17 May 2011

Q. I work as an associate in a practice that also employs two hygienists. We have an NHS contract and I treat mostly NHS patients but the practice owner has said that patients can only be referred to the hygienist for treatment that is on a private basis. What should I do for a patient with active periodontal disease if they do not want to pay for private treatment

If patients attend requiring treatment under NHS contract then they are entitled to receive all of the care necessary to secure their oral health, in your clinical opinion. That will be the clear expectation of every Primary Care Trust (PCT).

NHS patients are entitled to receive any part of their care under private contract should they choose to do so. However, this must be entirely their own choice, and there must be no compulsion or any unreasonable persuasion used to influence that choice. Moreover this arrangement must be made perfectly clear in an FP17DC form, or any other appropriate practice form, about what treatment will be provided under the NHS and what care will be private.

Finally as a combination of these two points if patients clearly require periodontal treatment, or any other treatment, and they are being treated under the NHS, and wish to continue being treated under the NHS, then they must receive this care under the NHS. If this treatment includes care from the hygienist, then this is a matter that needs to be resolved within the practice or alternatively you can of course provide this treatment yourself, if the latter presents difficulties.

Log onto the E-learning Library to discover more about the risk management issues associated with periodontal disease (Risk management module 1).

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