NHS Dentistry: No turning back to broken system in Wales

The British Dental Association Cymru has lauded the statement today from Baroness Morgan, which indicates there will be no return to the ‘failed system’ NHS dentistry operated to prior to Covid.

The widely discredited target-based contract for high street dentistry, in operation since 2006, was effectively suspended at the onset of lockdown. It capped patient numbers, failed to reward preventive work, and fuelled both access problems and a collapse in morale among the profession.

The Minister has pledged to ensure that all the gains experienced within the variation to the General Dental Services contract will be preserved as Wales moves out of the pandemic recovery of NHS dentistry.  

An evolutionary approach to reform has been working well under the leadership of the Chief Dental Officer Dr Colette Bridgman, and the BDA sees this partnership with dental branch continuing as it heads towards the next phase of contract reform in April 2022.  

Dr Bridgman retires this month, and she has ensured that continuity plans are in place until her successor is appointed. The BDA has stressed its commitment to work with the new CDO to ensure that the profession is fully consulted every step of the way towards a reformed NHS contract that works for the profession and patients.

Access to NHS dental services faced crisis prior to the pandemic. Back in 2012, 37% of practices in Wales were accepting new NHS patients, but by 2019 fewer than 16% were able to take on new adults. 

Russell Gidney, Chair of the BDA’s Welsh General Dental Practice Committee, said: “This is welcome news for families across Wales. It means there will be no turning back to a failed system that put government targets ahead of patient care. In Wales at least we are assured that the mantra of build back better is actually being applied to our health services.” 

Dental practices in Wales reportedly ‘operating at less than a quarter of capacity’

ITV News is reporting that dental practices are ‘operating at less than a quarter of capacity’ in Wales and that they will not be operating fully until ‘at least October’ according to some claims.

The report states that while services at dental surgeries across Wales are able to resume, as lockdown restrictions have been eased, stringent guidelines have made it difficult for them to operate fully. The Welsh Government allowed dental practices to resume from 1 July, however, a “phased approach” was taken due to the fact that, in some procedures, the risk of cross-infection is high due to the transfer of saliva.

Professor Mike Lewis told ITV News that this is why dentistry was going to be one of the areas of medicine that is going to “find it very difficult to return to normal because of the aerosol generation.”

Dental practices in England could fully resume on 8 June, while practices in Wales are currently operating under an ‘amber light’ in which some, but not all, procedures can resume.

A spokesperson for the British Dental Association said: ” The green status, where routine care returns, is unlikely to be reached till October at the earliest. Both nations are operating fallow time and maintaining 60 minute gaps between patients to reduce risk of viral transmission. This is a major barrier to access for all. It is not a return to business as usual in either nation. Most practices are operating at less than a quarter of their pre-pandemic capacity.”

Video consultation services in Wales extended to dentistry

The Minister for Health and Social Services in Wales, Vaughan Gething, last week announced that video consultation services in the country were to be extended to dental practices, as well as opticians and community pharmacies. This follows on from the successful rollout of such services in primary, secondary, and community care during the Covid-19 pandemic.

Video consultation has rapidly expanded across Wales during the last few months, ensuring that the public retains access healthcare services during the Covid-19 response. More than 6,400 GP video consultations have been undertaken so far, along with 8,800 video consultations to support community and secondary care. The Welsh government states that 92% of patients have rated the service as excellent, really good or good.

Not only has video consultation allowed essential services to continue, but it also helped to protect patients and NHS employees from an increased risk of infection. The service has reportedly saved 36,000 miles of travel and 1,200 hours of travel time. It has also reduced Co2 emissions by an estimated nine tons.

A pilot will now take place during July to extend the services to dentistry, optometry and community pharmacies, all of which have experienced an increased demand for additional services. As social distancing has restricted some services, video consultation will help support the reintroduction of some.

In dentistry, video consultations will support pre-visit consultations to provide an understanding of the patient’s medical history and to facilitate a clinical assessment.

“Delivering care closer to home through the use of technology has always been a key part of ‘A Healthier Wales’, to deliver healthcare away from hospitals to communities, and where possible in people’s homes,” said Gething. “The coronavirus pandemic has meant that we have had to rapidly expand and adapt services. Video consultation has allowed us to overcome the challenges that social distancing brings. The delivery of video consultation has been fast tracked and is testament to the work of NHS Wales in delivering this service ahead of time  to support patients. Thousands of people have already received care via video consultation. I’m pleased to be able to extend this service to dentistry, optometry and community pharmacies which will see even more people benefit.”