http://conversation.which.co.uk/con...n-nhs-private-dental-practice/comment-page-1/
Some balanced comments from dentists in this Which thread such as this one:
Dear Joanna,
Thankyou for your reply – adequate Quality (which needs adequate time to deliver it) is critically important, especially so in busy and over-stretched NHS systems.
Although the Pilots for NHS dentistry only officially started 1st Sept, already it is becoming clear that these Dentists are having to take 30 to 40 minutes to check everything well and communicate this with the patient properly!
Now if WHICH can support Dentists to be allowed this time to spend upon delivering this quality of care, you will see more Dentists (and patients) moving back to the NHS dental system in England by choice – however if the DH pulls it’s usual trick, the right noises will be made then at the last minute Targets will be changed, with the emphasis still on rushing through more patients in less time to meet Political Access targets, with NHS Dental Practices facing massive fines (called clawback) if they don’t meet productivity UDA targets on patients, which ironically would leave the Dental Practice with even less funding for NHS patients who need to be seen
Thus you have a not uncommon scenario of Dentists having to see more patients per hour to meet NHS productivity Targets, so less time is given per patient and then NHS NICE guidance on check-ups says send as many away as you can for 2 years to make room for more so DH can meet political Access targets WITHOUT spending any more money etc, etc.
This is then even more flawed because nobody has yet explained to me how you do Annual Oral Cancer checks on the NHS, if the NHS sends them away for 2 years!
Presumably if patients want this level of ‘Quality’, which your survey noted was an important dental check, they will presumably have to ask a Private Dentist to do this in the year between their 2 yearly NHS dental check-ups?
Given that November is Oral Cancer awareness month and Oral Cancer now kills more people annually than Cervical cancer and Testicular cancer in England combined, such poorly planned economic decisions in the NHS Dental system in England are far from ‘NICE’ and could even be contributing to the increases in Oral Cancer deaths we are now noticing.
So yes IF the new dental contract protects patient time needed to do everything properly on the NHS, it could be a great improvement Qualitatively, but will politics and cost-savings interfere yet again and compromise the delicate balance between Time/Quality ratio for patients???
Whilst Private Dentistry has suffered as generally paperwork increases and thus patient Frontline direct care decreases as a result, in general patients pay 100% direct to the Dentist for their time and expertise. Suddenly the reality then of how costly it is to pay for un-subsidised yet high-tech dental environments directly hits home and frankly patients notice what to them seems like ‘high-prices’, but remember Dentists have even higher overheads than GPs and they are paying for Dentist + Nurse + expensive materials, Xray machines, hospital level cleanliness and growing mountains of paperwork and audits they may never get to see, but which the CQC and other bodies now insist upon, driving costs up even further to patients.
Imagine if you went to Hospital and had to pay ALL the actual costs of your visit, Medics, Nurses, seterilisation, bandages, heating, lighting, Xrays, special tests etc. Basically it would be even more than Private Dental fees, but on the NHS the taxpayer pays it for you.
So yes Dentistry is a high-tech. high cost intensive and detailed medical speciality really, but if you want it to get better for patients, both NHS and Private, without the costs Spiraling ever higher, then reduce our wasteful paperwork burdens by 50%, free-up our hands to spend more protected-time on direct patient care and put pressure on government Systems to enable Professionals, rather than disabling Professionals, to do their best.
What is bad for Dentists and their Teams, is bad for patients too ultimately.
Please don’t get distracted in the petty politicised dogmas of NHS vs Private – the real truth is neither system can meet ALL the Nations needs by itself, so we should plan for synergy and a general raising of Quality in ALL systems.
But to come full circle, less Time = less Quality, so whilst some anxious people may want to get out of that Dental chair as quickly as they can, rushing things helps nobody, apart from NHS management tick-boxers who will tell NHS Dentists they are ‘under-performing’ if they take more time to relax the anxious patients and do everything properly too, I fear
I hope you’ll forgive my frankness, but it seems so easy to blame just the workers, when 80% of the fault lies in a poor-system that penalises time spent with patients – haven’t we learnt anything from the Mid-Staffordshire Hospital disaster where an additional 400-1200 people died, because medical staff were distracted chasing additional paperwork targets instead of providing more direct patient care?
Maybe only public-pressure from orgnisations like WHICH, can now help Professionals (Dental and Medical) get the protected time they need to put Patients before Paperwork targets!
Yours still realistically,
Anthony Kilcoyne.
