- Published: Thursday, 28 July 2022 07:33
- Written by Peter Ingle
- Hits: 1219
English dentists trying to predict what lies in store for them could do a lot worse than speak to their Welsh colleagues. The BBC News website is now carrying a story headlined, “NHS: Dentist check-ups in Wales cut to once a year”
As the home nation with the closest NHS dentistry arrangements to England’s, it may be that Wales is the test bed for efforts to manage the access crisis within the UDA system.
Announced in March, and reported on GDPUK at the time, Welsh contactors have the option of working to a reduced UDA target for their existing contract value, but are expected to achieve new targets. These include specific levels of fluoride varnish applications to at risk patients. Another is that a given number of new patients will be seen, proportional to contract size. Also included is a “recall interval component.” This is intended to ensure that recalls are based on individual risk assessment, with presumably an expectation that significant numbers of patients will move to longer recall intervals. There are also requirements in relation to urgent treatment and completion of ACORN, the Assessment of Clinical Oral Risks and Need.
The BBC story, with links to related reading including, ”Why can’t I find an NHS dentist in Wales?” quotes the Welsh CDO, Andrew Dickenson. Professor Dickenson claims that the changes will allow practices to take on up to 112,000 more NHS patients annually. The CDO, in post since this April, claimed that improvements in oral health mean that routine six-monthly check-ups are “outdated.”
Professor Dickenson added, "By increasing the number of dentists and helping them to work differently with their patients, we can ensure that everyone in Wales who wants NHS dental care, can get access to it." He did not made clear how the number of dentists would be increased.
The BBC quoted two members of the public, speaking about their dental care.
Barbara Davies, from Dryslwyn, Carmarthenshire, had been seeing a dentist privately.
"I have an appointment every six months," she said. "It’s very reassuring when I go every six months to know that my teeth are going to be okay, you know if I need treatment and I can get it when I want it.”
Liz Mahoney, living in Llandeilo, had been looking for an NHS dentist since before lockdown. "I’ve been trying to get an appointment but it’s all private - there’s no NHS," she said.
"If I could get one for once a year it would be better than nothing at all, but I can’t get anything unless I go private."
The BBC quoted Dr Imtiaz Khan, a dentist in Swansea with a practice which has about 90% NHS patients. He believes the move could add 500 patients to their list.
"I’ve had people call from as far as Newport saying they’ve called around 65 different practices already and they just can’t find a dentist," he said.
"I’ve had 10 to 20 different people call a day looking for a dentist. I wish I could take them all on but literally we don’t have the space.”
"No dentist really has space on their books at the moment… and it makes me sad."
But he said the change needs to be backed up by additional investment especially in recruiting new dentists.
Russell Gidney, chairman of the BDA in Wales, accused ministers of trying to "conjure up new appointments".
"Sadly, these claims look like they were cobbled together on the back of an envelope," he said.
BDA Wales also warned that "given the high levels of unmet need in the nation’s most deprived communities, a "high proportion" of patients across Wales will still require more frequent appointments. It added that "demoralised dentists are leaving the service in droves" and the "exodus" can only be halted through sustained investment, "which the Welsh government has thus far declined to offer".
Dr Lauren Harrhy, BDA PEC member and practice owner in Pontypool tweeted: “What they have failed to account for is that practices in high needs areas can preach prevention until the cows come home. The patients need intervention, several times per year. Also does being clear of decay & gum disease prevent you getting oral cancer?.. No it doesn’t.”
More than three-quarters (78%) of NHS dental practices have signed up to the new variation of the Welsh government’s dental contract.
What they have failed to account for is that practices in high needs areas can preach prevention until the cows come home. The patients need intervention, several times per year. Also, does being clear of decay & gum disease prevent you developing oral cancer?..No it’s doesn’t https://t.co/iGriGIc4Pu— Dr Lauren Harrhy BDS (@Laurenharrhy85) July 27, 2022
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Signing up"More than three-quarters (78%) of NHS dental practices have signed up to the new variation of the Welsh government’s dental contract. "
Was it that or nothing?
Wales limits dental check-upsSadly all the failed English pilots have shown, if you limit funding to the same amount, you can see more high-needs but less checkups and longer waiting lists, OR, you can prioritise quick-access numerically but then have much less treatment appointments and longer waiting lists too.
No More Money for an already overloaded rationed system, means robbing Peter to pay Paul - somebody else MUST lose if somebody new gets a gain; it is basic GCSE maths !!!
Anyway, the DH in the past admitted enforcing NICE guidelines won't change access overall, as many more new higher-diseased patients need 3 and 4 monthly check-ups additionally.
Yours numerically & logically,
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