England: Clawback set to break records pushing NHS practices to the wall
21 February 2023
NHS dentistry in England is now set for record clawback this financial year, that will inevitably push some practices to the brink.
Our analysis of Units of Dental Activity (UDA) delivery in the first 9 months of 2022/23 suggests there is no way for many practices to fill the gap by 1 April. Monthly UDA delivery has averaged little over three quarters of pre COVID levels up to January 2023, with no evidence of a sustained recovery.
Senior sources at NHS England have confirmed to the press that the service is heading for record 'underspends'. This means that during an historic access crisis hundreds of millions will be taken away from NHS dentistry. This does not reflect a lack of demand for care, but the reality of a recruitment crisis which is leaving practices unable to fulfil contractual commitments.
This is on track to translate into total losses of well over 10% of dentistry's £3 billion budget, potentially as high as £400m, given current trends. This money is not ringfenced, and the vast majority will end up plugging holes in other NHS England budget lines.
"Patients will struggle to comprehend why this Government is about to take hundreds of millions from the frontline during an access crisis" said BDA Chair Eddie Crouch. "It's not because there's any lack of demand for dentistry, it's simply that practices are working to a failed contract and can't fill vacancies."
"This will push dedicated NHS practices to the wall or to the private sector and leave whole communities with no options."
We know any progress requires reform and investment, but instead dentists are getting kicked while they're down. Under the current discredited contract NHS England is entitled to clawback money from practices delivering fewer than 96% of the contracted UDAs. Practices that are unlikely to meet targets are advised to put funds aside and contact Local Area Teams as soon as possible to discuss a repayment plan.
The Local Area Teams have a discretion, in exceptional circumstances, to allow practices to carry a shortfall in UDAs forward to the next year if a practice is confident it can demonstrate how it will make up that shortfall. Extra and Expert members can call our NHS and Business team for advice.
We continue to lobby for urgent substantive reform of the NHS dental contract and in-year support to ensure practitioners and patients get a fairer deal.