The British Dental Association has warned that reforms to NHS dentistry cannot be the end of the road for the struggling service, and that recent hikes in National Insurance may undo this progress.
According to survey evidence from 195 NHS dentists in Scotland:
- 69% of respondents agree that Payment Reform, which launched in November 2023, represents an improvement over the system that proceeded it. However, dentists say it has not met the Scottish Government’s stated objectives. Only 1 in 5 (21%) agree that the reformed system reduces bureaucracy, little over 1 in 4 (26%) say it increases clinical freedom. Only 7% believe it enhances access for NHS patients, and only 3% says it supports a reduction in oral health inequality.
- With practices facing higher costs as a result of the most recent UK Budget, 45% estimated their practices will struggle to remain financially sustainable. Over half (53%) warned it will accelerate the move to the private sector. 65% stressed these costs must be covered by either the UK or Scottish Government.
- Only 10% could describe the NHS as an attractive place to build and maintain a career. 91% felt their job was stressful, with 71% saying they felt burnt out by it.
- 86% identified higher needs patients requiring more clinical time as a challenge affecting their practice. 83% cited not being able to accommodate all the patients who contact them. Recruitment and retention of dentists was flagged by 72%, for dental nurses by 78%.
These headlines are being presented today (Friday 25 April) to the Conference of Scottish Local Dental Committees in Stirling, the single largest gathering of NHS dentists in Scotland.
Gillian Lennox, Chair of the BDA’s Scottish Dental Practice Committee, said: “Dentists on the frontline say payment reform is clearly an improvement on what preceded it. But in terms of sustainability, bureaucracy, prevention, access and inequality there is still so much more to do.
“The simple fact is that 9 out of 10 of my colleagues wouldn’t describe the NHS as an attractive place for dentists to build and maintain a career. We can’t go on like this. It’s the practices with vacancies they can’t fill. The NHS colleagues on the brink reporting high levels of stress and burnout. As dentists we believe in prevention, and that principle needs to be applied to the pressures we’re under. Broken systems have a very human cost, for colleagues and the millions we treat.”
Neither the UK nor Scottish Government have arrived at any tangible mitigations to the threat presented by National Insurance and National Minimum Wage hikes. Gillian Lennox added: “The National Insurance hike risks taking a wrecking ball to already struggling practices, undoing the progress we’ve secured with payment reform. We do have sympathy with Holyrood, this mess is not of their making. However, what remains clear is that one Government – North or South of the border – is going to have to fix it.”
