The Whole Tooth. Study into General Dentistry Services in Hampshire

The Whole Tooth Study into General Dentistry Services in Hampshire May 2015

Contents Introduction and Executive Summary.... 3 What we found... 4 Context.... 5 Methodology.... 6 Focus Areas 1. Pricing information.... 7 2. NHS Charging.... 8 3. Treatment plans.... 9-10 4. NHS dentist availability.... 11-13 5. Comments and complaints.... 14-15 Conclusions and Recommendations... 16-17 Useful links.... 17 References.... 18 Acknowledgements.... 18 Contact... 18 Appendices 1. Introduction letter.... 19 2.1. Price list.... 20 2.2. Information leaflet.... 21 3. Treatment plan... 22-23 4. Data tables... 24-26 Healthwatch Hampshire 2

Introduction and Executive Summary Healthwatch is the independent consumer champion for health and social care in England. Healthwatch s function is to engage with local people to seek views about locally delivered services, signpost service users to relevant information and to influence the design of local health and social care provision. Healthwatch Hampshire is part of a network of local Healthwatch across 152 local authority areas that launched in April 2013 to ensure local voices are heard and enable them to influence the delivery and design of local services. Our sole purpose is to understand the needs, experiences and concerns of people who use health and social care and to speak out on their behalf. Healthwatch have statutory powers, as stated in the Health and Social Care Act 2012, to ensure the consumer s voice is strengthened and heard by those who commission, deliver and regulate health and care services. Local Healthwatch helps people get the best out of their local health and social care services; whether it s improving them today or helping to shape them for tomorrow. Healthwatch Hampshire has heard many concerns about dental care charges, patient confusion over treatment costs, particularly for those who are exempt from charges and stories of people struggling to find an NHS dentist. Combined with Healthwatch England s recent review of primary care and the Which? campaign (2015) to Clean Up Dental Costs, Healthwatch Hampshire undertook an investigation to find out whether NHS general dentistry in Hampshire is meeting certain regulatory and professional requirements and to ascertain where in the county there is limited NHS dental provision. With the overall aim of developing an insight into people s local experiences and champion the population s dental care needs. Healthwatch Hampshire visited all listed NHS contracted dental practices in Hampshire (excluding Portsmouth and Southampton as these fall under other local Healthwatch) to find out if local general dentistry practices are meeting certain regulatory requirements and to identify: which local dental practices comply with NHS contractual arrangements and are displaying NHS charges, and using treatment plans dental practices that are currently registering new NHS patients and identifying where there is limited NHS availability in Hampshire Healthwatch Hampshire 3

We found... 95% 62% 73% 30% 14% 96% 46% of NHS contracted dental practices were displaying the NHS dental charges poster of NHS contracted dental practices display NHS charging information on their own website of NHS contracted dental practices are registering new adult patients of dental practices in Hampshire are solely private, significantly higher than the national average of NHS contracted dental practices don t have their own website of NHS contracted dental practices have a complaints procedure but only 84% have information on display of NHS contracted dental practices have information on their website about complaints People are having to travel further afield to find an NHS dentist in some areas Healthwatch Hampshire 4

Context Nationally dentistry service provides an essential service to millions of patients and is critical to ensuring the oral health of the population. In 2009-10 the UK dentistry market was valued at an estimated 5.73 billion a year (excluding cosmetic dentistry which has significantly grown since these figures were produced). Spending on NHS dental treatment was 3.32 billion and accounted for approximately 58% of the total market (Laing and Buisson 2011) 1. Dentistry is one of the very few NHS services for which patients have to pay a contribution to the cost of their care. The dental system also differs from other NHS services because dentists can mix NHS and private treatment. Everyone should be able to access good quality NHS dental services NHS England According to NHS England information, the number of people accessing NHS dentistry has increased steadily since 2008 to 29.9 million patients in December 2013 2. NICE (National Institute of Clinical Excellence) guidelines recommend the public should visit the dentists at least once every two years. The dentistry market has come under scrutiny several times in recent years. Prompted by a significant number of complaints, the Office of Fair Trading conducted a market study into dentistry in 2012 and made a number of recommendations, some of which still have not been acted on 3. More recently a survey by the consumer group Which? found that people could be paying more than they need to for dental treatment because some dentists aren t upfront about prices or clear about the treatments patients are entitled to on the NHS. Which? has launched a campaign to Clean Up Dental Costs calling on NHS England and regulators to ensure dental practices comply with existing rules and improve the way treatment options and prices are communicated to patients. Healthwatch Hampshire support the Which? campaign and this report is the result of our research into local general dentistry and whether practices are meeting certain contractual and regulatory requirements. Timescale & Resources During the period 13th 24th April 2015, Healthwatch staff and several volunteer Champions made unannounced visits to 212 dental practices and establishments in Hampshire, excluding those in the cities of Southampton and Portsmouth as these fall under other local Healthwatches. The dental practices were identified from the NHS Choices website and other sources. Healthwatch Hampshire 5

