Dental Health for Service Families
1. Dentistry in the UK
Introduction
We receive regular enquiries from Service families living across the UK who are facing difficulties accessing NHS dental services. We continue to gather evidence about the current situation and present this to NHS England, the Department of Health and Social Care and the MOD Armed Forces Covenant teams, to help inform future policy decisions and raise awareness of the additional challenges that our Armed Forces families face.
If you find that you are encountering problems gaining access to an NHS dentist, or continuing with a course of treatment, such as orthodontic care, when you are assigned and these problems are directly attributable to you being part of a serving Armed Forces family, please contact us via contactus@nff.org.uk or call 023 9265 4374. We are keen to build up a national picture, working in conjunction with the Army and RAF Families Federations, to identify where Service families face problems accessing NHS dental services, and we will continue to present this evidence to the NHS.
- Impact of Covid-19 on the provision of dental services
Unfortunately, COVID-19 significantly impacted NHS dental services and changes had to be made to manage services safely during the pandemic. NHS Dental Practices were therefore working at a much lower capacity in terms of number of appointments available as they had to follow social distancing and hygiene rules.
- Community Dental Services
The Community Dental Services provide treatment for people who may not otherwise seek or receive dental care, such as people with learning disabilities, housebound people, and people with mental or physical health problems or other disabling conditions which prevent them from visiting a family dentist.
The Current Situation – Accessing NHS Dental Services
Under the provision of the National NHS General Dental Services, NHS patients are not registered with a dentist in the same way that they are registered with a GP for primary medical services. A dentist is only obliged to provide ongoing treatment for a period of 2 months at a time from the start of a course of treatment. There is no contractual requirement for dentists to maintain a registered list or guarantee access to an individual. This has been the case since the introduction of the National NHS GDS dental contract in 2006.
This means that you can remain with the dental practice you were previously having treatment under (if feasible) as long as you have regular treatment. Often families are unaware that there is no catchment area for dentists and that they can legitimately still see a dentist in their previous posting location, although we realise that due to distances involved this is not always a practical solution.
While the ideal situation would be for you to access NHS dental care in your local area, we know that there are ‘hotspots’ in some areas which can make this very difficult, so you may need to consider accessing NHS dental services further afield.
Finding information
- More information about how to find an NHS Dentist can be found here:
- Other sources of information:
- Dental Choices checks the NHS daily so their list of NHS dentists taking on new patients is as up-to-date.
- You may also want to keep checking your local Healthwatch website as they often have up to date information about NHS dental services in their area.
Changes to the NHS Dental Contract
Patients across the country will benefit from improved access to dental care under changes announced by NHS England in July 2022. New reforms to the dental contract – the first in 16 years – mean NHS dentists will be paid more for treating more complex cases, such as people who need three fillings or more.
Dental therapists will also be able to accept patients for NHS treatments, providing fillings, sealants, preventative care for adults and children, which will free up dentists’ time for urgent and complex cases.
To make services more accessible for people, dentists must update the NHS website and directory of services so patients can easily find the availability of dentists in their local area.
Emergency Dental Care
If you require urgent dental care, you should contact NHS 111 and they will connect you to an Emergency Dental Service.
NHS England Customer Care Centre
If your search still doesn’t provide you with access to a dental practice taking on NHS patients you can also try contacting the NHS England’s Customer Care Centre: call 0300 311 22 33 or email england.contactus@nhs.net If you are struggling to access NHS dental services, or if you are mid-way through a course of treatment which you cannot continue, as a direct result of a Service posting, please ensure that you make the Customer Care team aware and let them know that you are part of a mobile Service family.
- Visit the NHS website to find out more about NHS Dental Charges.
- Private Dental Care:
Some families are opting to access private dental care and there are a number of options available through companies such as MyDentist or by signing up to DenPlan.
Some dental practices operate a children’s list, so if a parent is a private patient, they may be able to offer NHS treatment to their children – the Practice will have more information about this.
*Please note that the NFF does not endorse any private dental companies, these links are for your information only.*
2. NHS Orthodontic Transfer Information
Armed Forces entitlement
The Armed Forces Covenant is a “promise from the nation that those who serve or have served, and their families, are treated fairly”. Due to the transient nature of their role, the Armed Forces and their families should retain their relative position on any NHS waiting list if moved around the UK due to the Service Personnel being assigned.
General Information
The following sections are for use when patients request an orthodontic case transfer either within the UK or from abroad. It is recognised that patients receive the best treatment outcome by completing their treatment under the care of one orthodontist. NHS Orthodontic treatment can take between 18 months to over 2 years. The average length of time of treatment is 21 months.
Orthodontists with existing NHS contracts in England can accept a patient who has moved from another part of the country (or from overseas) who is already waiting for or undergoing NHS orthodontic treatment. Most orthodontists operate two waiting lists; one for assessment and one for treatment. The assessment appointment will determine NHS eligibility e.g. whether a patient can be treated under the NHS and prioritise clinical need.
