Dentistry’s veteran campaigner downs drill to fight for future of service in Scotland

The British Dental Association is delighted to announce dentist and experienced campaigner Charlotte Waite will take on a leading role in the fight for the future of dental services in Scotland.

She will take up the role of Director of BDA Scotland in October, supporting members in negotiations with the Scottish Government and overseeing outreach to the Scottish Parliament, officials, the press and wider stakeholders.

Prior to the pandemic Charlotte exposed the scandal of Westminster’s aggressive NHS fines regime, which saw millions of often vulnerable patients face £100 fines for attempting to claim free dental care or prescriptions. 

Working with the media and speaking up for patients in the UK parliament, she lifted the lid on a system that saw 1.7 million fines – worth £188 million – withdrawn because the ‘fraudsters’ targeted were actually fully entitled to claim support towards NHS dental or prescription charges. Off the back of her powerful evidence to the Westminster Public Accounts Committee, the UK Department of Health and Social Care abandoned a ‘fines first’ policy, based on the presumption of guilt. 

While redeployed on the front line during COVID she revealed chronic PPE shortages that left hundreds of Urgent Dental Care centres struggling to deliver care to patients in agony, when most practices were closed for routine care.

Working with partners including Mencap she has continued to press the UK government for action on backlogs for patients facing yearlong waiting times for dental treatment under general anaesthetic as a result of pandemic disruption. She has also led efforts to encourage the use of Makaton – a unique language programme that uses symbols and signs, alongside speech – within dental settings, to break down barriers to communication with dental patients with learning disabilities. She has also spoken out in the press and lobbied the UK Government for better investment and provision of dental services for people experiencing homelessness and for residents in care homes.

News of Charlotte’s appointment comes in a week the BBC revealed 82% of NHS practices in Scotland were not accepting new adult patients, with 1 in 5 stating they had waiting times of a year or longer. Researchers were unable to find any practices taking on new patients in 9 of Scotland’s 32 local authorities.   

BDA Scotland has warned Ministers and officials they risk undermining the future sustainability of NHS dentistry, with cuts to financial support leaving some practices delivering some NHS treatments at a loss. There is a growing exodus from NHS dental services, with official data showing the total number of high street NHS dentists in Scotland has fallen by over 5% since the onset of Covid.

Waite will be pursuing BDA Scotland’s call for development of a new, sustainable long-term model for NHS dentistry, support for dentists in all fields of practice, and effective action to tackle Scotland’s deep oral health inequalities, which are now set to widen as a result of the pandemic.

The Glasgow-born Waite qualified in Dundee, before completing general professional training in the East of Scotland, locuming in Australia and then working in the Community Dental Service (CDS). She will be leaving her longstanding role in the CDS where she has provided dental care for some of the most vulnerable in society.  

Charlotte Waite said: “I’m downing my drill to fight for the future of dentistry in Scotland. The service is on the brink and the public are living with the results. The Scottish Government pledged free NHS dental care for all, but we now face an exodus from the workforce, the risk of a two-tier system, and a shameful oral health gap that will only widen.  

“Our message to every MSP and every party is that this crisis will not end without real commitment. Sit down with us and we can secure a better future for a service millions depend on.”

NHS Dentists demand lifeline as ‘dental inflation’ soars

Dentists need real support from all four UK governments to withstand the impact of ‘dental inflation’, now standing at over 11% according to new analysis from the British Dental Association.   
  
BDA modelling of data from NHS Digital, the Office of National Statistics and its own surveys has shown the huge inflationary pressures that dentists are facing, with lab bills increasing on average by 15% and nearly one-fifth of dentists seeing their utility bills rise by more than 50%.   
  
Following the real-terms pay cuts announced this week, the BDA is demanding all UK health departments ensure that uplifts on expenses – anticipated shortly – at least keep pace with inflation, to ensure dentists are not left delivering NHS care at a financial loss. 
  
