The British Dental Association Scotland has responded to new freedom of information data from the Scottish Liberal Democrats showing the number of dentists providing NHS services has fallen from pre-pandemic numbers across most health boards.
The BDA stress this data only begins to show the risks facing the service, as the data does not capture the mix of NHS and private work dentists undertake.
The professional body says the data gives no picture of the whole time equivalent NHS workforce, and without that there is no scope for robust workforce planning.
The broken high volume/low margin model high street NHS dentists work to proved unsustainable during COVID, and while some amends to this system were rolled out in November, it remains to be seen if reforms are sufficient to give the service a sustainable future
David McColl, Chair of the British Dental Association’s Scottish Dental Practice Committee said:“For years the broken system NHS dentistry works to has left dedicated colleagues looking to the exit.
“We’ve seen some reform, but time will tell if it’s enough to put a halt to this exodus.
“One point is abundantly clear. If this service is going to have a future there can be no complacency at Holyrood.”
The British Dental Association has warned the Scottish Government must step up to prevent a wholesale exodus from the service in April, following new figures from the Scottish Liberal Democrats suggesting an 8% fall in the number of NHS dentists since lockdown.
The professional body warns that dentists have little sense of what payment system they will be working to come 1 April. On 1 October the Scottish Government cut the ‘multiplier’ designed to support the pandemic recovery, that increased NHS fees by 1.3. A lower bridging payment’ took effect uplifting NHS fees at a rate of 1.2 for the next three months, falling to 1.1 for the period up to April 2023.
While COVID emergency measures have been withdrawn, practices continue to face an historic backlog, with many patients requiring more extensive treatment having bottled up problems during the pandemic.
The BDA say that in the weeks ahead progress must be made to deliver needed change to the broken high volume/low margin model NHS dentistry is based on. Without reform it stresses we will see a further flight of dentists from the NHS that is already evident in other UK nations.
Facing surging practice running costs, the BDA says that without an adequate interim funding package several key treatments, and anything – like dentures – that requires laboratory work, risk being delivered at a financial loss.
Robert Donald, Chair of the British Dental Association’s Scottish Council said: “Ministers need to understand that Scotland can’t have NHS dentistry without NHS dentists.
“Today colleagues have little sense of what the future will bring when the last pandemic support is pulled away.
“What they do know is this service hasn’t bounced back, and that some NHS treatments are now being delivered at a loss. “The Scottish Government needs to make a serious long-term commitment to prevent a wholesale exodus from the NHS.”
Midwives are being driven out of the NHS by understaffing and fears they can’t deliver safe care to women in the current system, according to a new survey of its members by the Royal College of Midwives (RCM).
The College is warning of a ‘midwife exodus’ as it publishes the results of its annual member experiences of work survey. Over half of midwives surveyed said they were considering leaving their job as a midwife with 57% saying they would leave the NHS in the next year.
Of those midwives who either have left or were considering leaving, more than eight out of 10 were concerned about staffing levels and two-thirds were not satisfied with the quality of care they are currently able to deliver.
Alarmingly, the highest level of dissatisfaction among those surveyed came from midwives who had only worked for five years or less in the NHS. This will have a significantly detrimental impact on workforce planning and, says the RCM, the ability of maternity services across the country to provide acceptable levels of safe, quality care.
The RCM’s General Secretary and Chief Executive, Gill Walton, said: “Every midwife and maternity support worker goes to work to provide safe, quality care. That so many feel that understaffing means they are unable to do so is deeply worrying.
“What these numbers suggest is a midwife exodus, which will leave already-struggling services on their knees. Quite rightly, there is a strong focus on improving maternity safety, but there is a risk that the Government is ignoring the essential ingredient to that: having the right staff, in the right place.
“Investment and programmes to improve safety in maternity services hang in the balance here, because without adequate numbers of staff with are fighting a losing battle. Every safety report cites understaffing as an issue that is comprising the delivery of safe care, but when are the Government going to take note?
“We are calling on the Government to listen to those best advised and work with us to improve retention and recruitment. All NHS organisations must urgently review their maternity staffing levels using a recognised workforce planning tool to ensure staffing reflects the workload.”
A report published by NHS Digital in July revealed the number of NHS midwives working in England in May had fallen by almost 300 in just two months. This is the fastest fall for these two months for any of the years listed in the NHS report, which goes back to 20 years say the RCM.
Burnout among midwives and all maternity staff is higher than ever, particularly after COVID-19 which saw an increase in sickness absence adding to a pre-existing shortage of 2,000 midwives in England alone.
Last week leaked results of an NHS national staff survey showed a sharp drop in those who believe their health and wellbeing is being supported by their employer. This is echoed in the RCM survey, with over half of respondents saying that they did not feel valued by their employer.
Almost all (92%) of midwives and maternity support workers (MSW) said that they did not feel their work was valued by the current Government.
Gill added: “Not a day goes by that we don’t hear of a maternity service having to close temporarily, suspend services or divert women to other maternity units just because there simply aren’t enough midwives. This can’t continue because we know it compromises safety and means women don’t always get the safe positive pregnancy and birth experience that they should.
“It’s also having a shocking impact on maternity staff themselves. A shortage of midwives has undoubtedly worsened rates of physical and mental burnout among our members. Morale among staff is low and has been worsened by the recent pay award in England.
“Sadly, this survey shows that many midwives and MSWs have had enough. They are feeling very fragile and are simply at breaking point. Enormous demands are being made on midwives and the services they work for, yet investment in these services from the Government remains inadequate to provide the safe, high-quality care that women deserve.
“We have previously advised the Government on what can be done to begin to address this situation which hasn’t happened overnight. Prior to the pandemic the RCM has voiced concerns and solutions to the recruitment and retention issues faced by UK maternity services, and we are happy to do that again, but we are now sadly at crisis point.
“That is today we are again calling on the Government and NHS Employers to take action immediate to keep midwives in midwifery before it’s too late.”
