Will new reforms ease England’s dental care crisis?

Teeth have become Britain’s “biggest class divide”, said The Independent. With patients regularly “denied NHS appointments even in emergencies”, dental care has become “about hierarchy, not health”.

The government is hoping to change that, with newly announced reforms to NHS England dentistry that, it claims, will be “the most significant modernisation of the NHS dental contract in years”.

The reforms “will prioritise patients with most urgent dental needs and those requiring complex treatments” by changing the way NHS dentists are paid. Under the current payment scheme, complex dental care is “typically under-remunerated or even delivered at a loss”, according to the British Dental Association.

The changes mean patients with complex dental problems will be able to “book a package of treatment”, rather than having to arrange multiple appointments, and this could save them up to £225, said Lizzy Buchan in The Mirror. This is a “victory” after a “decade of Tory austerity” that left “people desperately struggling to get care”.

If the changes mean “fewer people” are “left to suffer with complex problems”, that would be a “big gain”, said The Guardian’s editorial board. But “it should not be mistaken“ for “a solution” to all the issues with dental care in England.

Before 2006, people had “the right to register with a dentist”, like you would with a GP, and the dentist would then receive “a payment for each patient on their list”. Then the NHS dental contract was changed, and dentists were paid instead per “unit of dental activity”. It wasn’t long before problems with this system emerged, “in particular the lack of access to dentists for poor people in poor places”. Labour’s reforms are “a big tweak” but they are “still a tweak and not the overhaul” of the fee structure “that most experts agree is needed”.

The new plan is a “welcome shift in direction”, said England’s former chief dental officer Sara Hurley on NHS Voices. But “it is important to be clear” that “this is not a new model of care, and it brings no new investment”.

What next? 

The reforms will be introduced in April, and Health Minister Stephen Kinnock said they mark “the first step towards a new era for NHS dentistry after a decade of decline”. A new dental contract is promised by the end of this Parliament, although it’s not clear if that will include the restoration of the right to register.

Dentists “broadly welcome” these new reforms, said Neil Carmichael, chair of the Association of Dental Groups. But it is essential that “necessary steps” are taken to “shore up the NHS England dental workforce” which is “currently short by over 2,500 dentists”.