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BDA voices concerns over reduced dental attendance rates

Since 2013/14, there has been a decrease of 2.2 million treatments provided to patients exempt from NHS charges. (Photograph: Evgeniy Kalinovskiy/Shutterstock)

Fri. 30 August 2019

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LONDON, UK: According to new statistics released by the NHS, there has been a 25% fall in dental treatments delivered to patients exempt from NHS charges over the past five years. In response, the British Dental Association (BDA) has voiced its concern that this trend is being exacerbated by the Department of Health and Social Care possibly backtracking on its pledge to break with its policy of automatically fining patients accused of incorrectly claiming free NHS dental care.

The NHS Dental Statistics for England 2018–19, Annual Report shows that there has been a decrease of 2.2 million treatments since 2013/14 delivered to patients exempt from NHS charges. In 2013/14, 8,818,170 free courses of treatment were provided, compared with 6,616,325 in 2018/19.

With the current healthcare fine system, nearly 400,000 NHS dental patients a year have received £100 fines for errors as simple as ticking the wrong box on a form. There has been a tenfold increase in healthcare fines issued since 2013/14, though, earlier this year, the National Audit Office reported that 30% of fines issued since 2014 had been withdrawn after being challenged because a valid exemption was confirmed to exist. However, officials are not currently able to distinguish how many claimants paid a fine they should not have received, nor do they have the ability to differentiate between fraud and common errors in the complex forms.

In July, the Department of Health and Social Care pledged that it would end the process of automatic fines and instead adopt a three-stage process for patient communication. For comparison, in Scotland and Northern Ireland, patients are sent an initial letter that openly invites them to document their entitlement or to pay the charge if they have made an error. However, the department has yet to enact its plan, causing the BDA to call on it to clarify its intentions, to definitively remove the presumption of guilt when an anomaly is identified and to simplify the complex claims process for those who are unsure about their entitlement.

“Vulnerable patients will keep turning away from check-ups as long as ministers refuse to let go of their failed fines policy,” said Dr Charlotte Waite, Chair of the BDA’s England Community Dental Services Committee. “Reform cannot mean sticking with practices MPs have condemned for ‘putting the frighteners’ on NHS patients. People will keep falling foul of a system that offers confusion, but won’t give an inch if you make an honest mistake.”

“Sadly the adults and children failing to attend are precisely those who could benefit most. Ministers should be rolling out the red carpet for these patients, not providing reasons to bottle up oral health problems. If this government is really serious about prevention, it’s time to change gear,” Waite added.

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