‘Dental deserts’ are emerging across England after more than 2,000 dentists left the NHS last year, leaving millions struggling to get checked or treated for toothaches, a new report reveals report.
The exodus is exacerbating a crisis that has seen patients struggle to get dental care because so few dental practices will see them as NHS patients.
The number of dentists providing NHS care in England has risen from 23,733 at the end of 2020 to 21,544 at the end of January this year, according to the latest NHS figures, which were obtained by the Association of Dental Groups (ADG) on release information laws.
Given that dentists each have a caseload of around 2,000 patients, workforce burnout has left around 4 million people without access to NHS care. The NHS now has the fewest number of dentists in a decade, according to the ADG, which represents the major chains of surgeries.
Access to NHS dental care is so limited that people in some areas are forced to wait three years for an appointment. Difficulty getting treatment is a major source of public frustration with the health service, with only one in three people satisfied with dental services.
Many are forced to go private, after unsuccessfully seeking an NHS dentist, in order to resolve their problems. Some have called dozens of surgeries in their area in a fruitless quest to be accepted as NHS patients, or had to travel outside their home area to get it. A growing number of dental practices are doing little or no NHS-funded work, citing problems with the dental contract.
Covid, Brexit and government underfunding of NHS dental services have combined to create a “critical” situation which risks getting worse before it gets better, the ADG has warned.
Patient groups have expressed concern over the “unacceptable” situation facing those in need of dental care.
“People struggle to get the dental care they need when they need it. This is an issue of great concern. Some dental practices have closed or gone entirely private, with some dentists exhausting their full NHS capacity and asking people for private fees instead,” said Louise Ansari, national watchdog director at NHS Healthwatch England. Children, people with disabilities and people living in care homes are the most affected, she added.
The loss of 2,000 NHS dentists last year follows a drop of 951 the previous year.
NHS dentistry has become ‘a rotten system’ which is failing patients and discouraging dental practitioners, said the British Dental Association (BDA), which represents the UK’s 42,000 dentists. He blamed the inability of patients to get NHS care in England on ministers only providing enough money in the dental contract to cover the cost of treating just over half the population.
Successive governments since 2010 have pledged to reform the dental contract but have not done so, although negotiations are ongoing. NHS England spends around £3bn a year on dental care, although this sum has remained stable for some time. Dentists don’t like what they call a “broken” contract which involves targets for the amount of care provided and, they claim, can pay them the same amount for one filling as they do for 10 and discouraged from handling complex cases because they don’t get paid for the time spent.
“Dentists simply see no future in the NHS, with a broken contract pushing talent away every day, it remains in effect,” said Shawn Charlwood, chairman of the BDA’s general dental practice committee.
“We must stop an exodus that is already underway. Millions of people are going without the care they need, and quick fixes are no substitute for real reform and fair funding.
The ADG’s report states that due to the decline in the number of NHS dentists, “we are now seeing ‘dental deserts’ emerging across the country where there is almost no chance of seeing an NHS dentist for routine care. Dental deserts pose a serious risk to the dental health of millions of NHS patients in England.
The trend is likely to worsen as dental practices increasingly rely on private labor to stay open, he warns. Deserts are particularly concentrated in rural and coastal areas.
It names the area covered by the NHS Clinical Commissioning Group (CCG) in North Lincolnshire as the part of England with the lowest number of NHS dentists per 100,000 people – just 32. The North East Lincolnshire and the East Riding of Yorkshire are the second worst, with just 37 NHS dentists per 100,000 people. Lincolnshire and Norfolk and Waveney are next, on 38.
The report also reveals that just 26.1% of adults in Thurrock in Essex have seen an NHS dentist in the previous two years – the lowest percentage in the country – followed by West Essex (27.3%) and then from Kent and Medway (29.3%). Thurrock is also where the lowest proportion of children have seen an NHS dentist in the last year – just 30.7% – followed by North East London (32.2%) and North Lincolnshire (35.3%).
“Dental deserts not only stretch across the east of England, from east Yorkshire, through Lincolnshire and down to Norfolk, but are now emerging in many other ‘red wall’ constituencies. that the government wants to level,” the ADG said. chair, Neil Carmichael, former Conservative MP.
The ADG also warns that the decline in access to dental check-ups points to “a looming health crisis” in which cases of oral cancer and type 2 diabetes are missed rather than being attended to by a dentiste.
He wants ministers to tackle the growing shortage of NHS dentists with action, including increasing the number of training places for dentists in the UK and extending beyond the end of this year the recognition of the qualifications of dentists trained in the EU.
Urging dental contract reform Rachel Power, chief executive of the Patients’ Association, said: ‘Our helpline regularly receives calls from patients who cannot find an NHS dentist. We know patients have been put on three-year waiting lists just to be on an NHS dentist’s books. This is an unacceptable situation.
“Dental deserts must not be allowed to develop. Dentists are often the medical professionals who spot serious health problems early. »
A spokesperson for the Department of Health and Social Care said: ‘We have given the NHS £50million to fund up to 350,000 additional dental appointments and we are increasing the workforce so that people can get the oral care they need – in December 2021 there were 264 More [private and NHS] registered dentists than the previous year.
“We are committed to improving health outcomes across the country – we created the Office for Health Improvement and Disparities to address long-standing health disparities and will release a white paper this year to ensure everyone has the chance to live longer and healthier lives, regardless of the context.