In an annex to a message sent by NHS England to Integrated Care Boards following rollout of commissioning for Labour’s manifesto pledge of 700,000 urgent appointments, officials state “This calculation gives a total estimate of 2.2m people each year (3.5% of the population) who are currently unable to get an NHS dentist appointment, and who have a treatment need. It is assumed that these are the people who would require urgent care appointments.”
We are not surprised that - having discovered this level of need - officials stuck to a relatively modest level of delivery. Treasury pressure had already seen pledges of new money from the ‘non-dom’ squeeze dropped in October, with the 700,000 appointments paid for by recycling underspends in the dental budget, which are fuelled by ongoing recruitment and retention problems.
At the launch of this policy last week, we stressed the extra appointments would translate into each of the 24,200 dentists recorded as doing some NHS activity last year seeing the equivalent of little over two extra urgent cases a month. Our analysis of Government data - the same data underpinning NHS England modelling for urgent care - shows total unmet need for NHS dental care in England amounts to 13 million, or one in four of the adult population.
It’s vital that Integrated Care Boards build in capacity for follow-up care for high needs patients in these local schemes. Many patients will need further dental treatment once their immediate urgent care needs are met. Some existing local schemes allow flexibility for these patients to return for follow-up care and this good practice should be adopted elsewhere.
We are seeing all too familiar stories nationwide.
A recent coroner’s inquest heard that Leigh Rodgers, 34, died last year in University Hospital, North Durham after being told a dentist appointment wait would be 'weeks'. Her partner called for medical help as the painkillers she had been taking were not helping the pain. A post-mortem examination determined that she had suffered a fatal allergic reaction to a chemical used in medical treatment.
Chris Langston from Oswestry reported removing a molar last February after enduring, he said, months of agony. Barts Pathology Museum has got in touch with a view to scanning the tooth for display.
In Scotland we've seen Nick Whelan, a student, left permanently scarred after he was forced to undergo life-saving emergency surgery following a dental infection.
"So, it seems a new Government discovered the need for urgent care, but chose just to cover a third of it,” says General Dental Practice Committee Chair Shiv Pabary.
"This is austerity on stilts. Rather than eliminating DIY dentistry, the Treasury is ensuring we keep seeing horrors that belong in Victorian era.
"We are clear that Ministers across England, Scotland, Wales and Northern Ireland have a moral responsibility to ensure no patient is ever left in this position.”