BDA requests capital funding from government

16 November 2020

The British Dental Association has written a letter to Matt Hancock requesting capital funding for dental practices.

The British Dental Association has written a letter to Matt Hancock requesting capital funding for dental practices.

The letter, written by BDA chair Eddie Crouch and addressing the DHSC and all devolved administrations, has asserted that the current procedures surrounding fallow time and air change per hour are not feasible for most dental practices, with the estimated cost of equipment and works to become compliant starting at £10k.

To this end, Mr Crouch has requested capital funding from the government in order for dental practices to meet these costs, saying, “Practices need capital investment from the government to help reduce their fallow time, increase capacity and, once and for all, improve access for all.”

The BDA’s chief concern is that the current restrictions on dental practices mean that almost 19m dental treatments have been missed since March and patients are not receiving the care that they need. Mr Crouch appeared on BBC Breakfast this morning to express the important role that dentists play in the public’s health, especially regarding the diagnosis of oral cancer.

In the interview with the BBC, Mr Crouch said, “Problems in the mouth, when they’re picked up early, are relatively easy for the dental profession to treat. The more advanced the problem is by the time the dentist actually gets to see it and start the treatment, the poorer the outcome – and that’s especially true in things that are really life-threatening, like oral cancer.

“Many lesions that occur in the mouth are asymptomatic to the patient; the patient wouldn’t know about them. The screening that dentists carry out regularly in six-to-twelve-monthly check ups will pick these up at an early stage, so the treatment is so much easier for the patient and their life chances are so much better. Sadly, this may be being missed on a daily basis and many of these patients will have a very poor prognosis.”

The BDA’s letter to the government requesting funding reads:

I am writing to you concerning the ongoing challenges facing dental services, and the knock-on effects this is having on the patients who need our care.

Dentists are continuing to operate at a fraction of their former capacity. ‘Fallow time’ – the gap between procedures designed to reduce the risk of viral transmission, and mandated in guidance since the first lockdown – remains the single biggest limiting factor to restoring access across both NHS and privately funded dentistry.

Recent changes to Standard Operating Procedures to help practices reduce fallow time are welcome. However, if we are to translate new guidance into an actual boost in patient numbers, we need your help.

Reductions in fallow time are contingent on dentists securing a level of air change per hour (ACH) within their surgeries that in many cases is impossible without new mechanical ventilation.

The problem is twofold. Based on a recent survey, a majority of practices in England simply do not hold data on their air change levels. Meanwhile, most practices also lack the means to invest in the ventilation equipment required to expand capacity. A typical high street practice therefore faces not only a steep bill for ventilation surveys to establish compliance, but also for the cost of equipment and other works, which on the basis of industry advice is estimated to start at £10,000.

In recent years neither NHS England nor the Department of Health and Social Care have extended any capital funding to dental practices. However, these are unprecedented times; new guidance requires a new approach, both to establish the levels of need, and to get systems in place that could have a transformative effect on capacity across dentistry.

Covid-19 restrictions on patient throughput, set by government, are placing significant limits on the number of patients we can treat for the foreseeable future. Your support could help bring tens of millions of patients back through our doors to get the care they need.

Colleagues in Wales, Scotland and Northern Ireland have also raised this matter directly with devolved administrations. I look forward to hearing from you soon and would be happy to discuss these issues with you.