Tag: public health

18,000 flu-related deaths in past two winters as jab uptake falls

UKHSA with DHSC and NHS to launch Get Winter Strong campaign to remind those at risk to get their vaccinations to fight off the onslaught of winter viruses

Latest UK Health Security Agency (UKHSA) data shows that over the past 2 winters (October to May, 2022 to 2023 and 2023 to 2024) at least 18,000 deaths were associated with flu, despite last winter being a relatively mild flu season.

While pandemic restrictions and social behaviours saw flu levels fall dramatically for a few years, these latest mortality figures are a stark reminder that flu is a deadly virus, particularly for older people and other groups at greatest risk.

Of real concern is the drop in the flu vaccine uptake rates last winter across all eligibility groups in England compared with the previous year (1).

While uptake in older people last year remained high, only 4 in 10 (41%) people with long-term health conditions, just over 4 in 10 (44%) 2- and 3-year-olds, and just 1 in 3 pregnant women received the flu vaccine.

Evidence shows the significant impact from last year’s flu vaccine with a 30% reduction in the number of those aged 65 and over being hospitalised and a 74% reduction in those between 2 and 17 years of age.

In the same two-year winter period the estimated number of deaths associated with COVID-19 was just over 19,500.

To help reduce the impact of winter viruses on those most at risk, as well as ease NHS winter pressures, UKHSA – with Department for Health and Social Care and NHS England – is set to launch a scaled-up Get Winter Strong campaign on the 7 October.

The campaign will urge those eligible to get their flu and COVID-19 vaccination when invited, ahead of winter, targeting those at greatest risk and for the first time will encourage pregnant women to also get their respiratory syncytial virus (RSV) and whooping cough vaccination.

Last year saw a sudden increase in the number of people having to be hospitalised, due to a flu peak in the week leading up to Christmas and then again at the end of January.

Pregnant women and older people aged 75 to 79 are also eligible for a RSV vaccination for the first time this year, with the maternal vaccine providing strong protection for newborns in their first few months, when they are most at risk of severe illness from RSV.

Dr Gayatri Amirthalingam, UKHSA Deputy Director of Immunisation: “As winter approaches we see many dangerous viruses circulating in our communities including flu, which tragically can kill thousands of people every year. Getting vaccinated ahead of winter is by far your best defence.

“If you’re pregnant or have certain long-term health conditions, you are at greater risk of getting seriously ill. Older people and young infants with flu are also much more likely to get hospitalised.

“So if you or your child are offered the flu, COVID-19 or RSV vaccines, don’t delay in getting them. Please speak to your nurse or doctor if you have any concerns.”

Maryam Sheiakh, a mother from Manchester, recounts the fear and anxiety she went through 2 years ago, when her then 4-year-old daughter, Saffy, spent more than a week at Royal Manchester Children’s Hospital after being admitted with flu, suffering with a severe cough and high temperature.

She was transferred to a High Dependency Unit as she was struggling to breathe and needed oxygen.

Maryam said: “I was seriously concerned we might lose Saffy. I honestly thought she might die from this. I was so distraught watching her struggling to breathe day after day, worried about her breathing difficulties and getting oxygen to the brain – would she be the same little girl before she got ill?

Thanks to the NHS staff, Saffy made a full recovery and, now aged 6, is thriving. Maryam, a nursery teacher, is now urging all parents to vaccinate their children to ensure they have the best protection against flu: “Just go and get it, don’t take the risk. No parent wants to watch their child suffer like we did with Saffy.

As of last week, millions of eligible people in England can now book their flu and COVID-19 vaccines through the NHS, with appointments starting from 3 October. For their RSV jab, pregnant women and older adults should speak to their maternity service or GP practice to arrange it, as the NHS rolls out additional protection for those most at risk ahead of winter.

Steve Russell, NHS National Director for Vaccinations and Screening: “Today’s data showing there were almost 20,000 deaths associated to flu over the past 2 winters is a shocking reminder that this is a seriously dangerous virus, and I urge those who are eligible to book their vaccine appointment as soon as they can as it is our best way of protecting those who are vulnerable as winter approaches.

