Plan to boost NHS dentistry has ‘resulted in worsening the picture’, say MPs

Measures introduced last year with the aim of boosting access to NHS dentists appear to have “resulted in worsening the picture”, MPs have said.

The Dental Recovery Plan has “comprehensively failed”, according to the Public Accounts Committee (PAC), amid warnings that vulnerable patients “continue to suffer the most”.

A new PAC report also says the dental contract “remains unfit for purpose”, with current arrangements only sufficient for about half of England’s population to see an NHS dentist over a two-year period.

The blueprint to bolster NHS dentistry was unveiled in February 2024, with a pledge that it would fund more than 1.5 million additional NHS treatments or 2.5 million appointments.

This included a new patient premium (NPP), with practices receiving credits for each eligible new patient they saw, a “golden hello” recruitment scheme which introduced ?20,000 incentive payments for dentists, and mobile dental vans targeting communities.

But the PAC found the NPP – which has cost at least ?88 million since it was introduced last March – has resulted in 3% fewer new patients seeing an NHS dentist.

The “golden hello” scheme had appointed fewer than 20% of the expected 240 dentists by February 2025, the report added, while mobile dental vans had since been dropped.

PAC chairman Sir Geoffrey Clifton-Brown said: “This country is now years deep in an avalanche of harrowing stories of the impact of dentistry’s system failure.

“It is utterly disgraceful that, in the 21st century, some Britons have been forced to remove their own teeth.

“Last year’s Dental Recovery Plan was supposed to address these problems, something our report has found it has signally failed to do.

“Almost unbelievably, the Government’s initiatives appear to have actually resulted in worsening the picture, with fewer new patients seen since the plan’s introduction.”

The report claims that current funding and contractual arrangements would only cover about half of England’s population to see an NHS dentist over a two-year period “at best”.

It added that just 40% of adults saw an NHS dentist in the two years to March 2024 compared with 49% in the two years before the Covid-19 pandemic.

There was also a “discrepancy” between what a dentist could earn doing NHS work and private work, which the PAC described as a “fundamental issue for improving access”.

According to the report, there were 34,520 dentists registered to provide services in England in April 2023, with 24,193 delivering some NHS care in 2023/24.

The PAC warned that without proper remuneration, more dentists would move exclusively to the private sector.

The report said “it does not appear” that NHS England or the Department of Health and Social Care “have a sense of what level of funding would provide a realistic incentive for dentists to prioritise NHS work”.

Sir Geoffrey added: “NHS dentistry is broken. The Government could hardly fail to agree on this point, and indeed I am glad that it is not in denial that the time for tinkering at the edges is over.

“It is time for big decisions.”

He also said the abolition of NHS England, which was announced by Prime Minister Sir Keir Starmer last month, gives the Government an opportunity to “completely reconfigure” how the health service is run.

“In particular, so that more resources can be devoted to the local health boards who commission dentistry services,” Sir Geoffrey said.

“At the same time, a new contract should be negotiated with dentists so that all in this country will have proper access to an NHS dentist for the treatment they need.”

The PAC report comes after the British Social Attitudes (BSA) survey, published by the Nuffield Trust and the King’s Fund, found satisfaction with NHS dentistry “has continued to collapse”.

Levels are at a record low of 20%, compared with 60% in the pre-pandemic year of 2019, while dissatisfaction levels (55%) are at a record high.

Responding to the PAC report, Nuffield Trust chief executive Thea Stein said: “We warned more than a year ago that NHS dentistry in England had fallen apart as a universal service, and small tweaks could not bring it back.

“This report today from the PAC confirms the worst, with little to show or even steps backwards.”

Shiv Pabary, chair of the British Dental Association’s general dental practice committee, added: “MPs have arrived at an inescapable conclusion, that tweaks at the margins have not and will not save NHS dentistry.

“We’ve never budged from our view that governments past and present have needed to go further and faster.

“We’re ready to roll up our sleeves and start on the fundamental reform required to give this service a future.”

A Department of Health and Social Care spokesperson said the Labour Government “inherited a broken NHS dental sector” and was fixing it through its Plan for Change.

It said that in February, it had delivered on its manifesto pledge by rolling out 700,000 extra urgent appointments and pledged to introduce a new supervised toothbrushing scheme for three to five-year-olds.