The Nuffield Trust said ‘difficult and frankly unpalatable policy choices’ would need to be made(Image: Rui Vieira/PA)

NHS dentistry at 'most perilous point in its history', report warns

The Nuffield Trust has called for a 'huge injection' of funding into NHS dentistry, warning that 'unpalatable' choices need to be made

by · NottinghamshireLive

Urgent reforms are needed to “slow the decay of NHS dentistry”, a think tank has warned. A report by the Nuffield Trust claims NHS dentistry is “at its most perilous point in its 75-year history”, with access issues, a lack of funding, the pandemic and widening inequalities in oral health causing a “widespread crisis”.

Analysis by the think tank found total spending for dental services was £3.1billion in 2021/22, a decline of £525million since 2014/15. It added that the central budget had been “consistently underspent” in every year apart from 2020/21, during the Covid-19 pandemic. According to the report, data from the British Dental Association (BDA) estimates NHS dentistry will underspend by about £400million in 2022/23.

Nuffield Trust chief executive Thea Stein said: “We need to see immediate action taken to slow the decay of NHS dentistry, but it is increasingly clear that we can no longer muddle through with an endless series of tweaks to the contract. Difficult and frankly unpalatable policy choices will need to be made, including how far the NHS aspires to offer a comprehensive and universal service, given that it does not do so at present. If, as seems, that the original model of NHS dentistry is gone for good, then surely the imperative is to provide enough access for a basic core service for those most in need.”

The report had made a number of short and long-term recommendations for the Government to consider. They include short-term resolutions such as increasing the intervals between routine check-ups to one year, recruiting dental therapists from the private sector, investing in preventative care for young people and targeted work in schools and care homes.

In the long-term, the Nuffield Trust called for the introduction of a fee-for-service payment model and student loans forgiveness scheme for dentists. It also called for a “huge injection” of funding in NHS dentistry.

Ms Stein added: “Whichever way we go, I’m afraid that NHS dentistry cannot continue without some kind of evaluation of the offer even if there are some major improvements to the way services are contracted and commissioned.”

Shawn Charlwood, chairman of the BDA’s general dental practice committee, said the report “reads like the last rites for NHS dentistry” and that “patients and this profession deserve some honesty here”.

He added: “The Government say NHS dentistry should be accessible for all who need it. The plain facts are we’re not seeing any evidence of the reforms or the resources to realise that ambition.”

It comes as the Labour Party revealed plans to introduce a dentistry rescue plan if they come into power at the next general election. It pledged to fund dental practices to provide 700,000 more urgent appointments, as well as incentives for dentists to work in areas with the greatest need for their services. They would also introduce supervised brushing in schools for three to five-year-olds, particularly in areas with high levels of childhood tooth decay.

Shadow health secretary Wes Streeting said: “The Conservatives have left NHS dentistry to wither on the vine and now the service is barely worthy of the name. Patients are told to go without or do it themselves, with DIY dentistry now shockingly common in Tory Britain. The slow death of dentistry is the Ghost of Christmas Future for the NHS, if the Conservatives are given a fifth term: those who can afford it going private and those who can’t left with a poor service for poor people.”

The blueprint will cost £111 million, Labour said, and would be funded by abolishing the non-dom tax status.

A Conservative Party spokesman said: “Labour’s sums simply don’t add up – they have spent the same money on six other policies.”

Responding to Labour’s announcement, Ms Stein said: “The measures presented in the Labour plan all make good sense and our own report recommends a similar focus on the most vulnerable and on reforming contracts. But piecemeal measures alone are unlikely to stem the decline we are seeing in NHS dentistry.”

The Department of Health and Social Care has been approached for comment.