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NHS dentistry inquiry: Act now or condemn service to oblivion

The British Dental Association has warned NHS dentistry's future will rest on both government and opposition committing to the recommendations set out by the Health and Social Care Committee today.

The cross-party inquiry makes sweeping proposals to end the crisis in NHS dentistry, including:

  • Reform: The Committee stress that "fundamental reform" of the failed NHS contract fuelling the exodus of talent from NHS dentistry must be delivered urgently.
  • Prevention The Committee share the BDA's view that the focus of a new system should shift from discredited targets to a system of 'weighted capitation' whereby dentists are rewarded for maintaining and improving their patients' oral health and the focus is on long-term, patient-centred preventative care, with additional support for higher needs patients. This would provide an emphasis on prevention that doesn't currently exist.
  • Funding: The Committee support the case for permanent ring fencing of the dental budget, so money is not lost from the frontline because of the penalties practices struggling to hit their contractual commitments currently face. The Committee also stress the government's forthcoming recovery plan must be underpinned by necessary funding.
  • Integrated Care Systems. The Committee stress dentistry must have a voice in new structures, with a seat on boards. 

The BDA has wholeheartedly backed the damning judgment of the Committee that the system is "unacceptable in the 21st century" and share the view that "Government and NHS England have not fully grasped the scale of the challenge for the workforce, and the need to urgently provide compelling incentives to attract new and existing dentists to undertake NHS work."

The recent NHS Long Term Workforce Plan has set out to expand the number of dental students by 40% but set out no concrete plans to stem the flow of talent from the workforce. The BDA described the move as an attempt to "fill a leaky bucket." Over half (50.3%) of high street dentists responding to recent BDA surveys reported having reduced NHS commitments since the start of the pandemic. 74% stated their intention to reduce - or further reduce – their NHS work.

In oral evidence the professional body stressed to the committee that all ministers were doing at present was "rearranging the deck chairs on the Titanic while the service slowly slips into the sea." Minor changes to the discredited NHS contract were rolled out in October, that the BDA warn do nothing to halt the exodus from the service. The government has yet to honour its pledge to fast track a 'recovery plan' for NHS dentistry, that the BDA stress is essential just to stabilise the service ahead of wholesale reform.  

Contrary to repeat claims made by the Prime Minister, official figures secured last month by the BDA under freedom of information indicate just 23,577 dentists performed NHS work in the 2022/23 financial year, over 1,100 down on numbers pre-pandemic, a level not seen since 2012.

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

"From reform to funding the Committee has provided an instruction manual to save NHS dentistry.

"The real question now is whether government or opposition are ready to use it. 

"Failure to act will condemn this service to oblivion."