Take action to improve access to NHS dental treatment

“When should I contact my MP?”

“Now!”

Find your MP

February update: “Faster, simpler, fairer”

On February 7th, 2024, the government released an action plan to improve patient access to NHS dentistry. They say what we want to hear – that NHS dental care will be “faster, simpler and fairer”.

The government plan outlined sounds like the positive action patients and workers in the dental sector have been asking for. It’s what we all want for NHS dental care.

Reading through the new government reform strategy we want to believe there is a positive drive forward, and feel optimistic that government innovations will make a difference. I hope this action plan will heft more impact than the last sticking-plaster solutions the government implemented when they nudged up the UDA rate and increased the pitifully low number of ORE places.

Click to read the Department of Health and Social Care policy paper

July update: Health and Social Care Committee Report

SpaDental responded to the Heath and Social Care Committee call for evidence on the state of NHS Dental Care. The key questions we replied to in our submission were:

• What steps should the Government and NHS England take to improve access to NHS dental services?
• How should inequalities in accessing NHS dental services be addressed?
• Does the NHS dental contract need further reform?
• What incentives should be offered by the NHS to recruit and retain dental professionals, and what is the role of training in this context?

The Health and Social Care Committee report cites Spadental. You can read our submission here: Committees.parliament.uk/writtenevidence/117225/pdf/

NHS dentistry – Ninth Report of Session 2022–23

Read the full report here:  C 964

Published on 14 July 2023, by authority of the House of Commons

May update: Access to ORE increased

On 16th May the GDC announced that they have at last responded to demand for opportunities to sit the Overseas Registration Exam (ORE). They have raised the number of places for the Part 1 examination  in August from 200 to 600.

Successful candidates will, however, still need the opportunity to take Part 2 of the examination, a practical, before they can work as dentists.

• GDC news

We are grateful to everyone, from patients to ministers, for helping to raise concerns affecting patients, and the dental sector.

April update: Ongoing concern about ORE examinations

SpaDental continues to share ideas and information to improve access to NHS dentistry. In the House of Commons, on 27th April, Steve Brine MP, Chair of the Health and Social Care Committee, cited SpaDental as a source of information as he expressed concern for the dearth of Overseas Registration Examinations (ORE) needed to allow dentists qualified overseas to work as dentists in the UK.

Earlier this year, SpaDental’s Managing Director submitted a lengthy response to The Health and Social Care Committee request for information for their inquiry into dentistry following a survey revealing 90% of practices across the UK are not accepting new adult NHS patients.

We urge you to contact your MP to let her/him know about the problems you are having with access to NHS dental care.

Access to NHS dental treatment is a topic of concern (May 2022)

Our concern is not limited to SpaDental – we are concerned for dentistry across England.

There is a need to speak up.

To summarise the main areas of concern:

• An unprecedented number of staff are leaving the NHS dental workforce and practices cannot hire UK qualified dentists to take on adult NHS work
• The General Dental Council (GDC) is failing to provide the opportunity for dentists who qualified overseas to take registration examinations (ORE) so they can work as dentists in the UK
• NHS under-funding of the dental sector makes it impossible to recruit and retain staff for NHS funded treatment
• Dental contracts must recognise and reward commitment to NHS care
• The government budget for dental care must keep pace with inflation and population growth

Please express your concerns to your MP and ask them to attend heath care debates to represent your views.

“Communities across England have made it clear that NHS dentistry needs to be fixed – so it’s affordable and accessible.” Healthwatch.co.uk

Why is it hard to get an NHS dental appointment?

A combination of the pandemic and Brexit has led to a shortage of dentists in England impacting on the number of appointments available for NHS dental treatment. In short, the result is that there are simply not enough dentists. At SpaDental, for example, we have staff who returned to Europe because of Brexit, or who took early retirement rather than continue to work during the pandemic.

Foreseeing the problem, we put a lot of time into recruiting. We have hired dentists qualified overseas to work as therapists until the GDC registers them as dentists. Unfortunately, we are not able to hire UK qualified dentists to take on adult NHS work, even though our rates are competitive and working conditions are good.

The April 2022 revision

Last April, the government introduced a ‘multi-skilled’ approach to NHS dentistry, allowing therapists and nurses to participate directly in patient treatment. This follows a model applied in the private sector for many years.

The new regulations allow a Dental Care Professional (DCP) to provide direct access treatment to NHS patients within their scope of practice, skill and experience.  This provision is important as it enables us to triage patients’ needs so a dental therapist, for example, can provide some treatments that previously required the involvement of a GDC registered dentist.

It is particularly beneficial for younger children’s appointments; they can access NHS funded treatment with a dental therapist.  Most treatment for children under 12 focuses on preventive care advice, and fillings in deciduous teeth, which are within a therapists’ clinical scope of practice.

We are often asked why we aren’t accepting adults but we accept children. The answer is that teenagers and adults often have treatment needs that are outside the GDC Scope of Practice for a Dental Therapist.  When a therapist comes across a problem they are not allowed to treat, they must refer it to a dentist, but there are simply not enough dentists offering NHS funded clinical time.

Qualifying dentists from overseas

Foreseeing a shortage of dentists, SpaDental hired dentists qualified overseas. To register as a dentist with the GDC, they must pass two Overseas Registration Examinations.  An additional sitting of these important examinations in November 2022 has not transpired and, at the time of publishing this, a date for the next ORE Part 1 is not indicated.

Moreover, the GDC has reduced the frequency of ORE exams, with only two sittings of ORE Part 1 since August 2019.  There are hundreds of overseas qualified dentists in the UK waiting for the GDC to provide them with an opportunity to prove their skill and provide treatment to the UK public.

The GDC explains: “Making changes to our routes to international registration is not a fast process and will require careful consideration of the measures to protect the public and to establish new processes.”

The GDC has failed to provide any guidance or timeline as to when they intend providing additional examinations or simplify the international registration process.

Unfortunately, although the GDC is tasked to protect the oral health of the public, by failing to facilitate the registration of enough qualified clinicians, their processes are having the opposite effect.

Questions to ask your MP:

1. What is the GDC doing to redress the acute shortage of dentists?
2. How will the government incentivise dentists to deliver NHS funded treatment?

How you can help

You can help by contacting your local MP’s office to let them know how you feel about the lack of access to NHS dental care.

The lack of NHS dentistry in England, cannot be fixed by individual dental practices. It requires the political will of your MPs.

The SpaDental team continues to try to help patients last treated as an NHS patient at our practices with emergency care but it is increasingly difficult. The treatment provided depends on the staffing recruited to the practice.

We need a solution for the provision of NHS care to be facilitated by the government.

Meanwhile, we will continue to provide NHS dental care where we can, but we anticipate provision will continue to contract.

Our sincere thanks to you for your continued understanding of the current circumstances, which will only improve when there is the political will to bring about change.

Please contact your local MP to demand change.

Thank you

Additional note:

• When we have empty appointments due to patient cancellations, we contact patients who have signed up on our ‘standby’ list. You can read more about becoming a ‘standby’ patient here.

Please note: This article was first published in January 2021, and has been added to and updated from the original.

Useful Links & Information