Dentistry@BD4 is committed to providing safe, prompt and high-quality dental care.
Appointment time is limited. Missed appointments, late cancellations, repeated late arrivals and failure to complete planned treatment prevent other patients from accessing care and cause significant costs to the practice.
This policy explains:
The policy will be applied fairly and consistently. Exceptional circumstances, disabilities, communication needs, safeguarding concerns and reasonable adjustments will be considered before a final decision is made.
Unlike GP practices, NHS dental practices do not hold a permanent registered-patient list.
Being seen by Dentistry@BD4 previously does not guarantee that the practice will always be able to offer further NHS appointments.
The practice receives a limited NHS contract and must use its available NHS appointments responsibly. Priority may be given to patients who:
Where NHS appointments or treatment are repeatedly declined, cancelled, missed or not completed, the practice may prioritise its limited NHS capacity for other patients.
If the patient later requests the same or further treatment, an NHS appointment may no longer be available. The practice may only be able to offer a private appointment at that time.
Private treatment will be optional and provided only with the patient’s informed agreement. The patient may instead approach another NHS dental provider or contact the local Integrated Care Board for help finding NHS care.
Patients are responsible for:
Text messages, emails, letters and telephone calls are courtesy reminders only. Patients remain responsible for attending even if a reminder is not received.
Appointments must not be booked provisionally when the patient does not intend or is unlikely to attend.
Patients should arrive at least five minutes before their appointment.
Patients should plan for foreseeable traffic, public transport and parking delays.
If a patient arrives more than five minutes late, the clinician will decide whether there is enough time to provide care safely without delaying other patients.
The decision will take account of:
If there is insufficient time, the patient will not be seen and the appointment may be recorded as a missed appointment or short-notice cancellation.
Repeated late arrival may result in the practice being unable to offer further routine NHS appointments. If the patient later requests care, only a private appointment may be available.
Patients must provide at least 48 hours’ notice when cancelling or rearranging an appointment.
The notice period is calculated using the practice’s normal working days and opening hours. Weekends and bank holidays are not included.
Patients should telephone the practice as soon as they know they cannot attend. A voicemail, email or text cancellation is not confirmed until it has been received and acknowledged by the practice.
Genuine emergencies and exceptional circumstances will be considered individually. The practice may request reasonable supporting information.
The practice does not charge patients for missing an NHS appointment.
However, repeated missed appointments or cancellations made with less than 48 hours’ notice may result in the practice being unable to offer further routine NHS appointments.
An NHS appointment review will normally be triggered by:
The review will consider:
Where a patient has repeatedly failed to use NHS appointments offered to them, the practice may prioritise its future NHS capacity for other patients.
If the patient returns later, the practice may only have private appointments available. Private care will be optional and will not be imposed as a charge or punishment for missing an NHS appointment.
Patients have the right to accept or decline treatment after receiving appropriate information about:
Where a patient declines clinically recommended NHS treatment, the decision will be respected and recorded in their clinical notes.
However, declining treatment does not reserve an NHS appointment or guarantee that the same treatment will remain available from Dentistry@BD4 in the future.
The practice may use the NHS capacity that would have been required for that treatment to provide care to other patients.
If the patient later changes their mind, they may require:
The condition may also have worsened, making the original treatment unsuitable or requiring more complex care.
Whether the treatment can then be offered under the NHS will depend on the patient’s current clinical needs, available NHS capacity, the practice’s contractual obligations and whether the treatment can be provided safely within the practice.
Only a private appointment may be available at that time. The patient is not required to accept private care and may seek NHS treatment from another provider.
Patients must arrange and attend the appointments reasonably required to complete an agreed NHS course of treatment.
Where a patient:
the dentist may decide that the course cannot be completed.
The course may be closed and recorded as incomplete in accordance with NHS requirements. The patient will remain responsible for any NHS charge applicable to the treatment already provided.
If the patient returns later, a new clinical assessment and new course of treatment may be required. A further NHS charge may apply.
Where a patient does not complete an agreed course of NHS treatment, the practice may prioritise its limited future NHS capacity for patients who are willing and able to proceed with the treatment offered.
Whether another NHS appointment can be offered will depend on:
As a result, the practice may not have NHS capacity to offer the treatment again, and only a private appointment may be available.
Any private treatment will be optional, clearly explained and provided only with the patient’s informed agreement.
Recall intervals are determined by the dentist according to the patient’s individual oral-health needs and relevant NICE guidance.
Depending on age and risk, recall intervals may range from:
Patients are expected to contact the practice and attend within a reasonable period of their recommended recall date, ordinarily within two months of that date unless otherwise agreed.
Recall messages are courtesy reminders. Patients remain responsible for arranging and attending their appointments.
If a patient does not attend within a reasonable period, despite reminders where appropriate, the practice may allocate its limited NHS capacity to another patient.
