A dental practice in the Barnet area

4. Mr H complains that, between April and September 2024, the Practice used different price bandings for differing courses of his care and treatment and did not properly explain the fees of the treatment he was to receive.

5. As a result, Mr H says the Practice overcharged him for his treatment, leaving a debit balance on his account, and referred the matter to a Debt Collection Agency (DCA) for fees he did not believe he owed.

6. He says being contacted by a DCA caused him anxiety and stress, particularly as his partner was undergoing treatment for cancer at the time. He is also concerned this situation could affect his credit rating.

7. As an outcome, Mr H seeks to have the charges amended to reflect the original fees he agreed to and for the DCA to stop pursuing him for the debt.

8. In April 2024, Mr H visited the Practice for emergency treatment for toothache. It performed an X-ray and gave him antibiotics and advised he return for an examination as it appeared further treatment may be required. It charged Mr H NHS band 1 fee of £26.80 for this course of treatment, which he paid in full.

9. In May, Mr H attended for an examination and received further X-rays. He was told he required fillings, Root Canal Treatment (RCT) and antibiotics. The Practice completed a filling and RCT begun. Because of its complexity, it referred Mr H to a specialist to complete the RCT. It charged an NHS band 2 fee of £73.50 for this course of treatment, which Mr H paid in full.

10. Root canal treatment is a dental procedure used to treat infection at the centre of a tooth.

11. Mr H booked an appointment for further work to take place in June, but later cancelled it, saying he would call back to reschedule. In mid-June, the Practice contacted Mr H by letter and text, advising him to book a new appointment to complete his treatment. As Mr H made no further appointment, the Practice closed this course of treatment.

12. In September, Mr H returned for the further work to be completed, which included a filling, a repair of a tooth and the preparation and fitting of a crown. On completion of the treatment at the beginning of October, the Practice charged Mr H an NHS band 3 fee £319.10, which he partially paid.

13. As part of the charges remained unpaid, the Practice contacted Mr H for payment. Mr H complained as he believed the charges were incorrect. In October, the Practice responded, confirming the charges were accurate.

14. In November, the Practice reviewed the complaint at Mr H’s request and upheld its original decision.

15. Because of the unpaid balance, the Practice referred the matter to a DCA, which later reported being unsuccessful in recovering the fees.

19. Before we decide if we should investigate a complaint, we look at whether there are signs the event complained about had a negative effect which the organisation has not put right. We have done this, and we have found the Practice has already done enough to put right the impact of these events.

20. Mr H says the Practice used different price bandings for differing courses of his care and treatment and did not properly explain the fees of the treatment. He says this meant it overcharged him for the treatment he received.

21. Mr H told us he understood the £73.50 fee he paid in May 2024, for NHS band 2 would cover all treatment he was to receive, included the completion of his RCT, a referral to a specialist to complete this, and a crown.

22. Mr H’s partner explained the delay in Mr H rebooking the appointment between June and September, was because of her treatment for a cancer diagnosis. She says once she received reassurance in July that her condition was stable, Mr H resumed arranging appointments, including for his dental care.

23. The Practice responses explained that it charged Mr H three times as it opened three separate courses of treatment. It said the first course for emergency treatment took place in April 2024, when it charged Mr H £26.80, in line with NHS band one for the emergency treatment he received.

24. It explained the second course of non-urgent treatment took place between May and June. It said, since Mr H cancelled his June appointment and did not rebook, despite being sent a letter and text message about his outstanding treatment, the Practice closed the course. It said as this course included RCT work, it applied a charge of £73.50 in line with NHS band two.

25. The Practice explained it opened a third course of treatment in September. It said it could not continue the earlier course as more than three months had passed since the last treatment. Therefore, it opened a new course.

26. It explained, as Mr H had a crown completed and fitted during this course of treatment, it applied a charge of £319.10 in line with NHS band three of which it had discussed with Mr H. The Practice also apologised for any confusion caused.

27. We considered whether the Practice charged Mr H correctly for his treatment and whether it properly informed him of the costs. To do this, we first looked at the NHS dental charges for 2024.