“Thanks to the hard work of our NHS staff, life-saving flu, COVID-19 and RSV vaccines are being rolled out across the country in places that are as convenient as possible for people who need them. Flu and COVID-19 jab appointments are now available to book via the NHS website, the NHS App, or by calling 119 for free – making it as easy as possible for people to get vaccinated.”

Minister for Public Health and Prevention, Andrew Gwynne said: “I encourage everyone who is eligible to get their flu, COVID-19 and RSV vaccinations as soon as possible. They are without doubt the best way to protect yourself from these viruses that can cause serious harm.

Every year the World Health Organization recommends which strains should be included in the flu vaccine, with the UKHSA contributing to this work. Vaccines are then developed to help fight off the types of flu viruses expected to be circulating in the coming season. As the viruses can change every year, and protection from the vaccine reduces over time, it is important those eligible get a vaccine every year.

The Get Winter Strong campaign will run for 10 weeks and will appear on broadcast TV, on demand and community TV, as well as radio channels, outdoor poster sites across England and on social media channels.

AND IN SCOTLAND …

💉 Vaccination will be offered to those at high risk of serious illness from flu and COVID-19. If you’re eligible, you’ll be contacted with information about your appointment.

For more information about the vaccine and eligibility, visit:

https://www.nhsinform.scot/wintervaccines

#WinterVaccinesScot

Alcohol: 15p rise in Minimum Unit Price

The minimum price per unit of alcohol will increase by 15 pence from today.

MSPs previously voted to continue the public health measure which had been scheduled to end automatically on 30 April as part of a ‘sunset clause’ when Minimum Unit Pricing (MUP) legislation was introduced in 2018.

They also voted to introduce a price increase, with a rise to 65p per unit chosen as the Scottish Government seeks to increase the positive effects of the policy and to take account of inflation.

Health Secretary Neil Gray said: “Research commended by internationally-renowned public health experts estimated that our world-leading policy has saved hundreds of lives, likely averted hundreds of alcohol-attributable hospital admissions and contributed to reducing health inequalities.

“Experts wrote to The Lancet, describing Public Health Scotland’s evaluation of minimum unit pricing as ‘high-quality’ and ‘comprehensive’, and expressing confidence that there are several hundred people with low income in Scotland who are alive today as a result of this policy.

“However, the Scottish Government is determined to do all it can to reduce alcohol-related harm and as part of that, I am working to ensure people with problematic alcohol use receive the same quality of care and support as those dealing with problematic drugs use.

“We have also made a record £112 million available to Alcohol and Drug Partnerships to deliver or commission treatment and support services locally, as well as investing £100 million in residential rehabilitation.

“I have also asked that Public Health Scotland is commissioned to review evidence and options for reducing exposure to alcohol marketing.”

Preparing health and social care for winter

Record high NHS 24 workforce to meet increased demand

A record number of NHS 24 call handlers will support the public to access the most appropriate care this winter as services deal with increased demand.

Through the Scottish Government and COSLA’s joint Winter Preparedness Plan, continued investment for NHS 24 will increase service capacity to provide clinical supervision for at least 150,000 additional calls per year and help prevent unnecessary A&E attendances.

Key measures to support services in the face of increased demand, include; improving discharge planning for patients admitted to acute or community hospitals, maintaining established care at home packages and a Government led delayed discharge response team to directly support Boards in need of assistance. Planned care capacity will also be safeguarded with a continued focus on clearing long waits.

The annual winter vaccination programme, which includes respiratory condition RSV for the first time, will support a reduction in severe disease, hospitalisation and mortality – while protecting health and social care service capacity. The joint plan also sets out action to support the mental health and well-being of service staff through increased flexible working options and dedicated mental health resources.

This year’s plan has been published a month ahead of last year, and earlier than ever before, to allow more time for NHS Boards and care providers to prepare for winter surges in demand.

