NHS Dentists...OMG

Samtheman1k · 7 Mar 2007 at 15:39

I had an oppointment booked with my NHS dentist for tomorrow, and I just had a call saying that the specific dentist had no 'UDAs'* left this [financial] year, and thus can not treat any more NHS patients until April 1st.

So that's great, we're going to have an NHS dentist sitting there for the rest of the month twiddling his thumbs because the NHS won't pay for him, whilst others can't even get on a NHS dentists' books.

Whilst it is only a minor inconvenience to me, it does seem to show fundamental failings in the NHS management.

Labour + NHS = Bad.

At least I've got an NHS dentist I suppose!

* Whatever that they are, persumably 'tokens' to allow only a certain amount of treatment per year. So, if you have a really efficient and fast dentist, then he gets penalised. Great.

ste_bla · 7 Mar 2007 at 15:42

units of dental activity iirc

Samtheman1k · 7 Mar 2007 at 15:44

ste_bla said:
units of dental activity iirc

So does that mean a dentist can only do so much work per year? So much for rewarding efficiency. :rolleyes:

leaskovski · 7 Mar 2007 at 15:46

Its not just dentists either. Doctors and Surgens are having to do it as well because the trusts are telling them not to do anymore non life threatening ops.

Now, did you hear the one about PFI Hospitals? :rolleyes:

kefkef · 7 Mar 2007 at 15:46

UDA = Unit of Dental Activity

Since 1st April 2006 all contract values are linked to UDAs (Units of Dental Activity).

For NHS treatments dentists will receive a contract offering a set annual amount (contract value) that is paid in 12 fixed monthly payments (similar to a salary).

The dentist will be expected to achieve an amount of UDAs specified in their contract.

There is not a single set contract value across the UK. You should expect to discuss this when speaking about specific roles.

Each dental procedure has been classified into a band which determines the amount of UDAs.

Band 1-1 UDA
urgent treatment only- 1.2 UDAs
Band 2- 3 UDAs
Band 3– 12 UDAs
Issue of prescription- 0.75 UDA
Repair of dental appliance (denture)-1 UDA
Repair of dental appliance (bridge)-1.2 UDAs
Removal of sutures -1 UDA
Arrest of bleeding -1.2 UDAs

Band 1: Diagnosis, treatment planning and maintenance Clinical examination, radiographs, scale and polish, preventative work e.g.: oral health assessment, study models, denture eases.

Band 2: Treatment
Simple treatment e.g.: fillings including root canal therapy, extractions, surgical procedures and dental additions, periodontal treatment.

Band 3: Provision of appliances
Complex treatment that includes a laboratory element e.g.: bridgework, crowns and dentures, excludes mouth guards.
Urgent treatment
Examination, radiographs, dressings. Re-cementing crowns, up to two extractions and one filling.

So by reading this, your dentist has fulfilled his contract and can now sit back and still get paid his last months 'salary' (Whether he wants to or not!). Doesn't look like there was any provision for working more than required. UDA's are worked out on historic records of how your dentist has performed over the previous years.

scorza · 7 Mar 2007 at 16:12

I doubt he'll be sat twiddling his thumbs - he'll be doing loads of work for his private patients surely?

pitchfork · 7 Mar 2007 at 17:43

There should be a health centre by you which will patch it up, have a look.

Thats what i've just had done a while back and my teeth are awful (haven't been since I was a child), the dentist I just got into says that a couple of them might have to be replaced if she can't do a crown.
Booked in for next monday.

clv101 · 7 Mar 2007 at 17:46

scorza said:
I doubt he'll be sat twiddling his thumbs - he'll be doing loads of work for his private patients surely?

Exactly - he's done what the NHS have paid him for, he can now go on holiday to work for himself. I see no problem. If you want more NHS service out of him, pay him more.

The alternative would be for him just to have worked slower through the year - is that better? Not in my eyes.

Samtheman1k · 7 Mar 2007 at 20:11

clv101 said:
Exactly - he's done what the NHS have paid him for, he can now go on holiday to work for himself. I see no problem. If you want more NHS service out of him, pay him more.

But what you are saying that NHS services are now on a first come first serve basis.

The alternative would be for him just to have worked slower through the year - is that better? Not in my eyes.

