According to reports, senior officials have now given license to Integrated Care Boards to use clawback to support their bottom line and to cover deficits as part of a deal to offset the costs of recent industrial action.
This couldn’t be further from the messages we’ve heard from the very top of government.
The funds returned by practices struggling to meet their contractual commitments were supposed to be ringfenced and kept for 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."
Last year, the Prime Minister himself committed to a ringfence 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.”
These ‘underspends’ do not reflect any lack of demand for NHS care. What we’re seeing is the result of a failed contract fuelling a recruitment and retention crisis across the service.
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.
In the spring we 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 we have been pressing Government to deliver a promised recovery plan, making effective use of these underspends. Expected before summer, there is still no sign of it.
In July the Health and Social Care Committee concluded its damning inquiry, describing the state of the service as "unacceptable in the 21st century". MPs 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.
“Once again NHS dentistry is being treated as the Cinderella Service” says General Dental Practice Committee Chair, Shawn Charlwood.
“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.”
We are pressing for urgent clarity from NHS England. This raid will remove a potential lifeline from hundreds of practices struggling to keep afloat.