Clawback from NHS dentistry to be used to cover strike costs

10 November 2023

The British Dental Association (BDA) has released its reaction to plans by NHS England to use ‘underspends’ in NHS dentistry to pay for costs incurred by recent strikes across secondary care. 

According to reports in the HSJ, senior officials have now given license to Integrated Care Boards to use these funds to support their bottom line and to cover deficits as part of a deal to offset the costs of recent industrial action.

This ‘clawback’ is supposed to be ringfenced and kept for use in providing NHS dental care. In April, Amanda Doyle, director of primary and community care at NHS England, told the Health and Social Care Committee, "certainly now—for ’23–24—a ringfence has been applied by NHS England, so no ICB can spend a dental allocation on anything that is not NHS dentistry." During the leadership election last year, the prime minister committed to a ring fence as part of his ‘Five-point plan’ for dentistry, to “strengthen the protections around the annual NHS dentistry budget” so funds would be “maintained exclusively for frontline dental services.”

The BDA says the NHS contracts dentists work to has fuelled a recruitment and retention crisis across the service, leaving many practices returning large slices of their budget when they are unable to hit their targets. 

Since April, the BDA has been pressing the government to deliver a promised recovery plan, making effective use of these underspends. In July, the Health and Social Care Committee concluded its inquiry, describing the state of the service as "unacceptable in the 21st century", and set out recommendations to the government for permanent ring-fencing, and for real, urgent reform, alongside a call for any recovery plan to be underpinned by necessary funding. The government’s response to the inquiry has been overdue since September 14, 2023.

Shawn Charlwood, chair of the British Dental Association’s General Dental Practice Committee, said, “Once again, NHS dentistry is being treated as the ‘Cinderella Service’. 

“When we desperately need ambition and investment, officials are raiding our budgets, robbing Peter to pay Paul.

“These ‘underspends’ are the result of practices struggling in a failed, underfunded system. If the government is banking on them to plug holes in their balance sheet, millions of patients will lose out.”