NHS dental patients told to ‘pay private fees’ if they want treatment

Some NHS dental patients are being asked to pay for private appointments “if they want treatment”, while others face two-year waits for appointments, a watchdog has warned.

Healthwatch England was contacted by one patient who was offered a procedure for £1,700 which was £60 on the NHS.

Another was told that their odds of successful treatment would increase substantially if they were willing to pay for private care.

A briefing document from the watchdog, seen by the PA news agency, also highlights how one patient was told they would need to wait for two years for an NHS dental appointment.

Services at “crisis point”

Another patient was told to use a nail file to deal with a broken tooth, and others were advised to “buy dental repair kits and treat themselves”.

Patient safety champion and chair of Healthwatch England, Robert Francis QC, said that the issues show how the coronavirus pandemic has “exacerbated the human impact of years of structural issues in NHS dentistry and is now pushing it to crisis point.”

Healthwatch England was contacted by hundreds of people between October and December last year complaining about dentistry issues in the health service.

The most common reason for people to approach the watchdog was to complain about a lack of appointments.

Feeling the pressure to go private

The Healthwatch England document states: “A lack of NHS dentist appointments remains the most common issue that people have told us about. People have been asked to wait for up to two years to see an NHS dentist.

“Few have said that they could access dental care quickly if they were willing to pay for private care.”

It adds: “People have indicated that dentists have prioritised private care or asked them to pay private fees if they wanted any treatment.

“While one individual was charged £500 for extraction of a single tooth, another person was offered a procedure for £1,700 which was £60 on the NHS.”

It features an account by one patient from Kent who reported to Healthwatch in October last year that their dentist had told them that NHS care would be “60% successful”, but if they were willing to pay for private care, the odds of success would increase to 90%.

“Throughout the appointment, the dentist kept making reference to private treatment,” the patient told Healthwatch England.

“He advised that I required root canal treatment, which on the NHS would only be 60% successful, but if I were to choose to pay an extra £450 for private treatment, it would be 90% successful.

“This made me think that the NHS care that I would receive would be sub-standard.

“(The) dentist kept pushing to choose these options and made me feel inadequate, sub-standard and thoroughly demoralised.”

The watchdog also raised concerns for pregnant women – highlighting how one woman with a suspected abscess waited for months for care and was eventually told that the only place she could receive care was a 45-minute drive away.

The report also highlights how for some patients, if they were not considered as an “emergency”, they were not eligible for NHS treatment.

“Patients have felt like they are being offered the treatment their dentist wants to provide rather than the care they need,” the document adds.

The sector has been badly affected by the pandemic – infection control, social distancing and personal protective equipment mean that dentists are not able to see as many patients as they used to, and the sector also faces huge backlogs after being forced to shut for a number of weeks last year.

Systemic issues

Dentists have been ordered to reach 45% of their pre-pandemic levels.

But dentists have raised serious concerns about increasing footfall in practices, particularly given the recent spike in Covid-19 infections.

Talks over the target are said to have “broken down”, according to a group of MPs led by Labour MP Virendra Sharma.

The group has written to health secretary Matt Hancock, asking him to intervene.

The letter states: “We are concerned that the current situation may lead to practices across the country closing their doors to NHS patients, depriving our constituents of dental care at a time when the effect of reduced access to dental care is still being felt.”

Healthwatch England has called on Government, the NHS and the dental profession to work with patients to fix systemic issues in dental care.

Francis said: “Our findings show that access to dental care is currently neither equal nor inclusive, leading to traumatic experiences for many people.

“This provides yet more evidence that the Covid-19 pandemic has exacerbated the human impact of years of structural issues in NHS dentistry and is now pushing it to crisis point.

“We are hugely concerned that this will have detrimental effects to the nation’s health for years to come.

“Although we have to grapple with the pandemic, all efforts should be made to treat those in need of urgent care and provide more accurate and up-to-date information to help people find and access NHS dental care.

“In the longer term, the Department of Health and Social Care must prioritise the importance of oral health and commit to improving access to dentistry for everyone who needs it.”

Shawn Charlwood, chair of the British Dental Association’s General Dental Practice Committee, said: “Patients with urgent problems need to be at the front of the queue for care.

“Sadly, Government is forcing dentists to prioritise volume over need by imposing inappropriate targets.

“This service is yet to return to anything resembling business as usual.

“We need Government to adopt a pragmatic approach, which keeps practices afloat and ensures those who need dental care the most can secure it.”

Government response

A Department of Health and Social Care spokesperson said: “We are committed to supporting the dental sector throughout this unprecedented pandemic so everyone can access affordable, high-quality dental care.

“Since last summer, all practices have been able to open to deliver the full range of face-to-face care with 600 extra urgent dental centres providing extra support.

“We continue to work closely with the NHS to increase access as fast as possible, while protecting staff and patients from Covid-19 infection.”

An NHS spokeswoman said: “It’s right that the NHS has set targets that help patients see their dentist, with many practices already going well beyond the target set. Despite the pandemic, millions of people received dental treatment last year and the NHS has set up over 650 urgent dental hubs so patients can get access to a dentist if they need it.”