ADG

Community Dental Services hosts Association of Dental Groups representatives

Community dental provider and ADG member, Community Dental Services CIC (CDS), recently welcomed representatives from the Association of Dental Groups (ADG) to the Dental Care Centre, Bedford. This was an opportunity to highlight special care and paediatric dentistry to dental group leaders from across the country. Community dental services treat patients with a range of complex needs based on referrals from dentists and other health professionals. Typically, patients have autism or ADHD, learning disabilities, complex mental health issues or severe dental anxiety, meaning treatment in general dental practice can be very difficult. Children with high levels of dental decay are also referred.  

Neil Carmichael, ADG Chair and Dr Sandra White, ADG Clinical Director, visited CDS’s Bedford clinic to hear more about how this patient group are treated.   

Helen Paisley, CDS CEO and ADG Director, said: “It was a pleasure to host the ADG leadership team and to share the work we do. The ADG are at the forefront of campaigning for improvements to dental access in the UK and it was really good to have the opportunity to talk about our patients and how the current crisis in the sector impacts on them.”  

Neil Carmichael, Chair of the ADG, added: “The ADG staff team had a fabulous day at the Dental Care Centre, Bedford; meeting such a dedicated and capable dental team which was also well equipped to provide support for virtually every condition was a highlight. We also achieved a huge amount during the away day. Thank you!”

IDO UK to launch on 6th March 2024

The International Dental Organisation UK (IDO UK) aims to improve the quality of and access to dental care, and to support overseas dentists in joining the UK dentistry workforce.

IDO UK, an organisation made up of dental practitioners, will formally launch in London next month. Its core mission is to support the UK dental industry by increasing the quality of dental care quality and improving access for consumers. IDO will also focus on reducing barriers for overseas dentists to practice in the UK to help bridge the deepening gap in the dental workforce.

Many thousands of qualified overseas dentists want to practice in the UK, some of whom are already in the country working as dental nurses or in unrelated sectors. However, registration processes are blocking easy recruitment. This is unacceptable at a time of acute staffing shortages within UK dentistry, and long waiting lists for patient appointments across the country.

The overseas registration exam (ORE), which overseas qualified dentists must pass in order to register with the General Dental Council and practice in the UK, is characterised by delays and long waiting times, with applicants sometimes waiting up to two years to complete the exam. There are also high costs associated with the process, which can cost individuals almost £4,000.

Reducing barriers for overseas dentists to join the UK dental workforce would significantly reduce pressure on the UK dental industry and improve patient care.

As well as pushing for reforms to UK dental registration systems, IDO UK aims to improve the quality of oral healthcare and advocate for high standards of patient care. Its vision is to create a vibrant community of dental professionals, both national and domestic, across the country, and drive innovation, collaboration and continuous improvements within the sector.

Commenting on the launch Chair of the Association of Dental Groups (ADG) and IDO UK Trustee Neil Carmichael said: “The Association of Dental Groups is delighted to support the work of the IDO. We know international recruitment is essential for the future of dentistry in the UK so the IDO’s role as a support structure, pathway to registration as a dentist, and beacon for professional development is incredibly valuable in delivering effective workforce planning.”

The launch event will take place on 6th March 2024 from 6pm at the Royal Over-Seas League in London.

About IDO UK

IDO UK aims to provide continued support to dentists in the UK, both nationals and those from overseas, and to unite, empower and advance the dental profession in the United Kingdom. We are committed to fostering excellence in oral healthcare, promoting professional development, and advocating for the highest standards of patient care. Through collaboration, education, and community engagement, we strive to enhance the knowledge, skills and impact of our members while promoting oral health awareness among the public.

GDC’s new dentists workforce survey is “a welcome step in plugging the data gap” in NHS dentistry, says ADG

The General Dental Council (GDC) has launched a workforce survey for registrants to complete, with the aim of helping it to understand more clearly the NHS dentistry crisis.

 

As part of the annual renewal process, dentists are being encouraged, for the first time ever, to answer a series of questions about the work they undertake, including where in the country they are based whether they are practicing on a full-time or part-time basis and how much of their work is under NHS contract.