Methodology Hampshire Healthwatch representatives introduced themselves and handed over a letter outlining the role of Healthwatch Hampshire and the purpose of our visit (see Appendix 1). In the majority of cases we spoke with the practice receptionist(s) and in a small number of cases the Practice Manager or dentist was called. Overall callers were openly welcomed, with only a small number initially declining to participate. The Questions 1) Do you have NHS registered patients? If yes... 2) Are NHS dental charges prominently displayed in the practice? 3) Are patients given an NHS Personal Treatment Plan FP17DC prior to treatment so they can make an informed choice? 4) Is there a complaints procedure available to patients? 5) Is there information about the complaints procedure on display in the practice? 6) Are you currently registering NHS patients? 7) Would you be willing to display some Healthwatch leaflets? Of the 212 dental practices visited we found that: 49 operating solely as private practices with no NHS contract 29 have an NHS contract for children only, including a small number who also registered exempt adults. 22 specialist services such as dental laboratories, orthodontists and hospital services 112 adult general dentistry practices on which, unless otherwise stated, we have focussed our analysis in this report. Questions: Are NHS dental charges prominently displayed in the practice? Are patients given an NHS Are patients given an NHS Personal Treatment Plan FP17DC prior to treatment? Is there a complaints procedure available to patients? Is information about the complaints procedure on display in the practice? Are you currently registering NHS patients? Yes 106 103* 108 94 82 * 7 practices use their own treatment plan Healthwatch Hampshire 6

1. Focus area Pricing information It is a legal and professional requirement for contracted NHS dental practices to display a price list. This must be on prominent display. NHS England produce a poster and patient information leaflet for this purpose (see Appendix 2), which is supplied to contracted practices and also available for download from the NHS Choices website at: http://www.nhs.uk/nhsengland/ Healthcosts/Documents/2015/nhs-dentalcharges-poster.pdf http://www.nhs.uk/nhsengland/ Healthcosts/Documents/2015/nhs-dentalservices-flyer.pdf Which? surveyed 1000 people, who had all seen their dentist in the past 6 months in England and 51% said no price list for treatment was displayed. We found: Of the 112 NHS general practices with registered adults, 106 or 95% were displaying the NHS dental charges poster. As NHS charges recently increased (from 1st April 2015) all were displaying the latest price list. NHS charges poster is in a prominent position either at the reception desk and/or in the waiting area. Two of the practices that didn t have a price list displayed said they were waiting for materials to be delivered and so we provided them with a copy in the interim. The 21% with children only or children and exempt adults NHS contracts, therefore non fee paying on the whole don t display NHS pricing. We feel that the disparity between Which? findings and our own is in part because we were specifically looking for a price list. Patients visiting a dental practice wouldn t necessarily be looking for an NHS price list and we felt that the current posters could easily be missed or overlooked as they re not very large or eye catching. We recommend posters are redesigned to make them more noticeable. We also looked to see whether dental practices have a website and if NHS pricing information is displayed. We found that 96 dental practices have their own website and 62% of those contained NHS charging information or linked to the NHS website. Healthwatch Hampshire 7

2. Focus area NHS Charging There are three standard charges for all NHS treatment, known as bands one, two and three which are set every year by the Department of Health. Current rates from 1st April 2015, listed on NHS materials are: Band 1 course of treatment 18.80 Band 2 course of treatment 51.30 Band 3 course of treatment 222.50 Band 1 This covers an examination, diagnosis (eg X-rays), advice on how to prevent future problems, a scale and polish if needed, and application of fluoride varnish or fissure sealant. If you require urgent care, even if your urgent treatment needs more than one appointment to complete, you will only need to pay one Band 1 charge. Band 2 This covers everything listed in Band 1 above, plus any further treatment such as fillings, root canal work or if your dentist needs to take out one or more of your teeth. Band 3 patients pay and also the amount of Units of Dental Activity (UDA s) a dentist gets. Since 1st April 2006 NHS dentists in England and Wales are on fixed contracts for their NHS work which specify how many UDA s they are allowed/paid for a year. Dentists have to be within 4% of their NHS contracted targets. If dentists don t achieve their contracted number of UDAs they are financially penalised. If dentists do more than their contracted number of UDAs they don t get paid any more 4. This translates into for example 12 UDAs for doing a crown. Taking a UDA to have an average value of 25 it means a dentist is paid 300 for doing one crown ( 25 x 12 UDAs). If a dentist does 2 or 3, or more crowns he still only gets paid 300 even though he has a lot more lab work to pay for. Another example is a root filling which might take 1-2 hours. A dentist is allocated 3 UDAs for a root filling so a dentist is paid 75 ( 25 x 3 UDAs) the same as for one extraction, which creates a disincentive for dentists. We recommend how dentists are reimbursed be reviewed with the Dental Contract in 2015 1. This covers everything listed in Bands 1 and 2 above, plus crowns, dentures and bridges. Each dental procedure has been classified into a band which determines what 1 Currently being reviewed - see https://www.gov.uk/ government/uploads/system/uploads/attachment_data/ file/395384/reform_document.pdf Healthwatch Hampshire 8

3. Focus area Treatment Plans Current arrangements under the NHS DGS/ PDS Contracts Regulations 2005 5 require dentists to provide patients with a written treatment plan for Band 2, Band 3 or a mix of NHS and private treatments (Treatment plans aren t usually given for Band 1 or urgent dental treatments, but patients can still request one). Dentists are obliged to discuss the treatment plan and what banding the patient requires. The NHS FP17DC Personal Treatment Plan sets out the proposed dental treatment (see Appendix 3). We found that 103 or 92% of dental practices are using the NHS Treatment Plan. A further 7 or 6% are using their own in-house treatment plan. They stated that this is because their records are computerised and it saves consultation time not having to hand write the FP17DC. This is accepted practice, however as the treatment plan constitutes informed consent any in-house plans must include the declaration below and be signed by the patient 6 : I understand the nature of the proposed NHS (or private) treatment services, and accept those services and the associated fees as detailed NHS dental treatment may be either be wholly funded by the NHS where patients are exempt, or may be part-funded by the NHS and part funded by the patient. As part of its study Which? used several undercover mystery shoppers and found that the weakest area of communication was in explaining both NHS and private treatments. Our own intelligence shows concerns around dental charges and patient eligibility for reduced prices. The Which? survey found that one in five people (22%) were overcharged for their treatment. Everyone is entitled to clinically appropriate dental treatment from the NHS they need to achieve and maintain good oral health. People attending a dentist who offer both NHS and private treatment, and requiring treatment should not be asked to pay for it privately. However, they can choose to have the treatment privately and the dentist should explain what options are available using a treatment plan. Dentists are not allowed to refuse any treatment available on the NHS but then offer the same treatment privately. Also patients should only be asked to pay one charge for a course of NHS treatment, even if that means several visits to the Healthwatch Hampshire 9

