The British Dental Association has slammed plans by NHS England to raid future ‘underspends’ in NHS dentistry to pay for costs incurred by recent strikes across secondary care.
According to reports in the HSJ, senior officials have now given license to Integrated Care Boards to use these funds to support their bottom line and to cover deficits as part of a deal to offset the costs of recent industrial action.
This ‘clawback’ – returned by practices struggling to meet their contractual commitments – is supposed to be ringfenced and kept for use providing NHS dental care. In April Dr Amanda Doyle, Director of Primary and Community Care at NHS England, told the Health and Social Care Committee "certainly now—for ’23–24—a ringfence has been applied by NHS England, so no ICB can spend a dental allocation on anything that is not NHS dentistry."
During the leadership election last year, the Prime Minister committed to a ring fence as part of his ‘5 Point plan’ for dentistry, to “strengthen the protections around the annual NHS dentistry budget” so funds would be “maintained exclusively for frontline dental services.”
The discredited NHS contracts dentists work to has fuelled a recruitment and retention crisis across the service, leaving many practices returning large slices of their budget when they are unable to hit their targets. The BDA believes taking away these funds is utterly perverse given the depth of the access crisis facing patients in England, and only reflects the fact officials are still banking on high levels of clawback from NHS contract holders this year.
Early this year, the BDA anticipated record underspends of up to £400m for the 2022/23 financial year. So many practices were at risk that NHS England were forced to move the goalposts on required contractual delivery so fewer practices would face financial oblivion.
Since April the BDA has been pressing government to deliver a promised recovery plan, making effective use of these underspends. In July the Health and Social Care Committee concluded its damning inquiry, describing the state of the service as "unacceptable in the 21st century", and set out recommendations to government for permanent ring fencing, and for real, urgent reform, alongside a call for any recovery plan to be underpinned by necessary funding. The Government’s response to the inquiry has been overdue since 14 September 2023.
Shawn Charlwood, Chair of the British Dental Association’s General Dental Practice Committee said:
“Once again NHS dentistry is being treated as the Cinderella Service.
“When we desperately need ambition and investment, officials are raiding our budgets, robbing Peter to pay Paul.
“These ‘underspends’ are the result of practices struggling in a failed, underfunded system. If Government is banking on them to plug holes in their balance sheet, millions of patients will lose out.”