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Handling complaints about exemption from NHS dental charges

24 February 2014

Dental professionals are advised to ensure they understand the rules about which patients are exempt from NHS charges to avoid complaints.

Dental charges are a common cause of complaint in dental practice. The DDU has recently helped members with several complaints where there has been confusion about a patient's exemption from NHS charges.  It is solely the patient’s responsibility to apply for assistance and practices should ask for written proof of their exemption status when they attend.

We have seen an increase in calls from members about patient exemption from charges and believe that the recording of exemption may now be policed more frequently. If it is found that the exemption has been claimed inappropriately, the patient has to pay a fixed penalty fine of £100 in addition to the cost of the treatment provided.

Some practices help patients apply for free treatment or help with NHS charges. However, if the patient's exemption status is investigated and they are later turned down for free treatment, the patient may blame the practice and make a complaint. 

Patients’ rights to help with health costs can be a confusing area, particularly the rules about Jobseeker’s Allowance.  Patients are entitled to free NHS dental treatment if they are receiving income-based Jobseeker’s Allowance when the treatment starts or when they are asked to pay. However, those claiming contribution-based Jobseeker’s Allowance are not exempt from charges.

The NHS leaflet Help with Dental Costs sets out in detail the help available to patients in England and similar guidance is available in Scotland, Wales and Northern Ireland.  It advises that when 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.

Avoiding complaints

It is important to ensure you understand the rules regarding patients’ entitlement to free treatment or help with NHS charges and ask for proof of their exemption status.  Ensure all staff are familiar with the Completion of Form guidance for the FP17, available from the NHS Business Services Authority website www.nhsbsa.nhs.uk.

The patient must complete the form appropriately and, depending on the reason they are claiming an exemption or remission, enter the additional information required. While dental practices can provide patients with the relevant information about where to find the form, it is important not to advise the patient about their entitlement as it is the patient’s responsibility to make the claim. In this way, you can avoid raising the patient's expectations, which can lead to a complaint if the patient is found not to be exempt.

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

This guidance was correct at publication 24/02/2014. It is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.

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