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Dentists warn of exodus from service, as access crisis deepens with 30m appointments missed

The British Dental Association has urged government to set out a clear route map for reform and relaxation of COVID restrictions, as new survey data points to an exodus from the service as the access crisis continues with nearly 30 million appointments lost since the first lockdown.

According to a new survey of dentists in England:

  • Nearly half (47%) of dentists indicate they are now likely to change career or seek early retirement in the next 12 months should current COVID restrictions remain in place. The same proportion state they are likely to reduce their NHS commitment.
  • Working in high level PPE mandated under current infection control procedures is having a devastating impact on dentists’ morale, with nearly 9 in 10 (88%) indicating it is having a high impact on their morale. 78% cite financial uncertainty as having a high impact, and their inability to provide pre-COVID levels of care.  Two thirds cite hitting NHS targets imposed by the Government on 1 January 2021. Since the new year the workforce report the highest levels of stress compared to any point since the onset of the pandemic.
  • Nearly two thirds of NHS dentists estimate they will not meet controversial imposed targets, where they will face penalties for not hitting 60% of pre-COVID activity levels. Those that have made progress have done so unsustainably. 62% say their practice had to invest in new ventilation equipment, without any government support, 41% say they were forced to refocus on routine over urgent appointments, with similar numbers saying they have reduced private work, or reduced or eliminated annual leave.
  • England remains the only UK nation where government has not committed to or embarked on exploratory work to provide capital funding for ventilation systems to enable practices to increase patient numbers while keeping to infection control restrictions. While securing new kit has been the number one strategy deployed by dentists to meet NHS activity targets, nearly 70% of practices say they now face financial barriers to further investment.
  • Nearly half of dentists (47%) lack confidence in terms of the business outlook for their practice should current standard operating procedures remain unchanged.

BDA analysis of Freedom of Information data indicates that nearly 70% of appointments – or 28 million courses of treatment – that would have been delivered in NHS services in England in the year from March 2020 have been missed.  The BDA estimates by now the figure is likely to have exceeded 30 million. While numbers have increased MPs had expressed concern in January that the current interim system of targets would “prioritise volume over need” and indeed urgent treatment delivered has fallen since the new year.

While dentist leaders have welcomed recent government commitments to reform the widely discredited activity-based contract at the heart of NHS dentistry, they have warned needed change could be fatally undermined by further reductions in capacity through colleagues leaving the service or reducing their NHS commitment. The BDA believe contractual and legislative change needs to be in place before 1 April 2022, the beginning of the next NHS financial year.

With the vaccination programme making real headway the BDA has also underlined the need for a clear timetable for revising high intensity infection prevention and control procedures – including heavy duty PPE and maintaining lengthy gaps between appointments – given the huge impact on both productivity and the workforce.

MPs are set to tackle these issues in a Back Bench Business debate led by Bedford MP Mohammad Yasin later today (Tuesday 25 May 2021).

Shawn Charlwood, Chair of the British Dental Association’s General Dental Practice Committee said:

“The pandemic has wiped out access for millions and taken a hammer blow to the workforce, with many now looking for the exit.

“Practices have managed to hit punitive targets but at a terrible cost. Churning through appointments against the clock in heavy-duty PPE now risks an exodus from this service.

“Fixing NHS dentistry will be impossible if dentists are left unwilling to work in it. We need a clear road map that lifts restrictions, provides needed support to all practices and makes a decisive break with a broken contract.”