If the patient contacts the practice at a later date, an NHS appointment cannot be guaranteed. They may only be offered a private appointment if no suitable NHS capacity is available.
Private care remains optional, and the patient may approach another NHS practice.
If several family members are booked together and the appointments are missed or cancelled at short notice, future family appointments may be booked separately.
This prevents a substantial amount of clinical time from being lost at once and protects appointment availability for other patients.
Parents and guardians are responsible for ensuring that children:
The attendance policy applies to children as well as adults. However, missed appointments involving children will also be considered under the practice’s safeguarding procedures.
Where a child repeatedly misses necessary care, the practice may:
A child will not be refused NHS care merely because their parent chooses private treatment or has an outstanding private balance.
Dentistry@BD4 is a general dental practice and is not a walk-in emergency service.
Urgent appointments are subject to clinical triage, available capacity and the practice’s NHS contractual requirements.
Previous attendance at the practice does not guarantee that an urgent appointment will be available immediately.
Where the practice cannot offer suitable urgent care, patients will be advised to:
In a life-threatening medical emergency, patients should call 999 or attend the appropriate emergency department.
NHS patients will be charged according to the NHS dental charging regulations in force when the course of treatment begins.
The practice may request the full NHS charge at the first appointment or agree to collect it in instalments during treatment.
Patients claiming exemption or help with NHS charges must:
The patient is responsible for checking their entitlement. Incorrect claims may result in a penalty charge being issued by the NHS Business Services Authority.
The practice does not charge deposits or missed-appointment fees for NHS appointments.
The dentist will explain which treatments are:
Patients will not be required to choose private treatment where Dentistry@BD4 has agreed to provide the clinically necessary treatment under an open NHS course.
However, if NHS treatment has previously been declined, abandoned or not completed, Dentistry@BD4 cannot guarantee that NHS capacity will remain available later.
In those circumstances, the practice may only be able to offer private treatment. The patient may decline the private option and seek NHS care elsewhere.
Private treatment chosen by the patient will be recorded separately and included in the treatment plan where required.
Before treatment begins, the clinician will explain:
A written NHS treatment plan will be provided where required, including for Band 2, Band 3 and mixed NHS/private treatment.
A written estimate will be provided for private treatment.
Estimates are based on information available at the time. If the treatment or cost changes, the clinician will explain why and obtain the patient’s agreement before continuing, except where immediate care is required and valid consent has been obtained.
Patients will be given a reasonable opportunity to ask questions and consider their options.
Private first appointments must be paid for in full before attendance.
A deposit or advance payment may be required when booking subsequent private treatment. The amount will be based on:
Unless otherwise agreed:
The payment will be deducted from the treatment cost when the patient attends.
Patients will be told the payment amount, deadline and cancellation terms before making payment.
If a private appointment is missed or cancelled with less than 48 hours’ notice, the practice may retain some or all of the payment or apply a reasonable cancellation charge.
The amount will reflect the practice’s reasonable loss, which may include:
The practice will take reasonable steps to reduce its loss, including offering the appointment to another patient where practicable.
A payment will not be retained where:
Patients may ask for an explanation of how a retained amount was calculated.
Private hygiene appointments are available through direct access. Patients do not need to be an existing patient or have a dental examination first, subject to the hygienist’s assessment and professional scope of practice.
The standard private hygiene appointment is £120.
The hygienist will:
A hygiene appointment does not replace a full dental examination.
Where scaling or periodontal treatment is clinically necessary and included within an agreed NHS course of treatment, it will be provided or arranged under the NHS in accordance with clinical need and NHS requirements.
If a patient declines or does not complete the NHS periodontal treatment offered, the NHS course may be closed as incomplete. The practice cannot guarantee that another NHS appointment for the same treatment will be available later.
If NHS capacity has been allocated to other patients, only private periodontal or hygiene appointments may be available at Dentistry@BD4. The patient may decline private care and seek NHS treatment elsewhere.
Cleaning requested for cosmetic or personal-preference reasons, where it is not clinically necessary, will be offered privately.
Patients may ask questions about their diagnosis or treatment and may seek a second opinion.
A request to see another dentist within Dentistry@BD4 will be considered, but an internal NHS transfer cannot be guaranteed. Our dentists have limited NHS capacity and may not be able to accept another dentist’s patient.
If no internal NHS appointment is available, the patient may:
If a patient chooses not to proceed with the NHS treatment offered while seeking another opinion, the practice may close the course as incomplete and allocate the unused NHS capacity to another patient.
If the patient later wishes to return, the original NHS appointment or treatment cannot be guaranteed and only a private appointment may be available.
Seeking a second opinion will not itself result in a patient being refused care.
