Dentist did not offer patient NHS treatment and NHS England did not resolve the complaint

What happened

In very early 2013 Mrs W saw her dentist about pain around a tooth. The dentist identified an infection at the site of an old root canal filling, and prescribed antibiotics. She told Mrs W to come back if the infection continued. A week later, Mrs W went back with continuing pain but she could not carry on with treatment because of a family bereavement.

Mrs W returned to the Dental Practice in spring 2013 for a check–up. An X–ray to the tooth showed that the infection had worsened. The dentist told Mrs W that she needed private treatment because the tools used in NHS treatment would not be good enough.

Mrs W complained shortly afterwards that the Dental Practice did not offer her NHS treatment and had misled her. The Practice did not accept that it had failed Mrs W, so she and her husband, Mr W, went to NHS England. As the Practice had asked them to find alternative dentists, they also asked NHS England to help them do this.

NHS England correctly told Mr and Mrs R that it was unable to act as a second tier in the complaints process, but it wrote to the Practice and told it that it had acted incorrectly by not offering NHS treatment and by stating that NHS treatment would be of inferior quality. NHS England did not respond to the request to help Mr and Mrs W find a new dentist.

What we found

Shortcomings in the dentist's treatment plan meant that Mrs W was not given the information she needed to make an informed choice about her treatment. She was misled into believing that the treatment she needed could not be provided to the necessary standard by the NHS. This falls short of the expectations of the NHS dental contract and the General Dental Council's Standards for the Dental Team. Furthermore, the Dental Practice's decision to deregister Mrs W in the middle of a course of treatment was not fair and was clearly prompted by the complaint. The Practice therefore failed to meet accepted standards in respect of this decision.

We were critical of NHS England for its delay in responding to the complaint. NHS England was aware of failings in the service given by the Practice and of inadequacies in the Practice's response to the complaint, but it failed to act in Mr and Mrs W's best interests and settle the complaint earlier. Finally, we criticised NHS England for ignoring Mr and Mrs W's repeated requests for help finding an alternative NHS dentist to carry out Mrs W's treatment.

Mrs W could not make an informed choice about her dental treatment. She did not receive timely dental treatment and she had unnecessary inconvenience and discomfort as a result. She had the trouble of having to complain and find a new dentist.

Putting it right

We asked the Dental Practice to apologise and pay Mrs W £600. We also asked it to explain to her how it would avoid a recurrence of these failings.

We asked NHS England to apologise to Mr and Mrs W, pay them £250 and explain what it has done and/or plans to do, to stop these failings happening again.