ADG: Government must face up to the workforce challenge to stop “dental deserts” in England

Neil Carmichael, Chair of the ADG has responded to the Healthwatch England report on dentistry the debate in the House of Commons on oral health and dentistry in England, both of which took place earlier this week:

“The two debates being held today in the House of Commons demonstrate that MPs from Bedford to Yorkshire and the Isle of Wight to Waveney know from their mailbags that many of their constituents still cannot get access to NHS care in a timely manner. Research by Public Health England and others confirms that these “dental deserts” are often in the most vulnerable and deprived communities.”

It was heartening to see the Opposition spokesman and Minister agree on the need for dental contract reform at pace. Many in the profession recognise that the Minister is committed to reforming the dental contract through flexible commissioning and we are ready to work with her to achieve this.

“However the Government must also face up to the challenge to recruit more dentists including those from overseas. As the minister said in the debate there are “dental deserts” in parts of England, and more practitioners are required with an “army style” recruitment strategy from Government to fill the vacancies in areas of greatest need.”

“I hope Healthwatch England’s report published yesterday will now focus the Government’s mind on the urgent need to reform NHS dentistry and address the recruitment crisis we now see emerging in many parts of the country.”

Healthwatch England’s report is published here.

Public Health England’s report on Inequalities in Oral Health in England is here.

ADG Chair welcomes new report calling for ‘’Armed Forces style” campaign to recruit more people into healthcare

Neil Carmichael, Chair of the Association of Dental Groups (ADG) has added his support to recommendations from a new report published today calling for a well-funded “Armed Forces” style recruitment campaign to inform and encourage people into the full range of healthcare careers, including dentistry.

The report also recommends that the Government’s central funds for “levelling up” should include a role for healthcare to reduce the nation’s regional health disparities.

Last month the publication of Public Health England’s report on “Oral health inequalities in England” revealed stark variations between regions in oral health and highlights an emerging “north/south” divide. Lying behind these inequalities is a growing recruitment crisis in the parts of the country that need NHS dentistry the most.

The ADG has already called for an increase in the number of UK training places for dentists and incentives for NHS dentists to move to areas with poorer access to dentistry such as Yorkshire and Lincolnshire coastlines, but also the South coast around the Isle of Wight, Portsmouth and in Cornwall. In the short term, overseas recruitment which makes up nearly a fifth of registered dentists, and mutual recognition of qualifications of overseas dentists should be streamlined.

Neil Carmichael, Chair of the ADG, said: “The Government has recognised the need to recruit more doctors and nurses, but we need more than this. As the NHS integrates care systems a long term workforce plan for the whole healthcare workforce is required; this report makes a strong case for a recruitment strategy.

“NHS dentistry provision is suffering from acute recruitment problems in many areas of the country the Government wishes to level up. Good health enables an individual to participate fully in society and must be a part of levelling up the UK. A national recruitment drive for the whole sector highlighting the opportunities in many parts of the country for those who want to make a difference is part of delivering this.”

The full report, The Economics of Health: How the healthcare sector can support the UK Economic recovery is available here.

Inequalities in oral health report confirms ‘’the urgent need to level up access to NHS dentistry” – ADG

The Association of Dental Groups has welcomed the publication of Public Health England’s report on “Oral health inequalities in England”. The report reveals stark variations between regions in oral health and highlights a clear “north/south” divide.

Standardised incidence of oral cancer was highest in the North West, North East and Yorkshire and Humber regions.

The report highlights relative inequalities in the prevalence of dental decay in 5 year old children in England and that these have increased from 2008 to 2019.

Prevalence of tooth decay in 5 year old children was highest in the North West and Yorkshire and Humber. This was repeated for 12 year olds.

Public Health England have also recommended water fluoridation as a whole population intervention as there is evidence that it reduces oral health inequalities with a greater benefit for those living in more deprived areas.

Neil Carmichael, Chair of the ADG, said: “This comprehensive report, the first time epidemiological data, NHS data and academic research has been brought together in this way casts a clear light on the oral health inequalities that still exist in England. What is more concerning is the emergence over the last decade of a clear “north/south” divide. The pandemic will have only exacerbated these inequalities. The Government has to address this as part of its commitment to “levelling up” the country.

