS for each patient (which only just covers overheads so they’re not profiting at all). In Covid times there have been delays and stoppages of these payments so understandably they’re reluctant to take on more patients that they would essentially have to treat with little chance of recouping the money any time soon, if at all. They are not being cheeky - they are trying to pay the bills.

NB: not a dentist but have worked in NHS contracting.

• However, the NHS contract says that if a dental practice (not the one dentist allocated to nhs patients), if the practice offers a service privately it must also be available to nhs patients under nhs conditions.

Anything else is fraud and a breach of contract. Please report to the GDC and the CCG.*

Completely wrong. There are services not available on the NHS but are allowed privately - any kind of cosmetic work for a start, implants, teeth straightening on adults

Given the number of patients dentists can see in a day has massively fallen they need private income to be even remotely viable.

I have a friend who is a dentist. Usually the practice would see about 30 patients a day. Currently with all the extra precautions they must take, they’re seeing about 5.

Have to say my (NHS) dentist has been great - when the one I saw (head of the surgery) rang out of her NHS quota for the year - think it was January, when my appointment was due they gave me the choice of either seeing her privately or switching to a new dentist in the practice under NHS. DH, the 4 kids (2 of which are adults) and I are all with the practice as NHS patients but spread over 3 or 4 different dentists (I think one of the girls switched from one they saw as a child)

At the moment they are only seeing those with problems in general though - they rang my 16 year old this week to say his check up was due but they are saying that if he has no problems does he mind waiting as they are getting through the back log of those who contacted them with problems throughout lockdown or who are havign pain first.

I contacted them during lockdown as had major toothache and they said unfortunately all they could do was either give antibiotics for an absess or extract the tooth - I was in so much pain I said they would have to extract it but they asked if I would try stronger pain killers for 24-48hours first and prescribed them - pain went. When they reopened they rang me the Monday or the Tuesday asking if I wanted to come in and be seen

I do think some push the private patients more than others - ours has a couple of partners (who also have private) but always has several newly qualified dentists who (I think) just do NHS - they stay for a year or two then go to a different practice and you get a new NHS dentist

@Sexnotgender

Given the number of patients dentists can see in a day has massively fallen they need private income to be even remotely viable.

I have a friend who is a dentist. Usually the practice would see about 30 patients a day. Currently with all the extra precautions they must take, they’re seeing about 5.

I understand that but why aren't they contacting patients? When I spoke to the dentist I was told I had to wait for them to contact me before making an appointment. That was weeks ago. Funnily enough a private dentist could see me the following week (I couldn't go as I wasn't well unfortunately).

YABU

It's been like this for years. Very hard to find any dentists listed on the NHS website who are actually taking on new NHS patients.

They get paid substantially lower rates, there is no incentive for them to let unlimited people register as NHS patients with them. Many of the NHS patients they have will have been registered with them for years and AFAIK they can't just throw them off their register so long as they keep attending their regular NHS checkups. So they just refuse to add any more and encourage new inquiries to sign up as private. Leads to situations where people move and actually remain registered at their NHS dentist tens or hundreds of miles away because they can't find another nearby, and will travel to attend their appointments.

You have a better chance to be registered as NHS if you are eligible for free treatment (e.g. children) vs just being regular joe blogs who wants to pay the standard £22.70 NHS checkup fee.

NHSE is devolving the management of the dental contract back to local levels and the ccgs will be picking up.

They do have to say how they're managing the UDA waiting list.