NHS Fine Dentist £150K For Keeping His Patients’ Teeth Too Healthy

A national health service dentist has revealed that the NHS is fining him £150,000 ‘because his patients are too healthy.

Rob Mews says his surgery in Exmouth Devon is being forced to pay £150,000 back to the health service because his patients ‘are being looked after better’. His practice has around 19,000 NHS patients and is one of the few left in the county still taking any.

He told the Mirror newspaper that he believes passionately in the NHS and its founding principle that it should care for patients from “cradle to grave” and that is why his practice still treats NHS patients.

His prcatice could earn hundreds of thousands of pounds more by going private.

The Mirror reports: Rob is currently being fined £150,000 by the NHS in a funding “claw back” effectively for keeping his patients too healthy with regular check-ups and preventative work. It is an example of the widely discredited NHS dental payment contract which is causing dentists to quit the health service in their droves to see only private patients.

Every Thursday the practice opens its NHS books to local kids who have not seen a dentist in years – and in some cases have never seen one.

Rob, who himself has three children aged ten, eight and four, said: “That’s one of the reasons I do it because I have young children but it’s quite emotional. We were seeing four and five year olds who had so much decay we just had to send them to hospital to get extractions. There’s such a backlog of sending these kids to have general anaesthetic to get the teeth out so we’re trying to maintain them until they get their teeth extracted.

“One of the dentists saw a seventeen year old who hadn’t seen a dentist in ten years and needed 28 fillings. You’ve got really emotional parents that are feeling really guilty that they have got themselves into this position. One of our nurses said she couldn’t work on that list because it was too upsetting because she has kids of a similar age. It’s a really sad situation.”

Fairfield House Dental Surgery has been running for over 100 years. Rob became a partner in 2012 before becoming owner when another partner retired in 2017. The practice does free supervised tooth brushing at local primary schools as well as sending practitioners to breast feeding and toddler groups to educate parents.

Rob, 43, said: “We’re blessed with a group of patients who’ve been with us for a long time, some have been coming here for more than 50 years. So that’s why I’m still with the NHS because it feels like the right thing to do, to keep going for them. It’s a kind of cradle to grave service which is what the NHS was supposed to be. But that’s the only reason we’re doing it – out of good will.”

Why is top dentist being ‘fined’ £150,000 for keeping his patients’ teeth too healthy?

Rob Mew owns a rare example of a thriving NHS dental practice in the middle of a dental desert. Fairfield House Dental Surgery employs ten dentists and does free outreach work in the local community to improve oral health.

However when we visited the surgery was in the process of returning £150,000 to the NHS because it had not carried out enough Units of Dental Activity (UDA). It was having to pay £50,000 a month over three months.

UDAs are the metric used by the NHS in its dentistry payment contract which has been deemed “not fit for purpose” by Parliament’s Health and Social Care Committee.

The contract requires practices to agree to perform a set number of UDAs – and they are penalised if they come in below or above this. A check-up is worth one UDA while giving a patient a filling racks up three UDAs.

Rob told the Mirror: “We are being penalised for preventing patients requiring more UDAs. We have £150,000 ‘claw back’ this year but we have 19,000 NHS patients which is more than the practice has ever had. The clawback is for not doing enough UDAs but when patients are being looked after better they don’t have as much need for dental work.”

The contract requires practices to agree to perform a set number of UDAs – and they are penalised if they come in below or above this. A check-up is worth one UDA while giving a patient a filling racks up three UDAs.

Rob told the Mirror: “We are being penalised for preventing patients requiring more UDAs. We have £150,000 ‘claw back’ this year but we have 19,000 NHS patients which is more than the practice has ever had. The clawback is for not doing enough UDAs but when patients are being looked after better they don’t have as much need for dental work.”