DT News - UK - Organisation exposes fraudulent dentists in England

Dental Tribune International

Wed. 9 May 2012

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LONDON, UK: NHS dentists have been claiming for work they have not done or manipulating the system to be paid more than they should, a review by NHS Protect has reported. According to the London-based organisation, which seeks to identify and tackle crime across the health service in England, about three per cent of the 37.5 million annual claims in 2009/2010 appear to be fraudulent, which equals a payment amount of £73 million (€90 million).

Under the current contract, the most common types of fraud include submitting false claims for non-existent patients, claiming for real patients who had not undergone the treatment claimed for and submitting claims for more expensive treatment than was actually delivered.

Following the exposure, the government has committed to introducing a new dental contract system that will focus on improving the quality of care patients receive, increase the availability of NHS dental care and promote good oral health. Part of this process will include reducing the risks of dental fraud before it becomes a problem and proactively analysing data on dental contract claims to spot irregular or suspect claim activity.

The government announced that it will work with NHS Protect to tackle the current problem of contract fraud by changing how some dental treatments are recorded; undertaking further analysis of dental fraud to help identify weaknesses in the system; developing an awareness programme for the risks of dental fraud, including workshops with local anti-fraud staff to help spot dental fraud activity; and moving to a new single way of working for managing all NHS dentistry services.

“This shows the current dental contract system is not fit for purpose and needs to change to ensure NHS funds are protected and used to benefit patients,” Health Minister Lord Howe said. “It is totally unacceptable that some NHS dentists have abused the system for personal gain. Fraud of any kind will not be tolerated and any allegation of fraud is taken seriously. We believe dentists should get paid for the quality of care they provide rather than simply for the number of treatments. That is why we are currently piloting this approach with dental practices ahead of the introduction of a new dental contract to make sure we get things right and minimise the risks of fraud.”

Barry Cockcroft, Chief Dental Officer at the Department of Health, said: “The vast majority of dentists behave ethically and provide high-quality dental care to their patients. Action needs to be taken against the small minority who behave dishonestly and submit fraudulent claims. We are working closely with NHS Protect to raise awareness of fraud risks to help prevent and deter fraudulent activity.” He urges colleagues in the profession and patients to report any suspicions of fraud or corruption to NHS Protect on their confidential fraud and corruption reporting line or to their primary care trust.

Dermid McCausland, NHS Protect Managing Director, stated that the organisation will continue to ensure that public funds are not lost to a dishonest minority of dentists and that action will be taken against those who attempt to take valuable NHS resources for personal gain. It will also seek the recovery of any NHS funds lost through the actions of fraudsters.

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