As we mark 75 years of the National Health Service, Ben Atkins explains why some hard work will guarantee a bright future for NHS dentistry.
Please introduce yourself
My name is Ben Atkins, I’m the past president of the Oral Health Foundation and I had seven different NHS contracts over the northwest of England, from triage centres to a homeless clinic. I’ve been really committed to NHS all the way through my career because it’s a wonderful thing.
And for me, as a business owner, it’s a regular source of income. We’ve been through quite a few recessions over the years, and, in dentistry, those contracts are quite bomb-proof. It’s really important to have stability.
Something I really like within dentistry is that you’ve got a mix of NHS and private – we’re quite masters of our own destiny, if we let ourselves.
What are your thoughts on the NHS in the current climate?
We all moan about who pays us. If you go through every single member of staff I’ve ever had, they all deserve more money in their own heads. I’ve never had one member of staff come to me and say, ‘You know what, I would really like less money’. We moan about the NHS, we moan about the rulebooks.
For me, the NHS has been so good to me in my career. It’s given me so many opportunities. But the key thing I’ve always recommended and talked to my associates about is, do you even know who your local commissioners are? Do you even know what they want? If you don’t know what they want, you can’t fulfil it and, quite frankly, get more money.
I love the NHS. We’re in such a massive opportunity at the moment because the government is looking at dentistry. They’re aware. I’ve never know such an awareness of dentistry in my whole career. We all know this is a massive, challenging time, but actually, for once, the government knows that too.
There is such a massive opportunity to make change. If the British Dental Association (BDA) hadn’t done such a good job to get us into the newspapers with Eddie and Shawn doing such an amazing job, we wouldn’t have the pedestal we have at the moment to make this massive change.
Dentistry, especially in the NHS, is absolutely amazing if you understand the rulebooks, and if you go and find out what your local commissioners want and where the dental disease is.
We’re at this pivotal point where dentistry has massively improved over the last 20 or 30 years. In the 80s, you had news presenters with missing front teeth. We laugh about that now, but that’s almost wincingly bad oral health.
However, we need the NHS to focus on where the disease is. We need dentists to focus their NHS money on where the disease is. Not, ‘Well done, you’ve got no holes in your mouth, I’ll see you in six months’. We need to do active management of disease and opportunity, but we need to really focus on where those opportunities are, and use your contract, work with your commissioners, put your hand up, and focus on new patients.
However, it’s hard. I’ve lost associates in the past because we did National Institute for Health and Clinical Excellence (NICE) recalls in my business.
I actually had one dentist say: ‘I don’t want to do that. It’s hard work.’ But you’ve got to create that strategy and it’s so motivational when you do. I used to see these turning points with some of my associates when they suddenly realised that they were managing their own little population.
People with perfectly good teeth can go on 24 month check-ups. They can still come to in the meantime for aesthetic dentistry – private dentistry should be there and celebrated.
I actually feel that is one of the biggest challenges we’ll have in our profession – turning that mindset. You can be the aesthetic dentist, but you can also be the caring, population-management, disease-focused clinician that we all know they are. There needs to be a guide for that journey. So, there are some amazing opportunities in the NHS if you put your head up and volunteer, and if you are actually a cause of action.
Are you a member of your local dental committee? Do you go to your BDA local meetings? Have you joined your local professional dental network and actually asked how you can get involved? You have to go the extra mile – you can’t just wait for things to land on your lap.
There’s a lot of people in the profession who are quite critical of the NHS and wouldn’t ever go back. Do you think that’s a deserved criticism? Or do you think that needs to change?
I have so many friends who are fully in the private market, who do such an amazing clinical journey for their patients. They are off the charts.
But I do feel turning their back on the NHS would have been a mistake for me. A massive mistake. The opportunities I’ve seen, the clinical dentistry I’ve seen, and the sheer joy that I’ve seen with my clinicians is great.
I did a clinical diploma certification with Professor Nick Grey, so I was lucky enough to have a professor sat next to me half a day a week, every week for about four or five years. I would have paid for that.
There are so many initiatives out there that makes such a difference to our patients, but you need to know about them. I used to do a day a week learning how to do conscious sedation and juggling with patients while I was taking a tooth out on special needs patients. It made such a difference to me.
Volunteer a day a month and you will see a different side of dentistry and no one mentions money. No one ever mentions money if they are enjoying it. We talk about the NHS being broken. No it’s not. We’ve just got to change it, and we have this massive opportunity to change and work with our commissioners.
When the NHS wants to be responsive, it can be and its acute care is second to none. You do not go to a private doctors practice if you’ve got an acute problem. We need to protect that, we need to celebrate it, we need to work with our patients. It needs to be evolved and we are getting there.
NHS dentistry has just turned 75 – what is there to celebrate? And why is it so important to be celebrating?
If you look back to where it was before, there was only private care. The poor people had their teeth out. It was private GPs, it was private everything. And there was such health inequalities too – if you’re poor, well, you can have a tooth out forever.
We need to spread the word that we shouldn’t abuse it and we need to look at more of a preventative focus because we are fighting such public health issues. That’s where we need to spend money, and that’s where we need to evolve.
We’re fighting such commercialisation of sugar with the big corporates who make a fortune out of our ill health. So, that’s why the NHS needs to be celebrated, because that is what we’ve got. What we’ve got there is something that needs to be celebrated, and should not abuse it as a population, because we do abuse it.
We need to focus on the patient communication journey and the NHS has the ability to do that. But we sometimes forget the journey we’ve been through and where we could be if we didn’t have the NHS.
What do you predict the future of the NHS?
The future of the NHS will be phenomenally targeted.
I would want it to be focused on where the decay is for low social economics, and focused on a preventative journey, and actually on a behavioural change system that empowers the patient and the clinician to say, ‘No, I’m not pulling your teeth, I’m healing them before we put the fillings in’.
The more you heal, the better it is, and the patient will trust you more. So, I would like to see a lot more of a holistic approach so that the patient understands the responsibility for their mouth. That’s our job as a clinician: to be a guide. If we can get that done in a nutshell, the NHS will work. I’ve seen this strategy work in my practices.
The NHS has got a bright future but it’s going to be hard. We’ve got to work on strategy and have that guidance.
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