The British Dental Association (BDA) has lamented the lack of urgency from government in rebuilding and reforming NHS dentistry, as new data shows a full years’ worth of appointments has now been lost since lockdown.  

Analysis of new Freedom of Information data indicates just short of 40 million fewer courses of treatment have been delivered in England since March of 2020, when compared to pre-covid levels. In the five years prior to the pandemic, average volumes delivered sat at 39.4 million. [1]

As MPs prepare for a major debate on the future of the service on February 10, the union has stressed urgent reform is now vital, both to manage the unprecedented backlog, and to halt the exodus from the NHS.

According to a new survey, over 40 per cent of dentists indicate they are likely to change career or seek early retirement in the next 12 months given the current pressures on the service. Two thirds (66 per cent) indicate they will reduce their NHS commitment, with more than a third (34 per cent) stating they plan to go fully private in the next year, and less than half (48 per cent) are confident their practice will continue to provide any NHS services from April 2022. [2]

Dentists now face financial penalties for failing to hit an imposed targets of 85 per cent of pre-covid activity during the Omicron wave, amid high levels of staff sickness and patient cancellations. Data indicates a significant majority of practices will be unable to hit this target.

The number of dentists working in the NHS in England fell by almost a thousand last year. To stop this flight dentist leaders stress ministers must make NHS dentistry a place where people want to work. Whilst reform has been pledged to the dysfunctional target-driven NHS, it is unclear if there is sufficient ambition and resources to secure meaningful change. The BDA have said reform is a matter of urgency, given any reform of the service will fail if there is no workforce left by the time it is finally introduced.

NHS dentistry has been subject to cuts not seen anywhere else in the NHS. In real terms, net government spend on general dental practice in England has been cut by about a third in the last decade. The government recently offered a time-limited £50 million ‘treatment blitz’ designed to cover 350,000 appointments, but this must be used by April 1, 2022.

Due to chronic underfunding and failed dental contract, the service has long faced chronic problems with burnout, recruitment and retention, particularly in rural and coastal areas. Those with the highest NHS commitment are now the most likely to want to leave. A BDA member survey from late 2021 indicated 93 per cent of owners of dental practices with a high NHS commitment found it difficult to recruit a dentist, with more than four in 10 vacancies unfilled for more than six months.

Research recently published in the British Dental Journal underlines the expectation that inequalities will have increased due to the disproportionate impact of the pandemic on particular groups including children, older people (especially those in care homes), and the socioeconomically disadvantaged.
Eddie Crouch, BDA chair, said, “A year’s worth of dentistry has been lost, and we are yet to detect any real urgency from government.

“Patients are bottling up problems and oral health inequality is set to skyrocket. Yet far from this crisis being a covid blip, it now risks becoming a fact of life for families across England.

“Ministers have recognised the system is rotten, but there is still no timetable for change and no tangible commitment to row back on a decade of cuts.

“Dentists need to see a light at the end of the tunnel. Exhausted colleagues are making exit plans while desperate patients are facing yearlong waiting times.

“It will take more than warm words to halt the exodus from this service and restore access to millions”

[1] BDA estimates based on Freedom of Information requests from the NHS Business Services Authority: Courses of treatment delivered by dentists working in NHS General Dental Services in England, January 2019-December 2021.

Total courses of NHS treatment

Child Patients

Adult Charge Payers

Exempt Adults

Total courses of treatment delivered pre-pandemic Jan 2019- March 2020

50,633,156

15,187,753

27,172,284

8,273,119

Total delivered post lockdown April 2020-Dec 2021

31,065,586

9,026,522

16,377,187

5,661,877

Average COTS delivered per month pre pandemic

3,375,544

1,012,517

1,811,486

551,541

Estimated treatments delivered April 2020-Dec 2021 in absence of COVID based on average levels of care

70,886,418

21,262,854

38,041,198

11,582,367

Estimated missed NHS courses of treatment since March 2020

39,820,832

12,236,332

21,664,011

5,920,490


[2] British Dental Association online survey General Dental Practitioners practicing in England. Fieldwork 13-21 January 2022; 1973 respondents.
What changes in your working life do you anticipate in the next 12 months?

Net 'likely'

(Respondents)

Net 'likely'
(%)

I will reduce my personal NHS commitment

1302

66%

I will go fully private

669

34%

I will change career/seek early retirement

808

41%

I will relocate to practice abroad

180

9%

My practice will cease operations

140

7%


What would you estimate is the likelihood of your practice returning its NHS contract (if it holds one) before 1 April 2022

Response Percent %

Response Total

Extremely unlikely

22%

430

Unlikely

26%

515

Neither likely nor unlikely

13%

258

Likely

11%

213

Extremely likely

4%

76

It has already returned its NHS contract

1%

25

Don’t know/prefer not to say

12%

230

Not applicable (ie: my practice does not hold an NHS contract).

11%

226

Net Unlikely

48%

945

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