“I am pleased with the government’s intention to act on water fluoridation which is recommended by the Public Health England report as reducing oral health inequalities in more deprived areas. We look forward to further recommendations from Public Health England on how to address inequalities. However we clearly have to increase access to NHS dentistry in much of the country. The current model of commissioning by UDA activity is not flexible enough to achieve this and in the same parts of the country where oral health is poor, recruitment of dentists is challenging. Addressing these issues will be part of the solution.”

Public Health England’s report on oral health inequalities in England is available here.

New figures show ‘’collapse in children’s dental visits as a consequence of the pandemic”

The Association of Dental Groups has responded to this morning’s publication of the latest NHS Dental Statistics Biannual report for England 2020-2021.

The statistics reveal that overall, 3.6 million children were seen by an NHS dentist in the 12 months up to 31st December 2020, which equates to 29.8% of the child population.

This compares to 7 million children seen by an NHS dentist in the 12 months up to 31st December 2019, which was 58.4% of the child population in the previous report demonstrating the dramatic effect of the pandemic on oral healthcare for children during 2020.

Neil Carmichael, Chair of the ADG, said: “Before lockdown, just under 60% of children had visited an NHS dentist in the 12 months to December 2019. The 1st lockdown when dentists were closed and subsequent constraints on activity has resulted in a dramatic collapse in child visits to their NHS dentist. “The fear is that dentists will now have their work cut out dealing with tooth decay among children and I know that many dentists have already raised their concerns about the future of children’s oral health. I would call on the Government to focus on addressing the backlog of oral healthcare for children as a priority in the year ahead. We need to take action now to prevent this unmet need translating into more hospital operations than ever to remove children’s teeth.”

The latest NHS dental statistics are available here.

ADG welcomes Government water fluoridation action plan

Neil Carmichael, Chair of the ADG, has welcomed the announcement today by the Secretary of State for Health of plans for “streamlining the process for the fluoridation of water in England by moving responsibilities for doing so from local authorities to central government,” as part of the NHS reforms in the White Paper published today.

Neil said: “This is a significant moment as water fluoridation is probably the single most important step any Government can take in protecting the country’s oral health.”

The Covid-19 pandemic and the cancellation of routine appointments, treatments and supervised toothbrushing programmes has highlighted the need more than ever for the introduction of preventative measures such as water fluoridation across the country.

Thousands of children could soon require hospital operations to remove unsavable teeth due to the pandemic. Before the pandemic, hospitals in England already carried out an average 177 operations a day on children and teenagers last year to remove teeth, costing the NHS more than £40m. It is estimated by the British Society of Paediatric Dentistry that water fluoridation could reduce this by as much as two thirds in the most deprived areas.

Neil Carmichael added: “It is widely accepted that water fluoridation is the most effective measure that can be taken to prevent dental disease. Only a tenth of the UK has access to fluoridated water showing that the previous approach was not working. We welcome the proposals outlined today as a clear resolution by the Government to take action on water fluoridation.”

“Moving a focus onto flexible commissioning and preventative measures is one way the Government can limit and recover the damage to the nation’s oral health in the future. Water fluoridation requires no behaviour change and the evidence shows it is highly effective. The next step must now be wider flexible commissioning of services to help those most in need.”

ADG Chair Neil Carmichael on Access to Dentistry (S03 E03)

Neil Carmichael, Executive Chair of the Association of Dental Groups (ADG), is a man with many hats, having served previously as a member of parliament, while currently the CEO of UCEC, which supports the exchange and integration of educational resources between China and the UK, and a board member at Funing Robotics.

In this interview, Neil explains how he became Chair of the ADG, what it’s primary aims are, and the organisation’s Access to Dentistry Campaign and why it’s needed. Other topics discussed include the need for shift to preventative treatment and how the pandemic and Brexit have affected the dental profession.