dentist. Patients should not be charged for individual items within a course of treatment. For example two fillings and a crown on the same treatment plan are covered under the one plan. If more treatment is needed within two months or within the same or a lower band, patients do not have to pay again. Where it s necessary to refer patients to another dentist for a specific treatment this may incur a second charge. We are concerned to find a small number of practices are asking patients to pay for dental care before having treatment carried out. This requires further monitoring and guidance. an NHS hospital dental service outpatient (though charges for dentures or bridges may apply) Free NHS treatment is also available under some circumstances if the patient is receiving: Income Support Income based job seekers allowance Income related Employment and Support Allowance Pension Credit guarantee credit Universal credit They are named or entitled to a valid NHS tax credit exemption certificate or are entitled to an NHS tax credit exemption certificate Named on a valid HC2 certificate If named on a valid HC3 certificate, patients may not have to pay for all their treatment. Checks are made on free and reduced cost treatment claims. Exemptions People are exempt from NHS dental charges are if, when the treatment starts they are 7 : aged under 18 under 19 and receiving full-time education pregnant or have had a baby in the previous 12 months staying in an NHS hospital and treatment is carried out by the hospital dentist Patients are not exempt from paying because they receive: Incapacity Benefit, contribution-based Employment and Support Allowance, contribution-based Jobseeker s Allowance, Disability Living Allowance, Council Tax Benefit, Housing Benefit or Pension Credit, Savings Credit, when paid on their own. Medical conditions do not exempt patients from payment for dental treatment. Patients are required to confirm their exemption by signing a form and showing the dentist written proof of their entitlement. Checks are made on all claims for free treatment and penalty charges are enforced. Healthwatch Hampshire 10

4. Focus area NHS Dentist Availability Everyone should be able to access goodquality NHS dental services. A number of online directories and tools are helpful to those with web access in finding a dentist. Content is variable so more confusing for people, a reliable central resource is needed such as NHS Choices. However we found in compiling our own list of NHS dental practices that large amounts of data is missing and/or not available on the NHS Choices website. Under the existing system each surgery manages their own details on the website. Currently there is no contractual obligation or regulation requiring surgeries to keep their NHS Choices details up-to-date. We recommend NHS Choices website content needs better management and updating to make it more accurate and useful for those seeking a NHS dentist. Healthwatch England is calling on NHS England and the Department of Health to address this. The Hampshire Dental Helpline can also help people to find a dentist. The helpline number has recently been changed to 111 but the website is still available: www.hampshiredentalhelpline.nhs.uk We found that the weakest area of communication was in explaining both NHS and private treatments. Healthwatch Hampshire heard stories of patients struggling to find an NHS Dentist. Our study found that currently 82 or 73% of NHS contracted dentists in Hampshire are registering new adult patients Dental patients are not bound to a catchment area as with a GP so there is no need to register in the same way. People can and may have to travel further to access an NHS dentist because of limited local dental services. We have examined the number of dental practices across the 11 Hampshire districts and found more NHS provision in areas with higher deprivation and more private practices in areas perceived to be more affluent. For instance Petersfield has only one adult NHS dentist and 4 private practices, compared to Gosport which has 8 NHS dentists and only 1 private dentist. Winchester district has the highest number of private practices with 11 and 8 NHS dentists. Healthwatch Hampshire 11

Hampshire District NHS Adult Contract NHS Private NHS Adult Children Practice Registering Only New Adults Basingstoke & Deane 13 9 2 5 Hart 9 8 3 3 Rushmoor 8 6 0 3 Test Valley 4 3 2 7 Winchester 8 8 1 11 East Hampshire 6 5 3 6 New Forest 16 9 5 1 Eastleigh 12 8 2 3 Fareham 12 9 7 5 Gosport 8 6 2 1 Havant 16 11 2 4 Totals 112 82 29 49 There is also a mobile service for some rural areas not reflected in ths table. The New Forest has least current NHS availability compared to the number of NHS dentists in the area. Test Valley the least number of NHS dentists of any of the districts. We also found that Hampshire has significantly more private dental practices than the national average. Nationally fewer than 10% of dentists carry out private dental treatment only, compared to 30% in Hampshire 1. We also found a large number of dental practices that have children only contracts which are frequently limited to the children of their private patients. Worryingly several practices with NHS contracts also said that they re moving to a children only NHS contract in the near future which is a trend to monitor 1. During our visits, the following dental practices raised specific issues with us: 1 NHS England have since informed us that such a changfe is not allowed under current contract arrangements. Shine Dental Clinic, Four Marks is currently a private practice. They would like to have an NHS contract but have been refused several times because of limited funding. The nearest NHS provision is in Alton. Grayshott Dental Practice on the North Hants/Surrey border reported they d been severely affected by local NHS dentist closure in Surrey. With no additional provision, they ve become oversubscribed and aren t able to take any new local patients. In a recent Healthwatch England report into Primary Care, six other local Healthwatches (York, Lincolnshire, Bolton, Kirklees, Leicester and Wiltshire) have alerted Healthwatch England to issues they were struggling to address with local commissioners around access to NHS dentists. Healthwatch heard from people struggling to register with an NHS dentist, with as few as 1 in 5 surgeries in some areas registering new patients. Healthwatch Hampshire 12

