Fundamental reform of NHS dentistry needed to end a ‘crisis of access’, say MPs
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Government must deliver on ambition for all who need an NHS dentist
to access one Urgent and fundamental reform of NHS dentistry is
needed if people are to receive the dental care they are entitled
to. Today’s report from the Health and Social Care Committee
describes evidence of pain and distress due to being unable to see
an NHS dentist as ‘totally unacceptable in the 21st century’. MPs
cite frustration that recommendations for reform made by their
predecessor...Request free trial
Urgent and fundamental reform of NHS dentistry is needed if people are to receive the dental care they are entitled to. Today’s report from the Health and Social Care Committee describes evidence of pain and distress due to being unable to see an NHS dentist as ‘totally unacceptable in the 21st century’. MPs cite frustration that recommendations for reform made by their predecessor Committee 15 years ago have still not been implemented. They brand the current contract, which pays dentists for NHS ‘units of dental activity’ (UDAs), as not fit for purpose. The Report finds common misconceptions among the public about entitlement to NHS dental services and calls for action to address this. MPs endorse comments given by the Health Minister Neil O’Brien in evidence that it was the Government’s ambition to ensure that everyone who needs an NHS dentist can access one. The Committee calls for the Government to set out urgently how it intends to reform the dental contract to deliver on the ambition expressed by its Minister. Chair of the Health and Social Care Committee Steve Brine MP said: “Rarely has an inquiry been more necessary than this one. To hear of someone in such pain and distress that they resorted to using pliers to extract their teeth demonstrates the crisis in NHS dental services. The problem is compounded by people being unaware of what they’re entitled to and a contract that is unfit for purpose when it comes to paying dentists for treating NHS patients. Today we register in the strongest terms possible our concern for the future of NHS dental services and the patients who desperately need access to them. “Declining levels of NHS dentistry activity should have been sounding alarm bells, as should a projected budget underspend of £400 million. “What’s particularly frustrating is that recommendations made by our predecessor Committee 15 years ago to reform the dental contract have still not been implemented. Yet contract reform alone is unlikely to bring back dentists who have already left the NHS or are considering leaving in the near future. “We endorse the Government’s ambition to ensure that everyone who needs an NHS dentist can access one. Belatedly, now is the time to deliver it.” ENDS Key recommendations to Government:
Please see attached Report for a full list of conclusions and recommendations. Crisis of access to NHS dental services MPs heard first-hand from a patient who had extracted their own teeth. Another case study described how someone who, denied access to dental treatment, had used pliers to pull out their teeth. A parent who found it impossible to register with an NHS dentist said their four-and-a-half-year-old son had not seen a dentist since he was a baby. Last August research by the BBC and the BDA showed that 90% of practices across the UK were not accepting new adult NHS patients. The Report highlights significant regional variation affecting people living in rural areas and in areas with the highest levels of deprivation, while ethnic minority people from lower socio-economic backgrounds were also twice as likely to avoid dental treatment because of costs compared to white people from the same backgrounds. In April, the Minister announced a forthcoming recovery plan for NHS dental services. It has yet to be published. Contract ‘not fit for purpose’ MPs say the current UDA-contract system needs urgent reform to boost recruitment and retention in NHS dental services. Recommendations made by the predecessor Committee to reform NHS dental contracts in 2008 have still not been implemented. MPs were told that the UDA system, the basis for dentists’ remuneration by the NHS, remains a "barrier to prevention". They conclude that the lack of appropriate renumeration acts as a disincentive to dentists seeing new patients, including those who have higher levels of disease and require more time to treat. NHS dentistry budget ‘underspent’ by projected £400 million The Report notes that levels of NHS dental activity fell by 71% in 2021-22 and by 31% in 2021-22 compared to 2018-19. FOI requests revealed that the primary dental care underspend for 2022-23 was forecast to reach £400 million. Workforce The Report warns that even rapid action could prove too little too late for those dentists who have already left the NHS. MPs heard repeatedly that a lack of dentists and dental care professionals undertaking NHS work was the main driver behind both lack of access to appointments for patients, and the underspend in primary care dentistry. MPs conclude that the absence of a mention of the dental contract in NHS England’s Long Term Workforce Plan reflects where reform stands as a priority. They express concern that the Government and NHS England have not fully grasped the scale of the challenge for the workforce, and the need to urgently provide compelling incentives to attract new and existing dentists to undertake NHS work. |