Exodus Continues: Half of English Dentists Cut NHS Commitment

Exodus Continues: Half of English Dentists Cut NHS Commitment

Connoisseurs of evasive answers will have noticed that the government, NHS, and GDC, all like to respond to enquiries about NHS dentistry by counting heads. This conveniently avoids the more relevant question of how much time each registrant devotes to NHS care. 

While the Prime Minister controversially stated that, “there are now more NHS dentists across the UK,” the BDA have now shown how far that claim was from reality. And new changes planned for doctors may accelerate the NHS exodus.

The latest BDA survey which received nearly 2000 responses has revealed that 74% intended to reduce, or further reduce, NHS work. 43% indicated that they planned to go fully private. There is clearly more at work than just the NHS, as high numbers of respondents were looking to change career, retire early, or practice abroad. This comes on top of the 50.3% who had already reduced their NHS commitment since the start of the pandemic.

Official figures give the same weight to someone carrying out one NHS examination a year, as they would to another dentist with a full time commitment. As a result not only can the authorities have no idea of actual NHS dental capacity, but are carrying out workforce planning in the dark. The BDA analysis underlines how this is impacting upon the public. They estimate that there was an unmet need for dental care from 11 million people in 2022.

GDPC Chair Shawn Charlwood said that, “NHS dentistry is running out of road” and that the crisis would not be fixed by, “soundbites or tweaks at the margins.” The BDA added that both the government and the opposition needed to “step up and offer a plan.”

It is against this background that GDPs remaining in the NHS might want to compare notes with their colleagues in general medical practice. In a move familiar to dentists, GPs will have a new contract imposed next month. It carries no extra funding but does come with specific demands on access.

Key changes include a demand that patients are offered an, “assessment of need” at first contact, changes to the Investment and Impact Fund payments with the majority of the fund, worth £246m, being shifted to improving patient experience of contacting their practice and providing appointments within two weeks.

The acting BMA GP Committee Chair, Dr Kieran Sharrock has said that the new contract will add to the GP workload and lead to more leaving medicine.

Last month, the GP Committee rejected a version of the new contract calling it “insulting.” Dr Sharrock described a recent meeting with the Health Secretary as “a tick box exercise.” He concluded, “General practice can no longer be expected to take whatever is thrown at it, and the Committee’s recent rejection of the contract offer still stands. We will now look to enter serious discussions with our membership and the wider profession on what action we take next.”

The disconnect between GPs and NHS England will look familiar to dental teams. According to Dr Ursula Montgomery, director of primary care at NHS England, “This contract supports GP teams to provide what matters to patients, and later this spring the NHS will publish the GP Recovery Plan on how access to care will be expanded even further.”

Meanwhile in the GP magazine Pulse one doctor commented, “Welcome to one of the final nails in the coffin.” Looking to the future another commented, “The only discussion worth having is how to create a system that would enable GP’s to continue to earn a living providing medical services outside the NHS, along the lines of Denplan perhaps.”


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