The Department of Health & Social Care (DHSC) has announced that 700,000 extra urgent dental appointments will be rolled out across England. Health Minister Stephen Kinnock made the announcement, with NHS England writing to Integrated Care Boards (ICBs) directing health chiefs in each region to stand up thousands of urgent appointments over the next year.
The appointments will be available from April and have been targeted at dental deserts – areas where patients particularly struggle to access NHS dentists. The appointments will be for patients who are likely to be in pain – including those suffering from infections or needing urgent repairs to a bridge – and require urgent treatment.
Each ICB has a target of urgent appointments to roll out, based on estimated local levels of unmet need for urgent NHS care. Levels of unmet need are calculated by measures including looking at how many people tried and failed to get an NHS dentist appointment.
“We promised we would end the misery faced by hundreds of thousands of people unable to get urgent dental care,” said Stephen Kinnock. “Today we’re starting to deliver on that commitment.
“NHS dentistry has been left broken after years of neglect , with patients left in pain without appointments, or queueing around the block just to be seen. Through our Plan for Change, this government will rebuild dentistry – focusing on prevention, retention of NHS dentists and reforming the NHS contract to make NHS work more appealing to dentists and increase capacity for more patients. This will take time, but today marks an important step towards getting NHS dentistry back on its feet.”
The extra appointments would translate into each of the 24,200 dentists recorded as doing some NHS activity last year seeing the equivalent of little over two extra urgent cases a month. Based on BDA analysis of government data, total unmet need for NHS dental care in England amounts to 13m, or 1 in 4 of the adult population.
Lord Darzi concluded in his ‘diagnosis’ of the crisis in the NHS that: “If dentistry is to continue as a core NHS service, urgent action is needed to develop a contract that balances activity and prevention, is attractive to dentists and rewards those dentists who practise in less served areas.”
The BDA has expressed concern that Integrated Care Boards have been offered no national framework for delivering these 700,000 appointments. Last summer the professional body proposed a tried-and-tested model of sessional payments, that has already significantly improved access to urgent care in the North East.
Shiv Pabary, Chair of the BDA’s General Dental Practice Committee said: “It’s progress, but Government could have fired the starting gun on commissioning urgent care last summer. Action here will translate into just two extra slots a month for each NHS dentist. Ministers must now confront the failed contract that’s left millions with no options.” Despite having pledged new investment in the Labour manifesto, delivery here is to be paid for using underspends in the dental budget, that are fuelled by underfunding and workforce problems.
In written evidence to the Public Accounts Committee inquiry into ‘Fixing NHS dentistry’ the professional body stressed these underspends do not reflect any lack of demand for care, but are the net result of a generation of systemic underfunding driven by the Treasury. A typical practice now loses over £40 delivering a set of NHS dentures.
The total cross subsidy from private care to loss-making NHS activity is estimated at £332m a year – set to rise to £425m when significant increases in overheads from the Autumn Budget kick in come April.
Shiv Pabary added: “Promised new money has gone. Instead, budget that should be funding routine care is being recycled. What’s clear to us is the Treasury are banking on the crisis in dentistry not being solved in this Parliament.”
Dr Nigel Carter, CEO of the Oral Health Foundation, also commented: “This is an encouraging step towards improving access to NHS dentistry and will make a real difference for patients in urgent need. However, it barely scratches the surface of the crisis facing NHS dentistry. Millions are still struggling to access routine care, and urgent appointments alone won’t solve the deeper issues in the system. We need a long-term strategy that prioritises prevention and ensures everyone can get the dental care they need before problems become emergencies.”
Neil Carmichael, Executive Chair, Association of Dental Groups, said that the ADG recognises the pledges as some progress towards resolving the UK’s dentistry crisis. However: “Our Association’s concern is that the Government is leaning on dental practices to fund urgent and routine care through their businesses’ ‘mixed economy’ structure. Without proper reform, realistic funding and a focus on the inadequate dental workforce (remember, there are currently over 3,000 vacant dentist positions that we are unable to fill) we cannot hope to see significant progress in getting dentistry in the UK back on its feet in the near future.”
