Q.Am I obliged to offer a treatment to a patient under the NHS even if it is not profitable for me? For example, if I do a bridge, it is more expensive for me to pay the lab fees than the 12 UDAs that I will earn for the treatment

There can be moments of frustration involved in balancing the provision of NHS care and the financial obligations when running a business. However, to answer your question simply, under the NHS contract you have agreed to provide your patients all proper and necessary dental care and treatment. There is no provision for declining treatment on the basis that the necessary treatment is not profitable.

In terms of the example of a bridge that you describe, it would be for you to determine whether in your clinical opinion the necessary dental care that a particular patient requires is a bridge or whether a denture would be suitable. If in your view a denture would be appropriate in that clinical situation, then it would be reasonable for you to inform the patient that you would be willing to provide a denture under the NHS but that provision of a bridge would be on a private basis only. This would be more difficult to argue in a clinical situation where perhaps a single tooth is missing and the existing bridge needs replacing.

In general terms the treatment options you provide a patient would need to be reviewed on an individual basis and it would be for you to argue your clinical recommendations should they be subject to challenge. It is also important to ensure that a patient is given an NHS Dental Care form confirming that the NHS option of treatment has been offered to the patient in addition to any private alternatives.