Residents in a UK city say they were given a financial "ultimatum" before being allowed to register with an NHS dentist in what has been dubbed an "alarming" turn of events. Prospective patients in Bristol said they were told they had to pay £69 for a hygienist appointment or be turned away from the Lodge Causeway Dental Centre in September. Alice Worthington, who lives in the south of the city, told the BBC she ultimately paid the fee despite "not needing a hygienist appointment at all" because it was "impossible" to find an NHS dentist elsewhere.

The practice said booking an appontment was optional rather than mandatory and apologised to patients for the confusion. Ms Worthington said: "We got into reception and they told us that if we wanted to register as an NHS patient, we would have to pay £70 for a hygienist."

"I didn't actually need a hygienist appointment at all," she added. "I'd recently had one with the private practice that I was going to, but we were told that until we'd paid the £70, we were not going to be registered with the NHS.

She said she felt bad for others queuing outside the centre during an open day on September 6, who waited hours without being warned of the fee, with one woman left "very upset".

Sam Mellor, from Bedminster, who queued for four hours only to be told by a receptionist that he was required to book the hygienist appointment before registering, described it as an "ultimatum".

A contract between the NHS and dentists requires providers to admit patients regardless of of whether they chose to pay for additional private services.

Eddie Crouch, chair of the British Dental Association (BDA), described the reports as "alarming".

"If they're being told they have to have a private hygienist appointment before having some NHS dental treatment, then I don't think that's correct," he said.

"We know there are 14 million people, sadly, at the moment, who want access to an NHS dentist, but those 14 million people need to be supported by government, and not abused by any bad practice within our membership."

Lodge Causeway Dental Centre said 95% of the patients it has seen since September needed urgent care, but for others, the "offer" of a hygienist appointment was made alongside a dental check-up. It said its system automatically took payments for such appointments in advance but acknowledged that some people found this "unappropriate", for which it "apologised unreservedly".

The NHS Bristol, North Somerset and South Gloucestershire Integrated Care Board (ICB) said NHS dentists can offer patients a choice of whether they'd like to book a hygienist appointment but they "should not be obliged to pay for an appointment at the time of registering".