Internet Explorer and Edge browser users:
To download Word, Excel or PowerPoint files please right-click on the file you wish to download, and select 'Save target as...'

NHS dentistry: How to stop an exodus

Blog Author Shawn Charlwood

Blog Date 20/01/2022

​The choices made by successive governments have sparked a flight from NHS dentistry. Only real reform can turn the tide.


BDA General Dental Practice Committee Chair, Shawn Charlwood, speaks to the BBC on the crisis facing NHS dentistry

The UK media is focusing on the very real threat to NHS dentistry. MPs have angry constituents knocking at their door – many who are having to wait years for treatment  whilst some have even pulled out their own teeth in desperation. 

We've worked to shine a light on this crisis, and now new analysis by the BBCindicates that NHS dentistry in England and Wales has lost the equivalent of 8% of the workforce.


Every vacancy that goes unfilled translates into thousands of patients unable to access care. The service is hanging by a thread. Here's what you need to know:


A grim picture

Clearly these new figures don't tell the whole story. We know counting heads in NHS dentistry is meaningless when those doing an hour a week of NHS work count the same as full timers.


What we are seeing here is just the tip of the iceberg. Dentistry was in crisis before Covid hit, with NHS commitments on the wane and many younger dentists simply not seeing a future for themselves in the service.


"Rather than punishing colleagues with impossible targets, we need a service that recognises and rewards commitment."

Now colleagues are exhausted, demoralised and looking for the exit. The government's handling of the pandemic has merely sped up what was already in motion, and we are now facing an exodus. Even dedicated colleagues who have never contemplated working anywhere else are now giving up on NHS dentistry. 


Ministers have failed to grasp that we can't have NHS dentistry without NHS dentists. Rather than punishing colleagues with impossible targets, we need a service that recognises and rewards commitment.


A four-nation struggle

The story in Wales is comparable to England, huge losses borne of the same failed contract. Certainly, over the last two years Wales has lost 8.4% of dentists working in the NHS and in the last year alone this amounted to 6%.


However, the Welsh Government has made the right call with no turning back to UDAs. We can hope that action here can turn the tide.


But BBC figures wrongly imply Northern Ireland and Scotland are islands of calm, with no major losses in recent years.


However, this underlying stability misreads what we know is happening at the coal face. The current low margin/high volume item of service model is also completely unsuited to working in a pandemic and can't form the basis for the recovery.


Evidence from members in both NI and Scotland underlines a real crisis is brewing.


Across the piece recruitment problems and unsustainable business models, mean real reform is the only way to draw the line.


Time to stem the flow

"If NHS dentistry is going to have a future, it will require all four governments to step up."

If NHS dentistry is going to have a future, it will require all four governments to step up. They have the responsibility to ensure decent funding and working conditions are in place for dentists across the UK.


It's not that the UK doesn't have enough dentists, it's simply that the choices made by successive governments mean NHS dentistry will keep haemorrhaging talent. Failure to do so will mean more senior professionals taking early retirement and younger ones looking to go private or even head overseas.


These failed contracts are in desperate need of reform, and across the UK our teams are on the case. In England we've had over a decade of empty words and tinkering, but now is the time to put the situation right.


We need a system that makes our dentists feel valued and offers the best service for our patients. We are asking for a place where dentists would choose to build their career. A service that offers the time and the resources to meet demand.


MPs are already asking Ministers to set a time by which UDAs will be history. In response they have been offered soundbites instead of straight answers.


Our work with the media and MPs is keeping this issue on the front pages and at the forefront of Ministers' minds.


This exodus is not inevitable. We will continue pushing for clarity and a clear commitment from government – no ifs, no buts.


Shawn Charlwood


Shawn Charlwood

Chair of the British Dental Association’s General Dental Practice Committee