With commissioning finally set to begin on the Labour Government’s pledge of 700,000 new NHS urgent dental care appointments, the British Dental Association has stressed progress is now urgently required on promises to reform the broken contract fuelling the access crisis millions still face.
The extra appointments would translate into each of the 24,200 dentists recorded as doing some NHS activity last year seeing the equivalent of little over two extra urgent cases a month. Based on BDA analysis of government data, total unmet need for NHS dental care in England amounts to 13m, or 1 in 4 of the adult population. [1]
Lord Darzi concluded in his ‘diagnosis’ of the crisis in the NHS that: "If dentistry is to continue as a core NHS service, urgent action is needed to develop a contract that balances activity and prevention, is attractive to dentists and rewards those dentists who practise in less served areas.”[2]
The BDA has expressed concern that Integrated Care Boards have been offered no national framework for delivering these 700,000 appointments. Last summer the professional body proposed a tried-and-tested model of sessional payments, that has already significantly improved access to urgent care in the North East.
Shiv Pabary, Chair of the BDA’s General Dental Practice Committee said:
“It’s progress, but Government could have fired the starting gun on commissioning urgent care last summer.
“Action here will translate into just two extra slots a month for each NHS dentist.
“Ministers must now confront the failed contract that’s left millions with no options.”
Despite having pledged new investment in the Labour manifesto, delivery here is to be paid for using underspends in the dental budget, that are fuelled by underfunding and workforce problems.
In written evidence to the Public Accounts Committee inquiry into ‘Fixing NHS dentistry’ the professional body stressed these underspends do not reflect any lack of demand for care, but are the net result of a generation of systemic underfunding driven by the Treasury. A typical practice now loses over £40 delivering a set of NHS dentures. [3]
The total cross subsidy from private care to loss-making NHS activity is estimated at £332m a year - set to rise to £425m when significant increases in overheads from the Autumn Budget kick in come April.
Shiv Pabary added: “Promised new money has gone. Instead, budget that should be funding routine care is being recycled.
“What’s clear to us is the Treasury are banking on the crisis in dentistry not being solved in this Parliament.”
Notes to editors
[1] BDA Analysis of dental data in the last GP Survey by Ipsos showed unmet need for NHS dentistry in England now stands at 13m, or well over 1 in 4 of the adult population (28%). This includes an estimated 5.6m adults who tried and failed to secure an appointment in the last 2 years. Nearly as many have given up trying with 5.4m not attempting to make appointments as they didn’t think they could secure care. The cost of care pushed 1.25m away, and around 780,000 indicated they were on waiting lists. While there has been some methodological change, with the survey moving online-first approach, this is clear growth from last year, when total figures stood at around 12m. Access problems predate COVID. Prior to the pandemic unmet need for NHS dentistry hovered consistently at around 4m or 1 in 10 of the adult population.
[2] Independent investigation of the NHS in England - GOV.UK
[3] NHS dentistry: Treasury now no.1 roadblock to saving service