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Dentists’ income under threat
22nd Nov 2006
Dentists could see their NHS income docked for failing to collect enough money from patients, according to the Department of Health (DoH). New guidance from DoH warns that a shortage of revenue is putting ‘pressures’ on a number of Primary Care Trusts (PCTs). It urges trusts to take urgent ‘corrective action’ to tackle the problem. This means making sure dentists are reporting all their activity and, if they are failing to carry out enough treatments, reducing their contract payments. The guidance, which is being circulated to PCTs, reveals the amount of patient charge revenue reported since the new contract and charges were introduced in April has been ‘lower than expected’. Revenue shortfalls exist where no activity – or lower than expected activity – is being reported or where reports list an unexpectedly high proportion of charge-exempt treatment. The document, NHS Dental Services: Patient Charge Revenue, includes a checklist of issues trusts ‘could discuss with dentists’ to establish the reasons for unexpectedly low revenue and ‘corrective action’. It says: ‘Where activity is significantly below the level that would be expected at this point in the year, PCTs need to establish urgently the reasons for this.’ Dentists can expect a call from their PCT if they are reporting zero or low activity, reporting activity late, or reporting a high incidence of multiple courses urgent or charge-exempt treatments. The DoH suspects some of the discrepancy may be explained by problems with gathering data. The NHS Business Services Authority, which processes payments for dentists, will be checking data submitted by practices. Where there are ‘clear anomalies’, they plan to take these up with the practices that they concern. Advisers from the Dental Reference Service will also visit a sample of practices with statistically unusual reporting patterns. Contractors are required to submit FP17 forms, or their electronic equivalent, within two months of the date of completion of a treatment course. The guidance reminds PCTs that ‘repeated failure’ to submit forms could constitute a breach of contract. It says: ‘Either there is a problem with reporting that, once fixed, will mean patient charge revenue can be deducted from contract payments. ‘Alternatively, the contracted level of service is not being provided, in which case it is likely the gross contract payments for the year will have to be reduced.’ A spokesman for the Department of Health (DoH) said: ‘The new system of patient charges is designed to raise the same level of charge income as a proportion of overall dental expenditure as under the old General Dental Services system. ‘It takes time to build up a full and accurate picture of patient charge revenue, not least because of the time it takes to report and process data from dental practices. ‘The DoH and the NHS Primary Care Contracting team has produced guidance to help PCTs identify any local factors that may be influencing levels of charge income.’ By Andy Tate, parliamentary correspondent
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