Transfers within the UK
Waiting list
Q: What if I am on a waiting list for orthodontic treatment and I move home within the UK?
A: If a patient moves and needs to change orthodontists, the current orthodontist should discuss alternative orthodontic providers with the patient and arrange a direct referral to the preferred provider. As Armed Forces and their families should retain their relative position on the waiting list, the referring orthodontist should provide the date of the patient’s acceptance on their list to the new provider to ensure their relative position is retained.
Moving away whilst receiving treatment
Q: What if I am receiving orthodontic treatment and I move home within the UK?
A: A patient should remain with their current orthodontist, if at all possible. If the patient requests a transfer, the treating orthodontist should discuss alternative orthodontic providers with the patient and arrange a direct referral to the preferred provider to continue treatment.
Transfers from Abroad
Where a patient begins treatment abroad (not just EEA) and returns to the UK and is entitled to NHS care, NHS criteria is applicable and not the criteria from the country where they began treatment. The patient should have been under 18 at the point of referral, have had an Index of Treatment Need (IOTN) of at least 3.6 and have good oral health. Patients can find information on who currently provides dental and orthodontic treatment on the NHS Choices website. Patients can enter their postcode and the treatment they require, and a list of practices will be displayed.
Patients should contact their preferred dental practice to arrange an initial appointment and discuss a referral to an orthodontist if appropriate. Alternatively, your GDP may refer you to an orthodontist for their clinical opinion.
Waiting list
Q: I have moved to the UK and have been on a waiting list for orthodontic treatment abroad. Can I access treatment?
A: Follow the general information which provides advice on how to find a local NHS dentist and orthodontist. Upon referral, if the orthodontist deems that the patient meets NHS criteria, the orthodontist will agree the appropriate waiting time based on clinical need and the need to retain the patient’s relative position on the waiting list. In order for the patient’s relative position to be retained, it would be useful for the patient to provide evidence of how long they have been waiting for treatment (e.g. date of patient acceptance on overseas waiting list).
Moving away whilst receiving treatment
Q: I have moved to the UK and have been receiving orthodontic treatment. How can I continue my treatment?
A: Follow the general information which provides advice on how to find a local NHS dentist and orthodontist. Patients should arrange for their original patient records including study models, radiographs, photographs and notes to be provided so that an NHS orthodontist can confirm whether they would have met NHS criteria on their original assessment date (i.e. that they were under 18, an Index of Treatment Need (IOTN) of at least 3.6 and have good oral health).
If the orthodontist feels that the NHS criteria would have been met, a course of treatment within the NHS can continue to be provided; If the orthodontist does not feel that the NHS criteria would have been met, or original patient records are not provided, a course of NHS treatment will not be provided.
Further information
If you have any further queries concerning orthodontic transfers, the Customer Contact Centre is the point of contact for patients and their representatives wanting information about accessing primary care (GP, dental, optical and pharmacy services). Any queries can be directed to NHS England’s Customer Care Centre, as follows:
Telephone: 0300 311 22 33
Email: england.contactus@nhs.net
3. ISODET locations
As there are no Service provisions for dental care by Defence Primary Healthcare (DPHC) (Dental) in ISODET locations, personnel are authorised to seek dental treatment from local civilian dental practitioners.
Dental treatment is accessed via One HMG Healthline (HEALIX) and provided by local Host Nation dental practitioners. Prior to attending any dental appointments, contact should be made with One HMG Healthline who will provide further clarification on their processes to follow and they will also provide the relevant forms and paperwork to take to your appointment.
Prior authorisation for all ‘non-routine’ dental treatment must be obtained from One HMG Healthline healthline@healix.com before the treatment can be carried out. Further details can be found in 2020DIN01-091. Patients are strongly recommended to acquaint themselves with this document prior to booking any dental appointments. All treatment requires authorisation from One HMG Healthline for funding before undertaking the treatment.
If One HMG Healthline is not available in your current location, prior approval is obtained from DPHC (Overseas) using 2021DIN01-113. Patients are strongly recommended to acquaint themselves with this document prior to booking any dental appointments. Guidance and prior approval can be sought from UKStratCom-DMS-DPHC-HQODen-Supp@mod.gov.uk.
Dental Fitness prior to Overseas Assignment. All Service, Entitled Personnel, and Civil Servants are to ensure they are dentally fit before taking an assignment abroad. With enough notice, DPHC(Dental) staff will prioritise treatment to SP who are assigned to isolated locations. All entitled personnel are to ensure they have a dental examination and all associated routine treatment completed prior to commencement of the overseas assignment. All family members are required to complete dental clearance through the One HMG Healthcare Hub up to 6 months prior to their posting. Dependants departing without dental clearance may not be entitled to full dental care while overseas.
You will also find location-specific dental care information on Global Support Organisation – GOV.UK (www.gov.uk). For more patient-focused information you can also visit the ISODET Dental Care -Rest of World page on My Healthcare Hub on Defence Gateway.