VULNERABLE dental patients are being forced to wait up to three months for NHS treatment costing over £350 because the approvals system "is in meltdown".
The British Dental Association in Scotland has been contacted by members who are becoming increasingly frustrated by lengthy delays in getting the go-ahead for treatment plans, with many dentists footing the bill themselves rather than wait for funding.
Cancer patients, dementia sufferers, elderly in nursing homes and children requiring orthodontic care are among those who have been hit by a bottleneck in turnaround time for approvals.
Dentists are required to submit treatment plans to the Practitioner Services Division in Edinburgh for "prior approval" if the cost of dental work to the NHS exceeds £350. This typically includes treatment such as fitting dentures, braces or dental implants.
The problem has been blamed on staff shortages in PSD, as well as a 2.51% hike in dental fees last October which has pushed more treatment packages over the £350 threshold. There is also frustration that the progress of requests cannot be monitored electronically as the system has yet to be computerised, with dentists instead filling out paper forms and sending them through the post.
The PSD's internal target for turnaround time for approvals is 95% within 20 days, but reported that it had responded within the 20-day timescale in just 60% of cases during the period October to December last year.
BDA Scotland believes the figures could be much worse and it has been contacted by a number of dentists who have waited between 56 to 90 days for approval.
Glasgow dentist David McColl, who is deputy chairman of the Scottish Dental Practice Committee, said the pace of approvals had become "steadily worse" over the last few years and he and colleagues were now waiting six weeks on average for approval.
Mr McColl said: "I had one that was a lady who lost her dentures because she had dementia. We sent off the prior approval form on February 6, but it didn't arrive back until April 30. That's a fairly straightforward case, no x-rays or anything else, but for some reason it took more than six weeks.
"I've spoken to another three colleagues in Greater Glasgow and Clyde and they all said 50% of their cases were taking well over the 20-day target to come back. It's a nonsense. My practice is fully computerised but we still have to fill out bits of paper and send them through the post to get prior approval."
Pat Kilpatrick, director of BDA Scotland, said: "The system is set up to fail because they have set the threshold so low and when they increased the treatment fees last year they didn't increase the threshold, so even more cases have to go for prior approval. It's at breaking point and dentists are feeling that, from a quality perspective, this is getting worse for patients.
"We can do more now to restore people's teeth, we can do more now to improve their oral health, we can do amazing things in dentistry now. That's all improving, but we have this issue of if you are an NHS patient and your treatment is going to cost over a certain amount then you just have to wait.
"There are lots of examples in care homes of elderly people who have lost their dentures and wait for weeks for a new set. That's a horrendous situation."
A spokeswoman for the Scottish Government said: "Cases requiring prior approval represent less than 1% of all treatment provided, with more than 99% of treatment being provided by dental practitioners without the need for approval.
"Currently, the majority of general prior approval cases are being seen with a decision made within the target date of 20 working days. However, we are aware there is some delay in clearing orthodontic cases, and that Practitioner Services are addressing this issue."
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