Our guide to NHS patients requesting second opinions
If a patient has been seen for an NHS assessment at one practice and wants to be seen for a second opinion elsewhere this causes potential difficulties – this is because that patient may have had an NHS acceptance form raised by the other practice and a claim made for starting the treatment. Additionally, some patients may have already commenced orthodontic treatment at one practice with placement of an upper removable appliance and they are just about to move on to the ‘fixed brace’ stage.
These guidelines should ensure we do not cause problems to another practice by undermining the treatment process there, especially if the patient is due to commence further treatment with them in the near future.
The most common reason for NHS patients/parents wanting to seek a second opinion seems to be in relation to any proposed extractions.
Although it might seem natural to want to seek a second opinion, it is perhaps the most courteous option for the dentist, or the parent, to try and seek further explanation and clarification from their current orthodontist as to the reason(s) for the extractions. It is highly possible a good reason for the extractions can be given, and any alternative options, whether that be NHS or private, can be discussed with the existing orthodontist who holds all of the patient’s clinical records and information.
If the patient/parent is still resistant to the proposed treatment plan, we can offer a second opinion, as long as the parent understands:
- Often there is a good reason for orthodontic extractions e.g. in the case of more severe crowding, overjet, centreline problems etc., and, although it is naturally desirable to try and avoid extractions, it is entirely possible that we may fully agree with the original orthodontist’s treatment plan. At our practice we promote a focus on avoiding extractions – however, this is more likely to be achievable if the patient can be assessed at around 8–9 years of age. Earlier interventions at this age can help to improve the arch form and make additional space, and the use of URA/bite plane or functional appliances can correct jaw discrepancies, which both make non-extraction treatment more likely in the adult dentition.
- In order for us to be able to offer a well-informed second opinion, we would need access to any previous records already held by the existing orthodontic practice (i.e. x-rays, photos, clinical notes and study models).
- Any treatment with us would be available on a private basis only.
We want to eliminate any element of ‘dissatisfaction’ from the parent in having to pay for a copy of their records, and then a second opinion with us, especially if we were to end up agreeing with the initial treatment plan. For these reasons, we want to avoid, as far as possible, giving second opinions to clarify or discuss treatment plans from another orthodontist.
Of course we are always pleased to see any referrals that are not already ‘in the system’ elsewhere, or have been ‘refused’ NHS treatment due to low IOTN etc.
On the other hand, if a patient/parent genuinely feels that they do not wish to pursue the NHS option and to consider private treatment instead, then of course we would be pleased to see them, but this would be on the basis of the benefits of private treatment/clinic, rather than specifically for any non-extraction approach. To enable this they must be fully discharged from the relevant NHS practice, ideally with a copy of their clinical records prior to being referred to us.
Why refer your patients to us?
- We make referring easy: just fill in the referral form on our website, write to us, email us, or call us, and we’ll do the rest. Alternatively ask the patient/parent to either call us or use the self-referral form on our website
- We have a proven track record of excellent results: in 2013 and 2014 the practice had 100% patient satisfaction for both treatment outcomes and the level of service provided – all delivered by a caring friendly team in a comfortable and contemporary environment
- We always try to avoid permanent tooth extractions: we prefer to maintain fuller more natural smiles, with arch development and functional treatment
- We’ll work closely with you and your patients: ensuring the most efficient and effective solution is delivered to each and every patient
- We’ll keep you up to date: regular updates at the key stages throughout treatment
Did you know?
On 18th March 2015 the Financial Conduct Authority (FCA) issued a new directive which changed the rules in respect of offering interest free credit. With immediate effect any fixed sum interest-free agreement which has a maximum of twelve instalments within a twelve month term will be exempt from instalment credit legislation. The net effect of this is that any practice who solely offers interest free finance for periods of up to 12 months will have no need to be ‘Authorised’.
Therefore, practices who only offer up to 12 month interest free finance may wish to cancel their authorisation. However, if they do so they will not have the option to offer an extended payment term to any patient under any circumstances, and they may need to re-apply if the rules are modified further in the future.
We hope you’ve enjoyed May’s edition of our newsletter. If you have benefitted from it, please forward to other colleagues.If you have any questions, require further information about any of the articles, or would like to give us any feedback on the service we provide, please give either of us a call or email us on ben@parklaneorthodontics.co.ukBen and Paula
If you believe this has been sent to you in error or you would like to be removed from the e-newsletter mailling list, please safely unsubscribe by emailing us at
shane@parklaneorthodontics.co.uk