Healthwatch Leicester found that just 18 of 58 dentist surgeries were registering, leaving large areas without any provision for new patients. There were also widespread reports of patients finding themselves being deregistered without warning if they hadn t been for a check-up. Typically practices in Hampshire are small or medium sized private businesses that are owned either by an individual or a partnership of dentists, or are owned by a corporate dental group (an incorporated company operating 3 or more dental practices). One should remember that dentists are profit seeking businesses. Integrated Dental Holdings (IDH group) and Oasis are two of the largest corporate dental groups in the UK. IDH group has 600 practices nationwide and 17 in Hampshire making them the largest incorporated denatl company operating in the area, accounting for 15% of the NHS adult dentistry market in Hampshire. Healthwatch Hampshire also came across The Tooth Bus initiative, commissioned by NHS England. This service provides a free dental check-up for adults and children who haven t seen an NHS dentist for 2 years. It operates across Hampshire (mainly in Southampton and Portsmouth) and Dorset. The Tooth Bus can visit schools, colleges and businesses by arrangement. For more information go to: http://www.toothbus.co.uk/ Healthwatch Hampshire 13

5. Focus area Comments and Complaints Patients who receive poor treatment from an NHS dentist, suspect they ve been mischarged or have been pushed into paying for private treatment can make a complaint. NHS dentists are required by regulations to provide guarantees on work they carry out against failure for 12 months. In general, the first point of contact for those who experience a problem is with the dental practice. The GDC regulates dental professionals in the UK and defines the business of dentistry and who can perform it. All practitioners including dental technicians and hygienists must be registered with the GDC. It publishes Standards for Dental Professionals 8 with which members must abide. One of the GDC s nine principles is that practices should have a clear and effective complaints procedure. The NHS has no control over dentists providing private dental treatment, but the GDC can provide help and advice to all dental patients. Where a complaint relates to treatment comprising both NHS and private, the complaint must be split and may need to be handled by several different bodies creating a complex burden on patients and dentists. The GDC will investigate concerns about: very poor treatment not having professional indemnity insurance cross-infection issues such as using dirty equipment being under the influence of drink or drugs fraud or theft Healthwatch Hampshire 14

Our study found that 96% of NHS dental practices (108) in Hampshire have a complaints procedure. 52 Dental practices have their complaints procedure on their website. Some also have a way for patients to make comments and give patient feedback other than the NHS Friends and Family test. A small number of dental practices such as Hedge End Dental Surgery and Copse Lane Dental Surgery use their own patient leaflets encouraging patient s comments and feedback. Some others are gathering patient feedback through patient questionnaires including SCA Trafalgar (Totton) and Oakdene Dental Surgery. Complaints should be made to the individual practice or NHS England. Their contact details are: By post to: NHS England PO Box 16738 Redditch B97 9PT By email to: England.contactus@nhs.net By telephone: 0300 311 22 33 (Monday to Friday 8am to 6pm, excluding English Bank Holidays) Some of the websites used to search for dentists also provide patient reviews of dental practices, though too few reviews are yet available to provide a balanced view. As with web based directories for finding a dentist, there isn t a widespread or consistent means for gathering patient feedback on satisfaction and quality of treatment. We recommend greater patient engagement and reliable means of gathering comments and feedback. Healthwatch Hampshire 15

Conclusions and Recommendations Patients typically make a number of choices in the dentistry market, including: Which dental practice they attend Which particular dental treatments to have Whether to have NHS or private dental treatment, and How to pay for their dental treatment To make those choices patients need access to dentists, information on which practices are registering patients and clear information on their entitlements and charging. A patient s ability to make informed choices regarding their dental treatment is restricted by low awareness and understanding of their rights. To achieve a more transparent and better functioning dentistry service in Hampshire we recommend: Dental Practices: All primary care dentists to provide the NHS leaflet or one of their own design with charging information and complaints procedure (see Appendix 2). Ensure dental practice information on NHS Choices website is completed and kept up-to-date by practices either through contractual obligation or regulation. This should be the primary list above any other commercial websites. Ensure NHS charging information and complaints procedures are listed on practice websites. Better patient engagement to measure patient satisfaction and quality of treatment Commissioners and NHS England: Redesign NHS price lists/banding information posters to make them more eye catching so they are not overlooked by visiting patients. Ensure dental practice information on NHS Choices website is completed and kept up-to-date by practices either through contractual obligation or regulation. More consistent NHS coverage across Hampshire by reviewing NHS contracts and areas without NHS provision. As part of contract reviews during 2015, better incentives should be given to dentists in banding/remuneration for more complex and lengthy procedures such as root canal fillings as oppossed to extractions, for which Dentists receive the same fee. More coordinated support to be given to Dentists from commissioners, LDC s and the CQC as well as patient organisations such as Healthwatch. Healthwatch Hampshire 16

