How can you avoid patients complaining about BSA fines and blaming the practice for incorrect submissions?

Anyone who believes they are exempt from charges for NHS dental treatment must make sure that they are in fact entitled to free or assisted treatment. The FP17PR form clearly indicates that it is the patients' responsibility to complete this form correctly and not the practice's, but if a patient incorrectly claims for free dental treatment because they didn't understand or properly complete their form, they will have to pay a fine of £100 on top of the original NHS fee.

And if this comes as an unexpected and unpleasant surprise, you might find yourself in the firing line for their frustration. The DDU has handled a number of complaints on behalf of members about this particular issue, and it is evident that the submissions are being regularly checked by the NHS.

Confusion around charges, and subsequently the potential for complaints from patients, can sometimes arise from a lack of understanding of who is responsible. Unfortunately some patients might not understand that the auditing of NHS payments and charges is undertaken by the NHS Business Service Authority (BSA), rather than the practice.

Patients are often understandably aggrieved by being fined when they believed they were exempt. A large number of complaints of this sort come from the fact that patients feel they were given poor advice or misinformation when they were filling out their FP17PR form.

What is the BSA?

It might help to explain to patients how the system works, and who's involved.

The NHS Business Services Authority (NHSBSA) describes itself as 'a Special Health Authority and an Arm's Length Body of the Department of Health (DH)'.

It operates independently of practices, and audits both dentists' and patients' application and use of NHS services. This includes processing prescriptions on the NHS, and managing payments to dentists for NHS work in England and Wales.

DDU advice

Here are our tips on how to minimise the risk of patients complaining and asking you to pay their BSA fine, as well as helping them to understand their obligations in the first place.

  1. Patient information: if patients understand their eligibility from the outset, they're less likely to inadvertently claim for free treatment. The NHS BSA guidance sheet indicates that patients should be encouraged to read the claiming free dental treatment factsheet. This document sets out who is and who isn't entitled to have the NHS cover the cost of their treatment and is available in a number of languages. Signposting patients to this information will allow them to clarify their exemption status and whether they qualify for free dental treatment, but it's important they do this themselves.
  2. Training: any staff who are involved with handling NHS FP17PR forms should generally not offer advice to patients, as it is not within their field of expertise. If a complaint were to come about as a result of a patient not filling in their form correctly, any advice given to that patient could potentially be seen as being misleading or unclear, leaving the practice vulnerable to criticism.
  3. Communication: if a patient complains, explain that the BSA is a government agency which scrutinises exemption status of NHS dental patients, and that the fines it administers to patients who incorrectly claim free treatment are based on the signed FP17PR form and not within the practice's control.
  4. Sympathise: try to understand things from the patient's point of view and don't give the impression that you're simply washing your hands of their concerns. Acknowledge that the NHS exemption can sometimes be a difficult system to understand, but explain that the practice unfortunately has no input on the BSA's decisions and that the responsibility for correctly claiming exemption lies with the patient.

Like many types of complaints, complaints about incorrectly claimed exemptions can often be resolved or reduced through good communication and clear information being given to the patient, either in advance or in the resolution stage.

Useful links

The NHS BSA's website allows patients to check their eligibility for free treatment, and also includes the Practice Staff Guidance factsheet, which offers good advice to dental professionals and staff.

This page was correct at publication on 19/09/2017. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.