NHS dentists decrease by 9% in Rochdale borough last year

Unions have warned NHS dentistry is "hanging by a thread" with some patients facing two-year waits for routine check-ups.

Data from NHS England and NHS Wales shows more than 2,500 dental posts were lost across both countries – made up of more than 1,000 dentists, some of whom worked in multiple areas.

Locally, the CCG for Heywood, Middleton and Rochdale lost 9% of its NHS dentists in the last 12 months. Thirteen posts were lost in 2021 compared to the previous year. In 2019, there were 151 posts locally, the highest number in the last five years.

The worst-affected was NHS Portsmouth CCG, which lost 26% of its NHS dentists over 12 months. Meanwhile, 28 other English CCGs – including Bolton, Oldham, Bury, Salford and Trafford – have lost at least 10% of their NHS dentists and at least one town in England has been unable to attract a single applicant for vacant NHS dentist posts for two years.

The British Dental Association (BDA) said unhappiness with the NHS dental contract was a key factor.

NHS England said patients who needed care the most should be prioritised, and added it had set up 600 urgent dental centres across England.

The BDA’s Shawn Charlwood warned significant numbers of dentists were planning on leaving the NHS.

“NHS dentistry is hanging by a thread, because without NHS dentists, there will be no NHS dentistry,” said Mr Charlwood.

“It’s a really serious situation and every dentist that is lost or every vacancy for NHS dentistry that remains unfilled affects thousands of patients in terms of care and their ability to access care.”

The BBC Shared Data Unit understands that one dental practice in Barnsley has had two NHS dental posts vacant for two years - without attracting a single applicant.

"Every practice struggling to fill vacancies translates into thousands of patients unable to access care,” said Mr Charlwood. 

"Years of failed contracts and underfunding have meant a growing number of dentists no longer see the NHS as a place to build a career. The pandemic has upped the ante, and we are now facing down an exodus.

"Ministers have failed to grasp that we can't have NHS dentistry without NHS dentists. 

“Rather than punishing colleagues, we need a service that recognises and rewards commitment.”

Concern has also been raised about the usefulness of NHS England’s ‘Find a Dentist’ online tool, which was created to help patients find an NHS dentist in their area.

BBC analysis shows around 75% of practices in England - and most in Rochdale - had not updated the site to show whether they were accepting NHS patients or not within the last three months.

Interim director of Healthwatch Chris McCann said getting up to date information as to where people can access service is a “real issue”.

“Information on practices on the NHS website can be outdated,” he added. “We've seen some people having to contact up to 20 practices before finding someone to take them.”

NHS dentists in England use the units of dental activity (UDA) system. UDAs are used to measure a practice’s activity. Courses of treatment - for example, a check-up or a filling, are banded into UDAs.

Practices are set targets of UDAs to achieve, and if that target is missed, the contract holder and the practice can be forced to pay back money - known as ‘claw back’.

Critics have claimed the UDA system does not incentivise preventative work, and is a key reason for dentists leaving the health service.

Wales moved away from the UDA system in 2020, but the system is still in place in England. 

The BDA has predicted the number of NHS dentists in Wales will increase in the coming years and has called on England to reform the dental contract.

The number of NHS and HSCNI dentists in Scotland and Northern Ireland has remained steady over the last three years.

Healthwatch England told the BBC that two-year waits for routine checkups were not unheard of, and sources have told the BBC of painful conditions still untreated after a year.

Though adults still have to pay for NHS dental treatment, the costs are much lower than the private sector. A root canal would cost £65 on the NHS, but a private provider could charge up to £970.

Fewer NHS dentists also puts a strain on those dentists who still treat NHS patients, increasing their workload and stress levels, and reducing the amount of time it is viable to spend with individual patients and on preventative care.

The British Dental Association claims 30 million appointments were lost as a direct consequence of the pandemic, and NHS data shows practices operating at around a third of pre-Covid capacity by March 2021.

Healthwatch England told the BBC that 25% of the healthcare feedback they receive now relates to NHS dental treatment - up from just 5% pre-pandemic.

And of that feedback, Healthwatch said only 2% is positive.

Responding, an NHS spokesperson said: “The NHS has taken unprecedented action to support NHS dentists throughout the pandemic by providing additional funding for practices unable to deliver their usual levels of activity, alongside rapidly setting up 600 urgent dental centres across England so patient services could be maintained during the pandemic.

“People should continue to come forward for the dental care they need, and the care and treatment of people who need it most should be prioritised.”

In Greater Manchester there is a dental helpline (0333 332 3800) available from 8am to 10pm every day, including weekends and Bank Holidays for those who need help urgently when their practice is closed, or do not have a regular dentist.