Issues arising for further monitoring and investigation: Emerging trend for payment upfront. Guidance needed for dentists and information for patients. Significant and rising number of dentists with NHS children only contracts. Dentists should not offer NHS treatment to children on condition that a parent or guardian becomes a private patient. Useful Links Which? Campaign to Clean Up Dental Costs www.which.co.uk/campaigns/dental-treatment-costs/ NHS Choices search by location to find dentist services www.nhs.uk/nhsengland/aboutnhsservices/dentists/pages/find-an-nhs-dentist.aspx The Dental Helpline The Helpline works in partnership with other health partners across Hampshire and the Isle of Wight to improve residents access to dental services. www.hampshiredentalhelpline.nhs.uk/ General Dental Council www.gdc-uk.org/pages/default.aspx Hampshire & Isle of Wight Local Dental Committee www.hants-iow-ldc.info/ NHS Dental Commissioning Quarterly information on units of dental activity commissioned by NHS area teams www.england.nhs.uk/statistics/category/statistics/dental-commissioning/ The Local Area Team responsible for the commissioning NHS dental services is: NHS England South (formerly Wessex Area Team) Practitioner and Patient Services Agency (PPSA), Coitbury House, Friarsgate, Winchester, Hampshire, SO23 8EE Telephone: 01962 876651 Healthwatch Hampshire 17

References 1. http://webarchive.nationalarchives.gov.uk/20140402142426/http:/www.oft.gov.uk/ shared_oft/market-studies/dentistry/oft1414.pdfoft Dentistry An OFT Market Study May 2012 [Accessed April 2015] 2. http://www.england.nhs.uk/wp-content/uploads/2014/02/dental-info-pack.pdf Improving Dental Care and Oral Health - A Call To Action Evidence Resource Pack NHS February 2014 [Accessed May 2015] 3. Which? (2015) Magazine Feature & Investigations Are we paying too much for our dental care?, February 2015 p.29 4. http://www.dentistforum.co.uk/nhs-dentistry/what-is-a-uda/ [Accessed April 2015] 5. http://www.legislation.gov.uk/uksi/2005/3361/contents/made The National Health Service (General Dental Services Contracts) Regulations 2005 [Accessed May 2015] 6. http://contactcentreservices.nhsbsa.nhs.uk/selfnhsukokb/askus_dental/template. do?name=fp17dc+and+fp17dco+-+treatment+plan+form+information&id=16205 [Accessed May 2015] 7. NHS.uk/chq/pages/1786.aspx [Accessed May 2015] 8. Standards for Dental Professionals, General Dental Council, www.gdc-uk.org/ Newsandpublications/Publications/Publications/StandardsforDentalProfessionals[1]. pdf [May 2015] Acknowledgements We are grateful for all those who have contributed to this study and for the willingness of dental practice staff to answer or questions. Special thanks to the volunteer Champions that took part in the visits: Colin Godfrey, John Perry, Martin Smethers and Sally Stoodley. Also to David Levey for his online research into dental practice websites. Contact Report compiled by Libby Thomas, Volunteers Officer, Healthwatch Hampshire Healthwatch Hampshire Westgate Chambers, Staple Gardens, Winchester, SO23 8SR Tel: 01962 440262 E-mail: enquiries@healthwatchhampshire.co.uk Web: www.healthwatchhampshire.co.uk Healthwatch Hampshire 18

