ADG

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 Podcasts, Google Podcasts, Spotify 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

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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.”

ADG: Children face ‘triple whammy’ of coronavirus dental dangers

Thousands of children could soon require hospital operations to remove unsavable teeth due to a ‘triple whammy’ of dental dangers, states the Association of Dental Groups (ADG).

Hospitals in England carried out an average 177 operations a day on children and teenagers last year to remove teeth, costing the NHS more than £40m.

Now the Association of Dental Groups is warning that lockdown will make the problem significantly worse as:

  1. Many children have stopped going to the dentist or been unable to get appointments
  2. Children are more likely to snack on more sugary foods and drinks while stuck at home
  3. Community oral health programmes for children have been interrupted

Neil Carmichael, Chair of the ADG, said: “Before lockdown, there were multiple operations being conducted every day to remove children’s teeth across the UK. Since then children have faced a triple whammy of dental dangers so it’s inevitable that things will get worse. When routine appointments restart, dentists could have their work cut out dealing tooth decay among children. In hospitals all the signs are that we’re looking at more operations than ever to remove children’s teeth.”

There is mounting evidence than millions of people have been staying away from dental surgeries or being unable to get appointments during lockdown. A major new poll by the ADG suggests that children in 50% of households across the UK have missed or decided against a visit to the dentist since lockdown began.

The UK already the lowest number of dentists per capita of any G7 country, leading to growing concerns that a backlog of care may well occur after the pandemic unless measures are taken to aid recruitment into the profession.

Dentists have also expressed concern over ‘lockdown diets’ including more sugary treats and fizzy drinks having an adverse effect on children’s oral health. One survey for a member of ADG found that 77% of dentists expect the ‘lockdown diet’ to have an adverse impact on the nation’s oral health. Other anecdotal evidence suggests an increase in sugary baking particularly at the beginning of lockdown and an increase in sugary snacking. 

Finally, dental professionals have expressed concern over community dental services which normally deliver child oral health improvement programmes through Local Authorities, which have now been disrupted. These are early intervention, preventative programmes in areas of likely poor child oral health.

Sue Jordan, Assistant Director, Oral Health Improvement for CDS-CIC, which deliver community dental services and oral health improvement across much of east and central England said: “Over lockdown 90% of our outreach to the most vulnerable communities in our regions has been shut down. In normal times we support more than 2000 young children to do supervised teeth cleaning and today not one child will be receiving that help. We have helped children as old as three who didn’t know which way to hold a toothbrush. They won’t be receiving that help any more or the structure that they need to prevent dental problems. They won’t be able to get that help until post-covid routines can be normalised either.

“All the evidence we have suggests that early preventative care for dentistry has a huge return on investment. We know that our work can save up to nearly £7 for every pound spent. After Covid, that bill will eventually come due with massively negative consequences for the children and the NHS. Dentistry really is a critical preventative service, the problems that get worse for these children suffer during lockdown can only get exponentially worse over time. we are going to have a real uphill struggle getting back on track when this is all over.”

The CDS-CIC work with Local Authorities, the NHS and other Community organisations to identify the most at risk children for dental problems. Their work helps identify and educate younger people in particular to improve their oral hygiene.  https://communitydentalservices.co.uk/

Data around number of dentists taken from https://www.nao.org.uk/report/dentistry-in-england/

ADG: Dentists set for post-Covid ‘horror show’ as millions of Brits pull own teeth out during lockdown

Millions of people have been pulling their own teeth out and attempting to treat their cavities at home since lockdown started.

A new poll by the Association of Dental Groups (ADG) reveals the shocking full extent of ‘DIY dentistry’ that has been undertaken across the UK this year. It is part of a major campaign that the ADG has launched calling on ministers to take action to deal with a worsening crisis in access to UK dentistry.

Pollsters found that a staggering 25% of households across the UK have attempted at least one form of DIY dentistry – including taking painkillers.

Within the 25% figure, the polling suggests that:

  • Someone has taken painkillers for tooth or gum pain in 12.7% of households / 3.5m homes
  • Someone has attempted to treat a cavity in a tooth 7.9% of households / 2.2m homes
  • Someone has attempted to extract a tooth in 7.6% of households / 2.1m homes

Many surgeries reopened last month after being shut during lockdown, but strict rules mean they can only deal with just a few patients a day.