Health Secretary Neil Gray said: “As winter approaches, the NHS will see surges in demand across all health, social care and social work services. Our joint Winter Plan with COSLA is just one part of a wider programme of work to respond to heightened demand.

“A record number of NHS 24 call handlers will be available this winter to direct people to the most appropriate care, helping reduce unnecessary A&E attendances. We will continue our work to reduce delayed discharge in hospitals with an increased focus on effective discharge planning and protecting care at home packages. We will also ensure planned care capacity is protected as much as possible in the face of winter pressure so patients are seen as quickly as possible.

“We are prioritising frontline services with over £14.2 billion investment in our boards this year – an almost 3% real terms uplift – and also investing £2 billion in social care services.

“I thank all health, social care and social work staff for their continued efforts and dedication to deliver high quality care. It is fundamental we safeguard their wellbeing, and improved options on flexible working and continued access to mental health resources will ensure staff are supported over this challenging period.”

COSLA Health and Social Care Spokesperson, Councillor Paul Kelly said: “It is our shared responsibility to ensure that people and communities have timely access to quality care and support when they need it most.

“We know that Local Government and Health and Social Care Partnerships across Scotland are working hard to plan and deliver the essential health and social care services our communities rely on every day.

“The context within which this takes place is increasingly challenging, which is why COSLA have worked jointly with the Scottish Government to produce this plan. Local Government plays a key role in supporting people to experience better wellbeing and better outcomes, so it was only right that this plan reflects the whole system of integrated health and social care, from acute and primary care to social work, our care homes, community settings, and our partners across the sector.

“Winter is often a time of exceptional pressure on our services so I am pleased that this plan, produced with our partners across the sector, reflects the challenges and the opportunities we face.”

Health & Social Care Winter Preparedness Plan for 2024-25

City Chambers turns pink to mark Organ and Tissue Donation Week

EDINBURGH is highlighting the importance of Organ and Tissue Donation Week 2024 which runs from September 23-29 September.

This year the NHS Organ Donor Register celebrates its 30th birthday. To raise awareness of the incredible gift of organ and tissue donation, the City Chambers is turning pink.

The annual campaign raises awareness for the ongoing need for organ donation, whilst also encouraging people to make a decision about whether they wish to opt in or out of donation and making sure these wishes are discussed with family members.

Edinburgh International Conference Centre (EICC), another landmark building on the city skyline, is also lighting up pink in support of the campaign.

Depute Lord Provost, Councillor Lezley Marion Cameron said: “Almost 60,000 lives have been saved since the NHS Organ Donor Register was created in 1994. Organ and Tissue Donation Week is the perfect opportunity to highlight this incredible fact.

“As we mark the 30th anniversary of the NHS Organ Donor Register, we must also be mindful of the fact that more than 7,600 people in the UK are currently waiting for a life-saving transplant. There are thousands of people who could be given a new lease of life by a donor. To help as many people as possible we all need to play our part by considering and registering our decisions to be, or not to be, a donor. 

“These are conversations that need to be had amongst families, friends, colleagues, and communities as we go forward.  Families are more likely to support donation when they are already aware of their loved one’s wish to be an organ donor. 

“Whilst it’s heartening that over half of people in Scotland have now registered their organ and tissue donation decision, a great many people still haven’t done so.  Whatever your choice may be, the important thing is to make it, discuss it with loved ones, and record it.

“I hope the aim of this week’s campaign of raising awareness of the lifesaving opportunities of organ donation encourages anyone who is 16 years old or over who have yet to record their decision to do so by visiting the official website today.”

Scots know if their loved ones prefer ketchup over brown sauce – but not their organ donation decision

  • New Scottish Government campaign encourages people to make their own organ and tissue donation decision and ‘Have the Chat’ with those close to them
  • Organ and Tissue Donation Week runs from 23rd-29th September, with 2024 marking 30 life-saving years of the NHS Organ Donor Register
  • Campaign reminds people of the choices they have under Scotland’s opt out system of organ and tissue donation

The Scottish Government has launched a new campaign to mark Organ and Tissue Donation Week (23rd-29th September 2024), encouraging more people to make a choice about their organ donor decision and, importantly, ‘Have the Chat’ with their loved ones about their choice.

