Dentists: Care home residents baring brunt of access crisis

Fourfold increase in residents unable to access routine NHS care: The British Dental Association has stressed Ministers must act on new research from the Care Quality Commission, which reveals a collapse in access to NHS dentistry among care home residents.

Feedback from providers indicates that since 2019, and the onset of lockdown, the proportion of residents never accessing NHS dental care routinely has grown from 6% to 25%. Homes stating residents were always or mostly always able to access routine care fell from 67% to 35%.

Dentist leaders stress that the access gap here will far exceed the wider population, given the high needs and complex medical histories of residents, which includes the elderly and vulnerable adults. The BDA has long expressed concern over the postcode lottery of provision and the horrific cases that have emerged from the sector, with some patients reported as being unable to communicate their pain, to eat or to sleep. It has stressed that any solution requires national leadership on commissioning and funding services that must cover mainstream, urgent and domiciliary care.

In response to health watchdog’s first 2019 report the BDA had urged a revolution in the approach to oral health in care homes. It has applauded the leadership shown by the CQC which has shown a paradigm shift on awareness among leadership teams, and in care planning and staff training. The professional body has stressed the responsibility for providing anything resembling normal levels of access rests firmly with government. The report continues to underline the difficulties delivering care under the flawed 2006 NHS contract, with only 5% of contracts held in England including domiciliary care in 2021/22.

Following the 2019 Public Accounts Committee hearing into NHS patient fines, the BDA has applauded the CQC’s call to make care home residents automatically exempt from patient charges. A heavy-handed system has seen hundreds of thousands fined for attempting to access free NHS dental care, with many with complex needs facing penalties simply because their carers ticked the wrong box on a form.

Giten Dabhi, Chair of the British Dental Association’s England Community Dental Services Committee said:

“The pandemic caused huge disruption to dental services, and sadly the worst impact is being felt by the most vulnerable in our society. “For years we’ve needed a revolution in oral health in our care homes. Now real progress risks being undone as access to care falls off a cliff.

“The Government must step up. Ministers have a moral duty to residents that can be left unable to eat, drink and communicate.”