The British Dental Association (BDA) has told the Department of Health and Social Care and all devolved administrations that a package of capital funding now offers the only hope of restoring routine services to millions of patients, as a new survey indicates a service in crisis is incapable of delivering investment to meet new rules that could boost access.
In an open letter to Health Secretary Matt Hancock, and raised with each devolved government, the BDA said it has set out the case for urgent support. According to survey data from practices across the United Kingdom:
- 70% of practices are now operating at least than half their pre-pandemic capacity, with 63% reporting less focus on routine dentistry, as urgent and emergency cases receive needed priority.
- The number one barrier to increasing capacity is fallow time, or the time gap mandated between procedures to minimize risks of viral transmission, with 88% of practices reporting it as a major obstacle.
- Personal protective equipment (PPE) availability, formerly the key challenge, is now cited by 36% as supplies have improved.
- Financial and cashflow problems are cited by 62% of practices, and patients’ unwillingness to make appointments was cited by 43%.
- While new regulations may enable practices to slash their fallow time, 57% now lack the funds to invest in the new equipment required to do so. Industry sources estimate costs for mechanical ventilation for meeting required levels of air change at £10,000 for a typical practice. Also, 52% of practices lack data on air change levels to even establish their compliance with new rules.
- Currently, 55% or practices estimate they are able to maintain their financial sustainability for 12 months or less.
Between the March lockdown and September in England, more than 14.5 million fewer treatments were delivered compared to the same period last year. The BDA now estimates that number to have reached 19 million.
With practices remaining open during the current lockdown, dentists have stressed the focus remains on managing an unprecedented backlog of current cases, often limiting scope for essential routine dentistry, particularly in National Health Service (NHS) care, the BDA said.
The BDA has warned of widening inequality, as patients face poorer outcomes given the huge barriers to early detection of conditions from decay and gum disease through to oral cancer.
It has been more than a decade since dentists in England have received any capital investment from the central government, said the BDA, which has estimated that the government would rapidly recoup costs through increased patient contributions as a result of rising patient volumes.
Since the lockdown, the Treasury has lost nearly £400 million from the patient contributions that are increasingly relied upon to fund NHS services in England, with around £50 million in revenues now being lost per month.
“COVID restrictions have left dentists firefighting with huge backlogs, unable to see more than a fraction of our former patient numbers, especially in the NHS,” said BDA chair Eddie Crouch.
“We now face a Catch-22. New rules could bring back a dose of normality, but come with a multi-million pound bill for new kit that practices simply cannot afford,” he said.
“On paper, we have a chance to restore services to millions, but without support from government, it won’t translate into better access,” Crouch said.
“The clock is ticking on an oral health time bomb, as dentists lose the chance to act on the early signs of decay and oral cancer,” he said.
“Ministers have a choice. Make an investment that would pay for itself and bring millions back through our doors, or leave patients waiting for the care they need,” he said.