NHS dentists blast “business as usual” order

NHS dentists blast orders to return to virtually ‘business as usual’: The British Dental Association has slammed moves by government to effectively return to normal working arrangements for NHS dentists in England. The move comes with no meaningful changes to the pandemic restrictions dental teams work to and with infection rates now at an all-time high.

For the financial quarter starting 1 April 2022 dentists will face financial penalties for failure to hit 95% of their pre-pandemic activity levels. While NHS England’s rulebook for providing care during the pandemic – the Standard Operating Procedure – is to be dropped with immediate effect, dentists remain mandated to work to infection prevention and control guidance that limits patient volumes – including requirements to leave fallow time ‘gaps’ following some treatments, and undertake time-consuming COVID screening. The BDA is continuing to receive widespread reports of staff sickness and patient cancellations, and has warned the approach to targets will continue to drive practices out of the NHS.

The BDA understand close to half of practices were on course to fall below the previous 85% target, set on 1 January 2022 in the midst of the Omicron wave, and would therefore face significant financial penalties. Following pressure from the BDA, NHS England has now set a new minimum threshold of 75% for the last quarter, easing the blow for some practices.

Over 40 million NHS appointments have been lost since lockdown – or the equivalent of more than a full year’s worth of dentistry in normal times. The BDA has stressed that no meaningful support has been put in place to help manage these backlogs. Recent pledges of £50m in time-limited funding to provide 350,000 additional appointments by 1 April are understood to have secured modest pickup, given the struggles to meet these existing contractual commitments at this unprecedented time. In the face of these pressures nearly 1000 NHS dentists left the service in the last financial year.

From 2019/20 to 2020/21 over £0.6 billion was lost in NHS patient charge revenue as a result of lower patient throughput. Direct government contributions – which had been in long term decline – have had to reach historically high levels in order to maintain operations during the pandemic, and the BDA remains deeply concerned that pressure to ‘balance the books’ has driven decision making across government.

The BDA has said the government must now deliver on commitments of fundamental reform to halt the growing exodus from the service. A package of ‘quick wins’ pledged by NHS England to improve the discredited contractual framework remains in development.

Shawn Charlwood, Chair of the BDA’s General Dental Practice Committee said:

“Whilst the retrospective concession will help some, NHS dentists have effectively now been told to return to ‘business as usual’.

“This service is still working to pandemic restrictions, tackling an unprecedented backlog amid staff absences and patient cancellations. This isn’t ‘living with COVID’, it’s setting practices up to fail.

“NHS dentistry is haemorrhaging talent while promises of reform remain unfulfilled. The government is yet to show it is ready to put the interests of patients ahead of Treasury accountants.”