Calls for greater choice and competition in dentistry

29 May 2012
Volume 28 · Issue 5

The Office of Fair Trading (OFT) has called for major changes to the £5.73bn UK dentistry market after a market study found that it is not always working in the best interests of patients.

The OFT study found that patients have insufficient information to make informed decisions about their choice of dentist and the dental treatments they receive. Alongside this, a new survey conducted as part of the study suggests that each year around 500,000 patients may be provided with inaccurate information by dentists regarding their entitlement to receive particular dental treatments on the NHS, and as a result they may pay more to receive private dental treatment.

The report also raises concerns about continued restrictions preventing patients from directly accessing dental care professionals, such as hygienists, without a referral from a dentist. The OFT considers these restrictions to be unjustified and likely to reduce patient choice and dampen competition.

The OFT also highlights concerns with the current NHS dental contracts in England. As the majority of these contracts are not time-limited, and only a small volume of new contracts are put out to tender each year, it is extremely difficult for new dental practices to be established, and successful dental practices which offer a higher quality of service to NHS patients are prevented from expanding.

Other issues of concern highlighted in the report include the complexity of the complaints process for patients and instances of potential pressure selling by dentists of dental payment plans.

The OFT has identified a wide-ranging package of recommendations to address these concerns, which includes:

  • Provision of clear, accurate and timely information for patients - the OFT is calling on NHS commissioning bodies, the General Dental Council (GDC) and the Care Quality Commission (CQC) to be proactive in enforcing existing rules which require dentists and dental practices to provide timely, clear and accurate information to patients about prices and available dental treatments. 
  • Direct patient access to dental care professionals - the OFT urges the GDC to remove restrictions preventing patients from making appointments to see dental hygienists, dental therapists and clinical dental technicians directly, as soon as possible. 
  • Reform of the NHS dental contract in England - the OFT is urging the health department to redesign the NHS dental contract to facilitate easier entry into the market by new dental practices and allow successful practices to expand. The OFT is not convinced that indefinite contracts to supply NHS dentistry are in the best interests of patients.
  • Simplification of the complaints process - the OFT considers that the current system should be reformed to make it simpler, easier and less time consuming for patients and dentists to resolve complaints.
  • Sale of dental plans - following discussion with the OFT, the British Dental Association (BDA) has agreed to develop a robust and effective code of practice covering the sale of dental payment plans.

John Fingleton, OFT chief executive said: ‘Our study has raised significant concerns about the UK dentistry market which need to be tackled quickly in the interest of patients. All too often patients lack access to the information they need, for example when choosing a dentist or when getting dental treatment. We also unearthed evidence that some patients may be receiving deliberately inaccurate information about their entitlement to NHS dental treatment, and we expect to see robust action taken against such potential misconduct by dentists.

‘This study has also highlighted that the current NHS dental contract in England may well not be working in the best interests of patients, and that regulations unjustifiably restrict patients from getting direct access to dental care professionals like hygienists. Reform in both these areas is needed without delay.’