Dentist leaders are stressing failure to keep pace with rising costs will have real consequences for practices as they struggle to deliver care and recruit and retain dentists and staff.   
   
In setting out its recommendation on pay, the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) noted that: “our recommendations this year are net of expenses and therefore do not take into account fluctuations in operating costs. Ensuring that dental practices’ financial sustainability and dental earnings are not affected by such fluctuations is an important responsibility that lies with the governments, in agreeing expenses uplifts.”
 
The DDRB recommends on pay, the four UK administrations are then responsible for determining an allocation for expenses to deliver an overall uplift in fees and contract values. They add: “Expenses uplifts must be sufficient to both deliver dental services and protect dental incomes, ensuring that our pay recommendations are received by providing-performers and associates alike, in order that they can address issues of recruitment, retention and motivation.”

In England the funding given to practices for training newly qualified dentists has also been frozen since 2010. This payment remains at £5,347, whereas – had it been uplifted in line with inflation – it would now be £8,030, a fall of a third.   
  
Thousands of dentists have left the NHS since the first lockdown. Given the exodus, the BDA is also pushing for full restoration of these training service costs to guarantee the pipeline of young talent entering the service.    

The BDA’s Deputy Chair Peter Crooks said: “Dentists have been handed another real-terms pay cut. It would be foolhardy for officials to apply the same logic to their expenses given the soaring costs of delivering dentistry.   
  
“No frontline health professional should be expected to provide NHS care at a financial loss.   
  
“Dental inflation is soaring. Many dentists are already reconsidering their future in the NHS, and if governments fail to step up it will have devastating consequences for millions of patients.”   

BDA: Failure to halt record-breaking cuts to real incomes will fuel exodus from NHS

The British Dental Association has warned the derisory pay awards confirmed today for dentists – at 4.5% – will only accelerate the workforce crisis facing NHS dentistry across the UK.

Dentists have seen their real incomes collapse by nearly 40% since the financial crash, with analysis of data from across the public sector and health professionals indicating the fall has no parallel in the UK public sector.  

Official data for 2020/21 is yet to be published, but dental accountants NASDAL have indicated a further fall in earnings – in cash terms – of over 10% for typical dentists.

The Health and Social Care Committee was warned in May that NHS dentistry faced a ‘slow death’, with endemic recruitment and retention problems, and thousands of dentists having left the service since lockdown. While typical levels of pay are only negligibly higher in the private sector, dentists are afforded greater time with patients, without the pressures of working to ‘tick boxes and targets’ model of the discredited NHS contract.

The BDA has said it now intends to canvass its membership to assess the appetite for a full range of action in response.  

Peter Crooks, Deputy Chair of the BDA said:

“For a decade we’ve seen euphemisms of ‘pay restraint’ and ‘efficiency savings’ amount to the deepest pay cuts in the public sector.  

“This derisory offer will only serve to give dentists more reasons to reconsider their future in the NHS, and millions of patients will pay the price.” 

NHS dentistry: Ministers papering over cracks, as dentists push for real reform

The British Dental Association has said government must press ahead on fundamental reform of NHS dentistry, following plans announced today that will do little to arrest the exodus of dentists from the service, or address the crisis in patient access.

The current target-based system funds care for little over half the population and sets perverse incentives to dentists, rewarding them the same for doing one filling as ten. The unsuitability of this model during the pandemic has accelerated the drift of dentists away from the NHS into a full-on exodus. Thousands of dentists have left the NHS in England since lockdown, with almost half reporting having significantly reduced their NHS commitment.

