A year’s worth of dentistry lost, but no urgency from government

The British Dental Association (BDA) has lamented the lack of urgency from government in rebuilding and reforming NHS dentistry, as new data shows a full years’ worth of appointments has now been lost since lockdown.  

Analysis of new Freedom of Information data indicates just short of 40 million fewer courses of treatment have been delivered in England since March of 2020, when compared to pre-covid levels. In the five years prior to the pandemic, average volumes delivered sat at 39.4 million. [1]

As MPs prepare for a major debate on the future of the service on February 10, the union has stressed urgent reform is now vital, both to manage the unprecedented backlog, and to halt the exodus from the NHS.  

According to a new survey, over 40 per cent of dentists indicate they are likely to change career or seek early retirement in the next 12 months given the current pressures on the service. Two thirds (66 per cent) indicate they will reduce their NHS commitment, with more than a third (34 per cent) stating they plan to go fully private in the next year, and less than half (48 per cent) are confident their practice will continue to provide any NHS services from April 2022. [2]

Dentists now face financial penalties for failing to hit an imposed targets of 85 per cent of pre-covid activity during the Omicron wave, amid high levels of staff sickness and patient cancellations. Data indicates a significant majority of practices will be unable to hit this target.   

The number of dentists working in the NHS in England fell by almost a thousand last year. To stop this flight dentist leaders stress ministers must make NHS dentistry a place where people want to work. Whilst reform has been pledged to the dysfunctional target-driven NHS, it is unclear if there is sufficient ambition and resources to secure meaningful change. The BDA have said reform is a matter of urgency, given any reform of the service will fail if there is no workforce left by the time it is finally introduced.  

NHS dentistry has been subject to cuts not seen anywhere else in the NHS. In real terms, net government spend on general dental practice in England has been cut by about a third in the last decade. The government recently offered a time-limited £50 million ‘treatment blitz’ designed to cover 350,000 appointments, but this must be used by April 1, 2022.

Due to chronic underfunding and failed dental contract, the service has long faced chronic problems with burnout, recruitment and retention, particularly in rural and coastal areas. Those with the highest NHS commitment are now the most likely to want to leave. A BDA member survey from late 2021 indicated 93 per cent of owners of dental practices with a high NHS commitment found it difficult to recruit a dentist, with more than four in 10 vacancies unfilled for more than six months.  

Research recently published in the British Dental Journal underlines the expectation that inequalities will have increased due to the disproportionate impact of the pandemic on particular groups including children, older people (especially those in care homes), and the socioeconomically disadvantaged. 
Eddie Crouch, BDA chair, said, “A year’s worth of dentistry has been lost, and we are yet to detect any real urgency from government.

“Patients are bottling up problems and oral health inequality is set to skyrocket. Yet far from this crisis being a covid blip, it now risks becoming a fact of life for families across England.

“Ministers have recognised the system is rotten, but there is still no timetable for change and no tangible commitment to row back on a decade of cuts.

“Dentists need to see a light at the end of the tunnel. Exhausted colleagues are making exit plans while desperate patients are facing yearlong waiting times.

“It will take more than warm words to halt the exodus from this service and restore access to millions”   

[1] BDA estimates based on Freedom of Information requests from the NHS Business Services Authority: Courses of treatment delivered by dentists working in NHS General Dental Services in England, January 2019-December 2021.

[2] British Dental Association online survey General Dental Practitioners practicing in England. Fieldwork 13-21 January 2022; 1973 respondents.
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