The future of NHS dentistry: Our comprehensive plan
Dire need for change requires concrete reform. Here is what needs to happen in contracts, funding and workforce support to secure the future of NHS dentistry and equitable access.
The NHS is developing a new 10 Year Plan, with a focus on moving from treatment to prevention, secondary care to primary care, and from analogue to digital. Dentistry is uniquely well-placed to contribute to and benefit from this transformation. We have set out to government how we think dentistry needs to change to the benefit of dentists and your patients.
1. Dental contract reform
The not fit-for-purpose Units of Dental Activity (UDA) system needs replacement, incentivising holistic patient care and prioritising preventive services.
2. Funding
A long-term funding settlement, ringfenced for dentistry, that keeps pace with rising demand. In addition to this, above-inflation pay uplifts to reverse the 40% real-terms income decline since 2010.
3. Recovery and support
Immediate support to retain NHS dentists, including increasing the minimum UDA value to £35 and continuing to uplift it until contract reform is delivered. Extending and enhancing the New Patient Premium to further incentivise NHS commitment.
4. Workforce retention
The exodus of dentists from the NHS must be addressed with targeted measures to retain dentists. Schemes that reward higher NHS commitment, support early-career dentists, and encourage late-career professionals to delay retirement are crucial.
5. Sustainable workforce expansion
Government must ensure that expansion of the dental workforce, as set out in the Long Term Workforce Plan, is done in a way that is achievable, especially in terms of funding. This includes the expansion of academic staff, allocating appropriate funding for Dental Foundation Training, and post-graduate training and development that address workforce shortages, like in the Community Dental Service (CDS). In addition, we must address the issues in the dental technician workforce, and expand the number of dental nurses. There remain questions as to whether the modelling underpinning the planned expansion in dental student places is robust and accurate.
Read about NHS England's Long Term Workforce Plan.
6. Care for the most vulnerable
Urgent action to end the year-long waits for dental treatment in hospitals for children and adults with special needs, plus adequate resourcing for the CDS to address these backlogs. Additionally, dedicated and properly funded provision to improve access for vulnerable groups, such as care home residents and people experiencing homelessness.
Read about our vision for the CDS.
7. A long-term vision for NHS dentistry
A clear plan from the Government with defined goals and secured fair funding that ensures the profession feels valued with a sense of collective purpose. This vision should take account of the mixed private-NHS economy and prioritise prevention, equitable access, and sustainable service delivery.
8. Consistent framework for clinical leadership
Government must strengthen Dental Public Health (DPH) capacity and ensure that Integrated Care Boards have strategic input on commissioning from qualified dental and clinical leaders. National leadership must provide overarching guidance to align local actions with the broader goals of NHS dentistry. We must address a shrinking DPH workforce, an insufficient number of trainees to replenish the outflow from the specialty, and limitations in training capacity due to existing workforce numbers. If we are to ensure that the Government receives the expert, impartial advice needed to improve oral health and reduce health inequalities, it is vital that we lobby for the expansion, development, and safeguarding of this specialist workforce.
9. A national children’s prevention programme
Most dental disease is preventable, so comprehensive action is needed on prevention. A national children’s prevention programme is essential for reducing oral health inequalities and preventing dental disease. Key components should include supervised toothbrushing in schools and early years settings, as well as targeted fluoride varnish applications. Such measures lay the foundation for lifelong oral health and reduce the risk of more severe conditions developing
10. Tackle the high-sugar food environment
Take on the high-sugar food environment with an expanded Soft Drinks Industry Levy to incentivise reformulation, warning labels on products with high sugar content, stricter marketing rules, and mandatory guidelines for sugar content in baby food. This can significantly reduce dental disease, but also obesity and diabetes.
11. Digital transformation and integration
NHS primary care dental services should have universal access to patient summary care records and e-prescribing capabilities, functions which are vital for improving efficiency and paramount to ensuring patient safety.
Dentistry needs investments in next-generation dental technology, such as digital scanning and 3D printing, will enhance efficiency and cost-effectiveness.
12. Reform of the General Dental Council
The GDC must uphold its duty to protect the public fairly and proportionately. Reforms are needed to ensure the regulator operates effectively, efficiently and commands the confidence of both patients and registrants. Legislative change is also required to allow the GDC to modernise and develop a more upstream, less confrontational approach in pursuing its key objectives.
13. Amalgam and restorative materials
As amalgam is phased down, government needs to revise the national plan, with prevention at its core. Ongoing amalgam supplies must be available for dentists, and government must invent in researching clinically effective and cost-efficient alternative restorative materials.
14. Antimicrobial resistance
Appropriate dental prescribing to address antimicrobial resistance is critical, as highlighted in the UK’s National Action Plan, and during the pandemic.
15. An environmentally sustainable NHS dental service
There needs to be planning for how NHS dentistry can become environmentally sustainable, as part of the wider NHS efforts to reach net zero. Fundamentally, preventing dental disease must be the focus of any such effort.