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Below inflation awards will further erode NHS dentistry

The recently announced 4.5% uplift of the General Dental Service (GDS) contract value in Wales is in line with the Doctors' and Dentists' Remuneration Board's (DDRB) recommendations made in the late summer and backdated to April 2022.

The uplift is subject to an agreement around the wider reform of the contract. We are seeking clarification given that 19% of practices are on UDA-only contracts in this financial year. Following discussions this week with the CDO, we understand that there will be no additional element of NHS pay for the dental team as had been suggested previously by the Health Minister. In other words, the uplift of contract values by 4.5% must cover all elements of staff pay and expenses.

Our call to factor in dental inflation as part of the GDS contract uplift went unheeded by the Health Minister in the summer. In this financial year the budget for core NHS services increased by 10.7%. Welsh Government stated the "highest priority is to address the backlog of treatments that have been delayed by the pandemic". However, this has not translated into a comparable uplift to dental contract values, which are left far behind. There seems little acknowledgement of the backlogs currently being faced by dental services.

Local health boards reported several GDS contracts have been handed back in the summer months and they are struggling to reallocate them. This has resulted in an increasing reliance on the CDS to cover these gaps, causing a further strain on those services, pushing vulnerable patients into longer wait times.

At the start of the month, energy costs hiked up, with RPI at 12.3%. This is making practices' budgets look more and more unworkable. The energy cap for businesses offers some stability but only for an initial six months. These figures mean practices will likely operate some NHS work within a financial deficit unless the Welsh Government or Westminster can find additional financial support.

Dr Russell Gidney, Chair of The Welsh General Dental Practice Committee, said "Below inflation contract increases are another nail in the coffin for practices already struggling to see a future in the NHS."

The latest NHS Digital figures revealed that in 2020-21 associates in Wales earned nearly £2,000 less than the year before; a drop in income of nearly 3%.

Dentists' income was awarded an uplift of 4.5% by the Welsh Government as laid out in the July pay circular and as recommended by the DDRB.

This increase applies to General Dental Practitioners and salaried dentists including those in the Community Dental Service. However, we note that there is a freeze on the value of awards for consultants such as Clinical Excellence Awards and Commitment Awards.

Dr Gidney said: "Spiralling surgery costs mean another year that practices owners, associates and staff could see a real terms reduction in income."

We have described the state of NHS dentistry in our written evidence to the Senedd Health and Social Care Committee which is conducting a comprehensive review of dentistry and oral health services in Wales. We will be giving our verbal evidence to the committee later this month. Our messages are simple – invest in NHS dentistry for the future and ensure contract reform fairly remunerates dentists and the dental team.