England: Pioneering NHS dentists thrown under the bus
14 January 2022
We have condemned the insufficient support offered to over 100 pioneering practices in England, who are being forced back to working to historic models of care from April.
These 'prototype' practices volunteered to form the test bed for new ways of delivering dentistry, to replace the widely discredited target-based NHS dental contract. In October, they were informed that regulations supporting new ways of working would not be renewed. NHS England has said that they will be offering these practices a helpline and patient leaflets to deal with the change. However, this will do little to mitigate the disruption caused.
Shawn Charlwood, Chair of the British Dental Association's General Dental Practice Committee, made our position clear: "The support offered to these pioneering practices is too little, too late. After committing years of effort their reward amounts to a helpline, a few leaflets, and the uncertainty of starting again, effectively from scratch. These NHS practices were given the time to care that all dentists require. Going back to chasing targets could take years, and there will inevitably be casualties. Patients will once again pay the price for the reckless decisions taken by government."
It has taken up to four years for practices that have left the programme in the past to revert to existing models of care. These practices therefore anticipate severe staffing problems, aggravated by already acute recruitment problems across the service. Many practices are already facing real issues with their long-term sustainability, and we believe hitting an 85% activity target is a wholly unrealistic ask during this phase of the pandemic.
The prototype systems allocated greater time to assess the oral health needs of patients and provide needed care. This reduced the volume of patients these practices could treat, and their patient base. Pledges were made to practices that there would be no detriment as a result of their participation in the programme. Reverting to the original model will now see them facing significant challenges.
There was a very real opportunity to take NHS dentistry out of a "drill and fill" activity-based system to one of prevention and care for individual patients. These aspirations have been consigned to history as NHS dentists are put back on an activity treadmill.
Looking ahead, it is likely that other NHS practices in England will have to hit 100% of pre-COVID activity from 1 April 2022 or face financial penalties. We understand that these former-prototype practices will be given leeway of hitting 90%. We will continue to push for more support to be provided to these practices, who were willing to take risks in the name of improving NHS Dentistry.