To ask you if our dentist can strike off husband from their nhs patient list without telling us?

[Teefteefteef]

So posting here for traffic:
Husband lost half of a filled tooth last night. The tooth is more filling than actual tooth. It looks very much like it needs to either be removed or crowned. Not in pain yet but only half the tooth is remaining. He called our nhs dentist to book an appointment. Was told that seeing as he hasn’t had an appointment over the last 3 years that they now consider him a new patient and he would have to pay full private fees because, (surprise surprise,) they aren’t taking on nhs patients at the moment. Does anybody know if there is a code of conduct I can reference? To see if they are actually allowed to just strike people off? We think this may be a bit unfair seeing as they weren’t actually seeing anything other than emergency patients the majority of the time for the first huge chunk of covid. Any insight would be very helpful.

I was removed when I missed an appointment (I didn't get the reminder)
They weren't even taking on private patients at the time but my dentist made an exception as I was such a nervous patient. Still with them now and on denplan

[quote Mrsmorton]@mumda that's the truth of it and is one of the reasons I left clinical practice to get away from patients telling me they'd paid for my 15 year old VW Golf... I now work in healthcare commissioning and would not return to front line care unless I'm at risk of losing my house.

The public just do not understand and they simply do not want to.[/quote]
Mine drives a Porsche I told him he was having a mid life crisis and he said to remember who was holding the needle
(Same dentist for 24 years)

I love my dentist, he puts up with my anxiety over my teeth, needing numbing gel (then sticking my tongue in it and panicking because my tongue is numb), and explains everything really well

My dentist has taken everyone off their nhs books who isn’t on benefits! Regardless of attendance

DD got booted from our dentists for missing one appointment. Except I’m as certain as I can be that she didn’t miss an appointment because DS, whose appointment was on the same day in the next consecutive appointment slot was marked as having attended his and I can’t fathom any reason on earth I would have only bothered to take one of my children to an appointment they both had. But there is no right of appeal, they said she missed an appointment and that’s that. There were some choice words when I learnt of this…

@LittleRoundRobin - there are effectively no NHS dentists left. As this thread shows.

I said you contradicted yourself because you said that dentists got paid the same for doing NHS work and private and then said you'd pay a couple of hundred for work on the nhs that would cost 4 figures privately.

And I meant what I said to that poster. To come onto a thread where people can't afford to get their children dental care and crow is sick.

Perhaps you're drunk.

Nhs dentist here. We have kept everyone on our list who has attended after 2018. It means we are overwhelmed but we are prioritising. We unanimously concluded that it would be unfair but know people will be prepared to wait. BUT it means that we are not seeing people as quickly as they should be. We are seeing later presentation of disease, self neglect for all sorts of reasons (without judgement btw, but some people have not done well, it's sad) It's been tough. Unfortunately NHS dentistry is not adequate for the amount of treatment needed. And it's funded far more poorly than GPs are.
The government or the budget or whatever is delaying diagnosing and treating far more serious things than tooth decay and gum disease so we cannot compete with that. They are forcing people and practices to go private just so Dentists can do what they are supposed to do and want to do without getting sued all the time because they have been told to see more patients eg, 6 monthly check ups, regular cleaning, taking their time to give an injection, doing one filling at a time rather than 3 in a visit as you don't get paid anymore if you do 1 or 3 fillings on a patient. Calling a patient back for a review just to check everything is ok after a difficult procedure, or give them a call at the end of the day to make sure they are ok after the numbness wears off. Taking them to desk after they've had treatment to explain to the receptionist what's needed next.

My advice to any of you is brush with a sonicare, floss. Reduce frequency of sugar and use a fluoride mouthwash at a different time of day other than tooth brushing (keep a bottle by the kitchen sink) Then go private. It won't be too expensive, and when you do need the odd treatment it will be pleasant and you won't mind paying. Your dentist will be pretty chuffed too.

Thank you @CommanderBurnham

I'm so glad to know that there are still some dental practices who are prioritising nhs patients.

@CommanderBurnham I pay privately (no choice) and don’t get any of that extra! The treatment is the same as the NHS patients, it’s just more expensive.. most practices round here are mixed nhs and private. Perhaps it’s better to register with a totally private practice?

You know @BungleandGeorge you have a point. It's really hard to be a better dentist for your private patients as all patients deserve to be treated the best you can. I tend to see most of my patients on the NHS but offer them private treatments and upgrades. I do have a handful of privates whom I see on a Saturday outside of my NHS contract - these patients definitely get seen according to their recall interval, and have longer appointments etc. but I do offer them a spot on my NHS list if I get quiet. However most don't take me up on it because, quite frankly they can't do weekdays and it's a bloody zoo sometimes, especially just after school.

The only reason I'm still in the NHS is because i love people of all walks of life, they teach me so much. I find the flashy cash types a bit tiresome. I am financially sorted, which means I have the luxury of going to work to fulfil my spiritual needs and social conscience rather than my bank account - nhs dentistry pays pretty shitty when you weigh up mental health, physical health against earnings. I get the difficult cases and second opinions cos I'm old but I'm on the edge of my goodwill being used up. The only thing keeping me going are my brilliant colleagues and patients.

