People forced to pay for private dental care if issue ‘not emergency’ – watchdog

Healthwatch England said it had heard from people unable to access treatment.

Dentistry
Dentistry

People “regularly” struggle to find a dentist across England, a watchdog has warned.

Healthwatch England said that in some instances people have “no choice” but to pay for private dental care if their issue is not considered to be an emergency.

The watchdog said it would continue to monitor issues with dentistry.

Its latest report focuses on issues raised across health and care organisations during the coronavirus pandemic.

The report highlights how even before the pandemic, the organisation “regularly heard from people who were struggling to find a dentist in some parts of the country”.

And the situation has “become challenging for even more people” since the pandemic hit.

The report also points to specific problems people had accessing dental care over the last few months.

Other issues included people not knowing how to access emergency dental care, people being misdirected between services and in some cases patients being charged for PPE.

It is known that some private providers put an additional PPE levy on their dental care fees but it is unclear from the report whether or not this occurred in some NHS dental services too.

NHS dentists are not permitted to pass on additional costs of PPE to a patient.

The report authors wrote: “While routine appointments were on hold, people did not know how to access emergency dental care – causing them extra stress while experiencing acute dental pain or other serious symptoms.

“In June, as dental practices started to reopen for routine appointments, we heard that the information being provided from some services was inconsistent or confusing, leaving people unsure about whether they were running again, and what treatment would be available.

“Some people reported being told to call their dental practice by NHS 111, only to be redirected back to NHS 111 by the dental practice’s voicemail message.

“We also heard about some cases of dentists applying additional charges to patients to cover the cost of PPE, making dental care even less accessible.

“It was not clear from our evidence whether people ended up paying for private treatment or were paying more than the NHS treatment band costs.”

They continued: “However, since the beginning of July, people have started to tell us they feel they have no option but to go private if they want to receive treatment for what their dentist has deemed non-emergency treatment.

“We will continue to monitor this feedback for our next quarterly report.”

The report also highlights other issues raised to Healthwatch England during the pandemic, these include: people accessing information in different languages and formats, including sign language; concerns about Do Not Attempt Resuscitation forms without sufficient discussion in the early stages of the pandemic; queries about access to testing and challenges with digital appointments for some patients.

On the Do Not Attempt Resuscitation orders, the authors explain that a “limited number” of concerns were raised that these forms had been applied to patients “without sufficient discussion or explanation with the individuals and their families”.

Healthwatch England escalated the issue in April to the Department of Health and Social Care.

In the foreword to the report, Sir Robert Francis QC, chairman of Healthwatch England, wrote: “While the crisis unfolded, Healthwatch did not stop our work.

“We mobilised staff and volunteers to advise a concerned public, and we alerted services to the issues that were confusing or preventing people from getting the care they needed.

“Professionals are now working to get services back up and running before winter, while also preparing for a potential second Covid-19 wave.

“From the stories shared with us, it’s clear that people are immensely grateful for the sacrifices NHS and social care staff have made and their dedication to keeping us safe. However, we can learn from issues.”

Commenting on the report, British Dental Association chief executive Martin Woodrow said: “Dental practices have been operating at a fraction of their former capacity since they resumed face-to-face care. This is due to social distancing restrictions and requirements to leave a big gap between many procedures.

“Official guidance has asked NHS practices to focus on urgent cases and unmet need for vulnerable groups. With the current reduced capacity, getting treatment may take time.

“Underfunding and failed contracts mean patients have long struggled to access services, but Covid has upped the ante. We need government to work with us to rebuild NHS dentistry on firm foundations.”

On access to dental care, an NHS spokesman said: “The NHS opened over 500 urgent dental centres to ensure all who needed emergency care got it during the pandemic and routine treatment has now resumed. Anybody with concerns about their dental health should get in touch with their local dentist as they usually would for further advice.

“Over the last two years, of those who wanted an NHS dental appointment, more than nine in 10 were successful in getting one with the vast majority reporting a positive experience.”

On Do Not Attempt Resuscitation orders, he added: “The NHS has been categorical that decisions on individual people’s care must be based on that person’s needs and their clinician’s expertise and advice, and that the blanket application of Do Not Resuscitate orders must not happen in any circumstance.”

Senior NHS leaders wrote a letter to NHS officials in April saying these orders should only be placed on an individual basis.

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