F5: Access to Dental Services

Submitted by: 10 Members.
Mover: Daisy Cooper MP (Spokesperson on Health and Care)
Summation:Lord Allen (Lords Spokesperson on Health and Care)

Conference notes with concern that:

1. People are resorting to DIY dentistry because they cannot get a dental appointment on the NHS and cannot afford to pay hundreds, if not thousands for private dental care.
2. Healthwatch England found that 41% of people are struggling to get an NHS dental appointment, with one in five unable to access all the treatments they needed.
3. The British Dental Association (BDA) estimates that 3,000 dentists in England have moved away from NHS work entirely since March 2020 with many more significantly reducing their NHS commitment, and have warned of an “unprecedented” collapse, barring significant government intervention.
4. 1-in-6 dentists are approaching retirement, the vast majority of local practices have already started shutting their doors to new NHS patients and some are preparing to stop taking NHS patients altogether.
5. Emerging ‘dental deserts’ with the fewest dentists per person and often in rural or deprived areas, has left people waiting for basic, often urgent care and is leading to millions missing appointments, as well as growing health inequalities.
6. Tooth decay is consistently the number one reason for hospital admissions among young children and children from the most deprived areas are already three times more likely to have hospital extractions than their peers.
7. The underspend of the national dentistry budget by a record £400m this year 2022/23, representing around 13 per cent of the £3bn primary dentistry budget; this is in spite of the ‘access crisis’ and increasing demand for dentistry and has been ascribed simply to practices working to a failed contract and with vacancies for dentists they can’t fill and/or a shortage of dentists willing to take on NHS work.

Conference believes that:

1. Everyone should be able to access an NHS dentist if they need one and no one should be forced to pay hundreds of pounds for private care.
2. The Government’s failure to address the shortage of NHS dental appointments and refusal to fund the system properly is leading to a two-tier system, with those that can afford dental care and those that cannot.
3. The NHS dental contract is putting government targets ahead of needs of patients and sets perverse targets that are leading to poor outcomes.
4. The number of NHS dentists is critical to tackling long waiting times and poor access to NHS dental appointments.
5. The Conservative Government's efforts to increase the number of NHS dental appointments has made no significant impact.
6. With integrated care systems (ICSs) taking over the commissioning of NHS dentistry from NHSE in April 2023, there is an opportunity to redress the failures of national government by local commissioning, with a focus on prevention, health equity, and better access for the most urgent cases through wider and better integrated pathways between primary and secondary care services, including prioritising an urgent dental care system (that connects individuals from NHS 111 to a clinical triage and designated urgent care provider) and more essential domiciliary dental care for residential settings and for vulnerable groups.

Conference calls for:

1. Reform of and increased funding for the NHS dental services contract, to ensure it:
   1. Encourages and incentivises dentists to take on NHS patients,
   2. Meets patient need and demand rather than arbitrary targets,
   3. Puts an end to ‘dental deserts’.
2. An increase to the number of dentist training places in the UK and continued recognition of EU trained dentists’ qualifications.
3. Proper workforce planning for health and social care to be written into law, including projections for dentists and dental staff.
4. The launch of an emergency scheme to ensure children, pregnant women, young mothers, and those on low incomes have access to their free check ups on time.
5. Supervised tooth brushing training for children in early years settings, such as nurseries.
6. The removal of VAT on children’s toothbrushes and children’s toothpaste.
7. A reversal of the government’s cuts to public health grants to support preventative dental health care, for example oral health programmes or promoting healthy eating choices.
8. Proper funding of ICSs to take on NHS dentistry commissioning, with a minimum of all of the underspend in the national commissioning budget in 2021/22 and 2022/23 transferred to ICSs to target local need and demand.
9. Longer-term consideration of more major reform to put prevention first, with much-needed sustained investment for prevention and oral public health as part of the Public Health Grant.

Applicability: England only, except 2 and 6 which are Federal.