NHS dentistry at breaking point, BBC study reveals

'Years of chronic neglect': a comprehensive investigation by the BBC has revealed that nine out of 10 NHS dental practices are unable to accept new adult patients.‘Years of chronic neglect’: a comprehensive investigation by the BBC has revealed that nine out of 10 NHS dental practices are unable to accept new adult patients.

The BBC’s recent investigation has revealed that NHS dentistry is at breaking point.

Nine in 10 NHS dental practices across the UK are not accepting new adult patients for treatment, the investigation found.

In addition, eight in 10 NHS practices are not taking on new children for treatment.

The BDA has called the BBC’s investigation ‘the the most extensive survey of patient access ever undertaken’.

BBC survey

The investigation was carried out from May to July this year.

Supported by the BDA, the BBC identified 8,533 dental practices in the UK that were believed to have NHS contracts.

The BBC was able to contact nearly 7,000 of them to ask if they were taking on new patients as part of a survey.

The investigation found:

  • Across England, 91% of NHS practices were not accepting new adult patients (4,933 of 5,416), rising to 97% in the East Midlands, and 98% in the south west, north west and Yorkshire and the Humber
  • Of those practices not taking on adults in England, 23% (1,124) said they had an open waiting list, and 16% (791) said the wait time was a year or longer, or were unable to say how long it would be
  • Out of 152 local authorities in England, BBC researchers did not successfully reach any practices accepting new adult NHS patients in 56 (37%) local authorities
  • In England, 79% of NHS practices were not accepting new child patients, (4,293 of 5,416)
  • About 200 practices said they would take on a child under the NHS only if a parent signed up as a private patient.

Patients in desperation

Since Covid-19, many practices have been operating at full capacity. Over three thousand dentists have left the NHS, with more expected to follow after feeling ‘chewed up and spat out’.

The pandemic worsened the already exacerbated NHS system after a year’s worth of dentistry was lost. This resulted in an overwhelming backlog of appointments.

The inaccessibility of NHS dentistry has even driven some patients to pull out their own teeth in desperation, or resort to DIY dentistry.

Caroline Young, from Blackpool, calls dentists in the phonebook every week to ask if they are taking on new patients. Her crowns fell out after deteriorating and now she can’t find a new NHS dentist to fix them.

After seeing it done on social media, she now makes her own homemade dentures out of plastic. However, dentists have warned that homemade dentures are a serious choking hazard. In addition, they can cause gum disease and tooth decay because they trap food.

‘NHS dentistry will die’

The BDA has called for the government to ‘stop rearranging the deckchairs’ and urgently commit to a ‘fair funding settlement and fundamental reform of the service’.

It would take an additional £880 million a year to restore funding to 2010 levels, the BDA has found.

Shawn Charlwood is chair of the BDA’s general dental practice committee. He said: ‘NHS dentistry is at a tipping point, with millions unable to get the care they need and more dentists leaving with every day that passes.

‘We’re seeing the results of years of chronic neglect, set into overdrive by the pressures of the pandemic.

‘The question now is will ministers step up before it’s too late?

‘Nothing we’ve heard from government to date gives us any confidence this service has a future. Without real reform and fair funding NHS dentistry will die, and our patients will pay the price.’

Where is access worst?

In addition, the BBC investigation found that the issue was significantly worst in the south-west of England, Yorkshire and the Humber and the north west. Here, 98% of practices were not accepting new adult NHS patients.

However, London had the best access to NHS treatment where almost a quarter of practices were taking on new adult NHS patients.

Shockingly, the majority of dental practices did not have waiting lists. The practices that did have them were a year or longer.

In Norfolk, a dental practice had over 1,700 on its waiting list. In addition, a practice in Cornwall had a waiting time of up to five years until it could take on a new patient.

English region Proportion not accepting adult patients Proportion not accepting child patients
East Midlands 97% 84%
East of England 93% 81%
London 76% 65%
North east 93% 76%
North west 98% 83%
South east 95% 83%
South west 98% 95%
West Midlands 84% 69%
Yorkshire and The Humber 98% 89%

Scotland, Wales, Northern Ireland

Nation Proportion not accepting adult patients Proportion not accepting child patients
England 91% 79%
Northern Ireland 90% 88%
Scotland 82% 79%
Wales 93% 88%

The lack of access to NHS treatment remains a serious problem in Scotland, Wales and Northern Ireland too.

Ciara Gallagher is chair of the BDA’s Northern Ireland dental practice committee. She said: ‘We can only hope dental care in Northern Ireland had not yet reached the point of no return.

‘Dentists are already moving on and practices are struggling to remain viable, because the numbers Health Service dentistry is based on simply don’t add up.’

She continued: ‘This postcode lottery our patients now face will only end when we see real reform backed up by fair funding.’

David McColl, chair of the BDA’s Scottish dental practice committee, commented: ‘The Scottish Government promised free NHS dentistry for all, but the public are now living with the harsh reality.

‘You can’t run a health service on soundbites and slogans. Ministers need to take a long hard look at the evidence, and bring forward the reforms and resources we need to deliver for patients across Scotland.’

‘A crisis unlike any in history’

Russell Gidney, chair of the BDA’s Welsh General Dental Practice Committee, said: ‘This service faces a crisis unlike any in its history, but sadly the Welsh government has failed to offer any concrete solutions.

‘We’ve heard half-baked policies based on back of an envelope calculations. Until we see real commitment the future of NHS dentistry in Wales remains in doubt.’

This comes after Wales recently introduced new reforms in an attempt to generate thousands of new appointments.

However, BDA Wales has stressed that in order to boost access and halt the exodus from NHS dentistry, sustained investment is necessary.

NHS dental contract

This comes after the government recently announced significant changes to the NHS dental contract.

The contract changes are intended to result in improved access to dental care for patients across the country.

But despite the recent changes, some believe they are too little and too late.

Calling them ‘modest’ and ‘marginal, the BDA believes the changes will do little to arrest the exodus of dentists from the service, or address the crisis in patient access.

Leading dentists across the profession believe that without any new investment, the contract changes will not address the problems patients face accessing services or keep dentists in the NHS.

Simon Gallier is the founder of Future Health Partnership who handed back a 24,100 UDA dental contract last year.

He said: ‘This is just tinkering at the edges to make it look as if NHSE is actually doing something when they are actually doing nothing.

‘To 99% of dentists working in the NHS this will make no difference. They still have the same UDA contract for the same fee.’

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