The new ‘Have the Chat’ campaign comes as research[1] reveals that while more people in Scotland know if their family and friends prefer tomato or brown sauce – fewer know their organ and tissue donation decision.

When polled, members of the public were more likely to say they knew their loved ones’ coffee order or whether they’re a dog or a cat person, rather than if they’d want to donate their organs and tissue.

Findings also revealed that while more than three quarters (77%) of respondents know their loved ones religious or spiritual beliefs, only half (51%) are aware of their organ and tissue donation decision.

To launch the campaign, former Miss Scotland and radio presenter, Keryn Matthew took to the streets of the capital to encourage members of the public to ‘Have the Chat’ with their own family and friends.

This year also marks the 30th anniversary of the NHS Organ Donor Register and celebrates the thousands of lives that have been saved thanks to people agreeing to the gift of organ donation. With many still awaiting transplants, it remains vital for people to confirm their organ and tissue donation decision.

Under Scotland’s opt out system of organ and tissue donation, Organ and Tissue Donation Week serves as a reminder for people to make their choices known and not leave their loved ones in doubt.

Nobody understands the importance of the gift of donation more than 29-year-old Martin Dillet, who underwent four liver transplants before the age of 30. The father of two has shared his story to highlight the life-saving impact it had for him.

Martin said: “I was diagnosed with a rare liver disease as a baby and had my first transplant at just three years old. Things went back to normal after that – I had a great childhood and went on to meet my wife, Danielle in 2012 before welcoming our first daughter in 2021.

“I always thought of my donor over the years. It wasn’t a conscious thought process – more a constant sense of being grateful for a second chance a life. However, in 2023, my health started to deteriorate rapidly and doctors discovered that the liver that had kept me alive for 25 years was failing.

“Things moved pretty quickly after that and I ended up going into full liver failure and was placed back on the transplant list at the same time as we were preparing for the birth of our second child. What should have been one of our happiest times as a family became one of the most anxious as we waited to hear that a liver had become available.

“Thankfully, we received a phone call and I received my transplant in September 2023. Everything went well with the operation, but unfortunately by the next day it became clear that my new liver wasn’t working. It’s an extremely rare complication and the only option was for me to go back on the list.

“We got the news that a new liver was available and I went back into surgery. This time it became immediately clear that the new liver wasn’t working properly. Doctors made the difficult decision to remove my liver entirely and I was added to the transplant list for a fourth time.

“We were nearly out of hope, but after 36 hours with no liver, I received my third liver transplant all within the space of five days.

“This time, everything went well and after being in a coma for 18 days I finally woke up and was reunited with my family. Danielle and I are so sincerely thankful to all my donors and their families.

“It’s so unfortunate that two of my transplants didn’t take, but it doesn’t change what my donors did for me and there are no words to describe how much it means to us.

“They gave me a chance to be here for my girls, Georgia and Amber, to see them both grow up.”

People in Scotland can choose to be a donor, or to opt out. If people aged 16 and over choose to do nothing, it may be assumed that they agree to be a donor if they die in circumstances where donation is possible, unless they are in a group for whom the opt out system does not apply or it would be against their views.

Data shows that 90% of families would support organ and tissue donation if their loved one had confirmed their decision on the NHS Organ Donor Register[4]; however, over two in five (43%) are yet to register their choice[5].

James Powell, Associate Medical Director, Surgical Services, Royal Infirmary of Edinburgh and Consultant Transplant Surgeon, NHS Lothian, said: “Martin’s story is incredibly inspiring and we wish him and his family all the very best.

“If you participate in any part of transplantation, you know that every transplant takes a full team including doctors, nurses, allied health professionals, donor services and family members, all working together.

