In Scotland, the Public Dental Service (PDS) plays a vital and unique role in treating patients who need special care dentistry. We provide oral care to a range of vulnerable groups – such as homeless people, those in care homes and children with learning disabilities – who may have complex needs and difficulty accessing the services within the community.
As such, the PDS is often seen as a "safety net". But continued funding cuts – including a 5.5% reduction from Scottish Government last year, and an additional 2.5% cut in some NHS Boards, a decreasing workforce, and the lack of a coherent national plan – are causing serious concerns about the future of the PDS in Scotland.
There is currently a lack of PDS dentists to meet an unprecedented high demand for unscheduled care at weekends, elderly patients, and patients in nursing homes. Health Boards are using short-term and fixed-term contracts to employ PDS dentists rather than commit resources to any longer-term investment in the service.
To aggravate this situation, health boards are not replacing PDS posts on a 'like-for-like' basis, and boards have been reducing the number of posts due to the transfer of GDS patients to independent General Dental Practitioner (GDP) clinics.
As a result, there has been an overall a reduction of 16.3% in PDS posts between 2013/14 and 2017/18 – or one in six – with the largest decrease (6.1%) between 2016/17 to 2017/18.
This continued reduction in PDS dentists will inevitably have major impacts on patient care, including fewer patient appointments and longer waiting times to see a dentist, and more travel time for patients to access PDS services.
In addition to continued reductions in workforce and funding, the PDS has concerns about the proposal in the Scottish Government's Oral Health Improvement Plan to allow 'accredited' GDPs to provide care for people in care homes. This role is currently filled by PDS dentists – and it is unclear what role the service will play in the future.
This is a crucial time for the PDS in Scotland, both for dentists and the patients we care for. Funding has not been ring-fenced and continues to be cut.
The Scottish Government and Health Boards need to ensure that this essential service is appropriately resourced to provide effective dental care to the most vulnerable members in our society.
Graham Smith, Chair
Scottish Public Dental Service Committee
BDA Scotland supports, represents and promotes, the interests of all dentists working in Scotland. Working with elected committee members, we negotiate on behalf of the profession on terms and conditions, and pay and contracts. Join us.