Is NHS Protect dental fraud allegation true?

Although NHS Protect's come to the conclusion that some dentists are acting fraudulently there is little proof of this in its report. 5000 patients were written to about treatment received as long ago as March 2010. In three quarters of cases no fraud was found and in a further 23% the patient refused to reply or couldn't remember. This left just 3% (187 in all) where something potentialy suspicious was found. In half of these the patient claimed not to have received the banded treatment claimed, and in 27% of them there appeared to be a split course of treatment.

From this flawed data, NHS Protect extrapolated to the sensational headline that there is £70m of fraud across NHS dental contracting.

NHS dentists see this story as a sign of a new initiative about to emerge from Department of Health that will restrict or clamp down on dentists in some way, which in turn, will increase the numbers of dentists quitting NHS dental contracts.

 

The report estimated that for all treatments combined 3.49% of dentist claims were 'inapporpritae. This is estimated to equate to a figure of 992,100 suspected inappropriate FP17s in England overall, with a loss to the NHS of £73.188 million and a suspected loss of 2,925,300 UDAs.


The report admits that it applied the civil rather than the criminal definition of fraud. On splitting courses of treatment it also admits 'there are no specific rules forbidding dentists from splitting up courses of treatment' and very importantly, in some cases this is clinically justified.


It also concludes that there is an ongoing risk to the value of £146.38m while the current dental contract is in place.
Minister, Lord Howe sid, that it showed the current dental contract was not fit for purpose and needs to change.
CDO, Barry Cockcroft urged 'colleagues in the profession' to report any suspicions of fraud and corruption.

NHS Protect website is here.  NHS Protect News page is here.

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