The British Dental Association (BDA) has warned the future of NHS dentistry in Scotland is in doubt, and action here must be high on the agenda for the next first minister.
A devastating new survey of dentists across Scotland reveals:
- Fifty-nine per cent of dentists say they have reduced the amount of NHS work they undertake since lockdown – by an average of over a fifth.
- Over four in five (83 per cent) now say they will reduce - or further reduce - their NHS commitment in the year ahead.
- Over a third (34 per cent) say they will change careers or seek early retirement.
- Just one in five (21 per cent) say their practices have returned to pre-covid capacity. Sixty-one per cent cite recruitment problems as an issue, and over two-thirds (67 per cent) cite treating patients with higher needs requiring more clinical time.
- Ninety per cent cite financial uncertainty as having a high impact on their morale.
Health secretary Humza Yousaf recently stressed that NHS staffing was “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 stress even this fall understates the full scale of losses in light of this new survey evidence. The Scottish Government has never attempted to make a ‘Whole Time Equivalent’ estimate of the NHS dental workforce. Most dentists combine NHS and private work, and the BDA warn 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 warns that any return to the service’s 'business as usual’ model – low margin and high volume – will put practices under huge financial pressure leading 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 this broken system move. The profession had anticipated the Scottish Government would reveal changes to the payment model on April 1, which would be rolled out in October.
The BDA stress that a sustainable model must be in place come October, when the current bridging payments that uplifted NHS fees finally lapse.
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 the 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.”