A report published in February found patients in Kirklees are routinely given misleading information about the availability of an NHS dentist in Kirklees, and found examples of poor practice leaving parents having to register as a private patient in order for their child to receive NHS funded treatment.
The report ‘Why can’t I find an NHS dentist in Kirklees?’ published by Healthwatch Kirklees – a consumer health and social care service based in Dewsbury – found six key areas where patients are being let down by services in the region.
Patients wanting to find a dentist taking on NHS patients are directed to the NHS choices website, a website which is supposed to be maintained by the dentists themselves. However, Healthwatch found information on the website was outdated. Many of the dental practices contacted, who have availability for NHS patients on the website, were not taking on new patients. Similar problems were found when contacting the NKCCG and NHS 111.
The most accurate service was the Leeds Dental Advice Line. Though not meant for Kirklees, LDAL contact local dentists on a weekly basis. The report found currently there are no dentists in Batley or Dewsbury taking on new NHS patients.
Some practices told Healthwatch they run a waiting list for NHS patients, but this has an indefinite time period and Paigaam found out in some cases people have been waiting for years.
Healthwatch were contacted by members of the public and were shocked to hear actual patient experiences. The report states, “We were told of some instances where we felt that dentists were acting inappropriately.
“It is unreasonable for example, to offer a child an NHS appointment on the condition that a parent signs up as a private patient.”
Patients aged 70 – 85 complained they could not find an NHS dentist to make dentures, having to pay in the region of £1000 privately to have the work done.
According to the Kirklees Joint Strategic Needs Assessment conducted in 2006, Batley and Dewsbury have the worst oral health in the region, and the number of decayed, missing or filled teeth of children under five was 3.8 teeth in Batley and 3.0 teeth in Dewsbury compared to the national average of 1.5.
Dentists are paid by a system known as Units of Dental Activity (UDA’s) for NHS patients. The highest activity in Kirklees takes place around town centres with Batley East, Heckmondwike and Greenhead far exceeding the rest. The report says people have to travel further for dental care and a contributing factor is believed to be transport, as local bus routes make these practices easily accessible.
Healthwatch Kirklees told Paigaam UDA’s are commissioned to dental practices on a monthly basis which they have to use. Any left over are taken back whilst any treatments exceeding the funding is not paid for. This has led some practices to cherry pick NHS patients; choosing patients who need the least work doing.
Many who spoke to Healthwatch raised concerns that they feel extractions are now becoming more frequent and an alternative to preventive work.
The report raises patient concerns of being removed from the dental practice without any prior warning and not realising until they tried to book an appointment.
Healthwatch told us, however, dental practices are not supposed to have a register of patients. The contract between the practice and the patient is only for the duration of treatment.
All Kirklees residents are entitled to NHS dental treatment but dentists are independent practitioners and therefore can choose how much NHS and private care they provide. The 2006 dental contract was introduced to ensure dental provisions remained stable, eliminate the culture of unnecessary over-treatment and make charges simple and easy.
The current spread of contracts and patients’ lack of access to local NHS Dentists is reinforcing health inequalities; making it difficult for the elderly and vulnerable to visit a local dentist. Healthwatch believe contracts are not working in the patients’ interest.
Some dentist spoke of the UDA’s not taking into account the complexity and time undertaken by the dentist. A dentist providing a patient with ten crowns will receive the same number of UDA’s as would a patient requiring one crown. Healthwatch said they believed this had led to ‘splitting treatments’ in order to make separate claims.
The report makes recommendations for NHS England and Kirklees Council to act in addressing their findings.