What do people want from NHS dentistry?
To inform future government action on dentistry, Healthwatch England have carried out their first-ever research on people’s understanding of NHS dentistry and what they want from the service.
A poll was carried out in September, revealing that most people in England have misconceptions about their 'right' to an NHS dentist and want changes to how they access dentistry.
Key findings
- Over two-thirds, 68%, of respondents mistakenly believe they have the right to register with an NHS dentist as they do with an NHS GP.
- When asked about their preference for getting NHS dental care, over half, 54% of 1,791 respondents said they want to be able to register with an NHS dentist as a permanent patient in the same way as they can with an NHS GP.
About NHS dental contract
People lost their right to register with an NHS dentist in 2006 when a new NHS dental contract was introduced to pay dentists per 'unit of dental activity' rather than getting paid per person registered on a list of permanent patients, combined with set fees for each treatment delivered.
The contract is unpopular with dentists, with many cutting back NHS work and leaving people without NHS appointments, often with little warning.
Last year, Healthwatch England supported the call by MPs on the Health and Social Care Committee to reintroduce permanent registration rights for patients.
Do you have a 'right' to register with an NHS dentist?
In September, we asked 1,791 adults whether they thought the following statement was true or false: 'I have the right to register with an NHS dentist and be taken on as a permanent patient in the same way as I do with an NHS GP.'
- More than two-thirds (68%) said they believed it was true;
- 16% said it was false;
- and 16% answered 'don't know'.
This statement is false because people do not have a right to be registered with a dentist as a permanent patient due to the 2006 NHS dental contract.
Have you ever been told you were 'de-registered'?
Most dentists see a mix of private and NHS patients. NHS patients value the care they receive from individual dentists, with 82% of those who were seen in the past two years saying the dentist put them at ease and 85% feeling the dentist treated them with respect.
However, dentists feel the NHS dental contract doesn't cover the actual cost of the work involved, meaning that more are choosing to stop seeing NHS patients altogether. They aren't required to give patients who aren't currently in active treatment any warning about this change.
This has resulted in patients losing their continuity of care and facing the inconvenience of looking for an NHS dentist or the dilemma of going to a private dentist.
No appointment guarantees at your regular NHS dentist
Even dental practices that provide NHS work can't guarantee that patients who've had an appointment with them before will get one. We heard from people who had been removed as regular NHS patients from dental practices because they hadn't attended a check-up in the last two years.
There is no ambiguity for GP patients – they can only be deregistered if they choose to sign up for another surgery if their relationship with the surgery breaks down or if they move out of the practice's catchment area.
People want GP-style NHS dentistry
- Over half, 55%, want the ability to permanently register with a local NHS dentist as they do with a GP surgery.
- One-sixth, 16%, want to be able to register with an NHS dentist in the location that suits them best (e.g. near work).
- A very small number, three per cent, said they use or would prefer to use a private dentist in the future.
- While 27% said they 'want the flexibility to seek an appointment at any NHS dentist each time, including those outside their area'.
What is the government considering?
The government is developing a Dental Rescue Plan to deliver 700k extra urgent NHS dental appointments for patients in the short term. However, no details have yet been set on the rescue plan, the timetable, or the terms for a long-term reform.
The previous government tried to improve dental access by offering dentists a new incentive payment from March 2024 to encourage them to see people who hadn't had an NHS appointment in the past two years. However, the polls which we carried out in March and September, showed no increase in the percentage of adults who'd been able to see an NHS dentist during that time.
What are we calling for?
- NHS dentistry should be reformed to give everyone a GP-style right to be permanently registered with a dental practice to get both preventative and urgent care throughout their lifetime.
- The public should be consulted on any proposals being considered for long-term reform of NHS dentistry.
- The new patient payment introduced for dentists from March 1, 2024, should be evaluated and any findings published.
- Dental practices should clearly communicate to people what they need to do to be maintained as an NHS patient.
- Public awareness of how the NHS dental system works should be improved, to help people consider or plan for alternative sources of care if their practice chooses to stop providing NHS care.