The plans – elements of which will require secondary legislation so cannot take force until after summer recess – include:

  • A minimum UDA value. The payment dentists receive for hitting a target – the Unit of Dental Activity – will now be set at a minimum of £23.00. The BDA has noted that only around 3% of practices will benefit, stressing that any increase will not reverse a decade of savage cuts in the service, which can leave practices providing NHS care at a financial loss, particularly to high-needs patients.
  • A higher reward for treating 3 or more teeth. Dentists will now receive 5 UDAs for treating 3 or more teeth, an increase on the current level of 3 UDAs, which applied to care delivered to any number of teeth. The BDA stress that given patients are now presenting requiring as many as 20 fillings, perversity will remain baked into the system, with less complex work still rewarded at the same rate as treatments that take hours. 
  • A new payment rate for complex treatment. Root canal treatment on molar teeth will now be rewarded with 7 UDAs, as opposed to the current 3, as a result of BDA lobbying. However the BDA stress the move is unlikely to be a game changer, given the nature of the challenging and time-consuming treatments – which can take up to 3 hours on a single tooth.
  • A greater role for dental therapists. There is no hard evidence of a workforce waiting in the wings for the chance to work under the failed NHS contract.

The dentists’ professional body is taking a neutral position on the new package of changes, neither endorsing nor rejecting what it characterises as modest and marginal fixes to the widely discredited NHS dental contract. It has stressed that it remains focused on wholesale change to the broken system, where formal negotiations with NHS England have yet to begin. It has expressed some concern that the Government has offered no guarantees that pledges of fundamental reform will be honoured, stressing this package cannot form a final destination for the service.

The BDA has stressed that these changes – which come with no new investment – show the limits of what can be achieved for patients without greater commitment from the Treasury. The BDA estimate it would take an extra £880m simply to restore funding to levels seen in 2010. [2] Over 44 million NHS dental appointments have been lost since lockdown in England alone – more than a year’s worth of care in pre-COVID times. [3]

Shawn Charlwood, Chair of the British Dental Association’s General Dental Practice Committee, said: “These are modest, marginal changes that will not fix the rotten foundations this service is built on. Our patients need Ministers to do more than paper over the cracks. These tweaks will do precious little to keep dentists in the NHS or ensure millions get the care they urgently need.

“The simple fact is not a penny of new investment has been pledged, and government targets will still come before patient care. Today is little more than a small step on the road to real reform. If government considers this a final destination then it will mean the death of NHS dentistry in England.”

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.

“As sugary as Cola”: Dentists call for sweeping action on baby pouches

The British Dental Association has warned that obscene levels of sugar in popular baby food pouches underline the need for wide-ranging government action across the early years’ food and drink sector.

Despite widespread claims of ‘no added sugar’ in these products, dentists have stressed that as far as teeth are concerned there’s little to no difference if the sugar is added or naturally occurring.  

Market analysis by the British Dental Association of 109 pouches aimed at children aged under 12 months indicates:  

  • Over a quarter contained more sugar by volume than Coca Cola, with parents of infants as young as 4 months marketed pouches that contain the equivalent of up to 150% the sugar levels of the soft drink. Those pouches are without exception fruit-based mixes.   
  • ‘Boutique’ brands appear to have higher levels of sugar than traditional baby food brands or own brand alternatives, with market leaders Ella’s Kitchen and Annabel Karmel coming in for criticism. While high levels of ‘natural’ sugar have been described by manufacturers as inevitable with fruit-based pouches, some brands offer products based on similar ingredients that contain around half the levels of sugar of the worst offenders.  
  • Some products examined aimed at 4 months+ contain up to two thirds of an adult’s recommended daily allowance (RDA) of sugar. Neither the World Health Organisation (WHO) nor the UK Government’s Scientific Advisory Committee on Nutrition (SACN) cite an RDA for children, simply stressing that as little should be consumed as possible.  
  • Both UK and WHO guidance recommends weaning from 6-months-old, so no products should be allowed to be marketed as ‘4months plus’. Nearly 40% of products examined were marketed at this age group.  
  • The sector has consistently adopted disingenuous language highlighting the presence of only “naturally occurring sugars” or the absence of “added sugars”, with others making opaque claims of products being “nutritionally approved” or in line with infants’ “nutritional and developmental needs”. All high sugar products adopt ‘halo labelling’ principles, focusing on status as ‘organic’, ‘high in fibre’ or ‘containing 1 of your 5 a day’, misleading parents into thinking they are making healthy choices.   
  • Over two thirds of the products examined exceeded the 5g of sugar per 100ml threshold set for the sugar levy applied to drinks. Dentists stress expansion of fiscal measures would likely have favourable outcomes in terms of encouraging reformulation.  

