Fines needed to help cut orthodontic waiting lists in Wales, says Assembly committee

17 February 2011

Dental practitioners who refer patients to more than one orthodontic waiting list to try and get them seen sooner should be fined, according to a report from the National Assembly’s Cross-Party Health, Wellbeing and Local Government Committee.

The inquiry found that, although orthodontic waiting lists are an issue in Wales, figures are not accurate because some dentists refer patients to more than one practice - or before they even need treatment - just to get them on a list.

The report calls for fines to be introduced for practitioners who persistently make duplicate or inappropriate referrals, to avoid clogging up the system.

It recommends that the Welsh Government addresses these issues and then provides one-off funding to clear the backlog of patients.

The report also questions the effectiveness of the Welsh Government’s current NHS Dental Contract, which sets out a quota of activity that orthodontists have to undertake each year – known as Units of Orthodontic Activity (UOA).

It states that the system is ineffective because, despite a significant increase in demand, the quota has remained fixed since 2006.

It also demonstrates that, through the system, money is being given to practices where little or no orthodontic treatment is provided and different practices are being paid different rates for the same work, because funding is based on their historical activity.

To combat this, the report calls for the appropriateness of the Contract to be reviewed and funding to be standardised.

Other concerns for the Committee were the shortage of NHS orthodontic practitioners in rural areas, the UK-wide lack of specialist orthodontists and the issue of patient ‘recycling’ – where patients who are referred are given unnecessary repeat assessments.

Committee Chair, Jonathan Morgan AM, said: “With one in three children and an increasing number of adults needing orthodontic care, it’s vital that these services are delivered effectively and efficiently.

“Our inquiry showed serious failings in the Government’s current NHS Dental Contract, including the ineffective quota system, the disparity in practices’ funding, and the high volume of inappropriate and early referrals.

“We were told that if these issues were addressed, services would be run more effectively, waiting times for new patient appointments would decrease and there would be sufficient capacity in Wales to meet the demand for orthodontic care.

“We urge the Welsh Government to take on board the recommendations of our report, so that orthodontic care in Wales can be the best possible for the many people who need it.”