Consultation asks whether newly qualified dentists should commit to delivering a minimum amount of NHS work after graduating or repay some training fees
- Proposals would require dental graduates to work in the NHS for several years after graduating or repay their training fees
- Part of Westminster government and NHS plan to recover dentistry and boost the dental workforce through 40% training expansion
Newly qualified dentists could be required to deliver NHS care for several years after they graduate under a government consultation being launched yesterday.
Training an individual dentist can cost up to around £300,000, of which costs in the region of £200,000 are not repayable by the student.
However, a growing proportion of dentists are opting to go straight into private practice or are choosing to deliver little to no NHS work shortly after completing postgraduate dental foundation training.
Of more than 35,000 dentists registered with the General Dental Council in England, just over 24,000 delivered some NHS care in England in 2022 to 2023. This means nearly one-third of registered dentists are not contributing to NHS dentistry and may be working solely in private practice.
Under its consultation, which will run for 8 weeks, the government is asking whether newly qualified dentists should commit to delivering a minimum amount of NHS dental care for a minimum number of years after graduating, and whether they should repay some of the public funding invested in their training if they do not.
Health and Social Care Secretary Victoria Atkins said: “I want to make access to dentistry faster, simpler and fairer for everyone – and part of this is ensuring that dentists are supporting the NHS with their skills and expertise.
Taxpayers make a significant investment in training dentists, so it is only right to expect dental graduates to work in the NHS once they’ve completed their training.
“This builds on our dental recovery plan, which set out how we will create up to 2.5 million extra appointments this year alone and is already showing results with an extra 500 practices providing appointments.”
Thursday’s proposals form part of the government’s overall plan to accelerate the recovery of NHS dentistry from the COVID-19 pandemic and reform how NHS dentistry operates.
They build on the aims of NHS Long Term Workforce Plan to expand the dental workforce and improve access to NHS dental care, especially in under-served parts of the country.
The UK government believes working in the NHS will give dental graduates the best start to their careers, by giving them the broadest range of experience, great support from strong teams of dental professionals and the most comprehensive training.
Experience in NHS dentistry helps to produce well-rounded clinicians who can work alongside different professions and deliver high quality and safe patient care, and can be supplemented by additional work in private dentistry. The government believes this balance is better for our skilled dental workforce and better for the patients they treat.
NHS dentists are currently delivering a greater volume of NHS treatment than the year before, with ‘courses of treatments delivered’ increasing by 23% in 2022 to 2023, compared to the previous year.
Primary Care Minister Andrea Leadsom said: “I want to thank our hard-working dentists for their efforts in treating more and more patients over recent years and helping us improve access to care.
“Through our dental recovery plan, we’re helping the sector recover from the pandemic and making NHS dentistry a more attractive career choice.
“Today’s proposals will ensure dental graduates benefit from the broad experience and comprehensive training of working in the NHS, while also delivering value for money for the taxpayer.”
There is currently no requirement for dentists to work in the NHS following the completion of their training. In contrast, a graduate medic in the UK must undertake a minimum of one year of foundation training to register as a doctor, followed by an additional year of foundation training and at least 3 years of general practice specialty training to become a GP.
Jason Wong, Chief Dental Officer for England, said: “Dental services were severely impacted by the pandemic, and it is a priority for the NHS to improve access, so it is easier for people to see a dentist.
“We launched our dental recovery plan earlier this year to deliver millions more appointments across England – and boosting the workforce is one step we can take to achieve this.”
Neil Carmichael, Executive Chair of the Association of Dental Groups, said: “We welcome the chance to engage with this consultation and ensure the NHS benefits from the skills of our graduate dentists.
“We need to see more trained dentists entering the profession and we will work with the government to ensure these proposals reflect the sector’s mixed economy and considers the needs of both NHS and private dentistry.”
Louise Ansari, CEO at Healthwatch England, said: “We welcome the opportunity for the public to have their say about these long-term proposals to address dental workforce issues, especially as access to NHS appointments continues to be one of the main issues we hear about from people across the country.
“We also look forward to seeing separate government proposals on reforming the NHS dental contract in the coming months, as set out in the dental recovery plan.
“In the meantime, NHS bodies that plan and fund dentistry across England should take concerted and imaginative action to ensure people in greatest need can get dental care quickly.”
The launch of the consultation is the latest milestone in the delivery of the Westminster government’s dental recovery plan.
Since the plan was published in February, the government and NHS have worked to:
- introduce a new patient premium, supporting dentists to take on new patients – with more than 500 more practices saying they are now open to new patients compared to January
- launch the ‘golden hello’ recruitment scheme to incentivise dentists to work in under-served areas
- raise the minimum units of dental activity (UDA) rate to £28 this year, making NHS work more attractive and sustainable
- open a consultation on proposals to make it easier for overseas dentists to work in the UK
Responding to the proposal that Dental graduates in England could be compelled to work in the NHS work or face repaying some training costs, Prof. Grant McIntyre, Dean of the Faculty of Dental Surgery at the Royal College of Surgeons of Edinburgh, commented: “As most dental graduates already start their careers in the NHS and contribute to NHS patient care as an undergraduate student and during their early professional career, we are uncertain of what practical benefits this proposal will have.
“Most dental graduates have also accrued significant personal debts to complete their dental training, usually in excess of £100,000. Therefore, we believe this proposal is likely to make NHS dentistry even more unattractive for dentists to provide NHS dental care as their career develops.
“As per our election manifesto, we believe a more constructive approach is needed that focuses on creating a positive working environment to encourage sustained delivery of NHS practice. This means reforming the current dental contract, improving workforce planning and a renewed emphasis on preventative health and reducing health inequalities.
“We believe positive rather than punitive steps are required to lift morale, improve dental recruitment and retention, and improve access to services for the benefit of patients and the population.”
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