Appendix 1 Introduction Letter Healthwatch Hampshire 19

Appendix 2.1 Price List Healthwatch Hampshire 20

Appendix 2.2 Information Leaflet Healthwatch Hampshire 21

Appendix 3 Treatment Plan Healthwatch Hampshire 22

Appendix 3 Treatment Plan Healthwatch Hampshire 23

Appendix 4.1 Data Table - NHS Dentists (Adults) 1=Yes 0=No Charges clearly displayed? Provide a NHS treatment plan? Do they have a complaints procedure available? Is information about the complaints procedure on display? Currently registering NHS patients? NHS CONTRACT NAME DISTRICT Web Address Charges? ACH Practice Aldershot (Rodericks Ltd) Rushmoor 1 1 1 1 0 http://www.achdental.co.uk/ 1 1 Acorn Dental Health Eastleigh 1 1 1 0 0 http://www.acorndentalhealth.co.uk/ 1 0 Aldershot Dental Centre Rushmoor 1 1 1 1 1 http://www.aldershotdental.co.uk/ 0 0 Aldershot Dental Practice (Rodericks Ltd) Rushmoor 1 1 1 1 1 http://www.aldershot-dental.co.uk/ 1 1 Alton Dental East Hants 0 1 0 0 1 http://www.altondental.co.uk/ 1 1 Appollonia Dental Practice New Forest 1 1 1 1 1 No website Beggarwood Dental Surgery Basingstoke & Deane 1 1 1 1 1 http://www.beggarwooddental.com/ 1 0 Bela Shah Dental Surgery Eastleigh 1 1 1 1 1 No website Birchfield Dental Practice New Forest 1 0 1 1 0 http://www.birchfieldpractice.co.uk/ 0 0 Burridge Dental Practice Fareham 1 1 1 1 1 http://www.burridgedental.co.uk/ 1 0 Chalet Hill Dental & Implants East Hants 1 1 1 1 1 http://www.chalethilldental.co.uk/ 0 0 Chequers Dental Partnership Basingstoke & Deane 1 1 1 1 1 No website Chesil Dental Practice Winchester 1 1 1 1 1 http://www.stjamesdental.co.uk/ 1 1 Chineham Dental Practice Basingstoke & Deane 1 1 1 1 1 http://www.chinehamdental.co.uk/ 0 0 Claremont Dental Surgery Basingstoke & Deane 0 0 0 0 0 http://www.claremontdental.co.uk/ 0 0 Clareville Dental Surgery (M & A Dentment Ltd) Rushmoor 1 1 1 1 1 http://www.dentist-farnborough.co.uk/ 0 0 Copse Lane Dental Practice Eastleigh 1 1 1 1 1 No website Cowplain Dental Practice Havant 1 1 1 1 0 http://www.cowplaindentalpractice.com/location.php 1 1 Dalkeith House Dental Practice New Forest 1 0 1 1 0 No website Damira Dental Studios Havant (formerly Aspire Havant Dental Practice) Havant 1 1 1 0 1 http://www.damiradental.co.uk/ 1 0 Damira Dental Studios South Ham (formerly Aspire Dental Care) Basingstoke & Deane 1 1 1 0 1 http://www.damiradental.co.uk/ 1 0 Damira Dental Studios Lee on Solent (formerly Aspire Dental Care) Gosport 1 1 1 0 1 http://www.damiradental.co.uk/ 1 0 Denmead Dental Havant 1 1 1 1 1 http://www.denmeaddental.co.uk/ 0 0 Dental Care Centre New Forest 1 1 0 0 1 No website 0 0 Dental Care Hook Hart 1 1 1 0 1 http://dentalcare.ltd.uk/hook/ 1 0 Dental Concepts Basingstoke & Deane 1 1 1 0 0 http://www.dental-concepts.com/ 1 1 Dentistry @ LB Healthcare Winchester 1 1 1 1 1 http://www.lbhealthcare.co.uk/ 0 0 East End Lodge Dental Practice Havant 1 1 1 0 0 http://www.eastendlodge.co.uk/ 0 1 Elvetham Dental Care Hart 1 1 1 1 1 http://www.elvethamdentalcare.com/ 1 0 Emsworth Dental Surgery Havant 1 1 1 1 0 http://www.emsworthdentalsurgery.co.uk/ 0 1 Fareham Road Dental Surgery Gosport 1 1 1 1 0 http://farehamroadsurgery.co.uk/ 1 0 Fernhill Dental Centre (Pritchard & Associates) Rushmoor 1 1 1 1 0 http://www.fernhilldental.co.uk/ 1 1 Fleet Dental Centre Ltd Hart 1 1 1 1 1 http://www.fleetdental.co.uk/ 1 0 Forest Gate Dental Practice New Forest 1 1 1 1 1 No website http://genixhealthcare.com/find-your-nearest/eastleighhampshire/ Genix Healthcare Dental Clinic (Eastleigh) Eastleigh 1 1 1 0 1 1 1 Genix Healthcare Ltd (Havant) Havant 1 1 1 1 1 http://genixhealthcare.com/find-your-nearest/havant-hampshire/ 1 0 Gosport Dental Clinic Gosport 1 1 1 1 1 http://www.gosportmedicalcentre.co.uk/ 1 1 Gosport Smile Clinic Gosport 1 1 1 1 1 No website Grayshott Dental Practice East Hants 1 1 1 1 0 http://www.grayshottdental.co.uk/ 0 0 Heath Dental Suite Hart 1 1 1 1 0 http://www.fleetmedicalcentre.co.uk/ 1 0 Heath Dental Suite (Solent NHS) Havant 1 1 1 0 1 http://www.solent.nhs.uk/ 1 0 Hedge End Dental Surgery Eastleigh 1 1 1 1 0 http://hedgeenddental.com/ 1 0 Highlands Dental Practice Fareham 1 1 1 1 1 http://www.highlandsdentalpractice.co.uk/ 0 1 Homemill Dental Surgery New Forest 1 1 1 1 0 http://www.homemilldental.co.uk/ 0 0 IDH Bedhampton Havant 1 1 1 1 1 http://idhdentisthavantbedhampton.co.uk/ 1 1 IDH Alresford Winchester 1 1 1 1 1 http://idhdentistalresfordweststreet.co.uk/?plain=1 1 1 IDH Andover Test Valley 1 1 1 1 1 http://idhdentistandoverwesternroad.co.uk/ 1 1 IDH Basingstoke Dental Practice Basingstoke & Deane 1 1 1 1 1 http://idhdentistbasingstokepopley.co.uk 1 1 IDH Bordon East Hants 1 1 1 1 1 http://idhdentistbordonhighstreet.co.uk/ 1 1 IDH Boyatt Wood Dental Practice Eastleigh 1 1 1 1 1 http://idhdentisteastleighboyattwood.co.uk/ 1 1 IDH Gillies Basingstoke & Deane 1 1 1 1 0 http://idhdentistbasingstokebrightonhill.co.uk/ 1 1 IDH Gosport Dental Care Gosport 1 1 1 1 1 http://idhdentistgosportsouthstreet.co.uk/?plain=1 1 1 IDH Havant Dental Centre Havant 1 1 1 1 1 http://idhdentisthavantpurbrookway.co.uk/?plain=1 1 1 IDH High Street Dental Centre East Hants 1 1 1 1 1 http://idhdentistpetersfieldhighstreet.co.uk/?plain=1 1 1 IDH Lenten Street Dental Centre East Hants 1 1 1 1 1 http://idhdentistaltonlentenstreet.co.uk/ 1 1 IDH New Milton Dental Centre New Forest 1 1 1 1 1 