The incompetent politicians need to al least provide free dental care for all children. This alone will pay back in the health budget in later years.. NHSreality has warned about heart valve disease and the risks from not having sufficient state dental provision for 12 years now...
Kat Lay 19th December 2023: Universal access to an NHS dentist is ‘gone for good’ – Nuffield Trust warning comes as eight in ten dentists refuse to accept new adult NHS patients
Universal access to dentists on the NHS has probably “gone for good”, according to an expert review of the service. The survival of NHS dentistry will require “politically unpalatable” choices, such as limiting provision to things like emergency treatment, pain management and check-ups, with harsher means-testing for any wider services, the Nuffield Trust think tank said. Its warning comes as analysis suggests eight in ten dental surgeries in England are not taking on any new adult NHS patients, while seven in ten are not accepting new child patients.
Those figures, from the Labour Party, are based on data from surgeries that have recently published updated information on the NHS website. The Nuffield Trust review identified a series of “serious problems with dentistry in this country”, including growing difficulties with access and persistent inequalities in both access and outcomes.
The contract between dentists and the health service was “unfit for purpose”, the review found, with much of the need for dental care unfulfilled. Tooth decay was the most common reason for a child aged between six and ten to be admitted to hospital. Last year nearly six million fewer courses of NHS dental treatment were provided than in the last year before the Covid-19 pandemic, the analysis revealed. Funding in 2021/22 was more than £500 million lower in real terms than in 2014/15.
The think tank criticised decades of neglect from politicians that had left NHS dentistry extremely vulnerable to the impacts of the pandemic, austerity and the cost of living crisis. Thea Stein, chief executive of the Nuffield Trust, said: “We need to see immediate action taken to slow the decay of NHS dentistry, but it is increasingly clear that we can no longer muddle through with an endless series of tweaks to the contract.
“Difficult and frankly unpalatable policy choices will need to be made, including how far the NHS aspires to offer a comprehensive and universal service, given that it does not do so at present. If, as seems, that the original model of NHS dentistry is gone for good then surely the imperative is to provide enough access for a basic core service for those most in need.”
Any future government must consider swift action to shore up the service, the report urged; for example, by increasing the intervals between long-term check-ups, boosting the recruitment of dental therapists from the private sector and investing in preventive care for children.
In the longer term, politicians faced a choice between adjusting the NHS offer by expanding it with a huge injection of funding, or scaling back to a “minimum offer”. Providing enough access for a basic core service for children, older people and those who cannot afford private care would mean “removing some of the rights to NHS services which people currently enjoy in theory, but usually go without in reality”, the authors added. Stein said: “Whichever way we go, I’m afraid that NHS dentistry cannot continue without some kind of evaluation of the offer even if there are some major improvements to the way services are contracted and commissioned.”
Wilf Williams, the lead author, said: “This report illustrates that continued neglect of dental policy is not a viable strategy. The result is a widening gulf between the government’s stated aim that everyone who needs one should be able to access an NHS dentist and the dire reality of elusive and increasingly unaffordable care.
“For the wider health system, the lessons are troubling: without political honesty and a clear strategy, the same long-term slide from aspiration to reality could happen in other areas of primary care too.” The Department of Health and Social Care has promised a “dental recovery plan” for months, issuing statements in August indicating it was due shortly, although none has been published.
Labour has promised a dentistry rescue plan, including funding for 700,000 more urgent appointments a year, incentives for new dentists to work in “dental deserts” with the worst provision and supervised toothbrushing in schools. It said its plans would cost £111 million a year and be funded by abolishing the non-dom tax status.
Wes Streeting, the shadow health secretary, said: “The Conservatives have left NHS dentistry to wither and now the service is barely worthy of the name. Patients are told to go without or do it themselves, with DIY dentistry now shockingly common.”
An NHS spokeswoman said: “The NHS has implemented the first reforms to dentistry in 16 years, which are helping dental teams address the inevitable backlogs that built up during the pandemic and the most recent stats show that this is working with dental activity up by more than a fifth on last year. “The NHS long-term workforce plan is committed to transforming dental services, by increasing dentist training places by two fifths [by 2031/32].”
Letters in the Times 20th December 2023: Dentistry warning
Sir, Dr Gerard Bulger is absolutely right when he says that the system of payment for GPs is responsible for exacerbating the crisis in NHS general practice (letter, Dec 18). This is borne out by the experience in dentistry, where the collapse of NHS services was prompted by the introduction of a new dental contract in 2006. It ended the system of paying dentists directly for the amount of work they did and replaced it with an anomalous contract with punitive targets, coupled with a ceiling on the amount of work a dentist could do and be paid for. Successive leaders of the dental profession have failed to persuade the government to rethink this misguided policy. One can only hope that GPs’ representatives are more successful.
John Grossman
Northwood, Middx
Sir, NHS Trusts work hard to boost productivity (report, leading article, Dec 16; letters, Dec 18 & 19), including conducting more operations, discharging patients more quickly and using artificial intelligence for faster referrals. Improving public health, increasing public investment and reforming social care are also vital to help reduce pressure on the NHS. But it is hard for trusts feeling the pinch from tight budgets and asked to find unprecedented savings to improve productivity when there are more than 121,000 vacancies in the NHS in England alone. Employees are already overstretched in the face of relentless demand and many more patients with complex conditions.
Saffron Cordery
Deputy chief executive NHS Providers
NHS reality. An NHS soapbox. Speakers' corner for the NHS. 