The Growing Crisis in NHS Dentistry: A Fight for Access and Reform
For over a decade, Healthwatch has documented a deepening crisis in access to NHS dentistry. What began as a concerning trend has escalated into a situation where individuals are resorting to desperate measures, including DIY dentistry, due to a lack of available appointments and affordable care.
A History of Broken Promises and Growing Desperation
Healthwatch first highlighted significant problems with NHS dental services back in 2016. The COVID-19 pandemic dramatically worsened the situation, prompting the #fixNHSdentistry campaign. Despite some contract changes announced in 2022 – notably a requirement for dentists to update their availability online – access remains severely limited for many.
The scale of the problem was formally recognized by the House of Commons Health and Social Care Committee, which concluded in its inquiry that “Everyone should be able to access an NHS dentist when they need one, wherever they live.” Healthwatch representatives provided direct evidence to this inquiry, detailing the harrowing experiences of individuals driven to dangerous self-treatment due to untreated dental problems.
The Failure of the Dental Recovery Plan
Evidence submitted to a National Audit Office (NAO) inquiry revealed that the previous Government’s Dental Recovery Plan failed to deliver the expected increase in NHS dental appointments for new patients. The NAO’s findings mirrored those of Healthwatch, confirming a systemic failure to address the growing access crisis.
The Core of the Problem: A Flawed Contract
The current NHS dental contract, introduced in 2006, fundamentally altered the relationship between dentists and patients. Prior to 2006, patients could register with an NHS dentist as a permanent patient, similar to the GP system. The new contract shifted payment from a per-patient basis to a per-unit-of-dental-activity model. This incentivized dentists to focus on treatments rather than preventative care and long-term patient relationships.
As Healthwatch England research shows, a significant majority of the public (68%) mistakenly believe they still have the right to register with an NHS dentist in the same way as a GP. This misconception highlights a critical gap in public understanding and underscores the need for clearer communication about how the system currently operates.
What’s Being Done – and What More Needs to Happen
The Government has pledged to deliver 700,000 extra urgent dental appointments each year and is implementing a supervised toothbrushing program for young children. However, Healthwatch is advocating for more fundamental reform, specifically a return to a system that allows patients to register with a local NHS dentist for ongoing care.
Transparency is also a key concern. Healthwatch is pressing for regular publication of data on the number of extra urgent appointments delivered in each Integrated Care Board (ICB) area, mirroring the transparency already provided for hospital waiting lists. Greater clarity is also needed regarding ring-fenced NHS dental budgets held by ICBs.
The Call for Permanent Registration
The overwhelming preference among the public is for a GP-style system, where they can register with an NHS dentist as a permanent patient. Over half (54%) of respondents in a recent poll expressed this desire. Reintroducing permanent registration rights is seen as a crucial step towards improving access and ensuring continuity of care.
Looking Ahead: Potential Future Trends
The current trajectory suggests several potential future trends:
- Increased Demand for Private Dentistry: As access to NHS dentistry remains limited, more individuals may be forced to seek private care, exacerbating health inequalities.
- Continued Advocacy for Systemic Reform: Healthwatch and other organizations will likely continue to campaign for fundamental changes to the NHS dental contract.
- Focus on Preventative Care: The supervised toothbrushing program for young children signals a potential shift towards greater emphasis on preventative care, but this needs to be expanded and integrated into a broader strategy.
- Greater Transparency and Accountability: Increased public pressure may lead to greater transparency in the allocation and utilization of NHS dental budgets.
FAQ: Your Questions Answered
- Do I have the right to register with an NHS dentist? No, you do not have the right to register with an NHS dentist as a permanent patient. This right was removed in 2006.
- What is being done to improve access? The Government has pledged extra urgent appointments and is implementing preventative programs, but Healthwatch is calling for more fundamental reform.
- Where can I find more information? Visit the Healthwatch website for the latest updates and reports.
Pro Tip: If you are struggling to find an NHS dentist, contact your local Healthwatch to report your experience and contribute to their ongoing advocacy efforts.
What are your experiences with accessing NHS dental care? Share your thoughts in the comments below and aid us raise awareness of this critical issue.
