An explanation of why the NHS dental treatment system is broken and why we are proud that we left years ago
As caring, conscientious and ethical practitioners we reluctantly left the NHS for adult patients in 1990 and then for children in around 2010. Even back then, we were unable to offer our particularly high standards of care economically under an NHS contract.
We did have a very small residual contract for children when we opened Smile Oralcare but we discovered during the annual inspection process that we were the only dental practice in Peterborough that was actually following the national guidelines on Fluoride applications that help prevent tooth decay. Furthermore, the local administrators were astonished when querying our out-of-hours arrangements for holiday periods when Martin pointed to his mobile phone; most practices ceased to offer any out-of-hours provision when it ceased to be a contractual requirement.
Putting Patients First At Smile Oralcare
We have always put patients first at Smile Oralcare, offering choices, explanation, good value and ongoing aftercare and support. In his time at the British Dental Association Martin tried for many years to encourage colleagues to adopt a similar philosophy.
The 2012 Contract For NHS Dentists
The 2012 contract for NHS dentists was fundamentally flawed: In an attempt to reduce the volume of treatment being provided, the government introduced a new currency called ‘Units of Dental Activity’ (UDAs), these UDAs were paid to dentists in bands of complexity:
- 1 UDA for simple treatments such as an examination and basic cleaning;
- 3 UDAs for fillings, – including root fillings;
- 12 UDAs for complex treatments involving laboratory fees, such as crowns, bridges and dentures.
The problem is that those UDAs applied to the whole course of treatment rather than each intervention/appointment. This meant that the fee paid by the government for 10 fillings was the same as that paid for 1 filling and the fee paid for 6 crowns or veneers was the same as for 1.
Problem Of Non-Standard UDA Prices
The further problem was that the price per UDA was not standard across the country and certain dentists, including many of the BDA negotiators, were paid more than double the fee per UDA (around £40.00 as opposed to less than £20.00). This wasn’t down to corruption but due to the UDA values being calculated based on the previous years’ activity and dentists who were on the more modern PDS (Personal Dental Services) contracts had already diversified their activity and had already been providing more prevention and less intervention.
Ordinary dentists who were already at maximum output levels were forced to continue churning out treatment in order to meet their UDA targets. If they failed, they were hit with penalties and reduced contract values. Over-performance was not rewarded.
It is relatively straightforward to make a practice viable at £40.00 per UDA, the underpayment on some treatments such as molar root fillings (£120) being counterbalanced with simple single-surface fillings (also £120). However, if a patient hasn’t attended for a few years they may well need several crowns, for example, to bring them up to the high standard of care we at Smile Oralcare take for granted; 12 UDAs at the lower £20.00 rate wouldn’t even cover the laboratory fee for a single crown at the quality we provide, let alone pay a dentist and cover the costs of running a practice. It is not surprising then, that almost all practices have moved away from NHS care, offering more and more private alternatives.
Aesthetic & Cosmetic Dentistry
Aesthetic or cosmetic dentistry treatments were never available on the NHS but it became standard practice to define any white fillings, particularly in molars, as cosmetic, and any white crowns on molars similarly as aesthetic treatments. Dentistry has evolved, white fillings are now the absolute treatment of choice in many circumstances, but the vagaries of the NHS contract have held back the move away from mercury-based amalgam fillings. No-one would ever want a steel-coloured crown showing when they smile, yet this is what was being offered.
Our advice to patients who are desperately seeking an NHS dentist is to consider what is best for your own oral health; find a dentist who can offer you choices and can work in partnership with you to maintain a healthy mouth and attractive smile.
Dental Hygienists
Dental hygienists, for example, are almost never available to treat NHS patients within band 1 practices and their dental practices often have to charge privately, as it is claimed that hygiene is not a necessity. We think that says everything you need to know. Our hygienists have always been a fundamental part of our patient care.
Private Dental Treatments In Peterborough At Smile Oralcare
Smile Oralcare offer a wide range of private dental treatments in Peterborough that can help transform your smile. Our core principle of working with our patients to achieve and maintain excellent oral health is at the heart of our practice and guides everything that we do.
We believe that every patient should be able to smile with confidence and with our fair and transparent pricing, our dental treatments are both affordable and stress-free.
Denplan Payment Plans
Our Peterborough dental practice offers a range of payment plans from Denplan including the Denplan Care, Denplan Essentials and our own Practice Membership plan.
Denplan is a popular choice for many of our patients, as with a monthly fee based on your dental history, all necessary treatment is covered by your plan (other than cosmetic improvement and laboratory fees). Our practice membership plan is an alternative option for patients, which offers access to all of Denplan’s insured benefits and a 10% discount on our fees. The practice membership plan does not cover the cost of treatments provided other than those covered by insurance.
If you are considering registering with our practice and would like further information or advice as to which payment plan would best suit you, please get in touch with us or call the practice on 01733 560 700.
Book An Appointment At Smile Oralcare
We welcome new private patients to our Peterborough dental practice anytime; we would love to care for your smile. Our practice uses the most advanced technology and has a friendly and caring dental team who are experienced at supporting patients with dental anxiety.
Whether you are looking for a routine examination/full check, a hygienist visit or to explore cosmetic dentistry treatments, the Smile Oralcare team are here to help Please contact our practice by getting in touch online or by calling us on 01733 560 700. If you are ready, you can book examinations, hygienist appointments, an implant chat and a cosmetic consultation through our online booking system.