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On Thursday 10th February 2022, MPs will hold a general debate on access to NHS dentistry in Westminster Hall. This debate was put forward to the Backbench Business Committee by Peter Aldous and Judith Cummins.

The Care Quality Commission (CQC) highlight that access to NHS dental care has been an issue since long before the pandemic, but there are “clear signs” the problems have been compounded by Covid-19.

Between 25 March and 8 June 2020 NHS dental practices in England ceased routine dentistry in response to the pandemic. Around 600 urgent dental care hubs were set up to deliver care for patients. Infection and control requirements were put in place on reopening, including a requirement for a “fallow time” between aerosol-generating procedures. This reduced the capacity of dental services.

Over the course of the pandemic, the British Dental Association have estimated over 38 million dental appointments have been missed.

The Office of the Chief Dental Officer England and NHS England published a Standard operating procedure: Transition to recovery on 4 June 2020 which set out how patients should be prioritised according to greatest clinical need.

The Government announced an additional £50 million in funding for dentistry on 25 January 2022 to by spend before the end of the financial year to help deal with the backlog.

The funding will reportedly secure up to 350,000 additional dental appointments for those in most urgent need. This includes people suffering from oral pain, disease and infections. Children will be prioritised, alongside people with learning disabilities, autism or severe mental health problems.

Dentists will be paid more than a third on top of their normal fee for delivering this care outside of core hours, such as early morning and weekend work.

Healthwatch have reported examples of patients turning to private dentistry to access routine treatment. A Healthwatch article Twin crisis of access and affordability calls for radical rethink of NHS dentistry (24 May 2021) says that “whilst some people were asked to wait an unreasonable time of up to three years for an NHS appointment, those able to afford private care could get an appointment within a week.”

On 24 January 2022, Health Minister, Maria Caulfield, provided the following response to a Parliamentary Question regarding the steps in place to ensure that dental practices accept NHS-funded patients:

The National Health Service contracts with dentists to provide an agreed level of dental activity each year, measured in units of dental activity. Where a dentist holds a contract with the NHS, they must deliver the agreed activity or if performance is below 96%, the NHS can recover the unused funds. Dentists therefore have a strong financial incentive to deliver the contracted service and not prioritise private patients in cases where they have undelivered NHS activity.

Throughout the pandemic, NHS England and NHS Improvement have set contractual arrangements which support safe increases in access, whilst maintaining compliance with infection prevention and control measures. The Department is working with the NHS to increase delivery of dental care. NHS dental practices have been asked to meet as many prioritised needs as possible, focussing first on urgent care and care for vulnerable groups, including children followed by overdue appointments.

In addition to the impact of the pandemic, NHS England and NHS Improvement have said that whilst overall national workforce numbers appear adequate, they are aware of “certain geographic shortfalls limiting service provision”.

Public Health England (PHE) published Inequalities in oral health in England in March 2021. The report said that oral health behaviours and outcomes were significantly worse amongst those from lower socioeconomic backgrounds and from more deprived geographical areas. It also included evidence that those from ethnic minority backgrounds were less likely to access NHS dentistry.

PHE also highlighted that some vulnerable groups face “substantial difficulties” accessing dental care, including homeless people, prisoners, travellers and looked after children.

Further Reading

House of Commons Briefings 

NHS charges

House of Commons Library briefing 7227

06 January 2022

Oral health and dentistry in England

House of Commons Debate Pack CDP-0072

21 May 2021

Effect of covid-19 on dental services

House of Commons Debate Pack CDP-0001

12 January 2021


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