Reply With QuotePostcode lottery - completely unfair that some people are able to register with an NHS dentist, and others have to go private. Either offer it to everyone, or withdraw from all adults (children I believe are entitled wherever they are)
Right... for the first time in my life I am trying to get registered with an NHS dentist, previously went from going to the one my parents had me go to as a child to being seen within the military.
I am a junior doctor and just flabbergasted by how much of a faff this is!! No-one is taking NHS patients it seems (any tips there?).
There is a dentist near me that offers a "prevention plan" which is £14 a month and offers 2 exams and 2 hygienist visits a year with 20% off routine dentistry treatments. I think my main question is if I did this plan and had an exam and a dentist said you need xyz and it will cost £8million but I can't afford £8million (even with 20% off) could I get NHS prices for the work needed if it was found on a privately funded exam?
Any help much appreciated!
As a side note, if there was ever a sign that healthcare should not be made more private in this country, it is the state of dentistry!
Postcode lottery - completely unfair that some people are able to register with an NHS dentist, and others have to go private. Either offer it to everyone, or withdraw from all adults (children I believe are entitled wherever they are)
Never understood it personally. I'm a private patient at a place that also takes NHS patients but they weren't accepting any new ones when I joined. Must be a funding thing.
We’re with Denplan and pay an arm and a leg every month for two checkups and two hygienist visits a year.
Treatments such as fillings etc are included, also the work required to fit crowns etc although the cost of the crowns themselves are extra. For the last few years we’ve not needed anything in addition to the regular checkups so I think they’re doing very well out of us.
They are usually asking if we need additional services such as teeth whitening at a “competitive price” but so far we declined.
Don’t really seem to have many options and the overall inertia has meant we’ve just continued year after year.
Can’t help notice they always seem to have the latest fancy equipment whenever I do go.
Denplan is clearly designed to improve the wealth of dentists rather than for the benefit of patients (described as customers now of course). They also seemed to forget to cancel the direct debits during the many months of lockdown.
Would be interested in other options anyone here has found.
Having just left the military a few months ago myself I thought I'd have the same faff - the first dentist I called told me they weren't taking new patients until I informed them I was ex-RAF. They then let me straight in!
My dentist is a good friend, he is very wealthy and only works two days per week.
The state of dentistry in the UK is why people go abroad for treatment
Last edited by adrianw; 4th August 2021 at 10:46.
If you were previously within the military then you should not be disadvantaged from accessing NHS care. You could try contacting the Armed Forces Covenant for advice.
Don't just do something, sit there. - TNH
I had Denplan for over 10 years, with prices increasing each year. I accepted it and apart from the odd filling, I did not need to pay anything other than the monthly direct debit. However during lockdown the direct debit continued to be taken. I cancelled the plan.
NHS Dentists are scarce here - we use Denplan and get great service from our local practice.
TBH never experienced it before moving here, but it is how it is.
When you look long into an abyss, the abyss looks long into you.........
I had NHS dental care all through the 80s, 90s and 00s and great it was too. Then my regular dentist change to private only.
I got another NHS dentist who told me I had X, Y and Z wrong. I decided to bite the bullet and go properly private.
I went into the private dentist with a shopping list of what the NHS dentist said I needed doing, and he disagreed with all of it.
Long story short, but in the 10 years I’ve been private I have had no work done but scale, polish and X-rays.
My faith in NHS dentists took a bit of a tumble.
I know this is anecdotal, but just my experience.
Problem is the NHS fixes prices and what treatments are allowed. Dentists know they can make far more privately and offer better treatments.
My dentists charges what she can to NHS but it seems she's unusual nowadays and cannot afford to have an open list - it's additional family only or one-in-one-out for the wait list now.
Absolutely.Originally Posted by adrianw
I have been going to Latvia for treatment for some years now. I was sceptical but the standard there is very good and we get excellent care.
We're due to head back in a fortnight after an obvious gap - I'm actually looking forward to seeing the dentist.. strange days indeed.
A check up is 20 Euros and the hygenist (who incidentally makes the last hygenist I saw in the UK look a complete joke - barely 20 minutes, hardly anything done, come back in six months, £50).. was 20 Euros for a 45 minute session. I come out looking like one of the Bee Gees.
I also see a chiropidist there.. again great value.
Some time ago, someone here described Denplan as 'managed neglect'. The cynic in me says that it's better for your private dentist to not do the work, but as your teeth haven't turned black or fallen out, it seems that he knows what he's doing.
