We fed into Lord Darzi’s independent review of the NHS, underlining how the broken contract has fuelled both the access and workforce crises in NHS dentistry.
Echoing the position of two Health Select Committees in two dedicated inquiries, the Nuffield Trust and this profession, the investigation states: "If dentistry is to continue as a core NHS service, urgent action is needed to develop a contract that balances activity and prevention, is attractive to dentists and rewards those dentists who practice in less served areas.”
“There are enough dentists in England” it concludes “just not enough dentists willing to do enough NHS work, which impacts provision for the poorest in society."
Health Secretary Wes Streeting said this report would serve as a diagnosis, to which he would provide the ‘prescription.’ Prime Minister Keir Starmer stressed it means the NHS needs “major surgery not sticking plaster solutions” – and this logic must be applied to the struggling service.
It’s abundantly clear what medicine is needed. The last Government offered a recovery plan that failed to offer a decisive break from UDAs and came with no new investment.
The new Government has pledged contract reform, and we have been encouraged by early talks. However, deeds need to match words.
The PM says the NHS must "reform or die". In our view that message could have come from any dentist working in the NHS since 2006. So, what the new administration needs to demonstrate is both urgency and ambition.
Maintaining momentum is key to meet the huge unmet need for dentistry and keeping demoralised dentists on board.
When it comes to funding, the PM stressed Government intends to “fix the plumbing before we turn on the taps". In our view fair funding needs to go hand in hand with real reform. However, in the short term at a bare minimum the huge underspends in the dental budget need to be ringfenced and redeployed to boost access and keep practices sustainable while we wait on real reform.
The report observes that across the NHS the prevention agenda has been stymied by a lack of resources and long-term thinking. That there is an imperative to shift the focus from our hospitals to primary care, both to improve outcomes and to secure a real return on investment.
These aspirations can be realised in NHS dentistry. But any ‘prescription’ must be written before the patient reaches the point of no return.