Commenting on the GDC’s new workforce survey, Neil Carmichael, Executive Chair of the Association of Dental Groups (ADG), said: “We are delighted that GDC has listened to the concerns raised by ADG and others as to the lack of data on the disastrous state of NHS dentistry. For the first time we will have a nationwide survey of dentists, which will throw light on the challenges faced by the profession – a welcome step in plugging the data gap. The results of the workforce survey will aid ADG’s own research on NHS “dental deserts” across the UK, which found rural and more deprived areas less likely to have access to NHS dental care services.

“We urge GDC to make the (anonymised) results publicly available as soon as possible, as the information collected will be vital in informing the wider political debate on the future of dentistry in this country. This is particularly important in a general election year. The workforce survey is voluntary and all information provided will be anonymised. The more dentists that respond to the survey, the more accurately the results will reflect the state of the workforce. We encourage all dentists to respond to the survey.”

About the ADG

The Association of Dental Groups (ADG) is the trade association for large dental providers in the UK. Our members include 25 of the largest groups of dental practices in the country, representing approximately 10,000 clinicians delivering NHS and private dentistry to more than 10 million patients every year.

The ADG works for its members to improve the conditions for by investing in their patients and their  people. We seek to improve quality and access to dentistry for patients by influencing the standards and shaping policy impacting Dental Groups. Our aim is to facilitate the provision of patient centred, high quality and consistent dental care by  improving Dental Groups’ working environment. 

Find out more on our website here: https://www.theadg.co.uk/

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

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.”

ADG welcomes expansion of dental training in NHS Long Term Workforce Plan

The Association of Dental Groups has welcomed the publication of the first ever Long Term Workforce Plan published by the NHS and backed by the Government today.

The Workforce Plan sets out how the NHS will address existing vacancies and meet the challenges of a growing and aging population by recruiting and retaining hundreds of thousands of more staff over the next 15 years, including dentists. dental hygienists and therapists.

The Plan proposes to increase training places for dental therapists and hygiene professionals to more than 500 by 2031/32 and increase training places for dentists by 40% to more than 1,100 by the same year.  In support of this training places for dental therapy and hygiene professionals will increase by 28% by 2028/29 with an increase of 24% for dentists to 1,000 places over the same period.

Neil Carmichael, Chair of the ADG said: “The fact that we now have a long term workforce plan including dentistry is a welcome recognition of the recruitment and retention challenges facing the profession.  We believe we should act now over international recruitment to address the immediate crisis and this plan then paves the way for the subsequent investment needed in our domestic dental schools and workforce for the future.  The ADG welcomes that this process is underway and that the Government is backing the plan to fund additional education and training places over the next five years on top of existing funding commitments.”

ADG welcomes long overdue expansion of the Overseas Registration Examination

The Association of Dental Groups has welcomed the announcement by the General Dental Council to triple the number of places available for candidates at sittings of Part 1 of the Overseas Registration Examination (ORE) for dentists from 200 to 600.

Passing the ORE is a requirement for overseas dentists from countries outside the EEA to register and practice in the United Kingdom.  With a backlog of over 1500 applicants and many more waiting for their applications to be processed it has been a significant “bottleneck” in the recruitment of overseas dentists who could ease the current access crisis in NHS dentistry.

The ORE has been recognised by many, including the General Dental Council as “no longer fit for purpose”.

Neil Carmichael, Chair of the ADG, said: “Reform of the ORE to enable more clinicians to pass the examination in a timely manner has been one of the key policy recommendations of the ADG’s “Six to Fix” to increase the dental workforce and solve the current crisis in access to dentistry in the UK.  We are pleased that the GDC recognises this and are now taking practical steps to bring this about.

“Clearing the backlog of ORE applicants waiting to take the examination is a big step in the right direction – but more needs to be done, as too many applicants are still waiting for their applications to be processed..  We believe the GDC can also now move much faster in the “mutual recognition” of overseas diplomas from dental schools from other countries which would also add new recruitment pathways for overseas dentists.”

ADG goes Stateside in new international partnership

The Association of Dental Groups (ADG) has hosted a visit to UK dental practices this month with its sister organisation from the United States, the Association of Dental Support Organisations.

