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The future for NHS dentistry: 3 key priorities

Blog Author Henrik Overgaard-Nielsen

Blog Date 06/02/2019



Last year over 1 million new patients tried and failed to secure an NHS appointment in England, and our ministers and officials really don't seem concerned.  


It's an eye watering statistic, and one that drew an unusual response when I took this argument onto Sky News, from the minister responsible for dentistry, Steve Brine MP.




It was a surprising response. We believe in prevention and want to put it into practice.

The very reason we undertook this research – and why we've been so determined to sit down with the minister for so long – is because we know that questions on access, on the workforce and prevention are intrinsically linked.


And only a joined-up approach can ensure this service has a real future.


1. Access

 "9 out of 10 people who need an NHS appointment get one".


Colleagues will be familiar with NHS England's stock response to any access story. Whenever we see problems, be they in Cornwall, Yorkshire or even the Health Secretary's own Suffolk constituency, officials trot out the usual line. 

But this reading of official data no longer captures the depth and breadth of access issues across England.

So we looked closely at the government's own numbers.


And tucked away in spreadsheets on NHS Digital are survey responses that show access problems across every English region – with over 40% of patients not on the books failing to secure access in parts of Norfolk, Derbyshire, West Yorkshire and Cornwall, reaching over 60% in parts of Lincolnshire.


It's a problem that's hitting nearly a third of new patients in parts of the capital. An inconvenient truth we've found ourselves telling TV and newspaper journalists the length and breadth of England.




That a million new patients have tried and failed to secure access to care is not a fact this service can take any pride in. Neither can the reality that charities that normally operate in the Third World have stepped in to fill the gap left by mainstream services.


We do not accept that a postcode lottery of provision is inevitable. And it's why we want to work with the Minister to ensure that those who want local NHS services, can access them.


2. Workforce

Every year we ask our members to tell us about their plans, their morale and motivation.


And you've told us that now 60% of NHS dentists in England are planning on moving on. And that those with higher NHS commitments are all the more likely to be considering their plans.


It goes without saying England can't have NHS dentistry without NHS dentists. And your evidence tells the same story we see in official surveys – that higher NHS commitments equal lower morale.


Our members have also seen an unprecedented collapse in real incomes, and with recruitment and retention problems mounting, Mr Brine needs to face up to a task of stemming a mass exodus of dentists from the NHS.


3. Prevention

We deal with almost wholly preventable diseases, and excluding the profession from the development of genuinely preventive policy framework would be a missed opportunity.


From the sugar levy to HPV vaccination, our members value and champion prevention, and we have long supported government's commitment to a move away from the current flawed target-driven system.


The challenge remains to ensure a new model actually provides colleagues with the time to care, while recognising and rewarding prevention.


A sustainable future?

As the professional body for dentists, Ministers need to appreciate that whenever systems or policies leave our members unable to deliver quality care for the patients who need it, it is our duty to voice those concerns.


We want NHS dentistry to have a future. And a properly funded, reformed contract will be the bedrock of any approach. Because when target-chasing fuels workforce problems, when under-commissioning caps patient numbers, or prevention is delivered as an optional extra against the clock, the impact is ultimately felt by the patients and by other parts of the NHS. 


We have written to the minister. We want to talk, and are not asking the impossible. 


Rollout of a reformed contract is set for rollout next year. And we want to see a sustainable workforce, appropriately resourced, capable of doing what it was trained to do.


Our members have provided the evidence. The government have a duty to respond.


Henrik Overgaard-Nielsen

Chair, General Dental Practice Committee


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