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Dentistry

Start date: 15 September 2011
End date: 14 September 2012
Next milestone: This market study is now closed

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Purpose of the study

The purpose of this study was to examine whether the UK dentistry market is working well for patients. It examined how dentistry services are sold and the extent to which patients have access to accurate and impartial information to help make informed decisions. It considered patients' ability to assess and act on the information that is provided, as well as the nature of competition between providers of dental services. These issues were considered within the context of both NHS and private dentistry. For further information please consult the Statement of Scope (pdf 156kb).

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Final reports 

The OFT published its decision not to make a market investigation reference of the UK dentistry market to the Competition Commission on 14 September 2012.

The OFT published its final report on the UK dentistry market on 29 May 2012.

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Outcome

In May 2012, we published the findings of our market study and our provisional decision not to make a market investigation reference of the market for dentistry to the Competition Commission (the CC). Our report found that:

  • Dental patients commonly have insufficient information with which to make informed decisions about their choice of dentist and the treatments they receive. We also found that that each year around 500,000 patients may be provided with inaccurate information by their dentist regarding their entitlement to receive particular dental treatments on the NHS and, as a result, may pay more to receive private dental treatment. 
  • Restrictions which prevent patients from directly accessing dental care professionals, such as dental hygienists, without a referral from a dentist are unjustified. The OFT considers these restrictions are likely to reduce patient choice and dampen competition and that they should be removed.
  • The current NHS dental contract in England creates barriers to entry and expansion in the dentistry market. As a result, it is extremely difficult for new dental practices to be established, and successful dental practices which offer a higher quality of services to NHS dental patients are prevented from expanding. The study highlights that the majority of NHS dental contracts in England are not time-limited and were awarded to incumbent dental practices in 2006 and that only a small volume of new contracts are put out to tender each year.
  • Other issues of concern in the dentistry market include the complexity of the complaints process for dental patients and potential pressure selling by dentists of dental payment plans.

The OFT has identified a package of recommendations to address these concerns:

  • Provision of clear, accurate and timely information for patients - the OFT is calling on NHS commissioning bodies, the General Dental Council (GDC) and the Care Quality Commission to be proactive in enforcing existing rules which require dentists and dental practices to provide timely, clear and accurate information to patients about prices and available dental treatments. 
  • Direct patient access to dental care professionals - the OFT is calling on the GDC to remove regulations which prevent patients from making direct appointments to see dental hygienists, dental therapists and clinical dental technicians. 
  • Reform of the NHS dental contract in England - the OFT is urging the Department of Health to redesign the NHS dental contract to facilitate easier entry into the market by new dental practices and allow successful practices to expand. 
  • Simplification of the complaints process - the OFT considers that the current dental complaints system should be reformed to make it simpler, easier and less time consuming for patients and dentists to resolve complaints.
  • Sale of dental plans - following discussion with the OFT, the British Dental Association has agreed to develop a robust and effective code of practice covering the sale of dental payment plans.

In September 2012, following a public consultation on our provisional decision, we published our decision not to make a market investigation reference of the UK dentistry market to the CC.

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Actions following the market study

During the course of the market study, the OFT considered whether a reference to the Competition Commission was appropriate.

The OFT has decided that a market investigation reference of the UK dentistry market to the Competition Commission was not appropriate at this time, as the OFT considers that the scale and likely persistence of the features of the dentistry market identified as meeting the reference test are not sufficient for a market investigation reference to be proportionate at this point in time. Further, in the context of availability of remedies, the OFT notes that the powers of both the OFT and the CC in relation to the relevant matters extend only as far as making recommendations to the relevant bodies.

In view of the factors set out above, the OFT decided that it should not exercise its discretion to make a market investigation reference in relation to the UK dentistry market at the present time.

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Related documents  

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Contacts

Team leader: Brian Jackson (020 7211 8446, brian.jackson@oft.gsi.gov.uk)
Project director: Tony Donaldson (020 7211 8784 tony.donaldson@oft.gsi.gov.uk)
Senior responsible officer: Mary Starks (020 7211 8307 mary.starks@oft.gsi.gov.uk)

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Media enquiries

Any media enquiries should be directed to a member of our Press Office.




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