An NHS patient had attended a practice on three occasions and was registered with the practice principal, although he had not attended for three years. He had recently seen an associate dentist due to a fractured filling at the LL6, which had been placed many years earlier at another practice. The associate placed a temporary dressing and advised that the patient return for a check-up and filling appointment with his usual dentist.
At this second appointment, the patient saw the practice principal, who carried out an extensive clinical examination (Item 1b of the Statement of Dental Remuneration) and placed an amalgam DO filling at the LL6. The dentist also identified early stages of periodontal disease and recommended a course of periodontal treatment. This was completed over two visits and it was advised that the patient return for a follow-up appointment in 3 months.
The patient did not attend for the follow-up but telephoned the practice one year later, requesting a scale and polish to remove stains that had built up on the teeth as he had a family function that he would be attending the following week. The patient was advised on the phone by the receptionist that he was due for a check-up, and asked whether he would like to book for this and a scale and polish at the same time.
The patient booked in for an examination and scale and polish. At the appointment he mentioned that he had experienced some food packing in the region of the LL6, where the previous filling had been placed. A clinical examination identified that the filling was stable, but the patient was given the options of either smoothing the filling interproximally or replacing it to see if the contact point could be improved. As the filling had been placed more than one year earlier, a new charge would apply for a replacement filling.
The patient left and the following week a complaint email was received. The patient was unhappy that he was going to be charged for a replacement filling when the dentist had identified that there was a problem with it.
Both dentists involved were members of Dental Protection, and they sought our advice. An explanatory letter was sent and the patient was offered a refund of the charge that he had paid for the examination and for the scale and polish. The patient responded requesting a refund of the fee charged for the filling placed at the LL6 the previous year and asked for compensation of £50.
A decision was made to offer the patient a refund of the NHS fee for the filling, as a gesture of goodwill and in an attempt to resolve the complaint swiftly and amicably. It was, however, decided that an offer of £50 in addition to the refund of the fee for the filling was not appropriate so this additional amount was not offered.
The patient accepted the refund and the complaint was satisfactorily resolved.
This case raises the question of what to do when a patient asks for ‘compensation’. The term has a specific meaning legally which differs from the common use of the word, and so compensation demands need to be viewed in the circumstances of the complaint. Depending upon context the case may or may not be considered a clinical negligence claim. Situations often arise when a patient writes a letter of complaint to a dentist and mentions that they are seeking compensation. A decision needs to be made as to whether the patient is actually making a valid clinical negligence claim and is acting as a Party Litigant (i.e. an individual conducting their own litigation), seeking compensation for pain and suffering, or whether the complaint raised can be managed in line with the practice complaints policy, with the offer of a refund of fees or assistance with remedial treatment costs. In many cases, the latter option is entirely possible.