Newly qualified dentists will be required to work in the NHS for a minimum period under new contract proposals from the Government.
The proposals, which have been unveiled as part of a consultation into dental contract reform, also include mandating a proportion of contract capacity to be directed to unscheduled care and incentivising children’s preventative dental care (see box for list).
Though the implementation of the proposals ‘may vary’, the Government added that its expectation was that this would be from April 2026.
Last week, the 10 year plan stated the Government’s ambition to introduce ‘tie-ins’ for dentists trained in the NHS as part of aims to improve access to dentistry. It also pledged to improve children’s oral health and make the dental contract ‘more attractive’.
Speaking at the Health and Social Care Committee (HSCC) session on dentistry yesterday (9 July), health minister Stephen Kinnock said: ‘We currently have about 36,000 dentists registered in this country, but only about 10,500 full time equivalent dentists doing NHS dentistry. That can’t be right, so we need to redress that.’
He added that it would not apply to current students and it would not mean 100% of a dentists’ work would be spent on NHS work. However, he said there was ‘time to establish’ how this would work.
He estimated it would be the graduates of 2030 who would be affected.
Mr Kinnock also committed to ‘clarity on what the financial envelope is for dentistry’ by the end of the summer ‘at the very latest’, and that a new dental contract would be ‘up and running’ by the end of the parliament.
Chair dental practice committee of the British Dental Association (BDA), Shiv Pabary, also speaking at the HSCC, said he welcomed the commitment to contract reform. But added: ‘We can’t wait for 10 years to do this.’
He added: ‘We’re seeing already an exodus of dentists leaving the NHS and once dentists leave the NHS they will not come back, so we will get to a tipping point,’ he said.
‘Even if we manage to get a reformed contract and that makes sense and works, it might be too late because we won’t have a workforce left.’
The Government launched a dental survey in May to assess the cost of running dental practices, ahead of contract reform.
It comes as one in eight dentists are approaching retirement age, which is creating a ‘ticking timebomb’, according to research earlier this month.
The Public Accounts Committee last month said there would be ‘no future’ for NHS dentistry unless the workforce was sufficiently supported to deliver NHS dental care.
Consultation proposals
The proposals we are consulting on are to:
- mandate a proportion of contract capacity to be directed to unscheduled care, supported by new payment arrangements and in line with a national service specification
- create new long-term and planned pathways with improved payments to support care and treatment for patients with significant dental decay and/or significant gum disease
- create a new course of treatment for the application of fluoride varnish on children, without a full dental check-up and which can be applied by extended duty dental nurses (EDDNs) between full check-ups
- incentivise greater use of resin-based fissure sealants in children’s permanent molar teeth by re-banding the treatment from band 1 to band 2 to reflect better the time and cost associated with this treatment
- introduce a new band 2 sub-band for denture modifications, relining and repairs
- options to support reducing clinically unnecessary check-ups
- introduce funded quality-improvement activities for practices
- provide practices with funding for annual appraisals for associate dentists, dental therapists and dental hygienists who provide clinical NHS care
- develop minimum terms of engagement set out in an NHS model contract for dental associates
- extend minimum requirements of NHS service for discretionary support payments to include all NHS service, not just time on the dental Performers List
- develop an NHS handbook for dental teams
Source: DHSC