I was last able to get NHS treatment in the North London then Hertfordshire region about 15 years ago - when that dentist retired the people that took over his practice would only see me privately. Been seeing dentists privately since then. No payment plan, I just pay for whatever needs doing. My dentist does all the dental and hygiene work himself - my wife goes to a much flashier looking practice over the road and the prices seem roughly double what I pay.
I've never had a problem getting NHS dentists in the areas I have lived but as others have said it could be a post code lottery. Have done private as well. The problem at the moment is getting an appointment cuz of covid. Still can't get an appointment for anything unless in pain.
One thing about being private, I have had no problems getting my routine six-monthly appointments (though I was surprised that the July 2020 appointment went ahead - all within the regulations at the time which have eased a bit since then).
NHS dentists are awarded a contract with a value measured in UDA's (unit of dental activity)
So for instance, if a practice is given 14000 UDA's they will know how many patients this will cover on average and once they reach this number they close the books. Sometimes they get some extra UDAs assigned to them at the end of a year temporarily. If they don't use all their UDAs then they lose them.
Each UDA pays them a sum of money fixed to that practice so effectively a 100% NHS practice knows what their turnover is going to be for the coming year.
The whole process is massively convoluted and in my opinion, is broken.
If you move to an area and try to get an NHS dentist you are effectively waiting for someone to die.
Its been nearly 5 years since I was in this industry so I could now be wrong and all the above could be fixed now but knowing the way the NHS works I doubt it.
Been private for about 25 years when my NHS dentist had tried a few time to sort a front tooth. He referred me to a private guy for an implant and never bothered going back to NHS. Whilst I’ve had another implant and a few crowns (bad NHS dentistry when I was young) I now just have 6 monthly checkups and half an hour hygienist session. Looked at Denplan but decided it wasn’t for me.
I couldn't believe it, but in lockdown they were paid 80% of the contract value to sit at home.
Isn't that the same as furlough?
I go to an NHS dentist.
Prices very reasonable. Twice a year check ups are around £14 IIRC. Recently had a tooth extracted, cost £60 odd quid.
Very happy compared with private costs.
Cheers,
Neil.
NHS check up is £23.80 in England.
It doesn't surprise me at all that people can't get an NHS dentist. I've worked in NHS dentistry for over 35 years & it's practically criminal the way it works. Imagine you went into Tesco & loaded up your trolley with 10 boxes of cornflakes, then went to the checkout & only paid for one box. The total price for one box is the same as 2,3,4....or 10 etc. Same with fillings on the NHS. A new patient could open their mouth & the dentist find one tooth to restore....or there could be half a dozen. The dentist receives about £40 no matter how many fillings are required. So if it's 4 fillings, that's £10 per filling. Out of that they have to pay for overheads, nurses salaries, materials, laboratory bills etc. In some cases the dentist's overheads etc. cost more than they receive for carrying out the treatment, so they are actually paying to do the job. If a patient needs a simple bridge I'd receive a fee of about £240 from the NHS for that. It's about 2hours of surgery time. The laboratory bill is around £400, which has to come out of the £240 fee. Once the patient has been accepted & seen, the dentist can't refuse to do the work even if it results in a loss to them.
As a side note I'm having a similar problem trying to book a face to face appointment with my NHS consultant. My GP, who I also can't get a face to face appointment with, looked at the radiograph I had taken of my hip & advised me that I needed an 'expedited' hospital orthopaedic appointment. I asked what 'expedited' meant & she told me that I'd get an appointment within the month. That was one year and one month ago & I've still heard nothing.
I phoned up my consultant's private clinic and was offered an appointment with the same NHS consultant the next day. I'm now having my hip replaced privately in 2 months time at a cost of about £15k. There's over 100,000 people waiting for one on the NHS & I'm not even on the waiting list. Money is tokens to get you to the front of the queue, it's up to the individual to decide where they're going to use their hard-earned tokens.
Correct. There are only 3 fees that you can be charged for a full course of NHS treatment:
Band 1 = £23.80 includes check ups but also costs the same if you need any x-rays taken or a scale & polish. You pay £23.80 whether you have a scale & polish or not.
Band 2 = £65.20 which covers everything in band 1 but also any number of fillings and root canal fillings which you may require for that one £65.20
Band 3 = £282.80 which covers everything in bands 1 & 2 plus anything which requires the dentist to pay a laboratory bill, like crowns, bridges & dentures.
The dentist doesn't necessarily receive these fees either. We're paid in UDA's (units of dental activity). Dentists' UDA values aren't all the same. Mine's about £21.50 iirc. Band 1 is 1 UDA, band 2 is 3 UDAs, Band 3 is 12 UDAs. Do the maths, it means that some of my NHS patients' fees go to the government's coffers.
