A practice principal DDU member contacted the advice line after a difficult interaction with a patient about NHS charges for treatment.

The following dilemma is fictitious, but based on the scenarios we encounter as a result of assisting members.

The scene

A long-standing patient of the practice had undergone restoration of a lower premolar with an associate in summer 2019 and the filling unfortunately fractured the following year. The patient was booked for an assessment with the same associate, who advised the filling needed replacing, but due to the lack of an AGP appointment, a temporary filling was placed and the patient was put on a waiting list. They were advised there would be no charge for the replacement as the filling was under guarantee.

The patient was contacted for the AGP appointment in early autumn 2020 but failed to respond - they then contacted the practice themselves again in early 2021 complaining of pain. The associate had since left the practice, so the patient was offered an appointment with our member.

The patient became angry when reception advised this would be a new course of treatment, stating that the previous dentist had said the replacement would be under guarantee and they did not feel they should pay again. They said they hadn't booked an appointment earlier because a family bereavement and became very upset on the phone and terminated the call without the receptionist being able to discuss the matter further.

DDU advice

The dento-legal adviser talked through the scenario with our principal member, to see how he wanted to deal with this verbal complaint. The principal dentist explained that the receptionist was very distressed by the call, and although he was sympathetic to the situation the patient was in, he rightly felt he needed to explain to the patient that the receptionist had been correct and was only doing her job.

Having talked through the options with the adviser, our member called the patient and offered condolences for their loss and apologised for their concern about the fees. He was able to calmly explain how the NHS fee structure worked and the fees that they were obliged and entitled to charge on behalf of the NHS.

As a goodwill gesture, he decided to offer to see the patient and waive the fee for the permanent filling. The patient was extremely grateful and attended the appointment with a written apology for the receptionist and thanked our member for being so understanding.

Key points

  • Both patients and staff are under a lot of strain in these difficult times, and showing support to staff and some leniency towards patients can go a long way to generating goodwill.
  • Talking through how you propose to handle a complaint can be very helpful before making a call to a patient, and can clarify your options.
  • You have no obligation to waive fees that you're entitled to claim, and while choosing to do so is your prerogative and can resolve a complaint without escalation, we are here to support you in whatever action you decide to take.
  • We're also here to support members in dealing with patients who exhibit unacceptable behaviour towards staff.

This page was correct at publication on 14/05/2021. 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.