I began my role as Director of BDA Scotland a few weeks ago and I have been considering the current challenges and opportunities facing dentistry in Scotland.
Over 6 million NHS dental appointments have been lost since lockdown. We know that the backlogs of dental need created by the pandemic are a legacy which will remain for years to come and will require investment, reform, and consideration within wider recovery planning across health and social care. Dentistry cannot be considered in isolation and suitable investment and funding must be delivered by Scottish government.
Waiting times causing issues
"1 in 10 dentists in Scotland have stopped carrying out NHS treatments since the onset of the pandemic."
Oral health inequalities look set to widen in the aftermath of COVID-19. The National Dental Inspection Programme data in October showed 9.7% of primary 1 school children had severe decay or abscesses, that ‘required a dental visit as soon as possible’. This was an increase from 6.6% in 2020.
Dental access is a key area for concern. Access to elective general anaesthetic lists to address waiting times for children and adults with complex needs must be considered urgently alongside access to specialist and secondary care referral services.
1 in 10 dentists in Scotland have stopped carrying out NHS treatments since the onset of the COVID-19 pandemic. Recruitment, retention, and workforce planning, to meet the needs of the population, will need to be considered when tackling dental access issues and will also need to be considered carefully during any reform of NHS dental services.
Financial pressure in every service
"With contract reform on the horizon, consideration of not only how any reforms will impact the GDS but also the PDS and HDS will be important."
The General Dental Service (GDS), Public Dental Service (PDS) and Hospital Dental Service (HDS) are all experiencing pressures, but the problems are not one size fits all. These services are intimately linked, but challenges are likely to be felt differently across the dental system. This means that the services respective recoveries towards pre-pandemic levels of care is taking place at different rates.
With contract reform on the horizon, consideration of not only how any reforms will impact the GDS but also the PDS and HDS will be important. The current financial situation being faced by all four nations, is likely to put increasing pressure on public spending, with the cost-of-living increases affecting not only our patient’s incomes and expenditures, but also the rising costs associated with the delivery of dental care.
As yet we have no sense of what will follow the ‘bridging payment’ which replaced the multiplier. With soaring costs, I know too many practices now face delivering NHS care at a loss. This situation is unsustainable and that is where I’m determined to get a clear picture of this from members on the frontline.
We’ve stepped up to ensure that safety nets were put in place for students during the pandemic, but we know that real challenges remain. We will continue to engage with and work on behalf of our student members, to ensure the issues being faced each day are addressed.
A voice for much needed change
"Ensuring the voice of the profession in Scotland is heard loud and clear will be at the heart of everything we do."
The unprecedented financial situation will put pressure on an already overstretched system and appropriate funding and delivery of care models must be developed if dentistry is to remain sustainable. Change can be difficult; the risk of destabilising services must be mitigated.
Ensuring the voice of the profession in Scotland is heard loud and clear will be at the heart of everything we do. In Holyrood, in the press, and working alongside your elected representatives to win the argument for real reform.
Alongside the profession, I also believe that the voice of our patients must be heard too. What do patients want and need from dentistry as we move forward? How has this changed and what will this look like as part of any reformed contract?
It is vital that these constructive discussions take place to make sure that any future, long-term, contract reform is not only driven by the dentists who deliver the care, but also by the people who will receive it.
BDA Scotland is the first point of contact for any members living and working in Scotland. We provide strategic support and advice to BDA committees in Scotland, these include Scottish Council, Scottish Dental Practice Committee, Scottish Public Dental Services Committee and Scottish Hospital Dentists Reference Group.
Our committees meet regularly to consider the issues affecting the dental profession and patient care. Our representatives take these issues forward into discussion and negotiation with the Scottish Government and the wide range of bodies responsible for the delivery of health and social care.
I intend to work with representatives from across the profession to ensure we can secure a sustainable future for dentistry in Scotland. This must include support for dentists in all fields of practice, together with real action to tackle oral health inequalities.
Our members voices must be heard. I am here to listen, provide support and work together, to shape the direction of travel for dentistry across Scotland.
Director BDA Scotland