Office of Fair Trading
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OFT calls for greater patient choice and competition in dentistry market

The OFT today called for major changes to the £5.73bn UK dentistry market after a market study found that it is not always working in the best interests of patients.

The OFT study found that patients have insufficient information to make informed decisions about their choice of dentist and the dental treatments they receive. Alongside this, a new survey conducted as part of the study suggests that each year around 500,000 patients may be provided with inaccurate information by dentists regarding their entitlement to receive particular dental treatments on the NHS, and as a result they may pay more to receive private dental treatment.

The report also raises concerns about continued restrictions preventing patients from directly accessing dental care professionals, such as hygienists, without a referral from a dentist. The OFT considers these restrictions to be unjustified and likely to reduce patient choice and dampen competition.

The OFT also highlights concerns with the current NHS dental contracts in England. As the majority of these contracts are not time-limited, and only a small volume of new contracts are put out to tender each year, it is extremely difficult for new dental practices to be established, and successful dental practices which offer a higher quality of service to NHS patients are prevented from expanding.

Other issues of concern highlighted in the report include the complexity of the complaints process for patients and instances of potential pressure selling by dentists of dental payment plans.

The OFT has identified a wide-ranging package of recommendations to address these concerns, which includes:

  • Provision of clear, accurate and timely information for patients - the OFT is calling on NHS commissioning bodies, the General Dental Council and the Care Quality Commission to be proactive in enforcing existing rules which require dentists and dental practices to provide timely, clear and accurate information to patients about prices and available dental treatments. 
  • Direct patient access to dental care professionals - the OFT urges the General Dental Council to remove restrictions preventing patients from making appointments to see dental hygienists, dental therapists and clinical dental technicians directly, as soon as possible. 
  • Reform of the NHS dental contract in England - the OFT is urging the Department of Health to redesign the NHS dental contract to facilitate easier entry into the market by new dental practices and allow successful practices to expand. The OFT is not convinced that indefinite contracts to supply NHS dentistry are in the best interests of patients.
  • Simplification of the complaints process - the OFT considers that the current system should be reformed to make it simpler, easier and less time consuming for patients and dentists to resolve complaints.
  • Sale of dental plans - following discussion with the OFT, the British Dental Association has agreed to develop a robust and effective code of practice covering the sale of dental payment plans.

John Fingleton, OFT Chief Executive said:

'Our study has raised significant concerns about the UK dentistry market which need to be tackled quickly in the interest of patients. All too often patients lack access to the information they need, for example when choosing a dentist or when getting dental treatment. We also unearthed evidence that some patients may be receiving deliberately inaccurate information about their entitlement to NHS dental treatment, and we expect to see robust action taken against such potential misconduct by dentists.

'This study has also highlighted that the current NHS dental contract in England may well not be working in the best interests of patients, and that regulations unjustifiably restrict patients from getting direct access to dental care professionals like hygienists. Reform in both these areas is needed without delay.'

NOTES

  1. The OFT's market study and research are available to download from the project page
  2. OFT market studies are carried out under section 5 of the Enterprise Act 2002 (EA02) which allows the OFT to obtain information and conduct research. Effectively, they allow a market-wide consideration of both competition and consumer issues. They take an overview of regulatory and other economic drivers in the market and consumer and business behaviour. Possible outcomes of market studies include: enforcement action by the OFT, a market investigation reference to the Competition Commission (CC), recommendations for changes in laws and regulations, recommendations to regulators, self-regulatory bodies and others to consider changes to their rules, campaigns to promote consumer education and awareness, or a clean bill of health.
  3. The OFT has provisionally concluded that it is not appropriate to make a market investigation reference on the UK dentistry market to the Competition Commission at this time, and invites views on the proposed decision. Interested parties are invited to submit responses to this consultation by 5pm on 10 July 2012 to dentistry@oft.gsi.gov.uk or in writing to the Dentistry Market Study Team, Services and Infrastructure Group, Office of Fair Trading, London, EC4Y 8JX.
  4. The OFT is unable to provide advice or resolve individual complaints for consumers. The Citizens Advice consumer service provides free, confidential and impartial advice on consumer issues. Visit www.adviceguide.org.uk or call the Citizens Advice helpline on 08454 04 05 06

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