NHS dentistry inquiry: ADG welcomes proposal as BDA tells government to ‘act now’


  Posted by: Dental Design      14th July 2023

The British Dental Association (BDA) has warned NHS dentistry’s future will rest on both government and opposition committing to the recommendations set out by the Health and Social Care Committee today. The Association of Dental Groups (ADG) has welcomed the MPs inquiry into NHS dentistry as “blueprint” for election manifestos.

The cross-party inquiry makes sweeping proposals to end the crisis in NHS dentistry, including:

  • Reform: The Committee stress that “fundamental reform” of the failed NHS contract fuelling the exodus of talent from NHS dentistry must be delivered urgently.
  • Prevention The Committee share the BDA’s view that the focus of a new system should shift from discredited targets to a system of ‘weighted capitation’ whereby dentists are rewarded for maintaining and improving their patients’ oral health and the focus is on long-term, patient-centred preventative care, with additional support for higher needs patients. This would provide an emphasis on prevention that doesn’t currently exist.
  • Funding: The Committee support the case for permanent ring fencing of the dental budget, so money is not lost from the frontline because of the penalties practices struggling to hit their contractual commitments currently face. The Committee also stress the government’s forthcoming recovery plan must be underpinned by necessary funding.
  • Integrated Care Systems. The Committee stress dentistry must have a voice in new structures, with a seat on boards. 

The BDA has wholeheartedly backed the damning judgment of the Committee that the system is “unacceptable in the 21st century” and share the view that “Government and NHS England have not fully grasped the scale of the challenge for the workforce, and the need to urgently provide compelling incentives to attract new and existing dentists to undertake NHS work.”

The recent NHS Long Term Workforce Plan has set out to expand the number of dental students by 40% but set out no concrete plans to stem the flow of talent from the workforce. The BDA described the move as an attempt to “fill a leaky bucket.” Over half (50.3%) of high street dentists responding to recent BDA surveys reported having reduced NHS commitments since the start of the pandemic. 74% stated their intention to reduce – or further reduce – their NHS work.

In oral evidence the professional body stressed to the committee that all ministers were doing at present was “rearranging the deck chairs on the Titanic while the service slowly slips into the sea.” Minor changes to the discredited NHS contract were rolled out in October, that the BDA warn do nothing to halt the exodus from the service. The government has yet to honour its pledge to fast track a ‘recovery plan’ for NHS dentistry, that the BDA stress is essential just to stabilise the service ahead of wholesale reform.  

Contrary to repeat claims made by the Prime Minister, official figures secured last month by the BDA under freedom of information indicate just 23,577 dentists performed NHS work in the 2022/23 financial year, over 1,100 down on numbers pre-pandemic, a level not seen since 2012.

Shawn Charlwood, Chair of the British Dental Association’s General Dental Practice Committee, said: “From reform to funding the Committee has provided an instruction manual to save NHS dentistry. The real question now is whether government or opposition are ready to use it. Failure to act will condemn this service to oblivion.”

MPs cite frustration that recommendations for reform made by their predecessor Committee 15 years ago have still not been implemented. They brand the current contract, which pays dentists for NHS ‘units of dental activity’ (UDAs), as not fit for purpose.

The Committee also concludes the current backlog of overseas clinicians waiting to sit the Overseas Registration Examination (ORE) is “unacceptable” and calls on the General Dental Council and the Government to “speed up the changes to the process of international registration for new applicants seeking to work in the NHS”.

Neil Carmichael, Chair of the ADG, said: “With access to NHS dentistry now one of the top issues in MPs constituency postbags, the inquiry has provided the opportunity for politicians on a cross party basis to map out a future for NHS dentistry which will improve access.” 

“Access to NHS dentistry and dental deserts in England have become a doorstep issue in by elections across the country this month.  This cross party report provides a blueprint for parties to address the issue in their manifestos for the General Election.  The solution to the workforce crisis is clear – the Government needs to act now to recruit more overseas clinicians and invest in the long term in our dental schools to boost dentist numbers.”

Iain Stevenson, Head of Dental at Wesleyan Financial Services, said: “Dentists are doing everything they can to support patients. But in reality, many practices delivering NHS care are hanging by a thread.

“They’re trying valiantly to recruit and retain staff, but at the same time being stung by punishingly high running costs. The operational headroom they have is razor thin, and conditions are so unfavourable that just one setback can quickly become near-catastrophic. For example, if many practices were to lose just one associate they’d face a long uphill battle to replace them, and in the meantime, weather increased waiting list pressure and financial strain – just pouring salt in the wound. It’s simply not sustainable.

“We’re seeing welcome attempts to address some of these issues, but the fear is that the problems are too entrenched and urgent to be fixed by short-term tweaks around the edges or ideas that will take years to come to fruition. We need a new vision for NHS dentistry, and we need it now. This simply isn’t a service that our society can lose.”

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