Our CDS Vision

The nation’s ability to deliver dental treatment for some of the most vulnerable groups in our society is at risk. As the voice of dentists and dental students, we are calling on all parties to make sure community dentistry is finally given the priority it deserves.

With an ageing population and a dramatic increase in those with long-term chronic conditions, a higher number of children with special needs, and high levels of decay in children, we are seeing an ever-increasing level of demand from patients whose conditions require treatment by dentists working in the Community Dental Services (CDS). This has been exacerbated further by increases in demand associated with the wider decline in overall NHS dental spend, the impact of the access crisis and spillover of demand from General Dental Services (GDS).

The vision below is a ‘call to action’ from community dentists themselves on how to end a crisis that has gone under the radar of decision makers for far too long. We believe that those who run the service are best equipped to set out a credible and realistic vision for its future.

Some of the actions that the Government, NHS England, and all parties involved with community dentistry must deliver are:

Immediate actions

1. Deliver rapid waiting list transparency on access to CDS services

CDS waiting list data must be published in the same format as other NHS services, providing information on:

• How referrals are received and triaged across CDS dentistry.

• Data collection arrangements around waiting lists and substantive plans to address the backlogs.

2. Commission additional activity

• Commissioners must commission additional CDS activity to allow for the waiting lists to be managed down and for access to routine services to be restored to pre-pandemic levels.

• Commissioning related services in the local area must be undertaken in a holistic and integrated way, making best use of the new ICB commissioning structures.

3. Provide accurate and comprehensive workforce data on CDS dentists and dental teams

• Detailed data on FTE CDS workforce numbers and the numbers within the wider CDS dental team must be provided and made available in the public domain.

• Decision making for workforce planning must be transparent, and all workforce planners and employers must work to an agreed national strategy to ensure that CDS dentists are in the right setting, with the right skills and at the right time for their patients.

Long-term actions

4. Tackle the relentless workload on CDS

• CDS dentists must be given sufficient time and funding to support active prevention work.

• A new culture of not expecting CDS staff to work beyond their contracted hours must be adopted.

• A comprehensive review of case load for CDS dentists must be undertaken to improve understanding of how this is evolving, and to ensure that these are clinically manageable for CDS staff to deliver safely.

5. Improve pay and conditions to make the CDS an attractive career destination

• Acknowledge the real-terms cuts to pay for CDS dentists and remedy the salary levels for all posts to ensure employers can recruit and retain CDS dentists at all stages of their careers.

• Those in leadership positions nationally and locally overseeing the CDS must renew their commitment to staff development, training, and governance/academic opportunities.

6. Clearly define the CDS and strengthen its links with the wider NHS system

• The CDS must be properly defined as a primary care dental service under a national service specification that sees patients initially on referral, ensures that domiciliary care needs are met, and also maintains services for its continuing care patients.

• CDS dentists must be granted universal access to summary care records and electronic prescribing so they can view medical histories, medications and safeguarding alerts which is critical for the safety and best outcomes for the patients being treated.

• There must be a coherent system in place that allows CDS teams to access GP and other health records within secondary care to enhance the continuity of care for patients. This can be effectively addressed by providing access to suitable NHS IT software.

Pledge your support to our CDS vision 

Together we are stronger: Help us make the case for community dentistry to be given the priority it deserves by spreading the word about our vision for the CDS in England below and pledging your support across your social platform of choice using #CDSVision.

Why are we asking for this?

CDS dentists, and their teams, provide vital dental care for paediatric and special care dental patients as well as patients with acute long-term conditions. They provide a highly skilled, specialised type of NHS care to a very specific cohort of patients, with many of these having high treatment needs. This requires the care provided to be carefully adapted and tailored to the patient's needs and is distinct from a routine dental appointment on the high street.

CDS dentists work within a referral-only service designed to support individuals who cannot be treated within the GDS. Many of the patients referred to and treated within the CDS are from disadvantaged groups and a high percentage also have high treatment needs. Some of those in this group will have learning disabilities, mental health issues or severe anxiety. They may be in situations or locations that traditional dental services cannot reach such as homelessness centres,  prisons, or care homes.

Despite these circumstances, the number of CDS dentists working within the service has been declining for many years, their workload has grown exponentially without any effective limits being put in place and some of the most vulnerable members of our society are waiting for years to access treatment. Our BDA Accredited Representatives (ARs) have a critical role in alerting us to issues affecting this group, and they have told us that frontline community dentists are saying loud and clear that ‘enough is enough’. Many now are directly expressing anger, depression, withdrawal and hopelessness regarding the situation.

Therefore, urgent action is now needed to ensure community dentists are supported effectively so their patients can readily access excellent quality care.

We have initiated a series of discussions with key stakeholders to ensure that they understand the many challenges facing this service. Our vision provides a strong foundation for tangible progress to be made in delivering the necessary changes that will ensure that community dentistry is secure and fit for the future.

Find out more and get involved

Interested in learning more about our CDS vision and how we work to make it a reality?

Please contact Stuart Abrahams, Senior Policy Adviser for Employed Dentists: [email protected]