Better access to NHS dental services under new reforms

New reforms to the dental contract – the first in 16 years – mean NHS dentists will be paid more for treating more complex cases, such as people who need three fillings or more.

Dental therapists will also be able to accept patients for NHS treatments, providing fillings, sealants, preventative care for adults and children, which will free up dentists’ time for urgent and complex cases.

To make services more accessible for people, dentists must update the NHS website and directory of services so patients can easily find the availability of dentists in their local area.

High-performing dental practices will have the opportunity to increase their activity by a further 10% and to see as many patients as possible.

In March last year, the Government asked NHS England to lead on the next stage of dental system reform to deliver better outcomes for patients and better support dentists.

The new reforms will ensure that dentists, who are operating at full capacity for the first time in two years, will be able to recover dental services following the impact of the pandemic.

Chief Dental Officer for England Sara Hurley said: “The NHS is determined to overhaul dental provision, with a focus on increasing access to necessary dental care and supporting prevention, today’s reforms are the first step on that journey.

“NHS dental staff are working hard to recover services, but the key to delivering this will be reform – these changes announced today will help teams carry out even more treatments and help address the inevitable backlogs that have built up during the pandemic.

“Anyone with concerns about their dental health should contact their local dentist as they usually would or seek advice from NHS 111.”

“Infection prevention and control measures to protect staff and patients were introduced during the pandemic, limiting the number of procedures that NHS dentists could carry out.”

NICE guidance states that dental teams should see patients for an oral check-up based on their health risk which can be once every two years instead of every six months – this will ensure appointments are given to those most in need.

Health and Social Care Secretary Steve Barclay said: “Improving patient access to NHS dental care is a priority and these changes are an important step, while also rewarding dentists more fairly for providing more complex care, allowing the best performing practices to see more patients and making better use of the range of professionals working in the sector such as nurses, hygienists, and dental therapists.

“The NHS commits around £3 billion to dentistry each year and we provided unprecedented support, including £1.7 billion, during the pandemic to protect teams and patients by paying dental practices for the work they would normally have carried out if it were not for Covid regulations.”

The NHS published six aims of dental system reform which have been endorsed by the British Dental Association and the NHS continues to work with the sector to reform NHS dentistry.

NHS England will now move towards the next phase of engagement to introduce wider reforms that benefit patients and staff.

Chris McCann, Director of Communications, Campaigns and Insight at Healthwatch England, said: “This announcement shows the power of the voices of thousands of patients who have spoken up in the last few years about their need to see an NHS dentist. The NHS is listening and taking action. The changes will make it is easier for people to see which dentists are taking on new NHS patients. Those with more complex dental problems should also have better access to care because of the shift in how the NHS pays dentists. Ultimately we hope these combined measures will end long waiting times, the extended periods of pain many people suffer, and the extreme cases of DIY dentistry we have seen. However, these reforms need to be just the start if we are to create an NHS that is able to deliver good dental care for all.”

Jennifer Owen, NHS practice principal in Gateshead and Chair of the Gateshead & South Tyneside Local Dental Committee, said: “I think these changes are a positive step in the right direction. The increase in UDAs for band 2 treatments will help dentists dedicate more time to those who need it most and lifting the cap on performance will mean that NHS practices can increase capacity and allow more NHS patients to be seen”

Abhi Pal, President of the College of General Dentistry, said: “While the NHS dental contract in England needs fundamental reform, we welcome these significant improvements. In particular, the removal of unnecessary restrictions on the roles played by members of the wider dental team, the direction of more resource to the treatment of patients with greater needs, and the potential for practices to deliver additional care so that all funding allocated to dentistry is used for its intended purpose.”

Piers Stennett-Howard, frontline NHS dentist in East Anglia, said: “When I heard the news about the contract reform, I wanted to punch the air with the sense of victory for hard working dentists treating high needs patients. Finally, some action which acknowledges and remunerates the time and skill of the dentist. By utilising dental therapists it should enable practices to clear the backlog of work. These reforms should be seen as a new lease of life for NHS dentistry.”

Debbie Hemington, President of The British Association of Dental Therapists said: “The British Association of Dental Therapists are pleased that the full skill set of DCPs has been acknowledged and welcomes these initial reforms to the NHS dental contract, and we particularly look forward in working with NHS England to clarify how skill mix and direct access in NHS practice can be utilised”.

Ravi Singh, NHS dental practice owner in Greater Manchester, said: “It is good to see the NHS valuing clinical engagement and dealing with the real issues in dentistry. These changes recognise the call for a payment system which reflects the needs of the patient and the time taken to provide the appropriate level of care. The barrier of therapists being unable to open an NHS course of treatment has also been resolved leading to a greater application of the theory of skill mix and practices have a new opportunity to grow”.

Neil Carmichael, Executive Chair of the Association of Dental Groups said: “We welcome these proposals as a first step on the road to NHS dental contract reform and clearing the backlog of care. The removal of administrative barriers preventing dental therapists from operating within their full scope of practice should be welcomed as full use of the whole dental team has an important part to play in widening access and retention of staff”.

British Association of Dental Nurses (BADN) President-elect Debra Worthington said: “BADN – the professional association for dental nurses in the UK – support this reform and look forward to working with the Office of the Chief Dental Officer in developing it further; in particular in promoting the effective use of dental team skill mix to ultimately improve oral health outcomes. BADN wholeheartedly support the effective utilisation of dental nurses in the clinical environment, using skills achieved by further education leading to post-registration qualifications, thereby expanding the role of the dental nurse and ultimately improving the patient experience.”

Diane Rochford, President of the British Society of Dental Hygiene and Therapy (BSDHT) said: “I welcome the initial phase of changes to the contract for general dental services in England. The focus on access to care for patients and the implementation of the wider dental team providing care within their full scope of practice is essential to assist in reducing oral health inequalities. BSDHT look forward to the next phase work for dental contract reform.”