These pouches have surged in popularity among parents, owing to their convenience. Beyond encouraging a preference for sweet tastes – which carries lifelong health risks – the BDA warns they also carry oral health risks when compared to foods available via jars. Contents are often sucked directly from the pouch, ensuring the food spends more time in contact with baby teeth, just as they are erupting, and putting teeth at risk of erosion and decay

Tooth decay is the number one reason for hospital admissions among young children, and the SACN has warned infant feeding practices and delayed or poor dental hygiene may be associated with decay prevalence and have recommended a preventive focus on both areas. Public Heath England (now the Office for Health Improvement and Disparities) national guidance states that from 6 months of age, infants should be introduced to drinking from a free-flow cup or beaker, and from the age of 12 months they should be discouraged from drinking from a bottle. Open-topped cups or cups with spouts that are free-running rather than valved are recommended so that there is no need to ‘suck’.  

The BDA has lamented the lack of clear messages from manufacturers not to consume products straight from the pouch in both packaging and their wider marketing collateral, with Annabel Karmel products explicitly stating “eat straight from the pouch.” 

The Department of Health and Social Care is expected to consult imminently on the marketing and labelling of infant foods. Dentist leaders say the excessive levels of sugar in many of these products clearly warrants government action across the sector, including confronting the tactics used by sales teams, implementation of a clearer ‘traffic light’ style for labelling, and potentially expansion of fiscal measures such as the Sugar Levy to encourage reformulation.  

Oral health inequality is now set to widen as a result of the pandemic, owing to ongoing disruption to routine care, the suspension of public health programmes, and the impact of sugar-rich ‘lockdown diets’.

Analysis in 2021 by Action on Sugar that showed among 73 baby and toddler sweet snacks such as rusks, biscuits, oat bars and puffs, only 6 products (8%) would get a green (low) label for sugars.

British Dental Association Chair Eddie Crouch said: “Disingenuous marketeers are giving parents the impression they are making a healthy choice with these pouches. Nothing could be further from the truth. Claims of ‘no added sugar’ are meaningless when mums and dads end up delivering the lion’s share of a can of Coke to their infants. Tooth decay is the number one reason for hospital admissions among young children, and sugar is driving this epidemic. These products sadly risk hooking the next generation before they can even walk. Ministers need to break the UK’s addiction. They must ensure sugar becomes the new tobacco, especially when it comes to our youngest patients.”  
                                                                                                                 
Methodology:   
Market analysis of brands undertaken May-June 2022, examining 109 products marketed at infants under 12 months, covering both sweet and savoury.  Full data here: https://www.bda.org/advice/Documents/Infant-pouch-market-scan-table-June-2022.pdf

The worst offenders 

*Ella’s Kitchen and Annabel Karmel fruit pouches dominate the top reaches of the market, in terms of the highest sugar levels per 100g. Other brands captured represent outriders from boutique, traditional mass-market baby food manufacturers and own-brand lines.

BDA: ARF increase risks undermining hard-won progress on regulation

The British Dental Association has warned that signals the General Dental Council will move to increase the Annual Retention Fee will only undermine progress in rebuilding trust and confidence in the regulator among the profession.

Despite significant reserve levels, the BDA states that the regulator has signalled its intentions to raise fees above levels set in 2019, to around £730 (+7%) for dentists and to around £120 (+5%) for dental care professionals, as part of its emerging strategic plan for 2023-25. 

