Dentist cancelled because of maternity exemption

[Acc0untant]

This isn't a huge deal in the grand scheme of things but I feel a bit put out regardless.

My dentist has cancelled my appointment next month and when I queried why the receptionist told me that they aren't seeing any patients who are exempt at the minute. In my case I have a maternity exemption certificate (runs out in March). She said it's because they aren't receiving any NHS funding for it at the minute.

The point of the maternity exemption is that due to pregnancy you can have additional things needing work (pregnant gingivitis etc) and you aren't unfairly penalised by having to visit often. In this case they're saying I can't be seen until I start paying the NHS prices again in April.

Not going to pull the discrimination card (although being told I can't use their services until I no longer have an exemption due to pregnancy certainly feels like it) but would like to hear the thoughts of others on this too!

OP had a check up 5 months ago , their check up for next month was cancelled , because of lack of funding , and was offered to remake it after April 1st when new funding cycle starts . So in other words OPs check up has been delayed by a few weeks.
A few weeks delay because of funding and practice has been seeing OP during pregnancy and afterwards , with explanation of why appointment cannot be offered until after April 1st seems reasonable.

What does not seem reasonable is ,given this situation is arising all over the country earlier and earlier each year ,that people are not advising the supporting one of the few dental practices providing NHS treatment by writing to those whose decisions have cut off funding that was promised last year , at the last moment instead of berating a practice over a delay of a few weeks in providing NHS check up.

They aren't refusing her an appointment because she's pregnant though. They are refusing all people who are exempt from charges

They are refusing them until April 1st when new funding comes in. OP had a routine check up cancelled from february when she had had one five months ago , and can rebook after April 1st.

Surely she would also have to defer having treatment that shows up as being required at the time of her checkup? As far as I know, that dental treatment would also be covered during her maternity exemption - in this situation, it’s potentially a double blow!

As they are with all exemptions, not just pregnancey

Exactly , they are postponing , by a few weeks , all treatments that would cost them money to fulfil , until the new funding year starts on April 1st.

Two months of treating many patients for whom there is no money coming in would mean bankruptcy for a practice that provides a large amount of NHS work.

As it is even many funded treatments will lose a practice money ie you would be better off giving people money to go away rather than doing a treatment with multiple fillings or root treatments or crowns or dentures .

I don't know why you keep quoting me.
I've said that the dentist is not discriminating against op.

To not pay out of their own pocket to treat the op?

I can believe this as my teen has now after 4 years of waiting finally been referred to an orthodontist for braces on the NHS. The orthodontist has told us they are unwilling to start her treatment until April when they receive funding from the NHS.

Yep and they do have a reasonable justification the funding has run out. That's sufficient justification. There is no law in the land that insists everyone must complete work for protected groups for no pay. ie charitable work. That's not a requirement for any dentist

@Acc0untant I'm sorry I haven't rtft, but am interested and indignant . I think writing to your MP is a good idea and perhaps copy in the pregnant then screwed charity, also General Dental Council and Faculty of Dental Surgery, their professional body, allied to the Royal College of Surgeons. The reason for including these dental organizations is not because you're complaining about or to your dentist as you've said numerous times, but because they will back your cause and be pleased you're following this up. Dentists actually want to do the best for their patients. Also consider starting a proper govt petition re this petition.parliament.uk/ , not a Change dot Org one. Sorry if this has all been said before on here

A good friend of mine, who is part of the BDA, has been lobbying for improvements in the current dental contract. Unfortunately the short term solution they brought in has lead to this situation. Most governments are very short sighted as we are all aware.
They were warned that their “solution” would lead to more shortages but they failed to understand how this would happen. This will always happen when you listen to monkeys rather than the organ grinders.

If you had read you would see that OP has had a check up 5 months ago , had another check up booked in February which has been cancelled and OP was offered a new appointment after April 1st when new funding comes in.

The dental practice has run out of NHS funding and cannot afford to see people for free but is seeing people for NHS fees because at least that brings a bit of money in. This means they are not seeing anyone who does not pay for treatment because they cannot afford to see people for free.

The OP has had their check up put back by a few weeks but has had appointments during pregnancy and afterwards and has been offered an appointment after April 1st when.

The situation is because 10% extra funding to see more patients was promised last year was withdrawn earlier this month and the money used instead to prop up over spends elsewhere in the health service. This is a report from the Midlands but at least 12 ICBs in England have notified dental practices this month that funding they thought they had has now been withdrawn. www.bbc.co.uk/news/uk-england-67866257

Reporting to the GDC will involve a massive investigation into the practice itself , which will last months and possibly years , adding yet more pressure on a service which is one of the few practices still providing NHS dentistry, they are the regulator of dentists not a campaigner for NHS funding. Any communication with them about a practice will result in an investigation , whether that is what you intended or not.

The BDA has been manning a campaign for a long time over funding for dental practices . The faculty of dental surgery has nothing to do with campaigning for funding.

The government is well aware that ICBs are using the dental budget to prop up the overspends because exactly the same thing happened last year at this time https://www.gdpuk.com/news/latest-news/4671-twelve-and-counting-the-number-of-icbs-ignoring-the-dental-funding-ringfence

The problem is worse this year because tweaks in the dental contract means funding is running out earlier and this is a problem that will get worse each year.

The only useful suggestion is to contact your MP because despite this new governments promises everyone acknowledges NHS dentistry is in its death throes and to contact the practice itself to see if there is anyone you could write to in the ICB to support them seeking extra funding.

