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Conference looks to future of community dentistry

Inspiring discussion and debate on important motions relating to the vital work of community dentists took place at the Conference of Accredited Representatives.

Giten Dabhi
Giten Dabhi England Community Dental Services Committee Chair

The dedication, passion and tenacity of community dentists was illustrated at the conference through the strength of feeling underpinning the motions debated throughout the day. At the same time, it was clear that that the system is at a breaking point and in need of change, new approaches, and new thinking.

A vision for the future

In England, the Community Dental Services Committee is actively shaping a vision for the future. Community dentistry has too often been treated as a Cinderella service, and we have had to explain to health leaders and commissioners who we are and what we do. We want to ensure key decision makers know that dentists working in the Community Dental Service (CDS) and their teams provide vital dental care not only for paediatric and special care dental patients, but also for other vulnerable members of society unable to be seen in a General Dental Service (GDS) setting.

There is a worrying lack of understanding that this referral only service is designed to support individuals who cannot be treated by a GDP. We believe that those who run the service are best equipped to identify the challenges it faces and to set out a credible and realistic vision for the future. We will work with key stakeholders to ensure that the solutions we seek become a reality so that the CDS is once again sufficiently resourced and organised to ensure that patients are able to receive the treatment they deserve.

The motions at the conference clearly show that CDS and Personal Dental Service (PDS) across England, Scotland, Wales and Northern Ireland have been working within a system that has been declining for many years, posts have remained unfilled and workload pressures have continued to grow, with many community dentists talking about unbearable levels of demand being placed on them resulting in burnout.

"There is a chronic shortage of Dentists, recruiting into the CDS service is becoming increasingly difficult. We ask the conference to support a motion that the BDA asks DDRB for a pay increase to manage issues of recruitment and retention."

Pay for community dentists

On the area of pay I told the conference that for the 2023/24 pay review round, we included detailed evidence and strong arguments for a pay uplift for CDS dentists across all four nations. In March 2023, following submission of the evidence I joined other representatives to provide oral evidence to the pay review body on behalf of CDS dentists. Despite our best efforts, we were dismayed that health departments provided very limited evidence on CDS/PDS issues and concerns.

We rightly challenged the absence of evidence and received assurances that this would be rectified in the next pay round. We will be watching closely to ensure this promise is fulfilled. The motions debated this year set out loud and clear the strength of feeling among CDS dentists on the area of pay and a willingness to consider stronger action, including forms of industrial action. Of course, it will be for CDS committees in each of the countries to determine the most appropriate way forward on these issues, including on possible industrial action.

We will make sure that your views inform our evidence for the 2023/24 pay round. Industrial action was also discussed this year, as it was at the last conference. A motion was passed supportive of the idea of us taking industrial action if steps aren't taken to improve our working lives. We will convey your strength of feeling and warn that, if action is not taken to improve the working conditions of CDS dentists, there may no longer be a workforce there to undertake the vital work we do each day.

"The DDRB pay recommendation for this year is so far below the current measures of inflation. Conference suggests industrial action to demonstrate our frustration."

Wider system issues

Moving on to wider issues, we know that the many flaws of the current NHS GDS contract and lack of provision continues to cause spill over into already overstretched CDS across the country. Motions were passed that reflected this concern and reinforced the need to clearly define the role of the CDS to key stakeholders.

"This conference believes that the role of the PDS, and CDS in other UK countries, is being compromised due to the number of non-core patients being seen and urges BDA to support salaried dentists in seeking to ensure that our core patient base returns to being our priority."

The committees representing the CDS were listening and will respond to your motions and work tirelessly to make a difference for you, to work for a sustainable future for community dentistry and ensure that key decision makers properly recognise the invaluable service that we all provide to our respective communities.

I can honestly say I have never felt so proud of community dentists than when hearing their passion at the conference. I am proud because when our patients need us the most we always endeavour to step up and deliver, working harder than ever for our communities, including the patients that are sometimes the most vulnerable in our society.