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Search for£50,000 bill for dentists who fail to carry out enough work for NHS
Friday, November 28, 2008, 08:15
Dentists agree contracts with the NHS which see them paid cash up front for the treatments they perform.
But a new report by private dental organisation DPAS reveals that 38 of the county's 87 NHS dentists, not including those in Derby, have not fulfilled their contracts, leaving treatment worth about £4m outstanding.
The report does not say which of the 38 county dentists have not fulfilled their contracts – there are also 14 in the city – but 12 county dentists are reported to owe health bosses more than £50,000 each for work that has not been done.
Dentists who fulfil less than 96% of their contract obligations are asked to pay the outstanding balance back.
If the under-performance is less than 4%, the practice is given the option to make up the shortfall the following year.
Since 2006, dentists have been contracted to treat NHS patients through primary care trusts.
Contracts are worked out in units of dental activity, known as UDAs, with one being valued at about £23.50, according to DPAS.
The number of units allotted to each dentist is based on the size of their practice and the amount of work they have done previously.
A single UDA covers a basic dental check-up, X-rays, scaling and polishing; three UDAs cover fillings, root fillings and extractions; and 12 UDAs cover more extensive work such as fitting dentures, bridges and crowns.
DPAS carried out the research using the Freedom of Information Act to ask every primary care trust in the UK whether their dental practices were fulfilling contract obligations.
Out of the 132 that responded, representing 89% of the UK's trusts, Derbyshire was the sixth worst.
Andrew Dale, secretary of the Local Dental Committee for Derby and a dentist at Chaddesden Dental Practice in Nottingham Road, blamed the way the contracts worked for the problem.
He said: "The way the UDAs are calculated means dentists get the same amount of money whether they do one filling or five. This means many dentists are unwilling to take on new patients who may need more work doing and be more expensive. We also get different payments for children and adults.
"A lot of dentists are leaving the NHS and doing private work – then paying back what they owe on NHS contracts."
During 2007-8, nearly 16% of the dental work commissioned and paid for by the NHS in Derbyshire, excluding Derby, was not carried out.
In contrast, dentists in the city failed to carry out just 3% of their contracted NHS dental activity for the same time period – worth about £631,000. The national average was 7%.
Derbyshire County Primary Care Trust commissioned 1,105,106 UDAs during the last financial year but 173,080 were not carried out.
A spokesman for the Derbyshire trust said: "We have contracts in place with 98 dental practices to provide dental services across the county.
"We work closely with dental practices to ensure realistic activity targets are set.
"If a dental practice does not perform the contracted number of UDAs, we decide whether over-payments need to be recovered."
Derby City Primary Care Trust commissioned 366,141 UDAs and 11,805 were not carried out.
A spokesman for the city trust said: "We are striving to further improve access to NHS dentistry for patients."
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