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England: Championing a bright future for associates

Blog Author Sarah Canavan

Blog Date 24/05/2022

Dentists’ deep frustrations with NHS dentistry are driving a move to private practice. We are making sure associates’ voices are heard, looking to ensure the system reform process results in meaningful changes for everyone.


In my role as Chair of the Associate’s Subcommittee, I champion the causes important to us. This includes seeking to ensure that the national reform negotiations result in a contract that works for everyone and more generally advocating for associates in both mixed and private practice.

I was delighted to recently be re-elected Chair of the Associates Subcommittee of the General Dental Practice Committee (GDPC). We meet to discuss general issues in dentistry, how they relate to us as associates and what can be done to amplify the important issues. We help ensure that associates have a strong voice within the Association and in discussions with government.

Reform that works for all

"Tooth decay and gum disease, unless you are incredibly unlucky, are preventable."
Contract reform discussions must result in meaningful changes that work for all dentists and patients. That is the absolute focus of our negotiating team, led by Shawn Charlwood. We are working hard on the Associates Subcommittee to make sure that the requirements, needs and wants of associates are considered in any future changes. We work closely with Shawn and his team to make sure associates’ views are heard. 

Much time and effort has been put into reform and we need a fundamental change to the NHS contract to make it work. Our role now is to continue to meet as a group to discuss the future and ensure the GDPC and the BDA board are aware of associate’s opinions especially as we are continuing to grow as a proportion of the dental community.

We believe that any future contract reform should include provision for us to prevent as well as treat dental disease, to help ensure better health for all patients whether they are NHS or private. Tooth decay and gum disease, unless you are incredibly unlucky, are preventable. If prevention and education relating to successful oral care is at the core of the dental contract, then fewer patients will have to go through the awful experiences being reported recently.

Private practice is a necessity

Over the years, I have found NHS dentistry to be incredibly rewarding, but have recently made a shift from doing a majority of NHS work to the majority now being private dentistry. NHS dentistry is underfunded and overstretched, and I felt for my own physical and mental wellbeing I needed to make that change. I wanted to be able to offer my patients the best care that I possibly could. 
"We’re being forced to make a choice: burn out working 24/7 in the NHS to make ends meet,
or “go private”."

Dentistry is a part of the NHS that has faced unparalleled cuts especially in the last 10 years. This means that I earn no more now for providing NHS dental care than I did a decade ago, never mind factoring in increases in the cost of living. Every NHS dentist will be in the same boat. This is untenable for too many. We’re being forced to make a choice: burn out working 24/7 in the NHS to make ends meet,  or “go private,” get the time we need with patients, and some work-life balance to boot.  It’s driving dentists out of the service.   

Let’s be honest it’s not just the contract alone that’s causing us to say, “enough is enough”. It’s the constant red tape, rules, regulations, KPI’s, clawbacks, the complaints and everything else that can be associated with NHS dentistry that make us want to leave.

I want to spend my time treating patients – I give the same amount of time to NHS check-ups as I do to private ones, but typically NHS patients, especially new ones, tend to come with far greater needs. Couple that with the fact that we must explain all NHS and private options to our NHS patients including why we can/can’t do certain treatments on the “Nash” you can realistically double the time you spend with NHS patients just to explain everything.

Despite the shift, at present I have retained enough NHS work to ensure I can see the patients that have been with me for many years. To not be able to see them after so much time would feel like I was abandoning them. However, let’s be honest it’s on the cards for me in the not-too-distant future and I really feel the guilt, but as highly skilled professionals under unprecedented pressure, we can't be expected to keep this service going on goodwill alone.

The BDA’s advice on making the shift to private practice has never been more relevant to us.

Looking ahead

"I don’t find the subject of the demise of NHS dentistry a laughing matter."
The current situation cannot continue. The contract and system must be fixed, to help stop the exodus from NHS dentistry and ensure access to care into the future. Associates must have options, and not feel forced into moving away from NHS care, if that is where they would like to stay. Normally when I write a blog or article, I can’t help but make a joke or two but, in all honesty, I don’t find the subject of the demise of NHS dentistry a laughing matter.

We need to be able to have fulfilling and rewarding careers and supportive working environments, regardless of whether its NHS or private. Over the coming months and throughout the contract reform process, we will continue to meet as the Associates Subcommittee to make sure these important issues are taken forward. We’ll continue to be the voice for NHS, mixed and private practice associates.

 

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Sarah Canavan  
Chair, GDPC Associate’s Sub-committee