http://idhdentistnewmiltonmountavenue.co.uk/?plain=1 1 1 IDH Oakfield Dental Practice Rushmoor 1 1 1 1 1 http://idhdentistfarnboroughsalisburyroad.co.uk/ 1 1 IDH Riverside Dental Practice Eastleigh 1 1 1 1 1 http://idhdentisteastleighscotterroad.co.uk/?plain=1 1 1 IDH Romsey Test Valley 1 1 1 1 1 http://idhdentistromseythehundred.co.uk/?plain=1 1 1 IDH Tadley Basingstoke & Deane 1 1 1 1 1 http://idhdentisttadleyfranklinavenue.co.uk/ 1 1 IDH Whitecross Dental Care Fareham 1 1 1 1 1 http://idhdentistfarehamweststreet.co.uk/?plain=1 1 1 Iosis Clinic Limited Winchester 1 1 1 1 1 http://winchester.iosisclinic.co.uk/ 1 0 King Street Dental Practice Hart 1 1 1 1 1 No website Kings Road Dental Surgery Fareham 1 1 1 1 1 http://www.kingsroaddentist.co.uk/ 1 1 Lee-On-The-Solent Dental Practice Fareham 0 0 0 0 1 No website Lockswood Dental Practice Fareham 1 0 1 1 0 http://www.lockswooddentalpractice.co.uk/ 0 1 Magnolia House Dental Havant 0 1 1 1 1 No website Manor Dental Surgery Fareham 1 1 1 1 1 http://manordentalsurgery.co.uk/ 1 0 Marlfield House Dental Practice Winchester 1 1 1 1 1 http://marlfieldhouse.co.uk/ 1 1 Merrygate Dental Practice New Forest 1 0 1 1 0 http://www.merrygatedental.co.uk/ 1 0 Milford Dental Practice New Forest 1 0 1 1 0 http://www.milforddentalpractice.com/ 0 1 Mr AM Souhani - Palmerston Dental Practice Fareham 1 1 1 0 1 No website My Dentist New Forest 1 1 1 1 1 http://idhdentistfordingbridgebartonroad.co.uk/?plain=1 1 1 Oakdene Dental Practice (Group Dental) New Forest 1 0 1 1 1 http://www.groupdental.co.uk/oakdene/oakdene-dental-practice.asp 0 0 Oasis Dental Care (Andover) Test Valley 1 1 1 1 1 http://www.oasisdentalcare.co.uk/practices/oasis-dental-care-andover/ 1 1 Oasis Dental Care (Fleet) Hart 1 1 1 1 1 http://www.oasisdentalcare.co.uk/ 1 0 Oasis Dental Care (Waterlooville) Havant 1 1 1 0 1 http://wwwhttp://www.oasisdentalcare.co.uk/practices/oasis-dental-care-waterlooville/.oasisdentalcare.co 1 1 Olivers Battery Dental Surgery Winchester 1 1 1 1 1 http://www.oliversbatterydentalsurgery.com/ 1 0 Park Lane Dental Care Havant 1 1 1 1 1 http://whttp://www.southerndental.co.uk/locate-a-practice/hampshire/cowplain-waterlooville/ww.southe 1 0 Parkway Dental Care Havant 1 1 1 1 1 http://www.parkwaydentalcare.co.uk/ 1 0 Practice in the Park Havant 1 1 1 1 1 http://www.practiceinthepark.com/ 1 0 Quality & Caring Dentistry Eastleigh 1 1 1 1 0 http://www.qcdentistry.co.uk/ 0 0 Queensmead Dental Practice (Rodericks Ltd) Rushmoor 1 1 1 1 1 http://www.queensmeaddental.co.uk/ 1 1 Rails Lane Dental Practice Havant 0 1 1 1 0 http://www.railslanedental.co.uk/ 0 0 Ringwood Dental New Forest 1 1 1 1 1 http://www.ringwooddental.co.uk/ 1 0 SCA Trafalgar Dental Practice (Holbury) New Forest 1 1 1 1 0 http://www.scagroup.co.uk/dentistry/trafalgar-practices/trafalgar-holburyoup.co.uk/ 1 1 SCA Trafalgar Dental Practice (Totton) New Forest 1 1 1 1 1 http://www.scagroup.co.uk/dentistry/trafalgar-practices/trafalgar-totton 1 1 http://www.scagroup.co.uk/dentistry/trafalgarpractices/trafalgar-gosport SCA Trafalgar Rowner Practice (Gosport) Gosport 1 1 1 1 1 1 1 Sharland House Dental Clinic (Damira Dental Studios) Fareham 1 1 1 1 1 http://www.aspiredentalcare.co.uk/ 1 0 Smile Makers Eastleigh 1 1 1 0 1 http://www.smilemakers.co.uk/ 1 0 Smiles of New Forest New Forest 1 1 1 1 1 http://www.smilesofnewforest.co.uk/ 1 0 Southwood Dental Centre (Pritchard & Associates) Rushmoor 1 1 1 1 1 http://www.southwooddental.co.uk/ 1 1 St Cross Dental Practice Winchester 1 1 1 1 1 No website St Francis Dental Surgery Eastleigh 1 1 1 1 0 http://stfrancisdental.co.uk/ 0 1 St James Dental Practice Winchester 1 1 1 1 1 http://www.stjamesdental.co.uk/ 1 1 Stanford Dental Practice Basingstoke & Deane 1 1 1 0 0 No website Startfield Road Dental Practice Basingstoke & Deane 0 1 1 1 1 http://www.stratfielddental.co.uk/ 1 1 Stoke Road Dental Practice Gosport 1 1 1 1 0 http://www.stokeroaddentalpractice.co.uk/ NA 1 Stubbington Green Dental Practice Fareham 1 1 1 1 0 http://www.zen14789.zen.co.uk/stub/ 0 1 Surgery House Dental Practice Hart 1 1 1 1 1 http://www.surgeryhouse.co.uk/ 0 1 Tadley Dental Care Basingstoke & Deane 1 1 1 1 Healthwatch 1 http://www.tadleydentalcare.co.uk/ Hampshire 24 1 0 The Elm Grove Dental Practice Havant 1 1 1 1 0 http://www.haylingdentist.co.uk/ 0 0 The Link Dental Surgery Hart 1 1 1 1 1 http://www.cdentalstudio.co.uk/about-hampshire-surrey-dentist/yateley-opening-hours-surrey-hampshire 1 0 The Mews Surgery (Group Dental) New Forest 1 1 1 1 0 http://www.groupdental.co.uk/themews/the-mews-dental-practice.asp 0 0 The Smiles Studio (Mahesh Nagpal) Eastleigh 1 1 1 0 1 http://www.maheshnagpal.co.uk/ 0 1 The Verne Dental Surgery Hart 1 1 1 1 1 http://www.thevernedentalsurgery.co.uk/ 1 0 Trafalgar (Brune) Gosport 1 1 1 1 1 http://www.brunemedicalcentre.co.uk/ 1 1 Vital Family Dental Care Eastleigh 1 1 1 1 1 No website Warash Dental Practice Fareham 1 1 1 1 0 http://www.warsashdental.co.uk/about-us/dentists/ 0 1 Wellum House Dental Practice Test Valley 1 0 1 1 0 No website West Street Dental Clinic Fareham 1 1 1 1 1 http://www.weststreetdental.co.uk/ 0 1 Winchester Road Dental Practice Basingstoke & Deane 1 1 1 1 1 http://www.winchester-road-dental-practice.co.uk/ 1 1 Complaints Procedure? TOTALS 106 103 108 94 82 69 52 All dentists are within the area served by Hampshire County Council 24

