Avoid advising patients about free treatment

The Dental Defence Union (DDU) issued the advice after being notified of a number of complaints resulting from confusion about a patient’s exemption from charges.

Nick Torlot, DDU dento-legal adviser, said: ‘Fees are a common cause of complaint in dental practise.

‘Recently, we have seen an increase in calls from members whose patients have had their exemption status queried, possibly because it is being policed more frequently.’

Patients who have claimed an exemption from NHS charges inappropriately can face a fixed penalty fine of £100 in addition to the cost of the treatment provided.

If practices have helped the patient apply for free treatment, the patient may blame them and make a complaint.

The rules on claiming exemption or help with charges are complex and while it is important for the dental team to be familiar with them, it is the patient’s responsibility to apply for assistance (guidance available from www.nhsbsa.nhs.uk).

The patient must complete the necessary form (FP17) to claim an exemption, signing and dating it and providing the additional information required.

It is important not to advise the patient about their entitlement to avoid raising their expectations, which can lead to a complaint if the patient is found not to be exempt.

NHS advice on dental costs suggests that if patients are not sure whether they are entitled to claim for help when they go for dental treatment, they should pay and ask for a receipt, as they may be able to claim a refund later (advice leaflet available from: http://www.nhs.uk/NHSEngland/Healthcosts/Documents/hc11-april-2013.pdf).

Dental professionals who need specific advice about dental charges can contact the NHS Business Services Authority or their dental defence organisation.

The DDU’s advice to dental practices to help avoid complaints about fees includes:

  • Ensure you understand the rules regarding patients’ entitlement to free treatment or help with NHS charges and ask patients for proof of their exemption status
  • Set out services and charges in practice notices and on the website. State whether you currently accept NHS patients and provide details of payment arrangements, such as whether patients are expected to pay for their treatment in advance or on completion
  • Provide a written treatment plan that includes costs and whether the patient has chosen to have some elements of treatment on a private basis and the charge. Retain a copy with the patient’s records
  • If you need to revise your treatment plan, get the patient’s consent. An amended plan should be issued in writing and include a cost estimate
  • Don’t put pressure on patients to accept private treatment. For example, it is not acceptable to tell NHS patients that they can only have a particular treatment privately, when that treatment is available on the NHS.

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