“Most important though is the generosity of organ donors who have given the ultimate gift of life. With their gift, and the support of family members in achieving their loved one’s wishes, the Scottish Liver Transplant Unit has been able to help many patients.”

The NHS Organ Donor Register was set up to promote organ donation and allow people to record their decision to donate.

It was the result of a five-year campaign by John Cox and his daughter Christine after their son and brother, Peter, died in 1989. He had asked for his organs to be used to help others.

To find out more and register your decision, visit the NHS Organ Donor Register at www.organdonation.scot.

NHS Lothian: Students urged to ensure their vaccines are up to date before the new semester starts

Students across Lothian are encouraged to ensure their vaccinations are up to date before heading off to college or university this year.

Infectious diseases such as meningitis, septicaemia (blood poisoning) and measles can spread easily in universities and colleges. Vaccination offers the best protection against these diseases, which is why it’s important to check your vaccines are up to date.

Students are 11 times more likely to develop invasive meningococcal disease, which causes meningitis and septicaemia. The meningitis ACWY (MenACWY) vaccine helps to protect against these very serious diseases.  Students who have missed having the vaccine, can get it up to the age of 25 years.    

Parts of the UK and other countries in Europe have been seeing an increase in the number of people getting measles, and evidence suggests students are at higher risk. That’s why it’s important to check you’ve had two doses of the MMR vaccine, which protects against measles, mumps and rubella and has saved over 4,500 lives across the UK.

 Pat Wynne, Nurse Director for Primary and Community Care, NHS Lothian, said: “These diseases can be severe and, in some cases, life threatening.

“Students are at increased risk due to the large amounts of mixing with new people in enclosed spaces. Increasing cases of measles and meningococcal disease in particular were observed earlier this year.

“Vaccines are the best way to ensure you’re protected and these are offered for free on the NHS in Scotland. These vaccines are offered as part of the routine childhood immunisation schedule however if they’ve been missed, it’s not too late to catch up.

“Ideally, they should be given at least two weeks before the new semester starts.”

There is also still time to get the human papillomavirus (HPV) vaccine.  It helps protect against HPV-related cancers including head, neck and cervical cancer and also protects against over 90% of genital wart infections.  Most students will have had the HPV vaccine at school if eligible but if not, students may still be able to get it up until the age of 25. 

To find out about more information about these vaccines, please visit nhsinform.scot/vaccinesforstudents

If you are under 25 years and you’ve missed any vaccinations, call the Vaccination Enquiries Line on 0300 790 6296.  If you are 25 or over, call your GP practice.  They can check your records and arrange a referral if it is required.

International students may be able to get additional vaccines that were not available where they lived before.

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World Suicide Prevention Day 2024

There were 792 deaths by probable suicide in Scotland in 2023. This World Suicide Prevention Day reminds us the importance of looking out for one another and seeking help if we need it. 💙

Talking about suicide can be hard, but there is support and advice out there if you or a loved one is having suicidal thoughts.

NHS 24 has a range of services that can help with mental health and mental wellbeing. Please share for awareness!

🔹NHS 24’s Mental Health Hub – Call 111 and select the mental health option for urgent mental health help.

🔹 Breathing Space – a free confidential listening service for people over 16 in Scotland who are experiencing low mood, depression or anxiety. Call 0800 83 85 87 or web chat at www.breathingspace.scot

🔹 Living Life – telephone support using talking therapies based on cognitive behavioural therapy (CBT). Call 0800 328 9655 or visit https://www.nhs24.scot/how-we-can-help/living-life/

🔹 NHS inform – Digital tools and free online courses to get help with your mental wellbeing https://nhs24.info/mental_wellbeing

#WorldSuicidePreventionDay

#WSPD

#PreventSuicide

#MentalHealthServices

Addressing racism as a significant public health issue

Measures to reduce health inequalities

Cabinet Secretary for Health and Social Care Neil Gray has issued a statement identifying racism as a significant public health challenge, and a key cause of health inequalities.

