Does the NHS fining system need to be cleaned up? – Charlotte Gentry

  Posted by: Dental Design      28th September 2018

Around a week ago I read an interesting article about patient fines. It discussed how dentists believe these fines are deterring the poorer patients within our community from attending the dentist. Working as a receptionist in my spare time, I’ve witnessed patients receiving these fines first-hand. It is often very stressful and upsetting for patients, particularly when they are exempt; they will struggle to pay the fine they’ve been given.

Around 370,000 fines were given out according to the latest annual figures and the BDA says the fining system is creating a ‘hostile environment’ for those most vulnerable patients. Those that are entitled to free treatment are often the most vulnerable, with complex needs that need addressing swiftly. However, with the worry of a fine lingering over them, they are often deterred from visiting at all.

So where is the system going wrong? In my opinion, the forms that exempt patients have to fill out can be very confusing. Although the free treatment benefits are listed clearly, there are often many different types of the individual benefit and not all entitle patients to free treatment. In the past year, I have noticed the FP17 forms have been changed slightly, with the aim of making entitlements clearer; yet this seems to have had little effect, the bold lettering clearly still isn’t helping in reducing the number of patients still getting fined.

The pressure is also on receptionists. Often patients come in and say ‘does this entitle me’ or come in after being fined saying ‘you told me I was exempt’. However, I feel receptionists are also put in a very difficult position. When explaining to a patient (not entitled) that their benefit doesn’t cover them, we often get the brunt of it. Patients often feel angry with reception teams when they are told they will have to pay. So in many ways, we can’t win. Although patients have to provide proof, entitlement letters are often very confusing and determining whether it is say, ‘income related’ or not, can be often be challenging. Although, it is made clear that filling in the form and claiming an exemption is entirely the patient’s responsibility, I feel as though receptionists are often made to feel responsible for the forms being filled out correctly.

In my opinion, there must be an easier way to determine the exempt from those that aren’t. It is very well arguing over whether or not dental practices or patients are to blame for the fine, however, in most cases, neither are. The FP17 form is not the clearest or easiest form to fill in. Lots of words and boxes often mislead the patient and they end up signing the boxes on the back, not ticking an exemption box and getting fined. The whole system needs to be cleared up.

I feel the way forward to reduce these fines and prevent deterring our most vulnerable patients, is to introduce a dental exemption card, similar to the medical exemption for prescriptions. If every patient who received a qualifying benefit received a card, it would be very easy to determine who is and is not exempt and the number of wrongly issued fines would dramatically increase. With so many fines being overturned after appeal now anyway, it is likely the fines aren’t doing the job they set out to do in the first place. By introducing a universal card, fraudulent activity would be easier to stop and patients would feel far more at ease coming to the dentist.