Twelve and Counting - ICBs Ignoring the Dental Funding Ringfence
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- Published: Tuesday, 16 January 2024 10:20
- Written by Peter Ingle
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The progressive failure of the ringfence around NHS dental funding is getting worse, with more funds being lost. This includes money that practices were led to believe would be available to help provide much needed extra appointments. The Health Service Journal (HSJ) has found that there are now 12 Integrated Care Boards (ICBs) looking to ignore the ringfence.
Some ICBs have said that they will not pay for extra activity intended to ease the access crisis, despite being told they can do so by NHS England. NHS England had authorised ICBs to pay dentists for up to 110 per cent of contracted activity in 2023-24 where resources are available. Over 25% of England’s 42 ICBs have now said they will not do so because their finances are too tight.
This was not an unexpected situation for ICBs to find themselves in, as dental budgets have been routinely underspent. As a result, boards would have been expecting to find considerable sums becoming available to provide a much needed boost to activity and access.
Messaging over whether dental funding was ringfenced has not been consistent. Health and Social Care Secretary Victoria Atkins said before Christmas 2023, that dental funding is protected, but NHS England told ICBs they could move dental funding to other areas. As far back as last year’s Conference of LDCs the then Chief Dental Officer wryly observed that there was a ringfence, but that the ICBs had a variety of ideas about what that meant.
The East Midlands region – which constitutes the Leicester, Leicestershire and Rutland, Nottingham and Nottinghamshire, Derby and Derbyshire, Lincolnshire and Northamptonshire ICBs – and South Yorkshire ICB, confirmed to HSJ that they will not pay for the extra work because of budgetary pressures.
These come in addition to the six West Midlands ICBs which have ruled out paying dentists for additional work, as reported by the BBC in January 2024.
HSJ claims to have seen correspondence from the East Midlands region, which reads: “It has been agreed that, due to the financial position, the East Midlands ICBs are not in a position to support a non-recurrent investment scheme for over delivery up to 110 per cent in 2023/24. We appreciate that this will be disappointing.”
The East Midlands group agreed to this approach as part of revised financial plans submitted to NHSE, which ICBs must complete by April in response to the service’s growing funding crisis.
Dental and ICB sources say there is little oversight from NHSE around the extent of funding being shifted away from dentistry, and that more areas are likely to follow suit in restricting funding for dentistry. Both Humber and North Yorkshire and Cheshire and Merseyside ICBs have indicated in board papers that dentistry funding will be squeezed to help them balance their books.
An NHS England spokesperson said: “NHS England has ringfenced dental budgets and on behalf of patients we continue to support dental contractors to deliver on their commitments in full so that budget is spent. However, if dental contractors under deliver on their commitments that public money is returned. In the first instance ICBs have been required to use this money to try to improve dental access. After that, this year ICBs have the option to use the money to help offset other inflationary pressures”.
A Department of Health and Social Care spokesperson was also quoted. They said that it will “increase the number of NHS dentists through our dental recovery plan” which “will be set out shortly”.
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