After many years of being promised reform of NHS Dentistry it appears that the government are finally timetabling some changes.
Last week MP Maria Caulfield announced in the House of Commons that change is expected before the summer parliament recess. However, the BDA have since suggested that any changes are expected to be modest marginal fixes.
Our dental team at Brabners are seeing a significant shift from NHS dentistry from our clients. They are literally handing back what were once seen as valuable contracts. The reality is that with increasing staff and material costs, and the current high level of patient demand (meaning greater opportunity to shift patients to a private scheme) it is for many making good business sense to move the entire business to a private model.
Whilst some still see a future with the NHS, it is becoming increasingly difficult to recruit associates into the environment which focuses on endless UDA targets. Further, the margins within a business offering NHS services are not allowing practices to pay what is a higher market rate for nurses. Whilst a practice owner may wish to continue to provide the services, if they are unable to staff their practices at the rates offered and under the conditions necessary for NHS dentistry then they may be left with little choice.
Recent reform in Wales earlier this year came quickly and suddenly (after many years of promises). Practices were given extraordinarily short timescales to consider whether to accept the new contract, certainly insufficient timescales to properly consider the financial consequences for individual businesses.
A promise in June of reform before the summer in England would indicate that English NHS dentists will also face limited time to fully digest the changes before they apply.
It also seems likely that change will focus on access for the lower income spectrum of a patient base. The cost of living crisis is a political hot potato and government will be keen to show that they are taking action to support those financially struggling. Where a practice in an affluent area hands back an NHS contract it may be that this action is welcomed to re-divert funding to poorer communities to increase pay rates for dentists in those areas. It seems unlikely that dentistry will be offered additional ‘new money’ so a levelling up is perhaps desirable.
The BDA’s comments that they expect the changes to be marginal would suggest that it is unlikely that there will be a full shift to capitation dentistry. Many will be disappointed with this, particularly after the extensive trials in various pilots across the UK.
Whatever is changed, it would be helpful for practices to know what is coming, and be given the time to plan their resources appropriately.
