NHS Dental Service Continues To Decline
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- Published: Monday, 02 December 2024 08:44
- Written by Guy Tuggle
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With no reform to the NHS Dental Contract in sight, a new survey by the British Dental Association (BDA) suggests that nearly half of dentists are ‘severing ties‘ with the NHS as the remuneration for engaging with service is increasingly failing to cover the cost of doing so.
The survey of 2,204 high street dentists in England made for uncomfortable reading when it was presented to Parliament’s Health & Social Care Committee Inquiry into Recruitment and Retention across Healthcare last week.
Amongst its findings, the survey reveals
- Nearly half (45%) of dentists have reduced their NHS commitment since the onset of the pandemic, by an average of over a quarter.
- 75% say they are now likely to reduce – or further reduce – their NHS commitment in the next 12 months. The BDA says this is the highest level in any BDA surveys since the first lockdown. 45% say they are likely to go fully private. Nearly half (47%) indicate they are likely to change career, or seek early retirement.
- Two thirds (65%) say their practices have unfilled vacancies for dentists. 82% of those reporting vacancies cite working under the current discredited NHS contract as a key barrier to filling posts, over half (59%) cite issues relating to remuneration levels, and 30% difficulties attracting candidates to remote, rural or deprived communities. 29% say posts have been unfilled for more than a year.
- Nearly 9 in 10 (87%) state they have experienced symptoms of stress, burnout or other mental health problems in the last 12 months, with 86% reporting colleagues in their practice have received physical or verbal abuse from patients. 75% say they are unable to spend sufficient time with patients, and only 25% say they are able to offer the kind of care they want to provide.
It is important to stress that the responses reflect only the opinions and feelings of the 2,204 who responded.
Since the start of the pandemic, thousands of dentists are understood to have moved away from NHS work entirely. However, BDA survey data suggests that this underestimates the real drop in NHS capacity as the proportion of dentists who report having reduced their NHS commitment is 10 times higher than those who report having quit altogether.
Most dentists provide a mixture of NHS and private care - in varying proportions. The BDA says it has established that most of the dentists reporting a move into exclusively private dentistry have come from a background of providing predominantly NHS care.
A statement issued by the BDA said ’ While the government has promised reform, there is no timeline for when this system will end, nor is there any indication the Treasury is willing to commit funds to underpin the rebuild of the service. After a decade of cuts NHS dentistry would require an additional £880m per year simply to restore resources to 2010 levels.’
In its coverage of the dental access crisis The Guardian quoted BDA analysis that suggested dental surgeries in England were increasingly being forced to“operate like a charity” when carrying out work for the health service, with dentists effectively subsiding any NHS care they provided from their private work to the tune of about £332m a year.
The financial shortcomings were laid bare by figures calculated by the BDA which reveal that dentists lost £42.60 every time they fitted dentures and £7.69 on each examination of a new patient’s dental health under the NHS. Similarly, a practice lost £40.60 when it carried out dental surgery involving the removal of bone and £21 on a molar root canal and crown treatment.
Shiv Pabary, Chair of the BDA’s GDPC said “Demoralised dentists are walking away from a system that is forcing practices to operate like a charity. This service is running on empty, kept afloat by private work and goodwill, which is now in very short supply."
Mark Dayan, a policy analyst and head of public affairs at The Nuffield Trust was only slightly less pessimistic saying “Dentists will not necessarily lose money on NHS work. But it is a real problem that they are often being asked to make a financial sacrifice to see a health service patient instead of a private one. We see from recent data that fewer dentists are carrying out less NHS work than before the pandemic, and even that they are doing fewer hours.”
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