50 (Million) Shades Of Grey
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- Published: Tuesday, 25 January 2022 13:49
- Written by Peter Ingle
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News of a 50 million pound boost to NHS dentistry in England will have cheered up the army of would-be patients struggling to find dental care.
This follows a torrid stream of stories about lack of access and the widespread failure of NHS provision.
Last week saw challenging questions in Parliament and then Thursday’s massive media onslaught, coordinated by the BDA. So, seeing headlines that now refer to a “treatment blitz” and the Daily Mail’s “Bonanza to fight NHS dental backlog,” may seem like £50m well spent.
Dental practices may be more cautious in their response to the NHS England announcement, as so often the practical experience of similar initiatives has been very different to the initial promises.
Details of exactly how the money will be made available are still emerging with limited information available.
The extra funding is intended to help the access problem and so is to be targeted on emergency and ad hoc treatments. Despite this CDO Sara Hurley spoke of “injecting an extra £50 million into routine services”
The work is to be delivered by the end of March, so many practices will be struggling to hit their 85% UDA target at the same time as setting up and delivering any extra sessions.
There is to be a focus on prioritising children, those with learning disabilities, autism and severe mental health problems, who may prove hard to reach. It would seem that allocation of the funding will be decided by local NHS teams.
There is no question about the scale of the problem. It is estimated that 38 million appointments have been lost through a combination of lockdown and the continued reduction in patients seen, as a result of the loss of capacity as practices followed the new SOP’s. NHS figures for the year ending March 31st 2021 show a drop of 68% in courses of treatment delivered. The Department of Health announcement expects this new initiative to provide up to 350 000 extra appointments. The new funding represents well under 2% of the annual NHS primary care dental budget of about 2.9 billion pounds. This is not the actual government contribution, since about 30% of the budget comes from patients via their NHS charges.
Unsurprisingly the BDA’s initial response is to welcome extra funding, but to be clear that this can only be a starting point if NHS dentistry is to survive. This is the first extra money for dentistry following the billions going to other parts of the NHS as part of the Covid recovery programme.
With widely reported workforce shortages facing practices, it remains to be seen if the claimed one third increase of sessional fees for this extra work, manages to recruit the extra dentists, nurses and receptionists, that will be needed to deliver it.
There could be changes in patient expectations. Many headlines lead with the promise of appointments at weekends and evenings, adding for good measure that dentists will be paid more. In practice, teams may see an influx of high needs, irregular and not always reliable attenders, adding to the pressures on an already shrinking and demoralised workforce.
There is no question that the announcement has made an impact. Going forward a great deal will depend upon whether it turns out to be a knee jerk response to bad headlines, or a genuine attempt to start sorting out the massive problems facing NHS dentistry.
NHS England have now confirmed that the 50 million figure does not include patient charges. They added that this offer is completely separate to UDA’s and it’s delivery will be unrelated to clawback calculations. Further information can be found here.
This refers to the three key areas for commissioners to use the funding, which are, purchase of added CDS sessions and potentially hospital based services as well as existing contract holders.
There is no question that the announcement has made an impact. Going forward a great deal will depend upon whether it turns out to be a knee jerk response to bad headlines, or a genuine attempt to start sorting out the massive problems facing NHS dentistry.
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