You have full access to this article via your institution. Download PDF The British Dental Association (BDA) has urged government to drop any pretence that NHS dentistry is on the road to

recovery and finally deliver a meaningful rescue package, as the exodus from the service reaches new heights. Freedom of information requests undertaken by the BDA indicate just 23,577

dentists performed NHS work in the 2022/23 financial year, down 695 on the previous year, and over 1,100 down on numbers pre-pandemic. The crash brings the workforce to levels not seen since

2012/13. These official figures are at odds with repeat claims from the Prime Minister that recent reforms have boosted dentist numbers, arguments also made by ministers and officials in

financial year reflect the success of recent government reforms. The minor tweaks to the discredited contract fuelling the current crisis were rolled out in October 2022, so do not even

correspond to the year the PM chose to cite. The BDA believes that any 'bounce' in 2021/22 likely reflects the unique circumstances from the first year of COVID in which practices

were closed from lockdown to June. The professional body stresses that recent commitments to develop a 'recovery plan' for dentistry were made by government based on false

assumptions that the workforce had 'turned a corner'. It says there can be no more tinkering at the margins, and real commitment is now required to form the basis of a rescue

package, simply to stabilise the service ahead of longer-term negotiations on wholesale reform. The BDA believes that the clearest way forward is to utilise record-breaking

'underspends' in the dental budget to bring a degree of sustainability to practices on the brink. The BDA estimated in February that funds returned by practices not hitting their

contractual targets would likely exceed £400 million this year, or over 10% of the total NHS budget. The BDA now believe this was a very conservative estimate. Practices face huge financial

penalties often as a result of being unable to fill vacancies. The BDA say a new higher minimum Unit of Dental Activity (UDA) value could bring all practices in line with areas with the

strongest access levels, give them the chance to fill vacancies, support retention and operate more sustainably in the face of soaring costs. The BDA stress any costs could be kept within

the anticipated levels of clawback for 2022/23. A minimum UDA level of £23 was rolled out in October, lower than the current patient charge level of £25.80, and below the level required for

most practices to cover their costs or attract new dentists. In August the PM pledged a Five-Point Plan for dentistry, including commitments to ring fence NHS dentistry funding. The

BDA's approach builds on this, and echoes observations made by Broadland's Jerome Mayhew MP, who in a recent debate urged members to 'follow the money', noting that the

best areas for access 'spend nearly £80 per month per year on dentistry; in the East of England, the figure is £39 - a full 50% less.' The BDA stress the fall in workforce numbers

significantly understates the full scale of lost capacity within NHS dentistry. The government counts heads not NHS commitment. A recent BDA survey of dentists in England revealed over half

of dentists (50.3%) had reduced the proportion of NHS work they did since the start of the pandemic - by more than a quarter. 74% indicated they plan to reduce - or further reduce - the

amount of NHS work they undertake in the year ahead. Shawn Charlwood, Chair of the BDA's General Dental Practice Committee said: 'Government needs to drop the spin, accept the

facts, and provide a rescue package to keep this service afloat. NHS dentistry is haemorrhaging talent, and further tweaks to a broken system will not stem the flow. 'The PM once called

for this budget to be ring fenced. We face an access crisis, and with hundreds of millions set to be pulled away, funds must be put to work solving these problems.' RIGHTS AND

PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Exodus from NHS dentistry reaches new heights. _Br Dent J_ 234, 855–856 (2023).

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