Listen here or wherever you get your podcasts, including Apple PodcastsGoogle PodcastsSpotify and more:

 

For more information, visit https://www.theadg.co.uk/

You can also find the report, 30 Years of Hurt, commissioned by the ADG and released in December 2020, here: https://www.theadg.co.uk/wp-content/uploads/2020/12/30-Years-of-Hurt-Report.FINAL_.Dec20.pdf – the report examines the urgent need to rebuild the dentistry workforce.

If you wish to contact the ADG, email admin@theadg.co.uk.

Neil Carmichael

The Probe Dental Podcast is presented by The Dental Awards.

The Dental Awards is the original and most respected awards programme in British dentistry. 2021 marks the 22nd anniversary of the Dental Awards, and over the decades, this prestigious event has recognised the outstanding individuals and teams whose commitment and drive continue to raise standards throughout the profession.

The Dental Awards is attended by over 600 clinicians each year. Winning, or being a finalist, is a tremendous accolade and provides a massive publicity boost to the profile of your practice and your team. After all, who wouldn’t want to be treated by the Dentist or Dental Team of the Year?

The Dental Awards are sponsored by B.A. International, Colgate, Colosseum Dental, Dental Elite, and Water Pik. The Probe and The British Dental Conference & Dentistry Show are official partners.

For more information, please visit the-probe.co.uk/awards

For more from The Probe, visit the-probe.co.uk. Theme tune courtesy of Bensound.

 

ADG welcomes Minister’s support for a “transformation in commissioning”

Neil Carmichael, Chair of the ADG has welcomed the comments in the House of Commons last Thursday by Government Health Minister Jo Churchill MP that she has “…asked officials and NHSE to ensure that high-quality preventive work is at the forefront of future provision and that a transformation in commissioning takes place.”

The Covid-19 pandemic has highlighted the need more than ever for reform of the current UDA contract for NHS dentistry and the introduction of wider preventative measures such as water fluoridation. MPs from all political parties in the debate highlighted dissatisfaction with the 2006 UDA contract for NHS dentistry which the Minister recognised “does not work particularly effectively.”

Neil Carmichael, Chair of the Association of Dental Groups, said: “Last week’s debate highlighted the professions concerns about reintroducing UDA targets at a time of national lockdown. However, what was also clear was a cross party consensus that the current UDA contractual arrangements for delivering NHS dental care are broken and have a negative impact on the profession’s morale. The Minister’s response to the debate that a transformation in commissioning is needed to ensure that high quality preventative work is at the forefront of future provision must be welcomed.

“The current backlog in dentistry will continue throughout this year and moving a focus onto flexible commissioning and preventative measures is one way we can limit and recover the damage to the nation’s oral health in the future.

“The case for water fluoridation has never been stronger and I am pleased to see the Minister also express her support for it. For the benefit of children’s future health I hope action will soon follow.”

MPs write to Matt Hancock as research reveals worst-hit constituencies for access to dentists

New analysis is authored by a former aide to the Health Secretary

Health Secretary Matt Hancock has been urged to take immediate action to deal with a developing crisis in dentistry by MPs in some of the worst-hit areas of the country. Fourteen MPs have signed an open letter to the Health Secretary on the back of new analysis projecting that around 8 million people across England will be waiting for NHS dental treatment this Christmas.

The research has been produced by the Association of Dental Groups, who commissioned Matt Hancock’s former special adviser Richard Sloggett to conduct an independent ‘state of the nation’ report on access to dentistry.

It has emerged that the worst-hit constituency is Manchester Central, where 19,510 people are projected to be waiting for NHS dental treatment this Christmas. Leeds Central is the second worst-hit constituency. London also fares badly with 10 of the capital’s constituencies in the top 20 worst-hit list.

