Tag: NHS Dentistry

Playing with fire: NHS dentistry on the brink as Ministers cut vital support

The British Dental Association Scotland has warned Ministers they risk undermining the future sustainability of NHS dentistry, as they move to scale down vital financial support for the service.  

For the last three months practices have received a 1.7 multiplier to the fees paid to provide NHS care, a reflection of the unprecedented backlog practices have faced as they try to ‘live with COVID’. The Scottish Government has now moved to pare the multiplier down to 1.3 for the next 3 months. 

This reduction follows no dialogue with the profession despite the BDA calling for regular discussions with the Government about the latest activity data and any proposed changes.

The discredited low margin/high volume model dentists in Scotland work to means treatment can often be delivered at a loss, a growing problem given the growing levels of unmet need, particularly among those from move deprived communities.   

Official data suggests the total number of high street NHS dentists in Scotland has fallen by over 5% since the onset of COVID. The BDA warn heavy-handed policies will only push Scottish dentists down the road of their colleagues in England, where thousands of dentists have left the NHS since lockdown, amid warnings from MPs south of the border that NHS dentistry now faces a ‘slow death’. 

The BDA has again urged the Scottish Government to, in the short term, develop a suitable interim funding package to support dentists and their teams as they work through the backlog, and begin work on a new, sustainable long-term model for NHS dentistry. 

Dentists remain anxious that the Government will look to remove the multiplier altogether at the first opportunity despite its stated intention not to return to the pre-pandemic financial arrangements. The BDA has repeatedly voiced its strong opposition to a return to the pre-Covid “treadmill”.

David McColl, Chair of the British Dental Association’s Scottish Dental Practice Committee said: “Ministers are playing with fire, pulling away the life support from a service millions depend on.  

“This multiplier helped ensure NHS dentists received fees for care that actually covered their costs.  Slashing them will leave colleagues churning out dentures at a loss while thinking twice about their future. 

“Scotland has already lost too many NHS dentists since lockdown. Ministers are now blindly heading down the path the Westminster Government has chosen, which has sparked an exodus. 

“Cuts have consequences. The Scottish Government promised free NHS dentistry for all. Short-sighted policies like this will likely result in the exact opposite, and stark oral health inequalities will only widen further.”

NHS Dentistry: Scottish Government plans set to spark exodus from service

The British Dental Association has warned the Scottish Government plans to revert to pre-COVID models of care risks sparking a flight of dentists from the NHS, with potentially devastating consequences for patient access across Scotland. 

In October Cabinet Secretary Humza Yousaf wrote to all NHS dental teams that all emergency support will be withdrawn by 1 April 2022. Since the first lockdown NHS practices have operated under a COVID support package, reflecting pandemic pressures and tight infection control restrictions that continue to limit capacity across the service. 

According to a new survey of dentists in Scotland [1]:

  • 80% of dentists estimate their practices will reduce their NHS commitment should the Scottish Government withdraw emergency support and return to pre-COVID models of care. Over a third (38%) of dentists indicate they are now likely to change career or seek early retirement in the next 12 months should the policy be taken forward. 15%  say they are likely to practice dentistry outside of Scotland, and 1 in 10 estimate their practice is likely to cease operations. 
     
  • Half of dentists report that they are operating at less than 50% of pre-COVID capacity. While the Scottish Government has offered a support package to boost capacity, many practices are unwilling to commit to a broken NHS model. Over 30% say they have not applied, andamong those half (50%) say they are now unable to commit to the NHS long-term. Support for ventilation costs requires a minimum 3 year commitment to the NHS.
     
  • 9 in 10 of dentists (89%) estimate the removal of emergency funding will have a high impact on the short-medium term sustainability of their practices.

BDA Scotland have warned from the outset that a return to a ‘business as usual model’ – low margin and high volume – will put practices under unsustainable financial pressure and will likely lead to closures or movement to the private sector. Practices are facing an unprecedented backlog, with recent data from Public Health Scotland indicating that the number of treatments delivered in the year to March 2021 was less than 25% of those delivered in the previous 12-month period, corresponding to over 3.5 million appointments lost as a result of the pandemic.

NHS dental care free at the point of use remains a centrepiece SNP policy. BDA Scotland has said the Scottish Government must change course to achieve that goal, develop an interim funding package to support dentists and their teams as they work through the backlog, and begin work on a new, sustainable model for delivering care.  

David McColl, Chair of the British Dental Association’s Scottish Dental Practice Committee said: “Free NHS dentistry for all is a worthy ambition. Rather than exploring ways to actually achieve that goal the Scottish Government has blindly headed down a road that could destroy this service.

“COVID has slashed our capacity, yet emergency support will end. Yes, Ministers have offered some support, but with small print many practices simply could not sign up to in good conscience.

“Dentists are unwilling to be shackled to a corpse. When aid hinges on committing to an NHS model that is now frankly unsustainable it is unsurprising take up appears so modest.

“We doubt Humza Yousaf wants to be remembered as the man who killed NHS dentistry in Scotland. Without a willingness to reflect on choices made in recent weeks that risks being his legacy.”