4. Ms A complains about the Trust’s actions in July 2021. She tells us she got a referral to the Trust for orthodontic treatment and the Trust rejected it saying it did not offer the treatment to patients over the age of 25.
5. She tells us the Trust’s actions left her feeling ‘depressed and suicidal’ and even when she attempted to access private treatment, it was denied because of possible complications.
6. Ms A would like an explanation and recognition of errors.
7. Ms A tells us she was referred to the Trust by her general dental practitioner (GDP) in July 2021 to be assessed for orthodontic treatment, to improve the occlusion of her teeth and her speech. Occlusion means the contact between teeth, more specifically the upper and lower teeth. Her referral was reviewed by the Trust's consultant orthodontist and clinical lead.
8. Following the review, her referral was rejected by the orthodontic department because the Trust did not accept patients over the age of 25 for orthodontic care. The Trust says this is because orthodontic treatment for patients over the age of 25 is not accepted on the NHS in England in any hospital setting due to the high likelihood of failure of treatment.
9. In its final response to Ms A the Trust referred her to the relevant webpage which outlines the NHS policy. The final response recommended that she try speaking with her GDP again to see if they could help her with any possible treatment in the future.
10. Ms A tells us she has followed the Trust’s advice and tried to get private dental treatment but says she has been ‘advised against it based on the complications’. Ms A would still like to have the orthodontic treatment at the Trust.
14. As part of our consideration of the complaint we looked at the evidence available to us, including the advice from our adviser, and considered the Trust’s decision not to give orthodontic treatment.
15. The Trust explained from the beginning that its decision not to give treatment was based on an NHS England policy, specifically its ‘Overview on Orthodontics’ which states, ‘Orthodontic treatment is not available on the NHS for adults’. The Trust’s own policy is in line with the NHS England policy, and it makes this clear on its website, saying ‘We provide dental orthodontics diagnosis and treatment for people under the age of 25 (at referral)’.
16. In its response to Ms A, dated 20 August 2021, the Trust gave her this information and said: ‘the Trust ‘does not accept patients over the age of 25 for Orthodontic care. This is because orthodontic treatment for patients over the age of 25 is not accepted on the NHS in any hospital setting due to the high likelihood of failure of treatment’.
17. The Trust’s response to Ms A is clear and concise and in line with our principles which state organisations should: ‘Be open and honest when accounting for their decisions and actions. They should give clear, evidence-based explanations, and reasons for their decisions’.
18. We can see that the Trust has clearly explained why it will not be able to give Ms A the treatment she wants, and how it reached this decision in line with the applicable clinical policy and guidance.
19. We appreciate that Ms A is unhappy with the Trust’s response, and she has given us information about how her day-to-day life is affected. This information clearly shows how worried she is about future dental care.
20. In our view, the Trust has given clear and straightforward information about why it cannot offer any orthodontic treatment to Ms A. The difficulties Ms A describes do not suggest the Trust can act outside of the relevant guidelines, or that it would be helpful to her if it did.
21. We considered if there are any discretionary elements the Trust should have looked at, in addition to the NHS England policy (and therefore the Trust’s policy). We have seen no guidelines, policies or standards that say the Trust should have taken any further or different steps in considering Ms A’s case.
22. If Ms A believes that her needs are different from those in her situation, including the way she has been affected by the Trust’s decision, she can make an Individual Funding Request (IFR), if her GDP is willing to support it. This can be done by contacting her local Clinical Commissioning Group (CCG) for more information.
23. We can see no signs of the Trust doing anything wrong and we will not be investigating the complaint further.
1. We have carefully considered Ms A’s complaint about Guy's and St Thomas NHS Foundation Trust’s (the Trust) actions in July 2021. We are aware that she is still very upset with the Trust’s decision not to give orthodontic treatment and that she is worried about future dental care.
2. Having carefully considered her concerns and the relevant guidelines and standards in this case, we cannot see any evidence of service failings in the Trust’s actions or decision making. As such, we will take no further action on this complaint.
3. We have given a more detailed explanation for our decision in the following statement, and we hope this is helpful to Ms A.