The BDA has said future hikes will inevitably damage goodwill among the profession, despite welcome commitments to improve ‘preventative regulation’, and recent improvements in the regulator’s performance in relation to fitness to practice.

The BDA will provide a full response to the consultation in due course.

Shareena Ilyas, Chair of the BDA Ethics, Education and Dental Team Working Group, said: “Any hike in the ARF is impossible to justify while the GDC is sitting on vast reserves. The costs of providing care are spiralling, while the real incomes for all team members have collapsed. Further fee increases will only undermine any gains when it comes to restoring this profession’s confidence in its regulator.” 

In response to the BDA’s comments, a spokesperson for the General Dental Council said: “This is a consultation on our strategic plans for the next three years and we look forward to hearing the views of everyone who holds an interest in our work, which of course includes dental professionals. Our target is to maintain a free reserve level equivalent to four and a half months of operating costs, and we believe the approach we’ve set out will maintain that level. If we are to continue ensuring patient safety and promoting the confidence that the public rightly have in dental professionals, the GDC must be financially sustainable and we are not immune to the inflation which is affecting everyone.”

NHS dentistry on the brink as Ministers cut vital support, says BDA Scotland

The British Dental Association Scotland has warned Ministers they risk undermining the future sustainability of NHS dentistry, as they move to scale down vital financial support for the service.  

For the last three months practices have received a 1.7 multiplier to the fees paid to provide NHS care, a reflection of the unprecedented backlog practices have faced as they try to ‘live with Covid’. The Scottish Government has now moved to pare the multiplier down to 1.3 for the next 3 months. This reduction follows no dialogue with the profession despite the BDA calling for regular discussions with the Government about the latest activity data and any proposed changes.

The discredited low margin/high volume model dentists in Scotland work to means treatment can often be delivered at a loss, a growing problem given the growing levels of unmet need, particularly among those from move deprived communities.   

Official data suggests the total number of high street NHS dentists in Scotland has fallen by over 5% since the onset of Covid. The BDA warn heavy-handed policies will only push Scottish dentists down the road of their colleagues in England, where thousands of dentists have left the NHS since lockdown, amid warnings from MPs south of the border that NHS dentistry now faces a ‘slow death’. 

The BDA has again urged the Scottish Government to, in the short term, develop a suitable interim funding package to support dentists and their teams as they work through the backlog, and begin work on a new, sustainable long-term model for NHS dentistry. Dentists remain anxious that the Government will look to remove the multiplier altogether at the first opportunity despite its stated intention not to return to the pre-pandemic financial arrangements. The BDA has repeatedly voiced its strong opposition to a return to the pre-Covid “treadmill”.

David McColl, Chair of the British Dental Association’s Scottish Dental Practice Committee said:“Ministers are playing with fire, pulling away the life support from a service millions depend on.  

“This multiplier helped ensure NHS dentists received fees for care that actually covered their costs.  Slashing them will leave colleagues churning out dentures at a loss while thinking twice about their future. 

“Scotland has already lost too many NHS dentists since lockdown. Ministers are now blindly heading down the path the Westminster Government has chosen, which has sparked an exodus. 

“Cuts have consequences. The Scottish Government promised free NHS dentistry for all. Short-sighted policies like this will likely result in the exact opposite, and stark oral health inequalities will only widen further.”

Government paying the price for failing to fix crisis in NHS dentistry, says BDA

The British Dental Association has responded to reports that access to NHS dentistry ranked alongside issues with local schools and Partygate in fuelling the Conservatives landslide defeat in the Tiverton by-election.

The news comes in a week in which MPs have pressed Ministers for urgent change in NHS dentistry in two major debates, and follows warnings from the BDA to the Health and Social Care Committee last month that the service faces ‘slow death’ without real reform and fair funding.

The current system funds care for little over half the population and sets perverse incentives to dentists, rewarding them the same for doing one filling as ten. The unsuitability of this model during the pandemic has accelerated the drift of dentists away from the NHS into a full-on exodus. Thousands of dentists have left the NHS in England since lockdown, with many more significantly reducing their NHS commitment.

