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What does the future hold?

The main question I get asked by colleagues in my role as a LDC director is, “What does the future hold for NHS dentistry?”

Speaking to colleagues in the profession, there seems to be a general feeling that currently NHS dentistry is on a downward spiral.

Workforce challenges and a poorly designed dental contract have been a source of frustration for the profession with many dentists choosing to leave the NHS workforce entirely.

With a general election due in July and potentially a new government in place, the future remains uncertain.

There is a backdrop of economic uncertainty which will hamper any incoming government’s ability to carry out drastic contract reform or to sufficiently fund an improved dental service that is fit for purpose in 2024.

So, how to answer the question? What does the future hold?

Let’s look at the numbers.

The current UK population is around 67.85 million people1. There are currently 44,209 dentists registered with the GDC2.

A simple calculation would tell you that’s approximately 1,535 people per dentist. Now on the face of it, a single dentist could easily look after a patient population of 1,535 in a year.

Let’s assume each dentist works 5 days a week and takes off 4 weeks a year for holiday. That is 240 working days.

To look after a list of 1,535 patients a year, each dentist would have to see 12-13 patients a day assuming each patient attends twice a year. This is a manageable number.

The NHS currently spends £2.9 billion on NHS dentistry3. Divide this by the population, this is approximately £43 per person.

Now the calculations above take a very simplistic approach to the dental service but the numbers would suggest the workforce is there but the funding per patient is clearly not enough.

So what’s the answer? Train more dentists? The NHS long term workforce plan aims to increase the dental intake from 809 to 1,100 by 2031/324.

This still does not address the funding per patient, £43 a head barely covers the cost of an average appointment with a dental hygienist. It is also unlikely that there will be a significant cash increase to the dental budget.

How about skill mix to make use of the many excellent dental hygienists and therapists out there as championed by the previous Chief Dental Officer Sara Hurley.

This is one option being looked at by NHS England with barriers to this provision being addressed. Flexible commissioning is another option being looked at by ICBs.

The truth, however, is that there is no simple answer.

It is, however, the job of the LDC to engage with all stakeholders to represent the view of primary care dentistry to make sure whatever the future holds for NHS dentistry, you will have a voice. 

  1.,of%20the%20population%20is%20male. ↩︎
  2. This is the total number of dentists on the GDC register, but does not mean that these are all general dental practitioners, active or indeed even in the country. ↩︎
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