Martin Woodrow looks at three ways Brexit is likely to impact dentistry across the UK.
Brexit has already happened. However, with the transition period coming to an end on 31 December, we want to outline how it’s likely to affect dentistry.
While the pandemic took centre stage this year, our teams have been working on Brexit throughout. We have not stopped voicing the interests of dentists and dentistry and seeking clarity on key issues. Now, we have a clearer idea of how Brexit will impact dentistry over the coming years although of course the deal or no-deal question remains to be answered.
Supply and cost of dental materials
“The NHS has asked that practitioners do not stockpile medications.”
85% of dental materials are imported into the UK, most of them from the EU. It’s therefore quite encouraging that the British Dental Industry Association have not yet raised any immediate significant supply issues with us. Industry awareness and preparation is thought to be good and stocks of most dental materials are thought to be appropriate moving into 2021. This doesn’t guarantee it will all be plain sailing of course, and the
NHS has asked that practitioners do not stockpile medications to help better manage supply.
As of 1 January 2021, the Medicines and Healthcare products Regulatory Authority (MHRA) will become a UK-only regulator and set up its own assessment and licensing scheme. For now, EU medical devices with CE marks can still be unilaterally imported into the UK, but goods will need to be recertified for the UK system by the summer of 2023.
There are some concerns that the new MHRA regulatory regime may create price inflation over the next few years. If true, this would come at a time when many practices are already under considerable financial pressure. NHS, private and mixed dental practices have all faced unprecedented challenges this year, seeing lost income and increased costs. Further cost increases would greatly concern us and we will monitor these developments carefully.
Registration changes and possible costs
Around 16-17% of the UK dentist workforce is registered on the basis of an EU/EEA degree. This includes UK citizens who have studied in Europe. Those currently registered on this basis will not be affected. Indeed, for up to two years from 1 January 2021, EU/EEA qualifications will still be recognised while the government and regulators consider a new registration approach for non-UK qualifications.
“Current registrants... should not have to foot the bill for these changes.”
The practicalities of a new system are still to be worked out. I am concerned that any new system would potentially need to be at least partly funded by those currently on the register. We will monitor very closely whether this will affect the level of the GDC's Annual Retention Fee (ARF) in the coming years. Current registrants, who are already facing significant financial pressure due to the pandemic, should not have to foot the bill for these changes.
We believe that admission to the dental performers lists (in England and Wales) is also likely to change. A more formal process of Performers List validation by experience (PLVE/VT equivalence) is likely to be introduced for EU nationals at some time in the future. This means higher numbers of practices might need to provide the training, and could also affect employment status. Our team have asked NHS England for insight on what it plans to do going forward, but they’ve not yet provided any clarity on the issue.
Challenges facing dentists in Northern Ireland
Brexit and the end of the transition period
will affect dentists in Northern Ireland more than any other part of the UK. Indeed, many practices in NI need to make urgent administrative changes to prepare for 1 January.
If your practice in Northern Ireland does any low-level trade with Great Britain, such as sending impressions to labs in Scotland, we’re advising you to prepare for the post-transition period by registering for an
EORI number and registering with the
Trader Support Service. If your practice receives human tissues, cells or acellular bone products from suppliers in GB meanwhile, you will also need an import licence from the
Human Tissue Authority (HTA) from 1 January 2021 in order to continue.
Disruptions to cross-border trade could also affect some practices. For instance, the provision in the Republic of Ireland for claiming back dental costs incurred in Northern Ireland will end on 31 December. We’ve queried this on your behalf and we understand that alternatives are being discussed as part of the negotiations on the future relationship. We’re concerned that this may impact some practices financially in the meantime.
It’s also important to note that, in the future, suppliers will face duplication of paperwork if selling into Northern Ireland, as they will have to comply with both EU Medical Devices Regulation (MDR) and the UK’s new regulation standard. We’re concerned that this could affect the cost and availability of supplies in Northern Ireland going forward.
I’ve touched on a number of complicated issues here, as I’ve tried to give you an overview of the key ways in which Brexit will affect dentistry. If you’d like to know more, I encourage you to go to our
Brexit webpage, which contains more information on key topics including immigration arrangements, research and development, data sharing and protection.
We’ll continue to campaign on issues that impact dentists and dentistry and will update you on any developments.
Chief Executive, British Dental Association