Action needed to clean up dental costs

Which? launches a new campaign to ‘Clean Up Dental Costs’ as we find people could be paying more than they need to for treatment because some dentists aren’t upfront about prices or clear about what treatment patients are entitled to on the NHS.  

Existing rules state that dentists must have a price list prominently on display in their surgery and set out treatment costs upfront. Yet our new research finds half (51%) of people who visited a dentist in the last six months didn’t see a price list and one in five (22%) weren’t clear about costs ahead of their treatment.

In a separate mystery shopping investigation, we sent undercover researchers in to dental practices offering both NHS and private treatment, but only half our researchers saw a price list displayed, with the majority of practices not showing any private prices. This makes it difficult for people to compare costs between practices, as well as between NHS and private treatments.

We asked an expert panel to assess the quality of the undercover visits and they found problems with communication of prices and treatment options. Half (12) of the 25 visits were rated poor or very poor for explaining the difference between NHS and private options, eight poor or very poor for explaining prices, and the same number poor or very poor for explaining treatment options.

In our survey, we also found evidence that some people could be being overcharged. One in five (19%) NHS patients who pay said they paid more than one charge for one course of NHS treatment over the last two years when they shouldn’t have.

With a quarter (26%) of people unsure about how NHS and private treatments differ and around four in 10 (40%) unaware that all clinically necessary treatment should be provided by the NHS, it’s important that dentists are clear with their patients about cost and treatment options – especially as a third (31%) of people who pay say costs have put them off having treatment.

Our ‘Clean Up Dental Costs’ campaign is calling on NHS England and regulators to make sure all dentists comply with existing rules and make information on prices clearly available, explain the treatment options properly, and make sure patients know whether or not their treatment is available on the NHS.

Which? executive director, Richard Lloyd, said:

“A visit to the dentist is an essential health check for millions of people across the country. Most of us will need dental treatment throughout our lives and it’s important that when that happens people feel clear about the nature of the treatment and what it will cost upfront. We are calling on the NHS and the regulators to clean up dental costs and make sure the existing rules are put into practice consistently.”

People can sign up to the campaign at www.which.co.uk/cleanupdentalcosts

Background:

1. Which? wants:

NHS England and the regulators to take action to ensure dental practices comply with existing rules and improve the way treatment options and prices are communicated to patients.

All dentists should:

  • prominently display prices in practices, on their websites, and in advance of treatment in a Treatment Plan.
  • clearly provide treatment options so patients can make an informed choice.
  • explain to NHS patients, and specify in treatment plans, whether treatment is NHS or private.

2. The Office of Fair Trading carried out a market study in 2012, which recommended the General Dental Council and NHS England enforce the displaying of price lists and provision of treatment plans, with the Care Quality Commission inspecting compliance. However, Which? believes more needs to be done to ensure these rules are implemented.

3. Methodology for survey: GMI, on behalf of Which?, survey 1,001 members of the general public in England online in November 2014. To qualify to complete the survey respondents needed to have been to the dentist in the last six months. People from private, NHS and mixed dental practices were surveyed. The data has been weighted to the known profile for England.

4. Methodology for mystery shopping: We sent five mystery-shoppers as NHS patients to 25 mixed (providing NHS and private treatment) dental practices in England, using hidden recorders. Their visits were analysed by an expert panel including: two dentists, both with mixed NHS/private practices and strategic, standard-setting and governance expertise. Our third expert carries out dental research with patients and analyses the patient experience of dentistry.

5. There are three standard charges for all NHS treatment, known as bands 1 (£18.50), 2 (£50.50) and 3 (£219). The costs are set annually by the Department of Health. 

Band 1: This covers examination, diagnosis (including x-rays), scale and polish (if needed), application of fluoride or fissure sealant and preventative advice.

Band 2: Covers everything listed in band 1, plus further treatments such as fillings, root canal work or tooth removal.

Band 3: Covers everything in bands 1 and 2, plus treatments such as crowns dentures and bridges.

If you attend a dentist that offers both NHS and private and need a treatment – for example a root canal – you should not be asked to pay for it privately, although your dentist should explain suitable private options you can consider and you may choose to have the treatment privately. Dentists are not allowed to refuse any treatment available on the NHS but then offer the same treatment privately.

You should only be asked to pay one charge for a course of treatment, even if you have to visit the dentist several times – for example, three fillings and a crown would be covered by the £219 charge. You don’t have to pay again if you need more treatment within the same or a lower band within two months of completing a course of treatment.

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