NHS dentistry a “Cinderella service”

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BDA says Ministers’ approach to ‘Cinderella Service’ fuelling crisis in NHS dental care

The British Dental Association has pointed to an emerging crisis in NHS dentistry following new research from the BBC showing just half of dental practices in England currently accept new adult NHS patients. [1]

Analysis of 2,500 dental practices on NHS Choices and follow-up phone calls revealed 52% of dental practices are accepting new adult patients, and just 60% accept new child NHS patients.

The BDA has pointed to continued failures from government to make a decisive break from the contract system which sets quotas on patient numbers, and the lack of effective public information campaigns and a growing reliance on patient charge revenue, which discourages patients on low incomes. [2]

Latest figures from NHS Digital show that half of all adults and nearly five million children are not seeing a dentist regularly. Patient charge revenue has grown by 66% in the last decade, while direct state investment is in decline. [3]

Tooth decay remains the leading reason for hospital admissions among children, and dentists have argued that continued failure to set strategy is placing huge pressures on GP and A&E services. [4]

The BDA advocates a shift to a genuinely preventive contract for NHS dentists in England, and a national programme to tackle decay modelled on successful initiatives in Scotland and Wales, and the anti-obesity campaign Change 4 Life. [5]

The BDA’s Chair of General Dental Practice, Henrik Overgaard-Nielsen (top) said: “These figures are a stark reminder that government has no interest in getting more people attending an NHS dentist. Many dentists would love to do more NHS work, but the contract imposed on them penalises them when they don’t hit quotas, and does not pay them when they do more. Despite years of promises we are no closer to a decisive break from a model that puts government targets ahead of patient need.

“Ministers’ principal interest is in keeping costs down, so they pay less while patients put more in through charges. This pursuit of quick savings is wholly counterproductive, as patients who cannot find or delay treatment are simply piling huge pressures on other parts of the NHS.

“Our patients are losing out because dentistry has been treated as a Cinderella service. Morale is at an all time low, and many colleagues are now looking for the exit. In place of indifference we urgently require a coherent strategy and real commitment from government.”

References
[1] http://www.bbc.co.uk/news/uk-england-41113507  
[2] The last Adult Dental Health Survey reports that just over a quarter of adults (26%) say that the type of dental treatment they opted for has been affected by cost - and almost one-fifth (19%) say that they had delayed dental treatment for the same reason.
[3] NHS Dental Statistics for England 2016-17, Annual Report
[4] Tooth decay now the leading cause of hospital admissions for children, and an estimated 600,000 patients with dental problems presenting themselves at GP practices and over 130,000 at Accident and Emergency services each year.
[5] Putting Prevention First, British Dental Association Manifesto 2017, BDA, May 2017.