Following an introductory meeting between the two organisations last year in New York, the ADG team of Neil Carmichael, Clinical Director Sandra White and Operational Director Ruth Chesmore hosted a return visit in March for the ADSO visiting dental practices managed by ADG members Rodericks and BUPA in London.

Neil Carmichael, Chair of the ADG, said: “What was clear from our meetings here was that the challenges facing dentistry such as recruitment are global in nature and we have much to learn from our sister organisation in the United States.  The ADSO have recently launched a workforce taskforce to tackle the severe shortage of dental team members in the US reflecting our own concerns in the UK

“Our meeting found common ground on many of the issues and we hope to build on the relationship with a joint summit later in the year.  The ADG is also reaching out to our partners in the European Union who as our closest neighbours continue to play a critical role in recruitment of dentists.”

Photo caption: Shalin Mehra, Neil Carmichael and Sandra White meeting with Executive Director Andrew Smith of the ADSO

ADG launches Scotland branch to engage in Scottish NHS dentistry reform

The ADG launched the first roundtable meeting of its new Scotland branch on Thursday 16th February in Edinburgh.

Attendees included representatives from ADG members Clyde Munro, BUPA Dentalcare, my dentist and Portman together with prospective new members.  The meeting discussed and agreed the ADG’s “Six to Fix” policy proposals to narrow oral health inequalities in Scotland and create a more sustainable workforce in NHS dentistry.

Neil Carmichael, Chair of the ADG, said: “All four nations, England, Scotland, Wales and Northern Ireland have embarked on processes of reform of NHS dentistry services. In recognition of this we are establishing new branches in Scotland and Wales to engage in the process of reform with policymakers in the months ahead.” 

 “We welcome the continuing “bridging payments” being made by the Scottish Government until October this year, and the ambition for a reformed funding arrangement for NHS dentists so that they are supported for the future.  We wish to see a more administratively simpler and clinically focused system – but it must also include and embed dental workforce planning.”

BDA: UK dentists picking up the pieces from dental tourism boom

The popularity of travelling abroad for dental treatment is on the rise, a new survey by the British Dental Association (BDA) suggests. The evidence highlights the problems this has caused for patients and practices, with so many appointments unavailable during the last two years and the inevitable backlog which this has caused. 
 
According to a survey of 1000 UK dentists in the UK:  

  • The appeal of travelling abroad for dental treatment appears to be widespread, with 94% reporting that they had examined patients who had gone on such trips: however, the findings indicate that the lure of a quick fix may carry considerable risks. Of these dentists:
    • 86% reported having treated cases that developed problems following treatment abroad.  87% identified crowns as the treatment most likely to require follow-up work, closely followed by implants at 85%.
    • The highest single risk factor identified was failing or failed treatment (86%), closely followed by pain (76%), and poorly executed treatment (72%).
    • Fixing the damage can be costly for patients and some dentists questioned whether the NHS should provide this care. Two-thirds of respondents (65%) said that it cost patients at least £500 to repair the damage done to their teeth, while over half (51%) reported that it was more than £1,000. One in five of these dentists said the cost exceeded £5,000. Over 40% (346 dentists) said the remedial treatment was provided by the NHS. 
    • Over half (56%) reported seeing cases in the past three years, with a fifth (20%) seeing cases during the pandemic.
  •  
  • 84.6% state dental tourism is a growing trend. Cheaper costs were identified by 98% of all respondents as the lead factor influencing patients’ decisions to seek dental care abroad, while almost a third (31%) of those surveyed said that a perception of shorter waiting times was responsible. Many dentists highlighted the ubiquity of social media promotions touting the “perfect” smile.
  • 93% of all dentists responding identified concerns around continuity of care, 79% were unhappy with the quality of care, 77% mentioned the difficulties associated with seeking redress or making a complaint, while 66% flagged concerns over communications between patients and practitioners. 

Several dentists reported concerns about over-prepared teeth – where more of a tooth is removed than necessary – as well as ill-fitting crowns and implants that fell out. Others were worried that treatment proceeded despite having untreated gum disease, which was likely to increase the risk of crowns and implants failing, as well as being a major contributor to infection and pain.

