For years now, NHS Dentistry has been ripe for reform, with the government promising time and again to give the system a complete overhaul. Finally, it appears that some changes could be on the horizon.
Within the past week, Maria Caulfield MP made a House of Commons announcement stating that change can be expected before parliament breaks for its summer recess. Unfortunately, though, it has since been suggested by the BDA that any possible changes will only be marginal and modest fixes and not the wholescale radical change that is necessary.
Shifting Away From The NHS
Dentists nationwide are moving in significant numbers away from the NHS. Whereas NHS dentistry contracts were once viewed as valuable, today they represent a poor deal. With increasing costs for materials and staffing, and an unprecedentedly high amount of demand from patients (which, in turn, means greater profits if patients shift onto private schemes), it isn’t surprising that so many dental professionals are moving their whole operations to the private dentistry model.
Although some practices still envisage their future lying with NHS dental services, it’s becoming harder to recruit new associates into an environment that places its focus endlessly on UDA targets. Not only that, but the business margins for dentists offering NHS dental services are simply insufficient to enable practices to hire nurses at the higher market rates.
Even when practice owners wish to carry on providing NHS services, when they cannot staff the practice at the offered rates and with the necessary conditions to perform NHS dentistry, they have no option left other than to switch to private practice.
What Shape Could Reform Take?
In Wales, the recent reform that came about earlier in the year was swift and sudden, giving practices an incredibly short timescale within which to consider accepting or rejecting the new contracts – far too short a time to give proper consideration to the potential financial consequences.
Making promises of reform in England in June before the break for summer indicates that NHS dentists in England will also have limited time within which to digest changes fully before they become applicable.
Furthermore, it appears likely that changes will only focus on ensuring improved access to services for the lowest patient base income spectrum. Politically speaking, today’s cost-of-living crisis couldn’t be a hotter topic, so the government is almost certainly going to be desperate to show it is taking action when it comes to supporting those with financial struggles.
If practices in affluent areas hand back their NHS contracts, it’s likely this action will be welcomed in order to redivert the funding to other, poorer communities and to boost the rate of pay for dentists operating in these areas. It’s unlike dentistry is going to be offered any extra “new money”, therefore, levelling up will probably be desirable.
According to the BDA, any changes are expected to be only marginal, and that suggests that it’s unlikely a complete shift will take place to capitation dentistry. That is going to disappoint many, especially following the extensive pilot trials nationwide. No matter what changes are implemented, it would be very helpful if practices could be made away of what was coming so they could have sufficient time to appropriate plan resources.