1 million new patients unable to access NHS dentistry, as recruitment and retention crisis mounts

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  Posted by: probe-admin      7th February 2019

Analysis of government data published this week has revealed over 1 million new patients tried and failed to secure access to routine NHS dental services, as a new survey of dentists by the British Dental Association points to a ticking time bomb of staffing problems: 

  • BDA analysis of the government’s own GP Survey – based on feedback from over 350,000 adults – reveals nearly 1 in 4 new patients (estimated at over 1 million in total) not currently on the books with an NHS dentist have tried and failed to secure an NHS appointment.
  • This data points to access problems across every English region – with over 40% of these irregular attenders missing out in parts of Norfolk, Derbyshire, West Yorkshire and Cornwall, reaching over 60% in parts of Lincolnshire.
  • The BDA’s new national survey of dentists suggests nearly 3 in 5 practitioners (59%) based in England are now planning to scale down or leave NHS work entirely in the next 5 years
  • Those with higher NHS commitments are the most likely to leave –  67% of dentists seeing more than 75% NHS patients expressed their intentions to move on – falling to 51% among those doing less NHS work.   

The publication on Saturday drew sharp responses from government Minister Steve Brine, who suggested the BDA may not be included in stakeholder work on prevention after raising its concerns on access. The BDA has written to the Minister, with calls for an urgent meeting,  and outlined its case for a joined-up approach to prevention, access and workforce challenges.

Dentist leaders have lambasted government unwillingness to heed warnings over the growing recruitment and retention crisis in the service. Despite pledges to put prevention and primary care at the heart of the NHS 10 Year Plan no commitments have been made to guarantee the future sustainability of high street dentistry. 

The UK government has yet to honour commitments made since 2010 to make a decisive break from the discredited 2006 NHS contract system which sets quotas on patient numbers. Dentists are penalised if they don’t hit targets for activity, but are unable to treat extra patients even if they have capacity to do more. 

The BDA is seeking assurances that government will provide funding for a reformed system to guarantee access. Government spend on dentistry per head has fallen by £4.95, from £40.95 to £36, in the last five years, while dentists have experienced a 35% collapse in real income over last decade, a fall without precedent in the public sector. 

The British Dental Association’s Vice Chair Eddie Crouch said: 

“High Street NHS dentistry is on the brink, and it’s the patients who need us most who risk losing out.  

“Across England practices are now unable to fill vacancies, as a system of unforgiving targets pushes talented colleagues out. The result is hundreds of thousands of irregular attenders – many with poor oral health – are falling through the cracks.  

“These aren’t just patients seeking a regular check-up. They are often people in pain, left without the care they need. 

“Dentists were looking for a lifeline in the recent 10 Year Plan, but were offered little more than a footnote. The practitioners who have done most to support the NHS – and the patients who need them – are now paying the price for that indifference.”

Data from the 2018 GP Survey, by Ipsos Mori on behalf of NHS England 

The survey captured weighted responses for each Clinical Commissioning Group from 369,474 patients including 42,869 from new patients, on a range of topics, including their ability to access dental care. The BDA modelled this data with adult population figures, also by CCG, from the Office for National Statistics. 

By NHS Region

 

Total new Patients unable to secure appointments (est.)

% New Patients unable to secure an appointment

ENGLAND

1,028,824

22%

North of England

288,234

25%

Midlands and East of England

337,986

21%

London

253,416

19%

South West of England

131,807

24%

South East of England

216,271

23%

 

Worst affected CCGs

 

Total new Patients unable to secure appointments (est.)

% New Patients unable to secure an appointment

NHS South West Lincolnshire CCG

6,120

62%

NHS South Lincolnshire CCG

7,729

46%

NHS Harrogate and Rural District CCG

7,385

46%

NHS Scarborough and Ryedale CCG

4,489

46%

NHS North East Lincolnshire CCG

5,336

46%

NHS Bradford Districts CCG

13,315

45%

NHS Kernow CCG

21,721

43%

NHS West Norfolk CCG

7,576

41%

NHS Greater Huddersfield CCG

6,147

41%

NHS North Lincolnshire CCG

5,343

39%

NHS Southern Derbyshire CCG

15,519

38%

NHS North Kirklees CCG

5,095

38%

NHS Vale of York CCG

8,777

38%

NHS Fareham and Gosport CCG

5,585

38%

NHS Bradford City CCG

3,952

37%

 

BDA survey

Figures from 2018 BDA surveys of General Dental Practitioners and Specialist Practitioners.  Fieldwork between 8 June and 10 August 2018. 1,129 valid questionnaires were completed and returned by post or submitted online. The BDA survey captured as “leaving the NHS”, those intending to increase their proportion of private work, to leave the UK to work overseas, to retire or to leave dentistry to work in a completely different sector in the next five years.


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