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Ambitious Advancing Dental Care plans are unrealistic without new funding

New funding is essential to realise the ambitions set out in Health Education England's Advancing Dental Care review published this week.

The report concludes a three-year programme examining training pathways in dentistry. It makes several recommendations for future change, including:

  • Focus on skills development: This includes a greater use of skills mix for the dental workforce and multidisciplinary team working.
  • Widen access and participation: It must enable flexible entry routes while supporting the development of apprenticeships.
  • Ensure flexible models of Dental Core and Specialty Training: It must aid workforce retention and career progression.

We have provided feedback on the ADC proposals since its inception, supporting ideas for more flexibility in training and sharing concerns raised in the report about the need to encourage diversity. We are also supportive of working with the GDC to continue developing a more workable route for mediated entry to the specialist lists.

We are concerned that the plans may risk destabilising some of the existing training structures that serve current populations. We were given assurances that posts will not be taken away and reallocated, and will only be created with extra funding, but the report itself does not offer guarantees.

As Shareena Ilyas, Chair of our Education Ethics and Dental Team Working Group commented: "These trainees provide care to thousands of patients. Redistributing existing places will only mean moving young dentists from areas already struggling to meet demand. All practices face huge and competing demands, and any idea we can secure new training places without new funding is pie in the sky".

We have warned that creating new Centres for Dental Development will require significant investment and that jobs must be available for those undertaking training for new qualifications. We will also wish to discuss further the idea for the introduction of a Lead Employer structure for the provision of future training pathways.

On the future of dental teams and how they will work, we remain unconvinced about the suggestion that teams working with high-needs patients do not require a dentist. We have reminded HEE that contract reform in England will need to lead to a more workable arrangement if the government is serious about countering the exodus of professionals from the NHS.

We have also expressed our disappointment that the financial modelling from consultancy London Economics - on which many of the assumptions in the report are based – has not been shared.

The report has been shared across our committees and we will develop further feedback and engage with the Dental Education Review Programme at HEE which is tasked with taking the resulting workstreams forward.