Business rates, PPE and key worker status – dentists call on government support
With practices given the green light for resuming services on 28 May, Mick Armstrong, chair of the BDA, has written an open letter to health secretary, Matt Hancock, calling for urgent support to 'keep the service afloat and avert a likely collapse in patient access' with few practices opening their doors, and those that do operating at a fraction of their pre-pandemic capacity.
In the letter, published today, the BDA is calling on the health secretary to 'address what has become an existential crisis for dentistry':
Ares of concern include:
Key worker status – clarification that the list on the government web page includes dentists and dental team members to prevent colleagues being turned away by both schools and nurseries. Mick Armstrong writes: 'Our members require access to childcare, and this will continue to hit parents in those years where schools have not yet reopened. This simple change to the wording could be made today, carries no costs, and would reflect assurances we have been given from NHS England from the outset.'
Business rates – 'Dental practices that will see no or low levels of activity are still paying rates. These are essential businesses safeguarding the nation’s oral health. We are struggling to understand why the Treasury, while offering needed relief to other high street businesses – and subsequently extending it to cover the gambling industry – remains blind to the risks facing this sector,' he writes.
PPE – And adds: 'Costs for PPE to complete a single course of treatment based on industry sources have increased by up to 6000%. Kit is now needed that was never previously required, and all items are subject to shortage. Dentists are reliant on volatile commercial supply chains for PPE. We need access to the Government supply chain for PPE, and for the temporary VAT cut on PPE – that closes on 31 July – to be extended, and potentially to be made permanent.'
The ‘New Normal’ – 'Barely 8% of practices now estimate they can maintain their financial sustainability longer term, in the face of sky high overheads and lower patient numbers. We need the conversation to be realistic about how an NHS service, forced to operate to a contract based on activity, can operate in a context where previous levels of activity are impossible.'
The BDA said it is now inevitable that patient access in England will fall below levels seen in access ‘hotspots’ such as West Yorkshire, Cornwall and Cumbria.
With social distancing policies remaining in place, and most practices reporting their ability to deal with a quarter of previous patient numbers, it adds that there is no possibility of the service delivering anything more than a fraction of the 39.72m courses of treatment that were delivered by NHS in England in 2018/19.
Dentist leaders have said the conversation must now begin on replacing a model for the service that has been rendered irrelevant in the face of lower patient numbers and higher costs. Industry sources have estimated the PPE costs alone for certain courses of treatment have increased by up to 6000%.
BDA Chair Mick Armstrong said: 'Today high street dentistry was meant to start resuming across England. The reality couldn’t be further from the truth. Few practices have opened their doors, and those that did were operating at a fraction of their pre-pandemic capacity.
'The Health Secretary must now take responsibility to avert the existential crisis facing a service struggling with sky-high costs and radically reduced patient numbers. For years, communities from Cornwall to Cumbria struggled to get appointments but were ignored. Without action from this government, access problems – on an unprecedented scale – are going to be visited on millions of patients, in every part in England.'