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​Dentists: lockdown targets leave patients in pain without options

29 January 2021


The British Dental Association has issued an open letter to Health Secretary Matt Hancock following the revelations exposed by the BBC today that a leading UK dental chain has instructed dentists to limit urgent care, in order to meet unrealistic targets imposed by government on NHS dental providers on 1 January 2021.


In a leaked memo, staff at the chain have been told by management to prioritise routine check-ups over patients requiring urgent treatment. The BDA believes this approach is the inevitable result of government policy, which Portsmouth MP Stephen Morgan recently told Parliament will force practices to “prioritise volume over need.” The perverse system means it is easier to achieve quotas – and escape financial penalties - via simple routine check-ups rather than time-consuming urgent care that the BDA believes needs to be prioritised.


The union has renewed its call on Mr Hancock to drop these targets immediately, and re-enter negotiations. NHS England data indicates that out of a total of 6683 contract holders, only 43% would have met this new target in November owing to current restrictions. 41% had fallen below the 'cliff edge', delivering less than 36% of their contract, and faced the return of the majority of their NHS funding for the current quarter, and with it risk of closure.


The BDA has stressed that this chain will not be alone in taking this approach, given the ever-present threat of sanctions and chaos caused by patient cancellations and staff availability during the new lockdown.


According to recent YouGov polling 46% of adults in England indicate they would be likely to cancel a routine appointment if they had one booked in during this lockdown. 45% are now less likely to seek routine care when due for a check-up, when compared to the period before the current restrictions were applied.


BDA survey data indicates nearly 8 in 10 practices (79%) have seen an increase in the levels of cancelled or missed appointments since the New Year, with 43% reporting they’ve seen a much higher than usual rate of no-shows compared to earlier in the pandemic. More than three-quarters of practices also report issues with staff availability since the New Year, with 39% citing COVID infection as having a high impact, with 53% citing staff self-isolation, and 42% problems in securing childcare owing to lack of clarity on their key worker status.


The Scottish Government, which had planned to impose similar targets on practitioners in Scotland – albeit at less than half the level expected of their English colleagues – has decided to delay their introduction until at least June in the light of surging infection rates and tighter restrictions. The Welsh Government has not introduced any activity targets at all.


Shawn Charlwood, newly elected Chair of the British Dental Association’s General Dental Practice Committee said:


“We warned Government where their targets would lead, and now patients in pain are going to be left without options.


“This is not a model of care we could ever deem acceptable during a pandemic. However, it is the inevitable logic of a policy this Government has imposed on NHS dentists across England.


“The government’s pragmatism, and willingness to change tack on policy in response to emerging evidence is something to be applauded. Its insistence on sticking to these targets in the face of the facts is not.


“It is time to abandon these discredited targets, and find a way forward that reflects the reality on the front line, and places priority on the patients who need us most."