As the Association of Dental Groups (ADG) awaits the Labour Government and DHSC’s action plan to deliver on their election manifesto pledges for NHS dentistry, the trade association for dental group providers in the UK warns of the significant gap in the dental workforce.
Critical numbers
The gap in the dental workforce is significant. ADG estimates that this shortfall means that the profession is unable to treat 4.5m patients annually[1]. Data published by NHS England for the period to March 2024 show there are 2,749 full-time equivalent (FTE basis) NHS dentist vacancies, which make up 87% of total dentist vacancies currently open – at 3,160 (FTE basis). These are roles that have been open for an average of 180 days per post, and most are more than three months old.
Furthermore, with 411 private vacancies (FTE basis) still open, it is clear that irrespective of the need for NHS contract reform, there is a system-wide shortage of dentists in the UK across the profession’s ‘mixed-economy’. The result of this huge gap in the dental workforce means that there is an issue with the number of patient treatments that can actually be carried out.
Three steps to plug the gap
There are three key actions that can come together to address the gap in the dental workforce. These interventions can be put to work in the short-term, without legislative change, and with no extra cost to the Government – since the current dentistry underspend provides sufficient funding:
- Integrated Care Boards (ICBs) to use their full commissioning powers: To meet the needs of the population and put to use fully the current dental workforce team available in the UK, ICBs either need to spend in full their dental budget or have it supplemented from central clawback funding.
- Improve workforce planning: Recognise the relationship between the ‘mixed economy’ and skills mix across the full dental workforce, including Dental Care Practitioners (DCPs – dental therapists, dental hygienists and dental nurses) and support improvements of dental schools.
- Commit to support recruitment: Accelerate long-term workforce planning and unlock barriers preventing high-quality international dentists registering and undertaking the Overseas Registration Examination (ORE). Recently granted changes to the international registration legislation should now allow the General Dental Council (GDC) to put this into action (see notes to editors).
Most dentists provide some NHS care
This year the GDC published data showing that dentists are willing to take on NHS appointments. Most dentists provide some NHS care, with only 19% saying they provided only private care and a further 14% said they predominantly provided private care. There is also effectively full ‘employment’ in dentistry with only 0.7% of dentists actively seeking work.
Part of the solution to the current crisis in dentistry in the UK, should also be to embrace the full dental workforce. DCPs are critical to providing patient care, and are now trained to carry out approximately 70 percent of the treatments that dentists can.
Neil Carmichael, Executive Chair, ADG said: “ADG keeps banging the drum for ‘Recruitment. Recruitment. Recruitment – and Retention’! Much focus has been put on the need for NHS dentistry contract reform, and whilst this is important, our Association’s members know that without the ‘boots on the ground’ in the form of more Dentists and Dental Care Professionals the benefits of any new contract simply cannot be brought to life.
“With the UK’s dentistry needs so high, the Government’s promise to deliver 700,000 appointments isn’t nearly ambitious enough to fix the current crisis in dentistry. The need is far greater to address patients’ needs, and also to fulfil the significant number of open vacancies across the UK dentistry’s ‘mixed economy’. Only approximately 400 additional FTE basis dentists would deliver this 700,000 pledge – whilst there are seven times as many vacant positions for dentists open currently that need to be filled to meet demand!
“Improving patient access and taking the pressure off NHS services across the country has to be the priority. However, currently there isn’t the commissioning capacity to achieve this. ADG is here to support the new Government to deliver on dentistry reform.”
Reference
[1] Approximately 88m Units of Dental Activity (UDA) are commissioned per annum, 72.5m were delivered 23/24 (18.4m adults / 6.7m children) which equals on average 3 UDAs per patient. With an approximation of 5,000 UDAs per FTE basis dentist and NHSE vacancies at 2,749, this totals a gap of 13,745,000 UDAs. Divide this by the 3 average UDAs per patient per annum – and that implies 4.5m patients treated per annum could be treated if all vacancies were filled.