Echoing the First Minister and other Scottish Government ministers’ comments on racism in the wake of recent violence in other parts of the United Kingdom, the Health Secretary has outlined various measures, including asking health boards to develop and deliver their own anti-racism plans.

Mr Gray said: “These changes can’t come fast enough. Racism already has a life-threatening effect on minority ethnic communities across the UK. That has been the case for generations.  

“The only way we can make a difference now is to actively work against racism. This work is just one step in the right direction. There is no place in Scotland for hatred or racism of any kind.”

Earlier in the week, the Scottish Government’s 2024/25 Programme for Government included plans to embed anti-racism across the public sector.

The full text of the Health Secretary’s statement

‘Raw and honest’ investigation ordered into state of our NHS

Professor Lord Darzi appointed to establish the state of the nation’s health service

  • Report will provide ‘raw and honest assessment’ of issues facing health service
  • Work will be led by Rt Hon Professor Lord Darzi, OM, KBE, a lifelong surgeon and innovator, independent peer and former health minister
  • Findings will feed into government’s 10-year plan to radically reform the nation’s health service

Health and Social Care Secretary, Wes Streeting, has ordered a full and independent investigation into the state of the NHS, to uncover the extent of the issues facing the nation’s health service.

Mr Streeting says he wants a ‘raw and honest’ assessment that will deliver ‘the hard truths’. He has appointed Professor Lord Darzi, a lifelong surgeon and innovator, independent peer and former health minister, to lead the rapid assessment, which will be delivered in September.

Its findings will provide the basis for the government’s 10-year plan to radically reform the NHS and build a health service that is fit for the future.

Health and Social Care Secretary, Wes Streeting, said: “Anyone who works in or uses the NHS can see it is broken. This government will be honest about the challenges facing the health service, and serious about tackling them.

“This investigation will uncover hard truths and I’ve asked for nothing to be held back. I trust Lord Darzi will leave no stone unturned and have told him to speak truth to power. 

“I want a raw and frank assessment of the state of the NHS. This is the necessary first step on the road to recovery for our National Health Service, so it can be there for us when we need it, once again.”

Professor Lord Darzi said: “As every clinician and every patient knows, the first step to addressing any health problem is a proper diagnosis.

“My work will analyse the evidence to understand where we are today – and how we got to here – so that the health service can move forward.

“This is an important step to re-establishing quality of care as the organising principle of the NHS.”

Amanda Pritchard, NHS Chief Executive, said: “Frontline NHS staff are doing an incredible job, despite the huge pressures they face, to deliver care to over a million people every day, but we know that they face huge struggles and patients are not always getting the timely, high quality care they need. 

“We will work closely with the government, independent experts and NHS staff to take a detailed look at the scale of the challenges and set out plans to address them – this comprehensive analysis will be an important step in helping us to build an NHS fit for the future.”

The Health and Social Care Secretary’s promise to fix the broken NHS was backed by action last week when he met with key figures across the health service.

This included meetings with junior doctors to discuss ending the strikes, and talks with the British Dental Association about rebuilding NHS dentistry.

He also visited a GP surgery in north London to see first-hand how the practice is delivering a patient-led service providing continuity of care – a key pillar of the government’s ambition to improve primary care.

Mr Streeting also set out his wider commitment to support the government’s growth mission by improving the health of the nation.

The aims are based on 3 key steps:

  • cutting waiting times to get people back to work
  • making the UK a life sciences and medical technology superpower
  • creating training and job opportunities through the NHS to deliver growth up and down the country.

BDA: Payment reform cannot be final destination for Scotland’s dental service

The British Dental Association Scotland has stressed that there can be no complacency over the future of NHS dentistry, following the first evidence from frontline dentists since the Scottish Government’s reforms rolled out in November last year.

