Reflecting on the future of the NHS

Claire Roberts gives her views on the future of NHS dentistry

Following publication of the independent NHS confidence monitor survey commissioned by Practice Plan and the much-anticipated meeting of the insights panel to discuss the results, Dentistry magazine caught up with Claire Roberts to get her views on the future of NHS dentistry.

Dentistry magazine (DM): The NHS confidence monitor revealed that 39% of respondents are less confident in their career prospects within NHS dentistry over the next 12 months than they were a year ago. What do you think about this?

Claire Roberts (CR): I’m not surprised the results show many of the respondents are less optimistic about their future career options, especially for the providers as I think they’ll be paying more attention to the detail of the prototypes.

If these reforms come to fruition, there will be less opportunity for young associate dentists to progress, or to earn enough to get to the point of owning a practice.

There are issues with vocational training and the current contract dumbs down the work you can do in terms of acquiring more experience in advanced techniques and treatments, which doesn’t look like this is being addressed within the reforms. This leaves a huge gap in skilling and the ability to progress, in my opinion.

DM: Almost half of dental professionals working within the NHS (44%) are less confident that the NHS will offer the right balance of treatment versus prevention over the next 12 months than they were a year ago. What are your thoughts?

CR: As far as balancing treatment verses prevention, the current contract doesn’t remunerate prevention because it focuses on treatment, so the balance is wrong to begin with, which is reflected in the results.

Unless the contract changes in the next 12 months, there will be no improvement in this area and so no wonder the profession are losing confidence in getting the right balance for the future.

DM: The survey highlighted that 65% of practices consisting of up to three dentists are losing confidence that practising dentistry within the NHS will offer an appropriate level of remuneration over the next 12 months, which is considerably higher than the percentage of respondents across all practice sizes (54%), who felt the same. Why do you think this might be?

CR: Looking through the detail, there seems to be an overall decline in confidence from the NHS provider group. As this is the group who manage the finances and know how much it costs to run a practice, this trend doesn’t surprise me.

Uplifts in contract value have been inadequate for years, profitability is down and many providers have seen their income slashed. Some associates have a view that they earn more profit than is actually the case. Also they often fail to take certain costs into account, such as the cost of regulation, costs that are difficult to ascertain, this may be why they feel a little more optimistic.

But as declining profits and increasing costs cause a greater downwards pressure on associate remuneration, I suspect this view may not last.

DM: The survey indicates that 61% of dentists are as confident that their patients will be happy with the outcome of attending an NHS practice over the next 12 months as they were in the previous 12 months. Do you agree?

CR: For the time being, I do not think that patient happiness will be affected, but as new information comes to light and things start to change, it will be the provider who oversees the complaints and listens to feedback from the dental team with regards to patient happiness, so they will have to keep a close eye and ear to the ground to monitor any changes.

DM: And finally, in your opinion, what more could be done to help the dental team in making sense of the contract reforms and their professional future?

CR: At the moment, I consider the current NHS contract difficult to work under. The main issue for me is all the grey areas, and by which I mean resolving questions such as ‘what is covered by the NHS, and what isn’t? When is mixing appropriate?

If we combine these grey areas with regulation requirements, it is potentially a stressful situation – dentists are worrying constantly that they might fall foul of regulations. At the end of the day it is the provider who sorts out any fallout when the performer gets it wrong.

What we need for the future is clarification for both ourselves and patients so that we can treat patients effectively and appropriately.

The NHS confidence monitor

What it is: a fully independent survey asking NHS dental professionals to rate their confidence in the NHS’s future.

Its purpose: to track the profession’s confidence levels over the medium term, whilst new information and detail is released on the NHS contract reforms, to give an insight into the thoughts and feelings of the profession.

The detail: the initial, never-conducted-before survey asked 80 dental professionals (NHS providers and performers) to rate their confidence levels on five key statements covering:

  • Their future career prospects
  • Getting the balance of treatment vs prevention right
  • Remuneration levels
  • If patients will be happy with the level of care provided
  • And, the ability for the team to work effectively within the NHS.

The NHS confidence monitor has been commissioned by Practice Plan to understand the profession’s confidence levels in the future of dentistry. To view the full results and join the debate, go to

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