Additional services

Do additional services really exist in the NHS? This may seem like a strange question but one which really needs to be resolved. In the current NHS contract there is a specific reference to additional services. These are dental services that are not ordinarily delivered as part of general dental services, for which PCTs have a commissioning responsibility. Services that could fall into this category could include oral surgery, endodontics and orthodontics. There are of course other services that may also fall into this category, for example special care dentistry, specialist restorative dentistry and periodontics to name a few. This issue for patients and their dentists is that the provision, availability and thresholds for referrals vary hugely across the country.

The problem can be the cause of much anxiety for patients and their dentists as the inclusion and exclusion criteria for additional services is not defined in one place. The interpretation in one part of the country could be very different from another part of the country depending on the commissioners’ intentions, availability of dental advice and local demands. However, none of these seem like good reasons for poor availability of services.