A new poll of high street dentists shows:

  • While two thirds (66%) of respondents say the new system represents an improvement on the previous model, 9 in 10 (88%) say this cannot be the final destination for NHS dentistry.
  • Only 22% say the new system enables a move to a preventive model of dentistry. Only 7% believe it will enhance access for NHS patients, and just 5% say it will support a reduction in oral health inequality.
  • 26% feel changes have made their practices more financially sustainable. 31% disagree. Nearly half have not formed an opinion.
  • 34% agreed reforms met the Scottish Government’s goal of increasing clinical freedom, while 38% disagreed. On reducing bureaucracy, respondents were tied for and against on 38%.

Just over a year ago the BDA’s Scottish Dental Practice Committee and the Scottish Government entered formal negotiations on the new fee structure and Payment Reform. This moved at pace within a challenging fiscal environment. The previous funding model was unsustainable, as surging costs had left dental practices delivering some NHS care at a financial loss.

In an open letter to the Scottish Government the BDA stress the Scottish Government must show it is willing to build on these reforms, and to double down on policies to ease the workforce crisis in the NHS.            

David McColl, Chair of the British Dental Association’s Scottish Dental Practice Committee, said: “Given the critical place dental services were at this verdict is welcome news, but there is absolutely no room for complacency.

“Dentists have seen improvements, but have told us reform falls short on access, inequalities and prevention. Changes might make some practices more sustainable today, but they do not provide the foundations for a 21st century service.   

“The Scottish Government has set goals on improving access and sustainability. These promises must be kept.

“Scotland cannot have NHS dentistry without NHS dentists – and this service must be a place which can recruit and retain talent.”

Online survey of Scottish General Dental Practitioners, February-April 2024, 229 respondents:

Please indicate your agreement or disagreement to following statements

1. The new system means the practice I work in is better able to remain financially sustainable           


Strongly agree                                   3%        

Agree                                               23%

Neither agree nor disagree              27%

Disagree                                          21%

Strongly disagree                            10%

Don’t know/not applicable               15%

Net Agree                                        26%      

Net disagree                                   31%

2. The new system represents an improvement on the previous payment model

Strongly agree                                 10%      

Agree                                               55%      

Neither agree nor disagree             15%

Disagree                                         12%      

Strongly disagree                              7%

Don’t know/not applicable                 0%

Net agree                                        66%      

Net disagree                                   19%

3. The new system reduces bureaucracy

Strongly agree                                   4%        

Agree                                               34%      

Neither agree nor disagree              22%

Disagree                                          21%      

Strongly disagree                            17%

Don’t know/not applicable                 2%        

Net agree                                        38%                                  

Net disagree                                   38%

4. The new system increases clinical freedom

Strongly agree                                                 3%
Agree                                                             30%
Neither agree nor disagree                            27%      
Disagree                                                        26%
Strongly disagree                                          12%

Don’t know/not applicable                               1%        

Net agree                                                      34%                                  

Net disagree                                                 38%                                   

5. The new system enables a move a preventive model of dentistry       

         
Strongly agree                                                 3%

Agree                                                             20%

Neither agree nor disagree                            24%

Disagree                                                        27%                                         

Strongly disagree                                          25%                    

Don’t know/not applicable                               2%        

Net agree                                                      22%                                  

Net disagree                                                 52%

6. The new system will enhance access for NHS patients            

Strongly agree                                                1%

Agree                                                              6%

Neither agree nor disagree                           18%      

Disagree                                                       34%

Strongly disagree                                         39%

Don’t know/not applicable                              2%        
Net agree                                                       7%                                        

Net disagree                                                 73%

7. The new system will support a reduction in oral health inequality

Strongly agree                                               1%

Agree                                                             4%

Neither agree nor disagree                          18%

Disagree                                                       35%

Strongly disagree                                          38%

Don’t know/not applicable                              3%

Net agree                                                       5%

Net disagree                                                 73%

8. The new system should be a final destination for reform of NHS        

Strongly agree                                               0%

Agree                                                             2%

Neither agree nor disagree                            7%

Disagree                                                       27%                                  

Strongly disagree                                          61%

Don’t know/not applicable                              2%        

Net agree                                                       2%

Net disagree                                                 88%