28. This explains, • Urgent dental treatment – £26.80 • This covers urgent care in a primary care NHS dental practice such as pain relief or a temporary filling

• Band 1: £26.80 • Covers an examination, diagnosis and advice. If necessary, it also includes X-rays, a scale and polish (if clinically needed), and planning for further treatment.

• Band 2: £73.50 • Covers all treatment included in Band 1, plus additional treatment, such as fillings, root canal treatment and removing teeth (extractions).

• Band 3: £319.10 • Covers all treatment included in Bands 1 and 2, plus more complex procedures, such as crowns, dentures and bridges.

29. It also explains ‘if within 2 calendar months of completing a course of treatment, you need more treatment from the same or lower charge band, such as another filling, you do not have to pay anything extra.’

30. It continues, ‘If the additional treatment needed is in a higher band, you'll have to pay for the new NHS course of treatment. But once 2 months have passed after completing a course of treatment, you'll have to pay the NHS charge band for any NHS dental treatment received.’

31. Our Principles say, ‘public bodies should do what they say they are going to do. If they make a commitment to do something, they should keep to it, or explain why they cannot.’

32. Our ‘Complaint standards’ say, organisations should openly identify instances when things have gone wrong and take responsibility for these.

33. The records show Mr H received emergency treatment in April and non-emergency treatment, including fillings and RCT, between May to June. We can see the Practice offered Mr H the treatment as an NHS patient, which he agreed to, as he advised he could not afford to have the treatment he required privately because of the cost.

34. The information shows the Practice provided Mr H with treatment plans showing the treatment he was to receive, and the charges of £26.80 (band one) and £73.50 (band two) respectively for each course.

35. We can see the May treatment plan mistakenly included the casting of a crown (shown as Band 3) as part of the £73.50 charge, which appears to have been an administrative error. However, as Mr H did not return to the Practice for the crown casting or fitting until September, over two months after his last treatment, this course of treatment was closed. The £73.50 charge he paid for his May to June treatment was correct for the treatment he had received, which included the RCT, and was in line with NHS price banding.

36. Records show that when Mr H attended again in September, he queried the cost of this course of treatment. The information shows the Practice explained the above and that it would charge the crown as band three because of being a new course and higher-level treatment. It explained should Mr H not be happy with this, that he takes time to think about the charges and reschedule his appointment. It also apologised for any confusion caused by its administrative error. This explanation appears to follow our Principles and complaint standards.

37. We can see Mr H agreed to continue with the treatment and signed a new treatment plan showing the charge to pay of £319.10. This charge aligns with the correct price band for the September course of treatment Mr H received of a crown.

38. We understand there may have been confusion because of the charge on the May treatment plan compared to the September charges. We also appreciate that Mr H focused on his partner’s diagnosis as a priority in June. Based on the treatment Mr H received, the time elapsed between treatment courses, and the explanations given to him in September before he agreed to proceed with treatment, the evidence shows the Practice appropriately explained the costs and charged correctly for the treatment received and agreed to.

39. Overall, we consider the Practice charged Mr H in line with the correct price bands for the treatment he received and gave him the necessary information to decide whether to continue with his treatment. The actions were consistent with the NHS webpage and our Principles, so there are no indications anything went seriously wrong.

40. We recognise Mr H’s situation and understand how confusing this experience may have been for him. We are pleased to see the Practice apologised for its administrative error and we think this is enough to put this right for Mr H. We hope our explanation provides reassurance that the Practice followed the correct process when charging him for the treatment he received.

1. We have carefully considered Mr H’s complaint about the care and treatment he received from the Practice. We are sorry to hear Mr H’s concerns about his treatment charges and how he says this affected him.

2. We have seen no indication that anything went seriously wrong in the way the Practice charged Mr H for his treatment. Where the Practice did make mistakes, it appears it has already done enough to put things right.

3. We will explain our decision in detail below. We hope this will help Mr H to understand our decision and give some reassurance about what happened.