The Department of Health and Social Care and Minister of State for Care Stephen Kinnock MP have revealed a set of reforms for NHS dentistry that it is hoped will provide a major boost for millions of NHS dental patients. The changes are designed to enable patients to access urgent care more efficiently.
What is described as an overhaul of NHS dentistry will see patients with most urgent dental needs and those requiring complex treatments prioritised. There are also new incentives for those under the NHS dental contract to offer longer-term treatments for major issues, such as gum disease and tooth decay, through the NHS.
The government states that deep-rooted reforms are fundamental to its wider rescue plan for dentistry, including the rolling out of urgent and emergency care appointments, supervised toothbrushing for 3-to-5-year-olds, and water fluoridation schemes to reduce decay.
Minister for Care Stephen Kinnock said: “We inherited a broken NHS dental system and have worked at pace to start fixing it – rolling out urgent and emergency appointments and bringing in supervised toothbrushing for young children in the most deprived areas. Now we are tackling the deep-rooted problems so patients can have faith in NHS dentistry – these changes will make it easier for anyone with urgent dental needs to get NHS treatment, preventing painful conditions from spiralling into avoidable hospital admissions.
“This is about putting patients first and supporting those with the greatest need, while backing our NHS dentists, making the contract more attractive, and giving them the resources to deliver more. This marks the first step towards a new era for NHS dentistry after a decade of decline, one that delivers for patients and our dedicated dental professionals.”
Jason Wong, Chief Dental Officer for England, said: “Dentists have been working tirelessly to care for patients, and I want to thank them for their dedication. We listened closely to the profession, and these reforms are centred on improving patients’ experience, from getting urgent care more easily to supporting longer-term and preventative treatment, especially for children.
“By recognising the work of the wide range of professionals in dental teams and making better use of their skills, the NHS can help ensure patients see clear benefits from the changes being made.”
The government will proceed with what is being hailed as ‘the most significant modernisation of the NHS dental contract in years’, following a consultation with the sector and the public. A government response to the NHS dentistry contract: quality and payment reforms consultation has also been published.
Additionally, to help boost for children’s dental health, dental nurses are to be encouraged to apply fluoride varnish to children’s teeth. Dental staff will also reportedly receive a fairer payment for applying fissure sealants to protect children’s teeth from decay as NHS dentistry shifts towards prevention first and foremost.
Dr Oosh Devalia, President, British Society of Paediatric Dentistry (BSPD), said: “BSPD welcomes today’s announcement on NHS dental contract reform as a positive step and we look forward to seeing what this means for children and young people. Having a contract with prevention at its heart must be the way forward, and the recommendations we submitted during the consultation period are focused on ensuring that the children most in need are prioritised to receive the dental services they deserve.
“A prevention approach will have the biggest impact when it is designed to target the most vulnerable children in our communities. As ever, BSPD looks forward to working with policymakers to establish the details to ensure that the dental contract really delivers for children.”
To improve staff retention, NHS dental teams will receive more support through annual reviews, and learning and development opportunities, in addition to government funding to support sick leave and guidance on NHS contractual terms and benefits.
Neil Carmichael, Executive Chair, Association of Dental Groups (ADG),commented: “We broadly welcome the dental contract reforms and look forward to receiving more details as soon as possible in the new year so that practices have the time and ability to prepare to implement these changes. The ADG was part of the consultation process and it is good to see that steps are being taken to address the underpayment of more complex care, as well as support urgent care.
“A continuing priority for our members, however, is ensuring that the necessary steps are being taken to shore up the NHS England dental workforce, which we know is short by over 2,500 dentists. Embracing the whole dental workforce is crucial, so to see in the plan further encouragement of the team, including dental nurses to take on treatments, with fairer recompense, is a positive move.”
Dental sector and industry responds
Dr Nigel Carter OBE, Chief Executive of the Oral Health Foundation, said: “The proposed reforms acknowledge some of the pressures within NHS dentistry, particularly for patients with complex needs, but they stop short of the fundamental change the system requires. Adjusting contractual mechanisms may improve continuity of care for a small cohort of patients, but it does not resolve the structural problems that limit access or drive dentists away from NHS provision. Without sustained investment in prevention, early intervention and population-level public health measures, demand will continue to exceed capacity. A model that remains weighted towards managing disease rather than preventing it risks perpetuating the very pressures these reforms are meant to address.”
Dr Kate Fabrikant, Medical Director, Northern Europe for Haleon, commented: “Improving access to emergency and complex dental care is a welcome and needed step forward. There is more work to be done in coming months to address structural challenges in NHS dentistry. Too many children and adults are still missing out on routine care. The result is a system that is still more focussed on treatment rather than prevention. A sustained shift towards prevention, routine access and early intervention is essential if we are to reduce inequalities and improve long-term oral health outcomes.”
Matthew Nolan, Chief Dental Officer at Denplan, welcomed the announcement as a meaningful step in the right direction, highlighting that it is easier for patients in severe pain to access urgent appointments is important, “It is encouraging to see the Government recognise the financial pressure practices are under when providing NHS care, especially for more complex cases. But we mustn’t lose sight of the role of prevention within oral healthcare. We know, from listening to our members delivering both NHS and private care, and to the patients they support, that while urgent care is often the most visible pressure point, the long-term impact comes from missed routine care. Oral health in England will see the improvements needed when patients can access the everyday support that prevents emergencies in the first place; regular check-ups, early intervention and strong preventive care.
“While the Government’s focus on supervised toothbrushing and expanded use of the wider dental team to deliver fluoride varnishes and fissure sealant, is a helpful starting point, the future of dentistry will only be possible when urgent care and preventative care are equally balanced., Our Future of Dentistry white paper highlights, the next phase of reform must recognise that most practices deliver both NHS and private care, and that flexible commissioning and funding models will be essential to supporting the full range of care patients depend on. We look forward to continuing to work with the Government as this next stage of reform takes shape.”
The British Dental Association (BDA) has stated its hope that ‘interim changes to the discredited NHS dental contract will offer a boost for patients and practitioners’ but stressed ‘this is not the wholesale change required to save the struggling service’.
Shiv Pabary, Chair of the British Dental Association’s General Dental Practice Committee, said: “These are the biggest tweaks this failed contract has seen in its history. We do hope changes can make things easier for practices and patients in the interim, but this cannot be the end of road. We need a response proportionate to the challenges we face, to give NHS dentistry a sustainable future.”
