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NHS dentistry: support extended, but there can be no return to "business as usual"

Dentists have warned that the Scottish Government's last-minute extension of financial support for NHS practices must go hand in hand with meaningful reform to avert a crisis in the service.

A new 'bridging payment' will replace the current 'multiplier' set to expire on 1 October, uplifting NHS fees at a rate of 1.2 for the next three months, falling to 1.1 for the period up to April 2023.

The Cabinet Secretary had previously told the BDA that the multiplier – which at its current level increased NHS fees by 1.3 - had not been included in the Scottish Government's budget forecasting. The professional body has not ceased reminding officials that without an adequate interim funding package several key treatments including extractions, and anything - like dentures - that requires laboratory work, risk being delivered at a financial loss.

The BDA stress that the new support package cannot presage a return to 'business as usual' from April 2023. Dentist leaders stress that in the months ahead efforts must be made to deliver needed change to the broken high volume/low margin model NHS dentistry is based on. Without reform, this package will simply delay an inevitable exodus of dentists from the NHS that is already evident in other UK nations.

While COVID emergency measures have been withdrawn, dentistry in Scotland has not returned to anything resembling pre-pandemic norms, with practices continuing to work under capacity in the face of an historic backlog. Latest figures indicate 261,537 claims were made by dentists delivering NHS treatments in July 2022, less than 60% of the number made in the same month in 2019.

Recent research by the BBC indicated 9 in 10 practices UK-wide were unable to take on new adult patients. In Scotland figures stood at 82%, the multiplier likely playing a decisive role.

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

"The Scottish Government seem to have recognised the wholesale inadequacy of the funding model for NHS dentistry.

"It's not rocket science. Without additional support, the basics of NHS care – from extractions to dentures – would have been delivered at a loss. No business can operate on that basis.
"We now need some serious long-term thinking. Unless Ministers are prepared to revisit the system this service is built on, this funding will amount to sticking plaster on a gaping wound.

"If this is just delaying the return to a broken 'business as usual' then millions of patients stand to lose out."