Some dentists expressed alarm that patients had extensive work done to previously healthy teeth in “smile makeovers”, which would require a lifetime of costly maintenance, or could even lead to the loss of teeth and a need for dentures. One reported that a young man had 21 full crowns inappropriately placed to manage “what was clearly an orthodontic case to correct misaligned teeth.” Another said that they saw a patient with dental phobia who had 14 crowns placed under sedation, and who now needs four root canal treatments. 

The NHS advises people to think carefully before booking any treatment abroad, and issues a list of warning signs, many of which have been echoed by the dentists who participated in the study.   The dental regulator also advises people to be fully aware of what to expect and what risks are involved.  BDA is calling on the authorities to provide genuinely proactive campaigns to ensure patients are aware of the potential risks.

British Dental Association chair, Eddie Crouch, said: “Dentists are aware that many people are struggling to access care and may be tempted to go overseas for cut-price treatment.  

“Patients need to provide informed consent for any treatment they have and be wary of a hard-sell, as the reality is rarely as simple as it appears on Instagram.  Sadly, many UK dentists are now picking up the pieces when things go wrong. Complex courses of treatment typically require detailed preparation and a number of follow-up visits. Patients should be aware of the risks and alternatives to the treatment desired, and get advice on what they should do in the event of problems occurring when they return. The cost of follow-up treatment needs to be factored in. If there are complications, the initial price may not be such a bargain.

“We strongly advise people considering this to check a dentist’s qualifications and experience and whether they are insured if things go wrong.”

ADG fears growth of “dental tourism” will add to pressure on access to dentistry in UK

The Association of Dental Groups has responded to the British Dental Association’s survey of 1000 dentists released today highlighting evidence of a growth in “dental tourism” and the potential consequences of going abroad for “cut price treatment.”

The BDA survey of clinicians found that the most important factors influencing patients to seek care abroad were lower treatment costs and shorter waiting times.

The findings of the survey indicate that the lure of a quick fix may carry considerable risks with 86% of respondents reported having treated cases that had developed problems following treatment abroad, the most common cases being crowns and implants. Many dentists in the survey highlighted the ubiquity of social media promotions touting the “perfect” smile.

Neil Carmichael, Chair of the ADG, said, “Many people are struggling to access care and treatments and the lure of “instant fixes” abroad via social media can be tempting for some. Patients need to provide informed consent for any treatment they have and should be wary of social media instant solutions. Complex courses of treatment typically require detailed preparation and a number of follow up-visits with a trusted clinician. You should always think carefully about continuity of care with a trusted provider when considering treatment abroad. The rise of “dental tourism” risks creating a feedback loop into access to dental care in England. Patients seeking solutions abroad due to lack of access and UK dentists then picking up the pieces of failed treatments.”

 

British Dental Association online survey of UK dentists – Fieldwork 8-28 February 2022. 1000 respondents. Unless otherwise stated data is from all respondents.

Have you examined or treated any patients that have travelled abroad for dental treatment?

Yes:     94.6%     (944)
No:      5.6%        (56)

When did you see the patient/s? (944 respondents who indicated they have seen a patient that travelled abroad for dental treatment)

During the pandemic                   20.2%   (191)
In the past 3 years                        35.9%   (339)
In the past 5 years                        24%       (227)
In the past 10 years                      18.4%   (174)
Don’t know/Don’t recall              1.38%   (13)

What was the treatment for?   (944 respondents)

Crowns:                                           86.5%   (817)
Implants:                                        85%       (803)
Veneers:                                         56%       (532)             
Cosmetic dentistry:                       55%       (524)
Teeth whitening:                           12%       (113)
Orthodontics:                                 5.9%     (56)
Other General dentistry               18.2      (172)

Did any of your patients experience complications following their treatment abroad? (944 respondents)

Yes                                     86.2%   (814)
No                                      7.5%      (71)
Don’t know                      6.3%      (59)

Thinking about the last patient you saw who had treatment abroad and required remedial assistance on their return, what conditions or complications did they present with? Select all that apply (814 respondents who treated patients requiring remedial assistance)

