Nigel Hawkes, Health Editor
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Patients needing NHS dental treatment before the end of the financial year may not be able to get it, the Department of Health has said.
Some dentists have already exhausted their budgets for 2006-07 and will have no money to treat NHS patients until the end of March.
The Department of Health blamed the dentists, saying that some had been “speeding through their work” rather than spending more time with patients. Such dentists, it suggested, needed help. “The local NHS is working with these dentists to help improve the service they provide,” it said.
Patients whose dentists cannot treat them have the option of going to other local dentists who have not run out of money — assuming they have appointments available — or contact their local primary care trust (PCT) for emergency care.
The problem has been caused by the introduction of the new dental contract, under which dentists agree to provide a number of “units of dental activity” (UDAs) for a price.
Peter Ward, chief executive of the British Dental Association, said yesterday: “We know, from our own research, that three quarters of dentists don’t believe that the UDA target they have been given accurately reflects the amount of treatment they are able to give.
“There is a real danger that some dentists will run out of funding to provide care. This is a ridiculous state of affairs when there are dentists who are ready to provide additional care, and patients struggling to access it.”
This is the second problem to hit NHS dentistry in as many weeks. The Government overestimated the money that would be paid to dentists by patients, who pay a proportion of treatment costs. Dentists are seeing more patients who are exempt from charges than was expected, so income is down.
A survey by Health Service Journal suggests that in each PCT a small number of practices will face problems. In Bradford and Airedale, for example, 10 out of 73 practices are in danger of completing their contracted work too soon.
The Cornwall and Isles of Scilly PCT is monitoring a “small number of practices” to try to ensure that they do not complete their contracts early.
In Essex, between 15,000 and 20,000 patients could be affected, according to Tony Clough, secretary of the Essex Dental Committee. He said that some dentists were putting off routine checkups until April.
Potentially worse, he said, were those who were underachieving, by up to 30 per cent. “Their funding for 2007-09 will be reduced, which means they won’t be able to treat as many patients in the future.
“Dentists struggling to meet their targets are put off big cases. Dentists are looking in patient’s mouths and saying: ‘what targets should I be achieving today?’ It’s ludicrous.”
The Department of Health said that the guidance given to PCTs about how to deal with the problem was available on its website. “The new contracts were designed to give dentists exactly what they asked for — more time with their patients,” a spokesman said. “A small minority of dentists say that they are going to deliver their agreed services before the end of the year. This suggests that they may be speeding through their work.”
Andrew Lansley, the Shadow Health Secretary, said: “The Government was relying on its hike in NHS dental charges to pay for changes to the system, but all this has done is force patients to the private sector.”
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This report is an accurate reflection of what is happening
I am an NHS orthodontist with an allegedly full contract. I completed my contract in January and have actually gone over contract in the sum of about £24,000 which will not be refunded by the NHS. If I go under contract I must refund of course.
I have a long waiting list for treatment starts of patients with a strong dental health need for treatment but my practice manager sent me home for two weeks in January to prevent me going even further over contract than I have already.
My job is to deliver health care. It is nonsense of the DoH to say I have been speeding through my work. I have carried on working as normal. What the DoH wanted from the new contract in April last year was to cash limit dentistry. Because of a flawed method of calculation they actually limited orthodontics to a level of 2½ years before. If you cash limit, you limit treatment too.
That is where the problem is. Blaming dentists for problems with NHS dentistry is the DoH favourite tactic for hiding their mistakes.
Chris Kettler, Bedfore, UK