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NHS Dentistry: Scottish Government plans set to spark exodus from service

The British Dental Association has warned the Scottish Government plans to revert to pre-COVID models of care risks sparking a flight of dentists from the NHS, with potentially devastating consequences for patient access across Scotland.

In October, Cabinet Secretary Humza Yousaf wrote to all NHS dental teams that all emergency support will be withdrawn by 1 April 2022. Since the first lockdown, NHS practices have operated under a COVID support package, reflecting pandemic pressures and tight infection control restrictions that continue to limit capacity across the service.

According to a new survey of dentists in Scotland:

  • 80% of dentists estimate their practices will reduce their NHS commitment should the Scottish Government withdraw emergency support and return to pre-COVID models of care. Over a third (38%) of dentists indicate they are now likely to change career or seek early retirement in the next 12 months should the policy be taken forward. 15% say they are likely to practice dentistry outside of Scotland, and 1 in 10 estimate their practice is likely to cease operations.
  • Half of dentists report that they are operating at less than 50% of pre-COVID capacity. While the Scottish Government has offered a support package to boost capacity, many practices are unwilling to commit to a broken NHS model. Over 30% say they have not applied, and among those, half (50%) say they are now unable to commit to the NHS long-term. Support for ventilation costs requires a minimum 3-year commitment to the NHS.
  • 9 in 10 dentists (89%) estimate the removal of emergency funding will have a high impact on the short-medium term sustainability of their practices.
    BDA Scotland has warned from the outset that a return to a 'business as usual model' – low margin and high volume – will put practices under unsustainable financial pressure and will likely lead to closures or movement to the private sector. Practices are facing an unprecedented backlog, with recent data from Public Health Scotland indicating that the number of treatments delivered in the year to March 2021 was less than 25% of those delivered in the previous 12-month period, corresponding to over 3.5 million appointments lost as a result of the pandemic.

NHS dental carefree at the point of use remains a centrepiece SNP policy. BDA Scotland has said the Scottish Government must change course to achieve that goal, develop an interim funding package to support dentists and their teams as they work through the backlog, and begin work on a new, sustainable model for delivering care.

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

“Free NHS dentistry for all is a worthy ambition. Rather than exploring ways to actually achieve that goal, the Scottish Government has blindly headed down a road that could destroy this service.

“COVID has slashed our capacity, yet emergency support will end. Yes, Ministers have offered some support, but with small print many practices simply could not sign up to in good conscience.

“Dentists are unwilling to be shackled to a corpse. When aid hinges on committing to an NHS model that is now frankly unsustainable, it is unsurprising take up appears so modest.

“We doubt Humza Yousaf wants to be remembered as the man who killed NHS dentistry in Scotland. Without a willingness to reflect on choices made in recent weeks that risks being his legacy.”