Pain                                                                 76.4%   (622)
Infection                                                        70.0%   (570)
Failing/failed treatment                              86.4%   (703)
Inappropriately planned treatment        71.6%   (583)
Poorly executed treatment                       72.5%   (590)
None                                                               0.4%      (3)

Was the remedial treatment in the UK provided on an NHS or private basis? (814 respondents)

NHS                     42.5%   (346)
Private                57.5%   (468)

Can you quantify the approximate cost to repair this damage? (814 respondents)

Less than £100                12.7%   (103)
£100-£500                        22.4%   (182)
£500-£1000                      13.9%   (113)
£1000-2000                      11.7%   (95)
£2000-5000                      17.4%   (142)
More than £5000            22.0%   (179)
 
What concerns if any do you have about people going abroad?

Continuity of care                                                                     93.5%   (935)
Communications between patients and practitioners       65.8%   (658)
Ability to complain/seek redress                                            77.0%   (770)
Quality of care                                                                          79.4%   (794)
Other (please specify):                                                            15.9%   (159)

In your view, is dental tourism a growing trend?

Yes                       84.6%   (846)
No                        2.3%      (23)
Don’t know        13.1%   (131)

What factors do you think are influencing patients to seek care abroad? (Select all that apply)

Lower treatment costs                               98.3%   (983)
Shorter waiting times                                 31.2%   (312)
Access to up-to-date technology              7.8%      (78)
Access to quality treatment and care      6.3%      (63)
Other (please specify):                               19.9%   (199)

199 cited other factors, with social media featuring prominently in responses.

England’s “Dental Deserts” and the urgent need to level up access to dentistry

The ADG has a launched a new report today highlighting the parts of England at most risk of becoming “dental deserts” without government action.

The pamphlet also includes new data obtained on the number of dentists undertaking NHS activity which reveals a further fall of over 2,000 from the March 2021 figure of 23,733[1].  ADG research and a Freedom of Information request[2] on workforce activity in January 2022 indicates a fall of 2,000 dentists in England undertaking NHS work this year, the lowest number for a decade.  Without addressing this workforce crisis, the backlog in care is unlikely to be recovered and “dental deserts” in England will continue to grow.

Last year, NHS data[3] showed that the Top 10 parts of England with the lowest number of NHS dentists per 100,000 of population were:

North Lincolnshire CCG                     32 NHS dentists (per 100,000 population)

North East Lincolnshire CCG             37 NHS dentists

East Riding of Yorkshire CCG             37 NHS dentists

Lincolnshire CCG                                38 NHS dentists

Norfolk & Waveney CCG                   38 NHS dentists

North Staffordshire CCG                   40 NHS dentists

Portsmouth CCG                                42 NHS dentists

Halton CCG                                         42 NHS dentists

Stoke on Trent CCG                           43 NHS dentists

NE London CCG                                  43 NHS dentists

Other areas of the country struggling to provide access to NHS dentistry in the “Top 20” include the Isle of Wight, Cornwall, Thurrock in Essex and Kent and the Medway towns.

With a joint foreword by Peter Aldous, MP for Waveney who represents one of the hardest hit parts of the country and ADG Chair Neil Carmichael, the paper proposes “six to fix” policy recommendations for Government to solve the crisis in access to dentistry in its pamphlet.

Neil Carmichael, Chair of the ADG, said: “Dental deserts not only stretch across the whole of the East of England from East Yorkshire, through Lincolnshire and down to Norfolk but are now emerging in many other ‘red wall’ constituencies that the Government wishes to ‘level up’.

“Our fears of an exodus from NHS dentistry are proving to be founded and the number of NHS dentists working in England is now at the lowest level for a decade.

“We welcome the Government’s commitment to reform of the recruitment and registration of overseas dentists – what needs to follow is NHS dental contract reform and investment in our future domestic workforce – only when this happens will we have a chance of tackling the oral health inequalities of England.”

References:

[1] NHS Dental Statistics for England – 2020-21 Annual Report – NHS Digital

[2] FOI 23376 – Datasets – Open Data Portal BETA (nhsbsa.net)

[3] NHS Dental Statistics for England – 2020-21 Annual Report – NHS Digital Annexe 2 Table 2A