So you'd get £240 from the NHS? The patient also pays a fee though? My NHS dentist would charge me £282.80 for a "Dental bridge (3 unit)". So £240 + £282 - £400 = £122, or £61 per hour?
I have exactly the same, Denplan monthly etc. For extractions, implants etc. My dentist refers to another setup in Sheffield, which I must say is excellent. When I asked this second dentist. If he would get into Denplan, he replied - no way, there is small revenue for the dentist and they keep most of it.
Obviously he is doing well outside NHS and outside Denplan. He told me that since he moved to Sheffield bought a house for cash in one of the best areas, an Honda NSX for himself, and an Evoque for the wife. Saw him getting in the practice however in a Fiat 500.
No Furlough is a percentage of the wages, if someone gave me 80% of contract value for nothing I would be laying on a beach
They rape you for money and cause pain.
No, I'd get my UDA value of £21.50 (ish) x 12 = £258 & that's the lot. That's about £25 less than the patient actually pays. Out of that £258 I'd have to pay a £400 lab bill in this instance. So I'd spend 2 hours of my time and have to pay out £142 more than the fee for the pleasure. Out of this also has to come nurse wages, receptionist wages, rent, bills, materials, indemnity insurances, etc. etc. etc.
They weren't doing nothing and believe the payments were based upon trading profits and capped at £7,500.
We were forced to close for the first lockdown. In that time we were triaging dental emergencies & providing 'the 3 A's'...advice, analgesics & antibiotics. We also had to input this data into the NHS portal & deal with rapidly developing situations like having to deal with preparing for reopening at a time when the Chief Dental Officer showed poor leadership & had failed to publish a new standard operating procedure. We were also desperately trying to source PPE and modify our practices to create a safe working environment. We were having the practiced 'fogged', had big extractors installed into every room. Probably a hell of a lot more than most people who were lying on a beach on furlough. We reopened on 8th June 2020 and have been working flat out ever since. I have personally seen about 3500 patients face to face since the first lockdown, in close proximity & with their masks off.
Lucky here to have been accepted as an nhs patient after finally being hacked off paying extortion rates privately
Have to say that I thought the 1948 national health act ( or whatever it was called) entitled everyone to nhs dental care
Postcode lottery or whatever, it’s a National disgrace IMO.
Unfortunately different areas of the country seem to be working differently, the practice I was talking about is still only doing emergencies and no check ups. Interestingly the local GP's surgery is pretty much the same.
….and if my patient needs 2 bridges I wouldn’t get paid any extra money and I’d have to pay another £400 lab bill, use more materials & spend more surgery time etc. It’s not good business.
Maybe but plenty of us are offering the full range of treatment despite operating under difficult & often inhuman conditions. The government said that dentists could return to work on June 8th last year ‘if they were prepared’ It was impossible to be prepared at that time because the covid standard operating procedure had not been published by the chief dental officer. We received that the next day iirc. It was post dated 2 weeks earlier iirc. It took me 2 months to clear my backlog of emergencies & then we started doing routine check ups again.
…and we don’t accept new NHS patients. Not especially because we’re full but more because it’s too risky to take on somebody new & committing ourselves to doing everything the patient needs for a fixed, low, non-negotiable fee without seeing what you’re letting yourself in for first. Basically underwriting the potential costs.
Would you expect to be able to phone a builder, ask him to come round & carry out some building work for, say, £1000. You don’t tell the builder what the job entails. It could be repointing a wall or it could be building you an extension. He can come & look at the job but once he’s looked he can’t refuse to do the work for that fee.
trident, how do you accept new NHS patients? Do you let them swap over from private once they're already on the books? Genuine question, no dig.
I have to go to the dentist who normally sees kids as I have a tiny mouth (hard to believe!)
Indeed.
We wouldn't expect to part pay towards an operation on the NHS so why with dentists?
Like medical stuff, dentistry should be free at the point of service.
Cheers,
Neil.
They’re different things. We pay for NHS prescriptions and eye tests (unless exempt).
Laughing at this back of a fag packet calculation.
No mention of dental nurse and dental receptionist hourly wage either..
Most NHS fees are a complete joke
The worst example is the extraction of a tooth under the NHS in the Scottish system earns the dentist £14
Go to most countries and you will be into 3 figures for this.
That’s why in areas where there is not high levels of deprivation it will be difficult to get an NHS dentist.