A blanket statement that all complications will be “private only” would not be contractually safe. NHS England says patients remain eligible for assessment and stabilisation of acute pain or infection, even where the original treatment was privately funded or completed abroad. However, you can firmly restrict elective repair, replacement and reconstruction at Dentistry@BD4 to private care, subject to NHS acceptance criteria and available capacity. NHS England policy
Use this replacement:
Dentistry@BD4 is not responsible for the quality, outcome, maintenance, repair or completion of treatment provided by another dental provider in the UK or abroad.
Patients experiencing a problem with treatment completed elsewhere should contact the original provider first. That provider should normally manage post-treatment concerns, guarantees, adjustments and remedial care within a reasonable period.
Dentistry@BD4 does not routinely use its limited NHS capacity to:
If a patient presents with acute pain, infection or another urgent oral-health problem, the practice will carry out appropriate triage.
Where an NHS urgent appointment is available and the patient meets the relevant clinical criteria, the practice will not refuse that available appointment solely because the original treatment was provided privately or abroad.
Any NHS urgent care provided may be limited to the treatment reasonably necessary to:
An NHS urgent appointment does not commit Dentistry@BD4 to completing, replacing or reconstructing the original treatment.
Once the immediate condition has been assessed and stabilised, any further repair, replacement, corrective, cosmetic or reconstructive treatment at Dentistry@BD4 will normally be offered privately only.
This is because:
Private corrective treatment will only be offered following a clinical assessment and where the treating clinician is satisfied that it is appropriate and within their competence. The patient will be given a treatment plan and estimate before proceeding.
If the treatment is outside the clinician’s competence or the facilities of the practice, the patient may be advised to:
Private treatment is optional. A patient may decline the private option and seek NHS care elsewhere.
Exceptionally, if the clinician determines that further treatment is clinically necessary, falls within NHS acceptance criteria and Dentistry@BD4 has suitable routine NHS capacity, the practice may consider accepting a new NHS course of treatment. This is not guaranteed and will be decided following clinical assessment, taking account of complexity, available services, NHS capacity and the practice’s contractual obligations.
The fact that treatment was originally provided privately or abroad does not, by itself, remove a patient’s eligibility for NHS care. However, it does not require Dentistry@BD4 to allocate its limited routine NHS capacity to elective correction, replacement or reconstruction of that treatment.
Patients should tell the practice as early as possible if they require:
The practice will consider each request individually and make reasonable adjustments where required and practicable.
A patient will not be penalised under this policy where a missed appointment, cancellation or late arrival was connected to a disability and an appropriate reasonable adjustment could have prevented it.
For longer private courses of treatment, an instalment arrangement may be considered. It must be approved in advance by Practice manager and confirmed in writing.
Any arrangement must comply with applicable consumer-credit requirements.
Where the practice relies on the relevant exemption from Financial Conduct Authority authorisation, the arrangement will normally:
Not every patient or treatment will qualify.
Complaints about an instalment arrangement should first be raised through the practice complaints procedure. Where applicable, the patient will be informed of any right to approach the Financial Ombudsman Service or another appropriate body.
Patients will receive an itemised and dated receipt when payment is taken.
The practice may accept a part-payment towards an outstanding balance. Unless expressly confirmed in writing, accepting a part-payment does not mean that it has been accepted as full and final settlement.
The patient will be given or sent a statement showing:
The practice regularly checks treatment provided against payments received.
Where payment remains outstanding:
Action may include:
Only information reasonably necessary to recover the debt will be shared, and this will be handled in accordance with data-protection law and the practice privacy notice.
An outstanding private balance may result in the practice declining further non-urgent private treatment or requiring full advance payment.
Decisions concerning NHS care will be made separately according to clinical need, available NHS capacity, attendance history and contractual requirements.
The practice will not automatically convert NHS treatment to private treatment solely because a debt exists.
Patients, relatives, carers and visitors must treat staff and other people within the practice respectfully.
The practice will not accept:
Depending on the seriousness of the incident, the practice may:
Immediate action may be taken where violence occurs or anyone reasonably fears for their safety.
Any decision to discontinue care will take account of professional responsibilities, equality law, safeguarding, clinical need and NHS contractual requirements.
Patients who believe exceptional circumstances affected their attendance, punctuality, treatment completion or ability to pay should contact the Practice Manager promptly.
The Practice Manager will consider:
Patients may ask for a decision under this policy to be reviewed and may use the practice complaints procedure.
A review does not guarantee that an NHS appointment will become available. If the practice’s NHS capacity has already been allocated, only a private appointment may be available.
By booking an appointment, patients confirm that they have been informed of the practice’s appointment, attendance, cancellation and payment arrangements.
This policy does not remove or restrict:
Dentistry@BD4 will review this policy regularly and update it when legislation, NHS contractual requirements or professional guidance changes.