The poll findings will add to dentists’ mounting concerns about the scale of the problems they will encounter when routine appointments start again. The problems look set to be compounded by falling numbers of NHS dentists in many parts of the UK. The UK already has the lowest numbers of dentists per capita among comparable Western countries.

ADG chair Neil Carmichael said: “Pulling your own teeth out is rarely a good idea as it can damage the surrounding teeth and lead to long-term problems. These findings suggest that when routine appointments restart, dentists across the country should brace themselves for an oral health horror show.

“All of the signs are that dentists will be called upon to repair the damage caused by broken and knocked out teeth – on top of a host of other oral health problems that lockdown has been storing up.

“This would be bad enough if we did not already have an access crisis in dentistry with many people struggling to get appointments. Ministers must now take urgent action to ensure that the we have the NHS dentists we need to deal with what’s around the corner.”

ADG: New figures show ‘dentists are deserting the NHS and poorest patients are paying the price’

The Association of Dental Groups has responded to the recent publication of the NHS Dental Statistics for England 2019-2020. The statistics reveal that overall, the number of dentists with NHS activity in England went up slightly – from 24,545 in 2018/19 to 24,684 in 2019/20.

But they also reveal significant regional disparities – with 65 NHS clinical commissioning groups seeing dentist numbers go down over the past year. At seven NHS clinical commissioning groups, dentist numbers declined by 20% or more from 2018-19 to 2019-2020.

Neil Carmichael, Chair of the ADG, said: “The figures are just the latest proof that the number of dentists working in the NHS is plummeting in many of the areas where they are most needed. In large parts of the country, dentists are deserting the NHS and it is the poorest patients who are often paying the price. That’s why we urgently need to increase the pipeline of new dentists here in the UK while also making it easier for overseas professionals to enter UK dentistry.”

 

The NHS Dental Statistics for England 2019-2020 can be accessed here: https://digital.nhs.uk/data-and-information/publications/statistical/nhs-dental-statistics

Workforce figures are taken from Table B1 in Annex 2 – Geographical breakdown of dental data.

They show that NHS Fareham and Gosport CCG, NHS Isle of Wight CCG, NHS Portsmouth CCG, NHS South Eastern Hampshire CCG, Southampton CCG and NHS Bassetlaw CCG saw a percentage difference of 20% or more from 2018/19 to 2019/2020.

ADG members consist of group providers of NHS and private dentistry across England and Wales. Find more information about the ADG on their website here.

ADG launches campaign as Covid-19 takes its toll on the nation’s oral health

The Association of Dental Groups has launched a national campaign calling on ministers to take urgent action to deal with the growing crisis in access to dentistry.

Ten weeks after dental practices started to re-open, the ADG is exploring the impact that lockdown has had on the national’s oral health. The centrepiece of the campaign will be new analysis showing how different parts of the country have been affected by Covid-19 restrictions.

The analysis will be shared with MPs and policy makers to ensure they are aware of how Covid-19 has further exacerbated existing problems with access to dentistry in constituencies across the UK.

It will include several recommendations for ministers to take forward to deal with the crisis in access to dentistry, with the focus on securing an increase in recruitment and retention of dentists.

The new campaign has been launched with a comment article here by Neil Carmichael, chair of the ADG.

Neil Carmichael says: “Few dentists are looking forward to seeing the full impact that lockdown has had on the nation’s teeth. But while dentists are already sounding alarm about where lockdown has left us, this is just the latest part of a bigger crisis we are seeing in UK dentistry. The reality is that Covid has made the situation worse and we will shortly be bringing forward new analysis that sets out just how bad it has become. At this stage, all of the signs point to a worrying picture with lockdown having led to less patients being seen and some of the most vulnerable groups being hit hardest.

“Our goals are attracting and training people here in the UK to become dentists and reforming the registration process for overseas dentists to work for NHS dentistry which has been exacerbated by lockdown and Brexit.”