Appendix 4.2 Data Table - NHS Dentists (Children) CONTRACT NAME DISTRICT Web Address Aberdeen House Dental Practice East Hants http://www.winningsmile.co.uk/ Avenue Dental Care Gosport http://www.avenuedentalcare.co.uk/ Beauchamp House Dental Surgery Test Valley http://www.dental100.com/ Beech Dental Practice New Forest http://www.beechdental.co.uk/ Bursledon Dental Clinic Eastleigh http://www.bursledondentalclinic.co.uk/ Castle Street Dental Practice Fareham http://www.castledentalpractice.co.uk/ Cowplain Dental Centre Havant http://www.cowplaindentalcentre.co.uk/ Crofton Dental Care Fareham http://www.croftondentalcare.co.uk/ Exelby Dental Practice Fareham No website Fareham Dental Care Fareham http://www.farehamdentalcare.co.uk/ Forestside Dental Practice New Forest http://forestsidedp.co.uk/ Guinea Court Dental Surgery Basingstoke & Deane http://www.guineacourtdental.co.uk/ Hook Dental Hart http://www.hookdental.com/ Merrystead Dental Surgery New Forest http://www.blackfieldsmiles.co.uk/ Mr DW Robinson ( Eghan Dental Care) Hart No website Mr R Herron East Hants No website Oakwood Dental Surgery Eastleigh http://www.oakwooddp.co.uk/ Omnia Dental Basingstoke & Deane http://www.omniadental.co.uk/ Quaintways Cottage Dental Surgery Hart http://www.quaintwayscottagedental.co.uk/ Ranvilles Dental Practice Fareham No website Solent House Dental Surgery New Forest http://www.solent-dental.co.uk/ Stephen Rhonda Day Gosport No website The Beeches Dental Practice Havant http://www.beechesdentalpractice.co.uk/ The Heatherstone Practice Test Valley http://www.heatherstonedentalpractice.co.uk/ The Lodge Dental Partnership East Hants No website The Oak Lodge Dental Surgery Partnership New Forest http://www.oaklodgedentalpractice.com Titchfield Village Dental Surgery Fareham http://www.whatclinic.com/dentists/uk/hampshire/fareh Whiteley Dental Practice Fareham http://www.whiteleydentalpractice.co.uk/ Whites Dental Care Winchester http://www.whitesdentalcare.co.uk/ All dentists are within the area served by Hampshire County Council After our initial checks we wrote to 33 practices and as of 13.7.15 we have noted the following changes CONTRACT NAME DISTRICT Charges clearly displayed? Provide a NHS treatment plan? Do they have a complaints procedure available? Is information about the complaints procedure on display? Currently registering NHS patients? ACH Practice Aldershot (Rodericks Ltd) Rushmoor 1 1 1 1 0 Birchfield Dental Practice New Forest 1 0 1 1 0 Damira Dental Studios South Ham (formerly Aspire Dental Care) Basingstoke & Deane 1 1 1 1 1 Damira Dental Studios Lee on Solent (formerly Aspire Dental Care) Gosport 1 1 1 1 1 Damira Dental Studios Havant (formerly Aspire Havant Dental Practice) Havant 1 1 1 0 1 Homemill Dental Surgery New Forest 1 1 1 1 0 Quality & Caring Dentistry Eastleigh Healthwatch 1 Hampshire 1 25 1 1 0 Rails Lane Dental Practice Havant 1 1 1 1 0 Stoke Road Dental Practice Gosport 1 1 1 1 0 The Elm Grove Dental Practice Havant 1 1 1 1 0 Winchester Road Dental Practice Basingstoke & Deane 1 1 1 1 1 25

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