Next First Minister ‘must halt exodus from NHS dentistry’

15 March, 2023 / editorial

The British Dental Association has warned that the future of NHS dentistry in Scotland is in doubt and that, for the next First Minister, “action here must be high on the agenda”. 

Its call comes as a new new survey of dentists across Scotland reveals:

  • 59 per cent have reduced the amount of NHS work they undertake since lockdown, by an average of over a fifth. The BDA said that this movement is going unseen in official data, which counts heads not commitment, and gives the same weight to a dentist doing a single NHS check-up a year as an NHS full timer. 
  • More than four in five (83 per cent) now say they will reduce – or further reduce – their NHS commitment in the year ahead.
  • More than a third (34 per cent) say they will change career or seek early retirement.
  • Just one in five (21 per cent) say their practices have returned to pre-COVID capacity; 61 per cent cite recruitment problems as an issue and more than two thirds (67 per cent) cite treating patients with higher needs requiring more clinical time.
  • 90 per cent cite financial uncertainty as having a high impact on their morale.

Humza Yousaf, the Health Secretary, has said that NHS staffing is at a “historically high level”, with “record” numbers of dental staff in hospitals alongside medics and allied health professionals.

However, NHS Education for Scotland data indicates an eight per cent drop in high street NHS dentists delivering care since lockdown; a fall from 3,038 in March 2020 to 2,791 in September 2022. The BDA said that, in light of the new survey, this fall understates the full scale of losses.

It said that the Scottish Government has not attempted to make a ‘Whole Time Equivalent’ estimate of the NHS dental workforce. Most dentists combine NHS and private work, and the BDA warned that without these estimates movement to the private sector is going undetected and workforce planning is effectively impossible.

NHS dental care free at the point of use remains a central Scottish Government policy. BDA Scotland has long warned that any return to the service’s ‘business as usual’ model – of low margin and high volume – will put practices under huge financial pressure and will likely lead to closures or movement to the private sector, with many practices left delivering some NHS care at a loss.

The SNP leadership election has seen key deadlines to reform the system move. The profession had anticipated the Government would reveal changes to the payment model on 1 April, that would be rolled out from October. The BDA stressed that a sustainable model must be in place come October, when the current bridging payments that uplifted NHS fees finally lapse, exposing many NHS practices to unsustainable costs.

David McColl, Chair of the British Dental Association’s Scottish Dental Practice Committee, said: “Behind hollow boasts on record workforce numbers is a service that is hollowing out.

“The majority of dentists have pared down their NHS work, and many more are set to follow. It’s an exodus that’s going untracked by government but is the inevitable result of working to a broken system.

“NHS dentistry’s survival requires rapid action, with meaningful reform and sustainable funding. 

“The steps taken in the next First Minister’s First Hundred Days will determine whether this service will have a future.”

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Scottish Dental magazine