Among the signatories to the letter to the Health Secretary are:

  • Hilary Benn (Leeds Central, 18,554 people waiting to see a dentist)
  • Margaret Hodge (Barking, 16,483 people waiting)
  • Kim Johnson (Liverpool Riverside, 16,132 people waiting)
  • Bob Seely (Isle of Wight, 15,445 people waiting)
  • Rebecca Long Bailey (Salford and Eccles, 15,000 people waiting)
  • Janet Daby (Lewisham East, 14,419 people waiting) – Apsana Begum (Poplar and Limehouse, 14,150 people waiting)
  • Diana Johnson (Kingston upon Hill North, 13,598 people waiting)

In the report, called “30 years of hurt”, Mr Sloggett notes that restrictions on the flow of people that can be seen in dental surgeries due to the pandemic are quickly making access a huge problem. He points out that the root cause is that the system has been underfunded and neglected for decades:

“For 30 years, dentistry in England has been the forgotten service of the NHS. It is time for that to change.”

Commenting on the report, Neil Carmichael, Chair of the Association of Dental Groups and former Conservative MP for Stroud said:“These figures reveal a critical list of constituencies where many thousands of people have gone without NHS dental care that they would ordinarily have received this year. It represents real suffering, which is why MPs are now calling for simple measures to boost dentistry recruitment and tackle the huge backlog of need that has been building up in 2020.

“Even when the Covid restrictions are lifted, dealing with this will take months. We need urgent action now to draft in more dental professionals to tackle the crisis.”

The letter asks the Health Secretary to tackle the dentistry crisis by taking three key steps to accelerate dentistry recruitment. They are:

  • Boosting training: increasing the number of placements in England along with incentives to work in areas with greater staff shortages and poorer patient access;
  • Maintaining routes for overseas professionals to fill short term gaps: because it takes five years to train a dentist, for the short term, automatic recognition of EU dentistry qualifications should be maintained after Brexit. Recognition of dental qualifications from good schools outside the EEA should also be extended.
  • Boosting retention of NHS dentists: Many NHS dentists are leaving the sector or moving to private practice due to dissatisfaction with the current NHS dental contract. Government needs to look into this urgently and open up a process of reform.

The report, “30 Years of Hurt”, is available here.

New ADG report shows at least 8 million people will be waiting for an NHS dentist this Christmas

A new report from the Association of Dental Groups (ADG), published today, projects that around 8 million people will be waiting for NHS dental treatment this Christmas, but unable to access a dentist to perform it.

The findings point to an unprecedented proportion of people being unable to access the NHS at any one time – 8 million people represents around 14% of the English population, or around one in seven people.

The fear among dentists is that record numbers of mouth cancer cases are going undiagnosed while more than a million fillings may have been missed this year.

The analysis is published today by the Association of Dental Groups, who commissioned Matt Hancock’s former aide to conduct an independent ‘state of the nation’ report on access to dentistry.

The work shows London to be the worst region in the country to access a dentist, with around 1.5m people in the capital waiting at Christmas – equivalent to around 17% of its population, or one in six people. The Midlands will have 1.3m waiting; around one in eight people.

Region Patients waiting at Christmas

  • London 1,500,000
  • Midlands 1,300,000
  • North East and Yorkshire 1,200,000
  • South East 1,200,000
  • North West 1,000,000
  • East of England 950,000
  • South West 800,000

In the report, titled “30 years of hurt”, Mr Sloggett notes that restrictions on the flow of people that can be seen in dental surgeries due to the pandemic are quickly making access a huge problem. He points out that the root cause is that the system has been underfunded and neglected for decades.

“For 30 years, dentistry in England has been the forgotten service of the NHS. It is time for that to change.”

The report suggests there is no way at present to tackle the backlog due to a crippling lack of NHS dentists and proposes several urgent recommendations for boosting dentistry recruitment, including by:

  • Boosting training: increasing the number of placements in England along with incentives to work in areas with acute staff shortages;
  • Routes for overseas professionals to fill short term gaps: because it takes five years to train a dentist, for the short term, automatic recognition of EU dentistry qualifications should be maintained after Brexit and recognition of dental qualifications from good schools outside the EEA should be extended.
  • Boosting retention of NHS dentists: Many dentists are leaving the sector or moving from the NHS to private practice due to dissatisfaction with the current NHS dental contract. Government needs to look into this urgently and open up a process of reform.

