The government has announced contract changes for NHS dentists which it claims will incentivise practices to take on high need patients who require treatment the most.
However, dentists said the changes were minor tweaks tinkering at the margins and with no new funding all ministers had done was to “rearrange the deckchairs”.
The government said the three main changes would improve patient access to dental care. They are:
- Practices will now be legally compelled to update nhs.uk regularly with details on the availability of appointments,
- A higher reward for treating three or more teeth,
- A new payment rate for complex treatment.
Previously dentists received the same payments for all treatments delivered within band two, which includes fillings and tooth extractions, regardless of the amount of time taken to deliver the work. So, they would receive the same payment for one filling as three fillings.
Government conceded that this has meant dentists may not have been able to afford to take on patients who had not seen a dentist for an extended period who require more extensive treatment as a result.
Dental practices must regularly update information on the ‘Find a Dentist’ tool on the NHS website, ensuring it accurately reflects available services. This is aimed at helping patients locate practices taking on new patients and access the treatments they need quickly.
Government added it is also introducing legislation which will provide the General Dental Council (GDC) with greater flexibility to amend its international registration processes for overseas qualified dentists.
‘Tinkering at the margins’
However, the British Dental Association (BDA) warned the “minor tweaks” would do little to arrest the exodus of dentists from the service or address the crisis in patient access.
It disputed claims this represented a new contract when the package amounted to “tinkering at the margins of the failed target-based model and comes with no additional funding”.
The BDA added that despite the changes to payments for more complex treatment perversity will remain baked into the system, with less complex work still being rewarded at the same rate as treatments that can take hours.
And it added that the requirement to update nhs.uk would simply underline the paucity of patient access across England.
Shawn Charlwood, chairwoman of the BDA general dental practice committee said: “Minsters have done little more than rearrange the deckchairs.
“These minor tweaks will not end the access crisis or give demoralised dentists any reason to stay in the NHS.
“It’s one thing to offer a shiny new website showing patients they can’t get an appointment. It’s quite another to put in place reform and funding so millions can get the care they need.”
‘Will not solve problems overnight’
Health minster Neil O’Brien said: “I am determined to make sure everybody seeking NHS dental care can receive it when they need it.
“Our new contract rewards dentists more fairly for taking on high needs patients and delivering treatments to those who need it most.
“It will not solve all the problems overnight, but it will help improve access and ensure the system supports dentists and their teams.”
Louise Ansari, national director of Healthwatch England said: “Thousands of people have spoken up about their struggles accessing an NHS dentist over the last few years, telling us about dental practices in many regions either closing down or not accepting new NHS patients. This announcement shows the power of their voices, with government listening and taking action.
“The changes should help people find clear and up to date information on dentists taking on new NHS patients. While people with more complex dental problems will find it easier to access care because of the shift in how the NHS pays dentists.
“Ultimately, we hope these combined measures will help to reduce long waiting times, the extended periods of pain many people suffer and prevent the extreme cases of DIY dentistry we have seen.
“These changes are a good start and when put into practice can help ensure dental care that is accessible and affordable to everyone who needs it.”