NHS is ‘disincentivising’ dentists from taking on new patients, MPs told

The NHS is “disincentivising” dentists from taking on new patients, an industry body has warned, amid concerns patients are increasingly turning to “DIY teeth extractions”.

England is witnessing the “slow end of [NHS] dentistry as we know it”, MPs were told at a meeting of the Health and Social Care Committee on Tuesday.

Shawn Charlwood, chairman of the British Dental Association (BDA) General Practice Committee, said dental colleagues feel “chewed up and spat out” by a “failed NHS system”.

There must be “urgent” reform of the NHS dental contract which “disincentivises” dentists from taking on new, and often the most in-need, patients, he warned.

The current system works by paying NHS dentists by units of dental activity (UDA), which place the same value on performing one filing as doing ten, according to the BDA.

‘No more funding’

“A dentist will be paid the same for 10 fillings as they would for one, they would be paid the same for three extractions as they would for one extraction because those particular treatments fall into a certain band… and the band determines what you’ll be paid,” Mr Charlwood said.

“The imported implications of that are that new patients are disincentivised from joining a practice because they’ll have higher levels of disease… Whereas patients that have been seen regularly are more likely to have been managed and their clinical health will be more stable.

“The UDA system doesn’t allow dentists to deliver prevention, it pays for targets rather than patient care, it’s easy for the Treasury to measure, it confines the budget, it doesn’t allow new practices to open, it doesn’t allow successful practices to expand their patient list.

“And, most importantly, it disincentivises NHS dentists from seeing new patients, because once they’ve reached their allocation of UDAs for the year there is no more funding.”

‘Something out of Victoriana’

Asked by Jeremy Hunt, the committee chair and former health secretary, if we’re seeing a “rationing by the backdoor” of NHS dentistry as a result of the current system, Mr Charlwood said, “yes, I am saying that”.

When asked where patients are turning to if they’re unable to get NHS care, Mr Charlwood said: “In some areas we have… NHS dental deserts, there is no NHS dental provision… There are some patients that are accessing private dental care when they can afford it.

“There are some patients who are not accessing any care and we’ve had increasing stories of DIY dentistry, which is completely inappropriate and it’s something out of Victoriana, frankly. People extracting their own teeth and filling their own teeth, it’s patently not acceptable and not appropriate.”  

The warning comes after a BDA poll found nearly half of dentists intend to go private which could leave millions of patients unable to secure NHS dental care.

NHS England was approached for comment. 

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