Commenting on the report, Neil Carmichael, Chair of the Association of Dental Groups and former Conservative MP for Stroud said: “These figures represent real suffering, with hundreds of thousands – potentially over a million – fillings going unperformed, plus a host of other treatments piling up, as well as undiagnosed cases of mouth cancer. Even when the Covid restrictions are lifted, dealing with this will take months. We need urgent action now to draft in more dental professionals to tackle the crisis.”

The report can be found at https://www.theadg.co.uk/.

Healthwatch report on dentistry and the impact of Covid-19 finds patients were unable to get the care they needed

Healthwatch has released its quarterly report on dentistry, which seeks feedback from NHS patients about their experiences. The briefing, which covers the three-month period from July-September 2020, drew responses from 1,313 people about their experiences of dentistry, compared to 238 people in the previous three-month window.

The feedback received showed that patients were often unable to get the care they needed, leaving them in pain and at risk of serious long-term oral health issues. Since the start of the Covid-19 pandemic and the initial national lockdown, there has reportedly been a significant increase in the number of people facing problems when trying to get an NHS dentist appointment, suggesting the impact the pandemic has had on the profession has been particularly acute.

The report, which can be found here, notes that in addition to dental care access proving difficult for NHS patients, that large numbers of the public are still unable to get an appointment for regular check-ups, hygienist appointments or fillings, and that NHS appointments as a whole are extremely limited because practices are either not taking on new NHS patients or have no available NHS appointments.

The Healthwatch report also highlights that, in some cases, dentists have not been able to continue treatment started before lockdown, meaning people have been left in pain and with unresolved issues, such as broken teeth, and that some been unable to reach their dentist for urgent care. In addition, it is suggested that some practices are prioritising private patients over NHS ones or are only offering non-urgent treatment if NHS patients opt to pay privately instead.

Other issues brought to light by the report claim there has been a inaccurate or misleading information provided by NHS 111 and NHS Choices, as well as dental practice websites, causing confusion. Confusion has also been caused over whether patients have been de-registered: a dental practice cannot de-register someone, but often people who have had a long gap since their last appointment are told they have been, when really what the dental practice means is that there are no available NHS appointments. 

Finally, the report finds that while practices did adapt to new measures once they reopened, not all of them understood how Covid-19 measures would impact some groups of people or didn’t follow all the measures needed to make people feel safe.

The report has already drawn responses from across the dental sector, with Dental Protection defending dentists following its publication. Commenting on the report, Susie Sanderson, Dentolegal Consultant at Dental Protection, reiterated the extremely challenging environment for dental professionals:

Dentists have faced a range of challenges throughout the pandemic, and many have returned to practise in equally challenging circumstances – adapting to additional PPE and new ways of working, worrying about their health and that of their staff and patients, and facing a significant backlog of patients with outstanding treatment due to the unavoidable delays. 45% of UK dentists say their mental wellbeing is worse compared to the start of the pandemic.

“Many dentists have also expressed their frustration that guidelines are not always easy to decipher and adhere to and are having an adverse impact on the operating capacity of the practices. The delays and disruption frustrate patients, but also create stress for dentists, who are doing their best but feel they cannot always act in their patients’ best interests for reasons beyond their control.

“We want to reassure all members that Dental Protection is here to offer support. I would also encourage members experiencing work-related stress to make use of our free counselling service. The service is provided through a third-party partner and is completely confidential.”

Meanwhile, the Association of Dental Groups (ADG) chair, Neil Carmichael, commented:

“Healthwatch England’s report published today on the impact of COVID-19 on dentistry confirms the ADG’s campaign for action be taken to increase access to dentistry. The ADG is seeking a new contract for NHS dentistry where oral health is a higher priority and flexible commissioning is encouraged. We must also recognise the need to recruit more dentists. To deliver dentistry effectively in all regions in England quite simply, more practitioners are required.”

“Healthwatch England’s report has cast a light on a period in dentistry where access was severely curtailed because of restrictions placed on the profession, which has further compounded pre-existing problems. I look forward to Healthwatch England’s positive engagement as we seek a new way of working in NHS dentistry and a comprehensive workforce strategy from Government to fill the vacancies in areas of greatest need.”