Dental charge - should I of paid?

[year09]

I'm lucky I know to be registered with a NHS dentist. I had a check up on 27/01/23 and a few fillings in the days afterwards, charged £65.20 band 2 treatment. I returned after 2 weeks because my gum next to the filling is sore and not getting better. The dentist cleaned around the area etc and there was no charge. I've just been back because it's still very sore and irritated, the previous dentist has now left so it's a new one. This one couldn't really see a problem, scraped around and gave me advice etc. said see you in 6 months. I went to the desk to arrange the appointment and was charge £23 for today's appointment. Even the receptionist seemed confused as to why I was being charged, she called through to the dentist who insisted I still needed to pay. I've come home to find my copy of the original dental treatment plan. On the back it states - within 2 months of completion of the course of treatment detailed overleaf, should you require further NHS treatment in either the same or lower charge band, you will not normally need to pay again.

I take this as I should not of needed to pay anything else. I hate complaining but am I correct?

I'm sorry but you should have paid as although it was the same practice it's a different dentist who will have a different contract with the NHS.
The two months only applies if it's the same dentist who sees you.

Yes, I think you should have paid as you were seen by a different dentist.

The dentist left the practice

This.

Each dentist in a practice is self employed and not connected to any other dentist in the practice. They pay a percentage of their earnings (50 to 60% typically) to the practice to cover costs.

Therefore if you see a different dentist you will have to pay again as guarantees ,continuation of treatment etc only apply if you see the same dentist. This is not the dentists decision this is NHS rules.

This is not stated anywhere on the treatment plan. It does mention that if needed you will be referred to another dentist under NHS arrangements for part of your course of treatment. Where this happens you will not be asked to pay a further charge for your NHS dental treatment.

I wasn't referred, my dentist left.

The referral part only applies to tier two or three services ie if you are referred to a specialist practice for eg wisdom tooth removal which cannot be provided in a normal dental practice. One dentist cannot refer to another unless they have a specialist contract.

The regulations regarding charging are complex and cover hundreds of pages. The printed patient information does not cover every eventuality.

However as said before each dentist in a practice is an independent practitioner , they have no business relationship with any other dentist in the practice and treatment is provided seperately from each other. Each dentist pays to use the practice and staffing/material costs etc. You cannot expect another dentist to lose money by providing continuation treatment from another dentists treatment and indeed there is no way to claim anything on the NHS for this.

So if my dentist leaves halfway through my treatment I have to pay twice?!

Bonkers isn't it. Dentists think so too. You should write to your MP.

Yes you would pay for your outstanding treatment with dentist one and then have a new treatment plan with dentist two. This is why dentists will do their utmost to finish a course of treatment . Also because dentists will not do someone else's treatment plan.
Dentistry is not an exact science and give two dentists the same patient and you will get three different treatment plans. All will be equally valid.

Sorry biotria but you are wrong. Dentists, even though they work in the same practice , are not connected . They work independently and each pays the practice for use of facilities etc.

There is no way for dentist 2 to put in a claim to NHS to continue dentist 1 treatment , the computer will reject it . Dentist 2 would , effectively be doing the treatment for free and outside of the NHS as it would not be accepted as a NHS treatment.

The rules governing NHS dental payments are very complex and cover hundreds of pages . What is printed on the back of the form does not cover every eventuality. NHS continuation of treatment only applies to certain types of treatment (ie emergency treatment is not covered ) carried out by the same dentist in the same practice .

Here is the relevant passage from the English regulations , Scotland, and NI have slightly different arrangements, Wales is more or less the same

Para 6 NHS (Dental Charges) Regulations 2005
“Where a provider of relevant primary dental services has completed a course of treatment
other than an urgent course of treatment
but, within 2 months of that course of treatment being completed, the same provider determines that the patient requires further treatment which falls within the same or lower charging band as the previous treatment
and that further treatment is provided (whether or not within 2 months of that course of treatment being completed) by the same provider,
no charge may be made or recovered in respect of that further treatment”

I've just spoken to the manager, she said I've been charged because it was put down as an urgent appointment. A sore gum to me isn't urgent. She's going to speak to the dentist and get back to me, see if it can be added as a continuation of treatment, I won't hold my breath

And this is why dentists are leaving the NHS……

To be honest pay is a lot of it.
It costs £120 an hour to run one room in a surgery in a cheap area with cheap overheads .
ops band two treatment will have , on average , earned a grand total of £75 . 2/3 of that will have gone on expenses to the practice etc leaving a grand total of £25 before tax , national insurance , training , registration, insurance , personal equipment etc. for at least three appointments not including the last one.
If dentist two does not claim a fee then they earn absolutely nothing , in fact if they miss their NHS target , like the vast majority of NHS practices will, they will have to pay back money at the end of the year so treating op will have cost them money as they did no work towards their NHS target.

I had no idea that dentists were self employed..I've learned something today!

Just heard back from the dental practice who have agreed to give me a refund.

Last time a patient was dissatisfied with waiting lists and complaining to me, I told them to contact their MP they laughed in my face.

'What will that do? I'm not writing to my MP!'
🤷🏽‍♀️

Well complaining to me isnt going to do anything either.

Pahahaa. So true. So frustrating. I don't miss the bureaucracy and bollocks like that.

Op isn't picking up what you're throwing down. HAVE.