Grossly underfunded system.
I don't generally accept new NHS patients but then I don't usually take on any more private patients either. Other dentists in my practice tend to get the new patients. I'm pretty busy as it is & only have one pair of hands so you can't overstretch yourself. One of my colleagues works at another all NHS practice and gets 5 minute appointments for NHS check ups. I have 25 minutes for most people, even the NHS ones.
If I'm seeing a private patient & they lose their job, or are a female who becomes pregnant & can claim free NHS dental treatment, I'll offer to see them on the NHS as a goodwill gesture until any exemption runs out. But back to private once they have to pay again. Most of my NHS patients are kids...my hands are like sippets & I have no problem with operating in small mouths! :-)
I don't think most people realise that there is no such thing as registration under the terms of NHS dentistry. Patients are taken on for a course of treatment and, when that treatment is complete, that's the end of the obligation. There's no ongoing obligation to continue to accept a patient for another course of treatment, although that mostly tends to happen. So patients can't be deregistered or 'struck off' because they weren't registered in the first place. Only in so much as if they happen to be under a course of treatment at any given time then there's an obligation on the dentist to complete it.
Haha, I work one day a week teaching the dental students practical dental skills. One of my 5th year students recently spent an hour and a half fitting a denture repair. His knowledge was admirable & he went to great lengths trying to get the repaired denture to fit nicely. It was rocking a bit....it was probably like that before it was repaired! I asked the patient how it felt & he said it was fine. That's normally good enough for me. I had to explain to the student that he wouldn't have the luxury of having a long appointment to fit a repair. The fee for a denture repair on the NHS is 1 UDA = about £20. Out of this he'd have to pay the lab bill. The lab bill is about £20 as well. Net fee = approximately zero.
This is the calculation -
The practice will get a UDA value (Different for each practice - nuts right?). I'd say an average is around £27.
12 UDA for the bridge including examination (Which is usually 1 UDA), therefore 11 UDAs assuming no other work done. Practice received £282.80 from patient + £41.2 from the NHS to top up to the contract value of £324 (12 UDAs x £27/UDA)
Associate might get £11/UDA (Again, average) therefore receives £121.
Lab bill for 3 unit bridge - I think trident quoted £400. (I think this is a bit more than the average NHS dentists spend to be fair.). Lab bill usually split 50:50 with practice.
Therefore when Trident is doing £400 bridges on his NHS patients, he's losing nearly £80 a go. £121-200 = -£79.
Not great for the dentist.
Similar to Trident's analogy ; it's like running a buffet for a fixed (low) price for people who've been starved for a week. Oh yeah, and apparently the NHS and private dentistry are both equal, that is to say you can't say if you're doing the work privately it will be any better.
Fair enough, don't blame you at all.
I miss having dental coverage at work. I used to get the softest bite guards and chew through a couple per year. Once I changed companies I got the toughest one and I'm still making do!
I’ve struggled for 10yrs to get an NHS dentist. I tend to work on the ‘visit if it hurts’ process, so haven’t yet seen one. Probably not the best approach, fancy a polish though, just don’t want to pay the price.
£12 for a scale and polish under the NHS here.
You would pay more for a haircut at the Turkish barbers.
It's actually insulting but hence few nhs dentists in certain areas.
Does anyone know the answer to this potential situation?
Go for a privately funded check up at the dentist, dentists finds dental work needs doing (as in there is a clinical rather than aesthetic need), can the private dentist then refer me to have the work done via the NHS if I couldn't afford the cost of the work?
Basically, in my area it seems like if you want a dentist to look in your mouth it is going to need to be private, I am happy to pay a sum under £20 a month to have this done routinely along with seeing a hygienist, but don't want to pay for expensive procedures, because, you know that's why we have an NHS...
Within out family, I am NHS, as is my son, my wife is Private. We all share the same dental practice and the same dentist.
Crazy. That said my last 5 minute, 6 monthly check up was £22.
Whoever does not know how to hit the nail on the head should be asked not to hit it at all.
Friedrich Nietzsche
Nope
You won't have been accepted as an nhs patient when he/she took you on so no entitlement for them to treat you under NHS.
If you were accepted as an nhs patient then yes the work would be done under nhs regs/prices.
There are obviously nhs limitations in materials used-you wouldn't get a tooth coloured filling on anything past your canines.
Also unlikely to get a hygienist appointment under the nhs -again because the nhs fee is derisory.
So do you know what you are supposed to do? You actually need dental work done but can’t afford it?
And there is not a single dental practice taking NHS patients…
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