The dental recovery plan, launched in
February 2024 with the aim that "everyone who needs to see a
dentist will be able to," is unlikely deliver an additional 1.5
million treatments by March 2025, which even if achieved would
still mean 2.6 million fewer treatments compared to six years
ago, according to a new report from the National Audit Office
(NAO).
The report also reveals that, based on
NHS England (NHSE) analysis to date, fewer new patients have
received treatment each month since the plan's implementation,
compared to the same period in the previous year (see notes to
editors).
Access to NHS dentistry across England
remains below pre-pandemic levels, with 40% of adults recorded as
having seen an NHS dentist in the 24 months to March 2024,
compared to 49% in the 24 months prior to the start of the
COVID-19 pandemic. There are also 483 fewer dentists providing
some NHS care compared to
2019-20.
By August 2024, the Department for
Health & Social Care (DHSC) and NHSE
had spent £57 million of the planned
£200 million budget, with only two of the four initiatives (see
notes to editors) fully rolled out - although the NAO does
recognise the general election has impacted progress in some
areas over that time.
DHSC and NHSE have completed the
roll-out of the new patient premium and an uplift to the minimum
amount Government pays dentists for treatments, known as Units of
Dental Activity (UDA) (see notes to editors), from £23 to £28.
NHSE data suggests that there has been about a 14-percentage
point increase in dental practices reporting that they are
accepting new adult patients, when availability allows, between
December 2023 and September 2024 (see notes to
editors).
There has been a small increase in the
number of UDAs delivered in the early months of 2024-25, but this
is in line with DHSC expectations that, even without the plan,
there would be a small increase (see notes to editors) in
delivery. As NHSE and DHSC are reliant on Integrated Care Boards
(ICBs) and dental practices to deliver the plan, there is
significant uncertainty about the impact the plan will
have.
The ‘Golden hello' incentives of
£20,000 (phased over three years) to recruit 240 dentists into
specific areas of the country have not yet contributed to the 1.5
million additional treatment target. While 274 practices have had
their application approved to recruit a 'golden hello' post, the
first dentist was not appointed until October this
year.
The last initiative of mobile dental
vans, aimed at delivering some dental services to targeted
communities has also not been rolled out, as no vans have been
procured. Any further progress on this initiative paused when the
general election was called and new ministers stated in November
that it will be left for ICBs locally to decide whether they go
ahead with procuring vans during the remainder of
2024-25.
The NAO's report confirms that access
to NHS dentists varies across the country, with some areas of
England on average receiving twice as much care as others.
Courses of treatment per 1000 people ranged from 382 in Somerset
to 800 in South Yorkshire in 2023-24.
There are several challenges facing
the Government if it wants to increase access to NHS Dentistry,
including:
-
The dental contract, which is widely
perceived as needing reform, with many in the sector viewing
the contract as a disincentive to perform NHS care when
practices have the choice of offering private care too.
-
A
fall in the number
of dentists providing some NHS dental care, having fallen
by 483
since 2019-20, a
decrease of 2%. There were 34,520 dentists registered with
the General Dental Council (GDC) in England in April 2023, but
their survey suggests that 22% of the dentists in England did not
provide any NHS dental care, only private dental
care.
-
A reduction in
overall spending
in real terms, dropping from
£3.7
billion in 2019-20 to
£3.1 billion in 2023-24, a drop from £65.15 to £53.88 per
person in England.
-
In 2023-24
there was an underspend
of £392 million against the total ringfenced NHS dental
budget.
ENDS
Notes to editors
- Press notices and reports are available from the date of
publication on the NAO website. Hard copies can be obtained by
using the relevant links on our website.
- The evaluation led by NHS England is ongoing to understand
this data more fully.
- Dental Recovery Plan four headline initiatives:
A new patient premium, in which participating dental practices
receive a credit of units of dental activity (UDAs) equivalent to
£15 or £50 (depending on the course of treatment) for eligible
new patients
'Golden hello' recruitment incentives of £20,000 (phased over
three years) for 240 dentists to work in areas with recruitment
and retention challenges in NHS dentistry
An uplift to the minimum value of a UDA to £28. Units of dental
activity (UDAs) are measures of overall dental activity based on
the kind of treatment provided.
Mobile dental vans to deliver some dental services to targeted
communities.
- The 'find a dentist' service provides information on
practices are accepting new patients "when availability allows",
but this is not defined by NHS England.
- Even without the Dental Recovery Plan, DHSC was forecasting
that there would be an increase of 3.7% in delivery of UDAs in
2024-25.
