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Government set to take 100s of millions from NHS dentistry during access crisis

The British Dental Association has warned that hundreds of millions are set to be taken away from NHS dentistry during an unprecedented access crisis, on track to amount to over a tenth of the service's £3 billion budget.

The Health Service Journal report that senior leaders in NHS England have major concerns that the service is set for record 'underspends' in 2022/23. The BDA stress this 'clawback' does not reflect a lack of demand for dentistry, but the reality of a recruitment crisis across the frontline which is leaving practices unable to fulfil their contractual commitments.

Practices face financial sanctions for failure to hit the widely discredited targets set in their contracts. Freedom of information data acquired by the BDA shows no sustained recovery in dentistry delivered in the first 9 months of this financial year. With activity – measured in Units of Dental Activity (UDAs) - delivered monthly averaging a little over three-quarters of pre-COVID levels up to January 2023 [1], the BDA stress this all but rules out a full recovery, even if practices pull out all the stops, given ongoing workforce problems.

Given this performance the BDA estimate this will translate into losses of well over 10% of dentistry's gross budget, potentially as high as £400m, given current trends. This funding is not ring-fenced, and the vast majority will simply plug holes in other NHS England budget lines.

The BDA warn record breaking clawback levels will push some practices to bankruptcy or speed moves to the private sector. This reflects long-term issues with the failing and under-funded NHS dental system, with a contractual framework in which many dentists are no longer prepared to work. Clawback increased by 310% between 2014-20.

BBC research in August 2022 showed 9 in 10 practices in England were unable to take on new adult NHS patients. The House of Commons Health and Social Care Committee is currently holding a dedicated inquiry into dentistry.

British Dental Association Chair Eddie Crouch said:

"Patients will struggle to comprehend why this Government is about to take hundreds of millions from the frontline during an access crisis.

"This cash will end up plugging holes in other NHS budget lines. It's not because there's any lack of demand for dentistry, it's simply that practices are working to a failed contract and can't fill vacancies.

"Any progress requires reform and investment, but instead dentists are getting kicked while they're down.

"This will push dedicated NHS practices to the wall or to the private sector and leave whole communities with no options."