As a wider issue as a taxpayer, how much should I be paying for people who don't look after their teeth? Do I want my tax dollars to save a child's life using fancy therapies or pay for a thousand fillings?? I don't envy the commissioners. Just because I have delegated decision making to the government I voted for (they're all as bad as each other when it comes to dentistry, and education) to these people, do I then not take any civic responsibility to look after my health so my money gets spent on those who need it as have needed and will do so??

It's complicated and until then just brush your teeth, floss, eat less sugar and use a fluoride mouthwash. And get a check up every now and then.

What? confused I have never known this happen - ever. Why would the GP do that??? (You're talking about the UK are you?)

Yep, in the South West.

DH was surprised too. But they said they hadn't heard from him so removed him from their books. That said, it's entirely possible they wrote to him first but he didn't bother to notify them that we'd moved so any correspondence would have gone to our old address. I did by way of changing surgery, so I just let the new surgery deal with it all.

Sorry to derail the thread OP but it might be useful to call the nhsbsa helpline to clarify what the definition of 'registered' means. As a profession we have not been given a proper definition. Which means NHS practices do what they like. But I do think they are mean spirited not to keep you on. Keeping families together, and valuing loyalty from patients should count for something.

I lack the will to explain the mess that is NHS dentistry! I worked in it for 15 years though. I never told a regular patient to find somewhere else unless they actually failed to attend an appointment.
What I will say is my advice would be to find a good private practice, join a plan to pay monthly and make peace with that. Prioritise it over things like sky tv and haircuts.
Also dental problems are largely preventable with good diet and oral care.
The 2006 contract is a con and I am glad I no longer work under it. It’s totally unethical as you have to lie to patients to make a living. If you refuse to lie you actually end up paying for their treatment yourself.
What should be happening is a base service for children and exempt of simple check ups, fillings and extractions, plastic dentures and gum treatment. With complex treatment reserved for front teeth.
Instead there’s a massive access crisis while the NHS lies to patients and tells them they can have molar root treatment on a second molar for 60 quid.
Anyway even privately you can struggle, we have closed our books as too busy.
I don’t need to work for the money either but I can only do dentistry if I have the time and materials etc to do the best I can achieve. This isn’t possible as an NHS associate.
I think it is time to accept that the NHS generally is in a massive crisis. At least with dentistry we have a choice.

We had a similar situation OP and my DH had not been removed from our NHS dentist’s books. We were regular attendees before covid but all our appoinments were cancelled. We were advised emergencies only were being dealt with.
Haven’t seen the dentist since the pandemic began, but when my DH’s tooth broke before Xmas they managed to slot him in. He had not been removed.

Ha ha @LegoPandemic, maybe 15 years is the crunch point! I am there now and have spent the last few months wondering if this is my future and if I want to stay in it. I stay in the NHS for my patients, and if I’m honest, also the pension. Not the day to day working conditions. As you say, you have to be so careful how you word things to patients to avoid getting complaints as it just isn’t all possible under the contract they offer. As of next week we will have no choice but to scrap social distancing and fallow times as the NHS want us back working to close to 2019 targets, but still somehow keeping everyone “safe!” It’s mixed messaging all the time, “do everything for your patients but with very limited time and budget.”

@MilkLady02
If you want out then now is a great time. Loads of associate jobs as everyone is so busy and Brexit. I know lots who are considering private conversion. Go for it!

I'm another NHS dentist. What others are saying is true, in England they have chosen to fund NHS dentistry for about 50% of the population only. That was fine as 40% of the population are not regular attenders and about 10% historically went privately (this is no longer accurate).

Since 2006 there is no such thing as NHS registration with a dental practice and strictly speaking a practice would only have a duty of care if someone was undergoing a course of treatment. We all know this is ridiculous and practices maintain a database of patients. But bear in mind the NHS contract expects us to stabilise or make someone dentally fit on a course of treatment irrespective of how much work they need. So irregular attenders needing lots of treatment everytime they come cost the practice money as we treat them at a loss. We are also allowed to ask anyone that doesn't turn up to their appointments to find another practice and before someone kicks off about this please remember we have targets set by the NHS and missed appointments mean we have to work even harder.

With all the restrictions of treating people with aerosols in the last 20 months and practices being closed until June 2020 there has been a massive reduction in our ability to see the same numbers and when we do see people they are needing more work. We think we have recalled most of our patients who were with us precovid but some haven't responded to e-mails or SMS so I'm sure they haven't updated contact details. We have also given leeway for Covid but if you hadn't attended since 2018 you'd be off my list too.

NHS England is squeezing dental practices with targets and financial penalties like never before. It is becoming financially unviable to run practices like this and contracts are being handed. If you have an NHS dentist attend regularly, update your contact details and turn up for your appointments.

If you can't find an NHS dentist and want one you need to complain to your MP. NHS dentistry is not a priority for the government.

My practice has this rule.

Have a look at their private fees and you may be surprised they are not as bad as you think

I'm in a similar position in that I haven't kept up my NHS routine appointments so will have to suck up the private fees

So this thread spurred me to call my dentist and it turns out each practice handle this however they prefer.

Raaaaaaarr you're right, each practice can allocate their contracted UDAs however they like - as long as they meet their targets at the end of the year. Practices with smaller contracts may find it fairer to use their UDAs for regularly attending patients, whereas practices with larger contracts are able to see more patients.

dentistry.co.uk/2022/01/05/completely-demoralised-why-the-nhs-targets-have-pushed-me-to-go-private/