Why? If he is treating the same number of patients? Surely it would be better for him to work fast all of the year?

basmic · 7 Mar 2007 at 20:19

My (friend) dentist just asked me to sign a form for last month, rather than this month.

Suggest it to your dentist, and see what they say.

clv101 · 7 Mar 2007 at 20:31

Samtheman1k said:
But what you are saying that NHS services are now on a first come first serve basis.

I'm saying Nothing of the sort. :confused:

However - assuming cases of equal need, first come first served (rationed by queuing) is precisely how the NHS does work.

Samtheman1k said:
Why? If he is treating the same number of patients? Surely it would be better for him to work fast all of the year?

In which case you expecting more work from him - as I said if you want more work pay more.

Energize · 7 Mar 2007 at 20:36

clv101 said:
The alternative would be for him just to have worked slower through the year - is that better? Not in my eyes.

Yes because then there would be more uda's avalible at any time in case someone needs emergency treatment. Now no one can get treatment no matter how bad they need it.

Pigeon_Killer · 7 Mar 2007 at 20:46

Both of my parents had check-ups scheduled for March and both were cancelled. I had an check-up in February but needed treatment and had it done on Monday. As far as I know my dentist has cancelled all check-ups in March and is using the time to treat patients.

I don't know why it's happened but the price for a check-up is £15.20 whereas the price for any kind of treatment begins at £42.50. March will look very good on the books.

Cookie-Monster · 7 Mar 2007 at 21:09

leaskovski said:
Its not just dentists either. Doctors and Surgens are having to do it as well because the trusts are telling them not to do anymore non life threatening ops.

Now, did you hear the one about PFI Hospitals?

makes me somewhat suspicious, as I had a cast removed on my leg, now i need an Op to remove the diastasis screw (connects Tib and Fib) but lo they cannot fit me in until the 11th April, how convenient.

Samtheman1k · 8 Mar 2007 at 08:13

clv101 said:
I'm saying Nothing of the sort. However - assuming cases of equal need, first come first served (rationed by queuing) is precisely how the NHS does work.

But if the dentist can only do X operations per year, then if you are the last person through the door, then they will turn you away, which is exactly what they are doing. Rationing by queing would be true if they treated the whole queue, but they are turning those away who are at the end.

In which case you expecting more work from him - as I said if you want more work pay more.

But you can't. You would have to go private. Kinda defeats the point of the NHS.

Sinizterguy · 8 Mar 2007 at 08:48

Samtheman1k said:
But if the dentist can only do X operations per year, then if you are the last person through the door, then they will turn you away, which is exactly what they are doing. Rationing by queing would be true if they treated the whole queue, but they are turning those away who are at the end.

But you can't. You would have to go private. Kinda defeats the point of the NHS.

Since there is no way that anyone can measure the whole queue and then divide treatment time, this is how it is, and this is how it is going to be. And its going to get worse year by year.

PCTs keep trying to renegotiate with dentists for lower UDA values - which means that they will be taking a pay-cut for the same amount of work even as inflation goes up.

Let's see any of you volunteer to do that.

Stanford · 8 Mar 2007 at 09:00

But the private prices increase above inflation to keep that gravy train rollin'!

Sinizterguy · 8 Mar 2007 at 09:05

Stanford said:
But the private prices increase above inflation to keep that gravy train rollin'!

So you are suggesting they work for less - just on the off chance that they can treat some private patients in the time that may or may not be left over ?

How about you take a pay cut and offer to make the extra back on overtime ?

The UDA system is not somethings thats straightforward. Whether someone does one crown or 12 crowns on one patient, he gets the same 12 UDAs. So why should a dentist even take on a patient with 12 crowns required ? You think the time requirement for this is the same ? The lab charges are also 12 times higher.

And trust me, no one wants to do an underpaid job just because another part of of the job which is not gauranteed might pay more per unit time.

Dolph · 8 Mar 2007 at 09:57

NHS dentists always seem to be butchers anyway, cheap and nasty service where they just kick the teeth out if there's anything wrong with them...

We use a very good independant dentist, doesn't cost us any more than NHS services (given that you have to pay anyway), the quality of the work is much better and they will do everything to help you save a tooth, rather than just leaving you with a gap...

Stanford · 8 Mar 2007 at 09:58

Are you, or is a close relative of yours, a practicing dentist?