Plans to improve dentistry a 'complete failure' say MPs

The previous government’s efforts to improve access to NHS dentistry have been a 'complete failure', according to a damning report by MPs.

The Public Accounts Committee’s Fixing NHS Dentistry report, published on 4 April, warned that there is no future for NHS dentistry without action from government to go further in supporting the dental workforce.

The report finds that, at best, only around half of the English population could see an NHS dentist over a two-year period under current funding and contractual arrangements.

Just 40% of adults saw an NHS dentist in the two years to March 2024, compared to 49% in the two years pre-pandemic.

And the committee found that the Department for Health and Social Care (DHSC) and NHS England’s (NHSE) February 2024 dental recovery plan was not ambitious enough and has ’comprehensively failed’.

• The New Patient Premium (NPP), in which practices received credits for each eligible new patient they saw, costing at least £88m, actually resulted in 3% fewer new patients seeing a dentist

• Less than 20% of the expected 240 new dentists have been appointed under the “golden hello” recruitment scheme, which offered incentive payments of £20,000

• A plan for mobile dental vans to deliver treatment in targeted communities was dropped

• Uplift to the minimum value of contractually agreed dental activity to £28 failed to deliver any identifiable improvements.

The report found the current NHS dental contract is not fit for purpose.

Of the 34,520 dentists registered to provide dentistry in England in April 2023, only 24,193 these provided some NHS dental care in 2023-24.

And the committee predicted that, without proper remuneration, even more will move exclusively to the private sector.

While the new government has committed to fundamental reform of the dental contract, there were no details on when this will happen or what it will look like.

The committee is therefore calling on NHS England and the Government to clarify the actual cost of delivering NHS dentistry, and on the Government to work with the entire dental profession and wider stakeholders to design and deliver short and long-term changes to prevent further decline of the service.

Sir Geoffrey Clifton-Brown, chair of the committee, said: “It is utterly disgraceful that, in the 21st Century, some Britons have been forced to remove their own teeth.

 “Last year’s Dental Recovery Plan was supposed to address these problems, something our report has found it has signally failed to do.

“Almost unbelievably, the Government’s initiatives appear to have actually resulted in worsening the picture, with fewer new patients seen since the plan’s introduction.”

He added: “NHS dentistry is broken.

“The Government could hardly fail to agree on this point, and indeed I am glad that it is not in denial that the time for tinkering at the edges is over.

“It is time for big decisions.

“NHS England agreed that the current contract is not fit for purpose, and that it is time to rip up the aged contract through which dentists deliver their services, and start again.

“This was said over a month ago at the time of our public hearing, since when we have seen massive change, including the abolition of NHS England itself.

“This gives the Government the opportunity to completely reconfigure the way the NHS is run, so that more resources can be devoted to the local health boards who commission dentistry services.

“At the same time, a new contract should be negotiated with dentists so that all in this country will have proper access to a NHS dentist for the treatment they need.

“Parliament, the dental profession, and patients all now need to know, as a matter of urgency, what comes next.”

David Fothergill, chairman of the Local Government Association’s Community Wellbeing Board, said the Public Accounts Committee was correct to highlight the challenges around access to NHS dentistry.

“No local authority area in the country has more than one dentist per 1,000 of the population who provides NHS treatment, with rural and more deprived areas more likely to have shortages in NHS dentists than their counterparts,” he said.

“Communities face significant challenges with regard to NHS contractual arrangements and patient charges.

“There’s a significant call from across the political spectrum for a rapid and radical reform of NHS dentistry, the way it’s commissioned and provided.”

He added: “We will not solve problems of decayed, missing and filled teeth by only improving access to dental services.

“Improving oral health and reducing oral health inequalities requires community-based oral health promotion programmes and a more prevention-focused dental service.

“In the Spending Review, councils need a real terms increase in their Public Health Grant so they can provide vital oral health improvement programmes to prevent longer-term health problems.”