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Dentistry: COVID impact on scale unseen in any other part of NHS

The British Dental Association has warned MSPs the pandemic has had an unparalleled impact on NHS dentistry, that leaves the service facing an existential threat.

As the professional body prepares to give evidence to the COVID-19 Recovery Committee inquiry into NHS dentistry today, it has published new analysis showing the scale of the backlogs. 
Initially closed to routine care, and then facing exacting infection and prevention control guidelines that reduced patient throughput, lost capacity on the high street exceeds general medical practice and secondary care, resulting in backlogs that will take many years to clear:
  • Dentistry has lost over half (52%) of its capacity since lockdown, when comparing examinations  delivered since March 2020 with typical levels pre-COVID
  • For GPs, that figure is just over 30% (when looking at lost face-to-face appointments). It is just over 6% for hospital outpatients and in terms of volume, inpatient care appears to have already recovered lost ground
  • By any measure captured in official data, whether it is examinations or Statement of Dental Remuneration (SDR) activity claims, Scotland has lost more than a year’s worth of NHS dentistry
  • Ongoing access problems are fuelling backlogs, with patients presenting with higher levels of clinical need. In recent BDA surveys over two thirds (67%) of dentists cite higher needs patients requiring more clinical time as a key issue on return to ‘full’ capacity. The only comparable problems are those concerning recruitment and retention of dentists (61%).
Dentist leaders say it will be impossible to restore pre-pandemic activity without radical change. The low margin/high volume model the service works to was incompatible with working through the pandemic and cannot form the basis for a meaningful or sustainable recovery. 

This leaves the service at a crossroads: with a contract that is unfit for purpose, underfunded, overstretched and facing the challenge of deep and widening oral health inequalities. BDA Scotland fear that an exodus of dentists from the NHS is already in motion. This shift is going unseen in official data, that counts heads not the amount of NHS work dentists do. These workforce statistics give an NHS full-timer the same weight as a dentist doing one NHS check-up a year. 

Recent BDA surveys indicate only 1 in 5 (21%) of practices have returned to pre-COVID-19 capacity. The professional body say hard limits on restoring capacity, and the existential threats to NHS dental services require a proportionate response from the Scottish Government.

David McColl, Chair of the British Dental Association’s Scottish Dental Practice Committee said: 

“COVID hit dentistry like no other part of the NHS in Scotland.   

“We’re not asking for special treatment, just a proportionate response. One that recognises the scale of the backlogs and the existential threat to this service.

“NHS dentists are already walking away from a broken system. There can be no recovery without reform.”