NHS:
2000 PCA(D)20
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Health
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St Andrew's
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GENERAL DENTAL SERVICES INTRODUCTION OF DENTAL POINT OF TREATMENT CHECKS Summary 1. This letter advises Primary Care Trusts and Island Health Boards of the introduction of new checking procedures when a patient claims entitlement to exemption from or remission of NHS dental charges, via dental point of treatment checks. Action 2. NHS: 2000 PCA(D)16, issued on 2 November 2000, advised of a delay to the introduction of dental point of treatment checks. Primary Care Trusts and Island Health Boards are asked to note that these checks will now commence with effect from 15 January 2001. 3. Information on how to undertake point of treatment checks has been produced in the "Dental Point of Treatment Checks A guide for dentists and dental staff", 2 copies of which have been sent directly to dentists together with the attached Memorandum. 4. Primary Care Trusts and Island Health Boards are asked to ensure that dentists taking part in emergency dental service arrangements are made aware of the introduction of point of treatment checks and that copies of the guidance on undertaking the checks are made available to them. A supply of the "Dental Point of Treatment Checks A guide for dentists and dental staff" will be sent to Primary Care Trusts/Island Health Boards for this purpose. Further copies can be obtained from Sheila Taylor at the |
Addresses For information
Chief Executive, Director, Head of Fraud Investigation Unit Tel: 0131-244 2466 _________________________ |
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Scottish Executive Health Department, Room 31,St Andrew's House, Edinburgh, EH1 3DG (Telephone 0131 244 2469 or e-mail Sheila.S.Taylor@scotland.gsi.gov.uk). 5. 'Don't take a bite' posters and leaflets have already been issued reminding patients of entitlement to free NHS dental treatment and help with the cost of treatment. The leaflet has been revised to cover PoT checks and supplies will be sent directly to dental practices prior to the checks starting. The Scottish Executive will hold a small supply of the revised leaflet and Primary Care Trusts/Health Boards can obtain copies from Sheila Taylor, contact details as at 4. above. 6. A new patient information leaflet is being produced which will explain the patient Penalty Charge (see paragraphs 8 and 9 of the Memorandum to this letter). Initial supplies of the Penalty Charge leaflet will be sent to Primary Care Trusts/Health Board in due course, without requisition, for onward distribution to dental practices. Further supplies can be ordered from Banner Business Supplies Distribution Centre (formally The Stationery Office) in the usual way. Yours sincerely
DR HAMISH WILSON
MEMORANDUM TO NHS: DENTISTS INTRODUCTION OF DENTAL POINT OF TREATMENT CHECKS
2. The Memorandum to NHS: 2000 PCA(D)16, issued on 2 November 2000, advised of a delay to the introduction of dental point of treatment checks. These checks will now commence from 15 January 2001. 3. The new Point of Treatment (PoT) checking procedures have been agreed with representatives of the profession. They will be simple to operate and non-threatening to your patients. The requirement to carry out the new checks will be reflected in additional remuneration. What will this mean to you? 4. Previously, when a patient has claimed that they do not have to pay NHS dental charges, their word has been taken for this and no further checks have necessarily been made in the surgery. (The exception to this has been when partial help with NHS charges is awarded under the NHS Low Income Scheme and the HC3 charges certificate needs to be seen in order to know the amount the patient has to pay). 5. The Dental PoT checks have been designed to be as straightforward and quick as possible. You or your staff already have to ask patients whether they pay NHS charges for their treatment. The new requirement is for a supplementary question to ask those who claim exemption or remission whether they have the appropriate evidence to support that claim. 6. Where a patient is unable to produce acceptable evidence of their entitlement, you should carry out their treatment in the usual way but the GP17 or GP17PR form is to be marked with an 'X' in the 'Evidence not seen' box. 7. Forms marked in this way will become subject to later checks by the Fraud Investigation Unit (FIU) to establish whether the patient's claim is correct. These further checks should not usually involve you or your practice staff. Any queries or follow up action will be raised directly with the patient or their representative, if necessary. In the meantime Practitioner Services Division (Dental) will pay you the appropriate treatment fees in response to your GP17 claim in the normal way. The payment will not need to be reviewed even if it is subsequently established that the patient was not entitled to claim exemption of or remission from NHS charges. What happens when claims of exemption or remission are checked by the FIU? 8. If claims are not substantiated, the FIU will ask the patient to pay the appropriate charge. The FIU will collect all such charge income directly from the patient. In addition, the FIU may also impose a Penalty Charge on the patient, since sections 99ZA and 99ZB of the NHS (Scotland) Act 1978, as inserted by section 59 of the Health Act 1999 provide for a penalty charge to be imposed where a person fails to pay any amount in respect of NHS charges. The penalty charge is the lesser of 5 times the unpaid charge or £100. 9. A new patient information leaflet is being produced which will explain the Penalty Charge. Initial supplies of the Penalty Charge leaflet will be sent to dental practices in due course, without requisition. Further supplies can be ordered from your Primary Care Trust/Health Board in the usual way. Information dentists and their staff will receive 10. 2 copies of the guidance on Dental Point of Treatment checks are enclosed for yourself and your staff to enable you to familiarise yourselves in time for the introduction of the checks on 15 January 2001. The guidance details the procedures needed and the circumstances under which the patient may be eligible not to have to pay their NHS dental charges. 11. The guidance includes illustrations of acceptable evidence, examples of how to deal with situations likely to be encountered during checking and responses to likely queries from patients. The guidance also contains helpful information for dentists, staff and patients - such as the number of the NHS Helpline for PoT check queries. 12. 'Don't take a bite' posters and leaflets have already been issued reminding patients of entitlement to free NHS dental treatment and help with the cost of treatment. The leaflet has been revised to cover PoT checks and supplies will be sent to you prior to the checks starting. Please ensure that the poster and leaflets are displayed prominently. GP17PR 13. The Dental Point of Treatment Checks Guidance went to print before the revised GP17PR was finalised. The example of the GP17PR in the guidance is therefore the previous version. The GP17PR part numbers have, however, remained the same and the guidance at part 5.4 still applies.
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