Rise in fines for incorrect claiming on exemption of NHS fees

Ensure your patients understand the rules about NHS exemptions to avoid future complaints, the Dental Defence Union (DDU) says.

The warning comes after the total number of fines for incorrectly claiming an exemption on NHS fees, rose to 385,770 in 2016/17.

Since September 2014 there has been a total of 689,770 dental penalty charges issued by the BSA, meaning more than half of which were issued in 2016/17.

‘Patients are responsible for ensuring they are entitled to claim free NHS dental treatment, but the rules can be confusing,’ Nick Torlot, DDU dentolegal adviser, said.

‘Dental professionals can help by signposting patients to information such as the NHS BSA guidance sheet so they can understand their eligibility and are less likely to incorrectly claim for free treatment.

‘Unfortunately some patients might not understand that the auditing of NHS payments and charges is undertaken by the BSA, rather than the practice.

‘Patients are often aggrieved by being fined when they believed they were exempt.

‘A large number of complaints of this sort come from the fact that patients feel they were either given poor advice or misinformation when they were filling out the exemption form.’

Rise in charges

A number of dental practices have contacted the DDU to ask for advice after patients were fined £100 by the NHS Business Service Authority (BSA), on top of their fee for NHS treatment, after incorrectly claiming an exemption.

In some cases practices were asked to reimburse patients who felt they had been wrongly advised about their NHS exemption.

The DDU has issued tips on how to minimise the risk of patients complaining, as well as helping them to understand their obligations:

  1. Encourage patients to read the claiming free dental treatment factsheet, which is available in a number of languages
  2. Ensure staff involved with handling NHS exemption forms (known as FP17PR) do not offer advice to patients, as it is not within their field of expertise and could leave the practice vulnerable to criticism if there is a complaint
  3. Explain that the BSA is a Government agency and that the fines it administers to patients who incorrectly claim free treatment are not within the practice’s control
  4. Sympathise with patients, acknowledging that the NHS exemption system can sometimes be difficult to understand, but that the responsibility for correctly claiming exemption lies with the patient.


Comments (6)

Seb, you say that in some cases practices were asked to reimburse patients who felt they were wrongly advised, but you don’t say who asked practices to reimburse? Was this the NHS ombudsman or the BSA or indeed the indemnity organisation?
Surely it’s not dental practices fault that the rules are so complicated that many don’t understand them. We would be equally criticised if we advised people to pay unnecessarily as well. You say that our staff should not advise either, so who are you suggesting should be accepting responsibility?

Probably not the patient, dentist or dental staff in the wrong here. Looks like NHS BSA have a lot to answer for:

“When these [PCNs] have been challenged, about 90% have been overturned as having been incorrectly applied.”

NHS BSA’s response seems to be to try and improve awareness, but surely they should be looking at making sure the fines are accurate?


Come guys all dental practices providing NHS treatment are part of the NHS; if dentists wish to be paid by the BSA for treating NHS patients they must operate within the NHS values and terms of their contract. This includes helping vulnerable patients to establish whether they hold a valid exemption or not. This avoids patients often on a low income paying when they are entitled to free treatment and avoids any patient being fined for claiming free treatment in error because they held a mistaken belief they were entitled to free treatment and no one in the practice helped them to check before making the declaration.

Problem with their system: I was fined due due to postcode entered by dentist receptionist onto computer system using the letter “o” instead of zero.. Minor data entry mistake and i receive an undeserved and distressing PCN

I am semi-retired and I have a son who is 19 and completed a QCF level 3 course and therefore I am able to claim Child Tax Credits that as my pension is below a threshold means that I am eligible for A Tax Credit Exemption Certificate and that my son named on my Tax Credit Award Notice is therefore eligible for free dental treatment. These were produced in evidence at the dentist and the eligibility is stated on the NHS website.

As my son is 19 and an adult the checking service won’t communicate with me as it is not my liability and my son can’t pay as he has no income. They also refuse to suggest how a complaint can be made.

I proved them with a copy of the Tax Credit Exemption Certificate and Award Notice showing my son and my income and they came back and asked me to prove my son was studying. This is not stated on their website as necessary evidence. However I was able to do this by providing a letter obtained from the college. This Email Ping Pong continued until they asked for my date of birth that I supplied to them at which point after many emails to a fro and much use f my time and theirs they decided they could not communicate with me without my sons permission. The evidence however would be forwarded to yet another department to check its validity

What a waste of time and money for both me and tax payers generally to collect £20.70 that is not due to them together with a fallacious penalty charge that is both threatening to anyone vulnerable and factually incorrect.

My husband is 65 and was claiming Pension Credit in November 2018 (he was 64 at this time). He started a course of treatment in the November because of on going problems with infection in a tooth/gum; had a tooth removed in preparation for a bridge. The dentist said that he would have to wait a while to complete the bridge in order for the area to settle. He was given an appointment for two months or so later. He went back and completed the course of treatment. In the time he started the treatment and the completion, he stopped receiving Pension Credits. I can only assume that when he went back to complete the course of treatment the dentist/receptionist had mistakenly got him to sign another form. Earlier this month he received a penalty notice for £100 from the NHS and told to pay for the treatment £256; £356 in total. They are insisting that he pay the total amount as the NHS say he was not on pension credit when he finished the treatment. I have to ask is it usual for dentists to get people on Pension Credit (or any benefits; universal credit) to sign for two lots of treatment when only one was completed? If we had not been on pension credit and had to pay for the treatment I would certainly have questioned having to pay twice for one course of treatment. I feel as if we are being labelled as benefit cheats when in reality it is the dentist that is receiving two lots of payment for one course of treatment.

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