Dentists have ruled out English NHS patients due to skipped checks during a pandemic
Patients across England who have not visited their dentist since the start of the Covid-19 pandemic have been systematically excluded from NHS treatment by some clinics.
Dental practices across the country told patients they could no longer receive NHS treatment, citing absences for a period of two years or more, including lockdown.
The Observer has found that many of these patients have not received any written warning and are now facing potential future treatment costs of thousands of pounds.
The decision to ‘remove’ some NHS patients comes as the government faces growing anger over the state of dental care in the country, with many patients resorting to ‘do-it-yourself’ surgery out of desperation dentistry’. Ministers last week launched a recovery plan, with £20,000 bonuses for dentists in areas with the worst access to NHS care.
Prime Minister Rishi Sunak has repeatedly cited England’s £3 billion annual budget for NHS dentistry, but down by more than £500 million in real terms in ten years. It also includes dental costs paid by NHS patients worth almost £747 million in 2022/2023, according to the latest accounts from the Department of Health and Social Care.
This weekend there will be a response to the ObserverAccording to the findings, health and social care champion Healthwatch England said it wanted reforms to allow patients to register with a dental clinic in the same way as a GP practice. Chris McCann, director of campaigns, said: “It is not uncommon for people to think they are ‘registered’ with a dental practice, only to find they have been ‘delisted’ when they go to make an appointment.
“People want to register with a local NHS dentist in the same way as a GP, knowing they will be there for them in the long term.” Under the current system, there is no official NHS dental registration system in England and practices can choose whether to provide NHS treatment on an individual basis.
Sylvia Suddes, 59, an editor from Huddersfield, said she contacted her dental practice in autumn 2021 after the pandemic and was told she could no longer receive NHS treatment due to absence. She hasn’t seen a dentist since the lockdown. “None of my neighbors have an NHS dentist,” she said. “If they have a serious problem they call NHS 111.”
When Boris Johnson announced a lockdown in March 2020 to prevent the spread of the coronavirus, routine dental care was suspended. Dentists were allowed to resume in June, but infection control measures meant clinics were only able to see a fraction of their usual patients. The British Dental Association (BDA) said that around 28 million courses of NHS treatment were missed in England in the year from March 2020.
Many people were concerned about appointments and some who were ‘delisted’ said they had never been contacted after the lockdown. Trevor Maggs, 64, a writer, and his partner Gillian, 64, who live near Penzance in Cornwall, were told last week that NHS treatment at their local practice was no longer available due to absences. They had been patients there since 2012.
“They have not refused to treat us, they have refused to treat us as NHS patients,” Maggs said. “We have modest savings and spending thousands of dollars to get our teeth fixed is a bit of a pain.”
Maggs said his last appointment was in early 2020, before the lockdown. He said: “We are both still very cautious about Covid infections because we had it quite hard very early on in the first wave and at least once afterwards.”
Lizzie Dunthorne, 32, a communications manager living in the Cotswolds, called for a post-Covid dental appointment in August 2021. She was told she could not get NHS care as she had not visited the clinic in Kidlington in Oxfordshire since . in late 2019. She was given no prior written notice. Unable to find another NHS practice, Dunthorne paid £90 for a private appointment. “They told me they needed two fillings renewed at £220 each,” she said. “I haven’t booked to go back.”
In Scotland, patients must give three months’ notice to a dental practice if it intends to remove them from a register. The rules do not apply in England, which allowed practices to ‘remove’ some NHS patients after the pandemic as they faced a backlog of care and the prospect of better returns from private practice.
There is now little chance of finding NHS treatment in many areas, as seen in Bristol last week where hundreds of people queued outside St Pauls Dental Practice hoping to register.
Shawn Charlwood, chairman of the BDA’s general dental practice committee, said hundreds of practices were cross-subsidizing their NHS activities with private work. “Many dedicated colleagues are just looking for the exit,” he says. “The money offered to dentistry does not even begin to undo a decade of brutal cuts.”
The BDA does not have figures for patients in England who have been told they are no longer eligible for NHS care at specific clinics, but says practices have faced “clear limits on patient flow” following the pandemic ”.
The BDA says more than 12 million adults in England have an unmet need for NHS dentistry, more than one in four of the adult population. An online survey of 500 British dentists by the BDA last month found that more than eight in 10 had treated patients who had carried out “do-it-yourself dentistry”.
NHS dentistry was founded in 1948, with clinics typically operating independently and offering both NHS and private treatments. Dental charges for NHS patients were first introduced in 1951 and included more than 400 items in 2006.
The BDA has called for a “decisive break” with the current dental contract for dentists, which was introduced in 2006 and pays providers an annual fee for delivering an agreed number of treatment courses. MPs have said the contract is not fit for purpose. The government said last week it was developing further proposals for dental contract reform.
The Department of Health and Social Care said: “Our new dental recovery plan sets out how we will make access to dentistry faster, easier and fairer. The plan – backed by £200 million of government funding – will create an additional 2.5 million dental appointments for patients over the next 12 months.”
“The government is already investing more than £3 billion every year to support NHS dentistry and we are starting to see progress. Last year, 1.7 million more adults and around 800,000 more children visited an NHS dentist compared to 2022.”
A Commons Health Select Committee report published in July recommended that the government require patients to register with an NHS dentist. The government has said it has no plans to introduce official patient registration for dental services, saying the current model allows “greater choice and flexibility for patients”.
An NHS England spokesperson said: “The NHS Dentistry Plan will make it easier for patients to get an appointment by supporting dentists to take on new patients and helping practices set up shop in areas where there are not enough NHS appointments.”
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