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Time to go further and faster to fix the dental patient access crisis in Wales

Blog Author Tom Bysouth

Blog Date 03/07/2019



Chances are, if you work in high street dentistry in Wales, you will have heard from us in the last few months. 

We contacted every practice across the country to get the facts on access – the results are painting a grim picture.

You told us what we have been suspecting for many years: Wales is facing a crisis when it comes to patients trying to get access to an NHS dentist. 

We’ve published detailed analysis of our findings in the British Dental Journal, based on 2017 figures. 

However ahead of publication we went out of our way to bring these figures bang up to date. 

The simple fact is in April 2019 only one in six practices in Wales were able to take on new adult patients.   

Some Health Boards have seen a significant deterioration in access since 2017. In Hywel Dda access for both children and adult NHS patients has fallen. 

No practices were capable of taking on new adults, and only one practice was taking on children. 

Practices accepting new adult NHS patients by Health Board, April 2019

While a quarter of practices in Wales have waiting lists, you also told us that maintaining them has become an exercise in futility.

In Hywel Dda one practice reported having 1,000 people on their list, another over 3,000. In Betsi Cadwalader, one practice reported that their waiting list has been in existence for five years at least, they are not adding new names to it as the would-be patients have "no chance" of getting an appointment. 

Nearly half (41%) of practices told us they are taking daily enquires from new patients. One practice in Cardiff and Vale reported receiving more than 60 calls a day. Another in Powys said that they get "endless calls daily". 

The problem, you are telling us, is that your NHS contracts are not sufficient for the population you are trying to serve. We have been telling this to commissioners for years, but it feels like now we really are at crisis point.  

One practice reported they’ve struggled to make appointments for any new residents from the 3,000 houses that have recently been built in the area. This is a failure in commissioning that just shouldn’t happen.

Readers should be in no doubt that BDA Wales supports the contract reform process. 

However, our message to the Welsh Government is they need to go further and faster. We need officials to admit there is a problem, rather than glossing over the facts or bending stats to fit a more positive ‘narrative’. 

The truth is, we’ve seen 0.4% reduction in courses of treatment in the last two years, and a reduction of 2.7% in total UDAs. These are figures that are clearly going in the wrong direction, in relation to demand. 

We’ve been highlighting these issues in the national press and we’re pleased that our comments on the need for Welsh Government and the local Health Boards to push on with contract reform have been aired.

We will continue to push them on this issue and we look forward to the Welsh Government’s response this month, to the Senedd’s Health Committees Report on their Inquiry into Dentistry.

We worked hard to get AMs to recognise the unsustainability of the current NHS contract system, and as their Chair Dai Lloyd said in his response to our figures, “…doing nothing is not an option”. 

We hear a lot about the need for prevention to ensure good oral health – but if we are serious about this, our patients cannot continue to be left without access to an NHS dentist. 

Tom Bysouth, Chair

Welsh General Dental Practice Committee