Modest, marginal changes to the current discredited target-based NHS dental contract are set to be announced before summer recess. Formal negotiations on meaningful wholesale reform of the contract are yet to begin. 

British Dental Association Chair Eddie Crouch said:

“The Tiverton by-election underlines the real political cost of failure to fix the crisis in NHS dentistry.

“It’s easy to understand why the inability to access basic healthcare services is resonating on the doorstep.

“The barriers facing millions of people in pain are made in Westminster. Until government turns the page on a decade of underfunding and failed contracts we will not see progress.

“Patients and voters deserve better.” 

LDCs call on government to resuscitate NHS dentistry before it’s too late

Motions on the existential crisis in NHS dentistry took centre stage at this year’s local dental committees’ (LDCs) annual conference, amid 3,000 dentists who walked away from the NHS in England.

The urgent need for contract reform and funding NHS dentistry properly were among the 35 motions debated at the conference held in Newport, Wales, on June 10th, and chaired by Dan Cook.  250 delegates attended, the majority in-person, with those unable to travel joining virtually.

In his update to conference, GDPC chair, Shawn Charlwood warned that NHS dentistry is in intensive care and the government needs to resuscitate it from catastrophic decline before it’s too late. “I told Jeremy Hunt and his Health Select committee colleagues that I feared a slow death for this service,” he said. He expressed his disappointment that, contrary to expectation, the Minister for Dentistry, Maria Caulfield, did not attend, citing ‘urgent departmental business’. In her absence,  Shawn presented a number of pressing questions he would have asked the Minister had she attended, including whether there is a future for NHS dentistry.

Delegates passed motions calling for dentistry to be ‘built back better’ following the pandemic, with contract reform that delivers for patients and the profession. Given the real terms cuts over the past decade, there was significant debate about the limits to what NHS dentistry can provide. A motion from ‘Red Wall’ Wakefield LDC urging NHS England to ensure that everyone can access an NHS dentist was passed.  A motion from North Yorkshire on the need to engage patients and dental teams to increase pressure on the government to implement ‘immediate changes to the NHS dental contract” via an online petition was also passed.

Dental leaders also expressed their frustration over being side-lined by the new integrated care systems (ICS) because they are not represented on either the Integrated Care Board or the Integrated Care Partnership. For this reason, a motion from Manchester LDC expressing no confidence that local dental problems would be solved by the ICS, was passed.

Several motions highlighting  a ‘recruitment and retention crisis’ of dental nurses, and calling for barriers to be removed, were also passed.  These include one from Wirral LDC, which called on the government to recognise that the dental team is ‘part of the NHS’ and therefore should be offered NHS benefits, including the NHS pension scheme.

The new chief dental officer for Wales, Andrew Dickenson, joined the conference online from Germany.  He discussed his priorities for the transformation of dental services in Wales and said these would focus on preventative care, and expanded team working. He said oral health evidence would drive improvement, taking into account population health and whole system change would be underpinned by contract reform. 

The Conference heard from dental consultant, Alan Suggett, UNW Chartered Accountants, on the financial realities dentists and practices are facing. This showed starkly how the national funding constraints have led to a real financial pressure for dentists.

Countering the growing frustrations with the NHS,  a panel of four dentists held forth on the optimism they felt about various opportunities to diversify their incomes and careers. This prompted lively discussions on a wide range of ways in which dentists can take control over their own working lives.

Agi Tarnowski from West Sussex LDC was voted as chair-elect for the Annual Conference of LDCs 2024.

Mark Robotham, from Gwent LDC, Peter Tatton from Hertfordshire LDC and John Sheldon from the South West London LDC were honoured with the Unsung Hero Award.

Further information about the event, including the full list of motions carried, will be available on the dedicated LDC Conference website shortly.

 If you require pictures, please contact LDCSupport@bda.org.