The fact that all their initiatives to increase access was funded out of existing contract values has directly made this worse .

That being said we all said in 2006 the new contract would never work, within 18 months even the government (labour) realised it was unworkable and almost 17 years later we still have it and dentists leaving NHS in droves , broken by it.

However I really,really ,really wish people would stop advising contacting the GDC. They really have no idea of the fear , investigations by the GDC cause over months/years . Talk about crucifying a practice and dentists trying their best in the dying days of NHS dentistry.

This is a link about the effects on a dentist about reporting to the GDC . The GDC are a regulatory body , they have nothing to do with NHS funding or funding of dentistry. Mention a practice in any capacity and you will start an investigation which can have devastating consequences on dentists , including , unfortunately , suicide . https://densura.com/post/the-hidden-toll-of-gdc-investigations-on-dentists/

I work in GP surgery and we've had several patients say their dentist can't see them as they have run out of money. We have to tell them to contact 111. They can help in an emergency but not for appointments.

I got mine at 6 weeks for antisickness meds, just asked my GP reception and they gave me the form

I just went through the same thing. Had a filling replaced 5months ago because was old silver filling (paid full price). Started getting serious pain booked another appointment and was told I needed a root canal which can be fixed on Tuesday. Informed them I am now 16weeks pregnant so entitled to exemptions and they cancelled my appointment and said I had to wait for a NHS appointment which they are not sure when they will have one. I was in utter shock.

But were you an NHS patient before? You said you paid full price for the filling, do you mean you paid privately? If you weren’t an NHS patient to start with then that’ll be why. They can’t just take private patients and make them NHS when they become exempt. They’ll have a waiting list for NHS which I imagine you can join the back of.

Complaining to the GDC is a waste of time. Contractually a dentist has no obligation to see a patient unless they are in active treatment, and even then they can alter appointments if and when necessary.

Registration with a dentist is no longer part of the NHS dentistry. Pre 2006 dentists were paid a retention fee for all NHS patients as long as they attended with 15 months of their previous appointment and had regular check up. Registration was abolished in the new contract to save money and to encourage access for patients who were unable to register with a dentist because lists were full.

Because dentists were obliged to see registered patients for emergencies within 24hrs of them contacting the practice it was not practical to have huge lists. A big list of patients was good insurance for the practice but many practices with huge lists were spending too much time seeing emergencies and patients were having to wait months for treatment.

The new contract was an attempt to open up access but further compounded the problem by limiting the amount of patients a practice could see and treat.

The feeling within the profession is that NHS will become a core service. Severely limiting the types of treatment available. It may even become a trial for the wider NHS. Basic examinations and preventative treatments will be offered but anything more complex such as fillings, root canal or extractions will have to be paid for privately. We may even see a government run insurance scheme that is properly ring fenced for health care.

Because NHS dentistry is already set up to deal with payments and insurance schemes it would be very straight forward to introduce such a scheme.

We have sophisticated IT programmes that could be used within the wider NHS that have already been integrated into the NHSBSA so there is no real excuse of costs. The IT is already there and functions well. I suspect that because it has been developed outside of the NHS it is far more efficient and fit for purpose.

This does not help the current situation but hopefully change is coming. Nobody wants a privatised healthcare system but we have to accept that the NHS, as it was set up, is no longer viable. Having a municipal health insurance scheme where you are not penalised for your medical history will create a fairer system and most of us would happily pay NI if we know that when we need healthcare we can claim for it. Free at point of access has never really been the case, funds available when you need care, through insurance, would create a better service. I would happily pay a fee to see my GP when I need to rather than having to wait weeks. It may also discourage the frequent fliers who visit weekly or even daily in some cases.

Having said that I have found the new message system much easier. I don’t have to visit the GP and rather than seeing the GP, when I really need to speak to the practice pharmacist or need physio ( who is much better at examining a problem) I get a referral without the pointless GP consult. Thus leaving the GPs time for those who are actually sick.

We also all have a responsibility to attend screening appoints, in fact any appointment. As dentists we are able to charge a deposit which massively decreases the non attendance. We often make shorter appointments for patients who are chronic non attenders because it is such a waste of time. We only get paid when patients attend and we cannot charge cancellation or non attendance fees. We still have to pay staff and running costs for that time so have a rule of 3 strikes then we will no longer see a patient.

I left the NHS 2 yrs ago and I now love my job again. I only work one day a week ( due to health reasons) but I no longer dread going into work. I spend more time with my patients so can achieve a much higher standard of care. I am probably going to retire fully in a couple of years but as a practice the general feeling is that unless things change soon we will convert to fully private in the next couple of years. We have a team of dentists who each have their own speciality so we can refer within the practice. My boss already refers a lot of his private fillings to me since that’s where my talents lie, along with denture work because I have the experience.

If you were to ask me whether I would be a dentist if I had my time again, no I wouldn’t. I would tell my younger self to be an architect or a forensic scientist.

Yes I was I have been with the same dentist since I was a kid. However I was complaining of sensitivity and the dentist advised it was due to the old silver filling and changing a filling from silver to white is not covered by NHS hence why I paid full price.

Unfortunately NHS dentists have limited contracts for a limited amount of treatment so have to space out treatment so they do not run out of contract by the end of the financial year .

There is no such thing as registration in England and Wales so anyone not under a course of treatment will have to wait until there is capacity to see them, which may be months away .

However most NHS practices will also do private work because it subsidises the losses they make on NHS. So there is often capacity to offer a private appointment , but not NHS.