People all across the country are venting increasing frustration about access to and the quality of NHS dentistry services. We have highlighted issues with people being able to access NHS dentists, and the story has been covered by the Daily Mail, ITV News and the Telegraph.
Our research found that in some areas just 1 in 5 surgeries accepting new NHS patients. There are reports of patients being deregistered / struck off books without notice and emerging concerns of dentists providing poorer quality services on the NHS and insisting on private treatments.
Recent reports received from local Healthwatch including those in Kirklees, Bolton and Leicester have highlighted a variety of concerns:
- People are having to travel further afield to find an NHS dentist, with one surgery near Plymouth in Devon saying they were accepting new NHS patients who were calling for appointments from 40 odd miles away in Mid-Cornwall.
- People being struck off registers for missing check-ups even when there are extenuating circumstances, including one incident of a patient having to miss an appointment to care for her husband whilst he received treatment for cancer.
- Emerging concerns that dentists are performing more basic treatments on the NHS like tooth extractions rather than fillings, and in some cases forcing patients to have private appointments with a dental hygienist in order to stay on their books.
But by far the most common problem is finding a surgery willing to take on new NHS patients in the first place.
According to the NHS Choices website, which holds important signposting information for NHS services in England, just under half of the country’s 8,000 dentist surgeries are currently registering / willing to take on new NHS patients.
Yet a spot check of 300 surgeries conducted by Healthwatch England showed that in some areas the numbers are as low as 1 in 5, with Yorkshire and Humberside the worst affected region.
Under the existing system each surgery manages their own details on the NHS Choices website, but in every single region we found examples of dentists failing to do so. This is resulting in understandable frustrations for new patients trying to access services.
Currently there is no contractual obligation or regulation requiring surgeries to keep their NHS Choices details up-to-date, but Healthwatch is calling on NHS England and the Department of Health to address this and other concerns raised by local Healthwatch in the review of the Dentist Contract expected next year.
Anna Bradley, Chair of Healthwatch England, said:
“We hear a lot in the news about people struggling to access their GPs but it would seem getting an appointment with an NHS dentist is even more frustrating!
“Patients are constantly being fed confusing and inaccurate information about who is and isn’t currently offering NHS treatment, and are feeling like they have to opt for costly private treatments such as hygienist appointments so that they don’t get struck off the books.
“It’s simply not acceptable and such basic consumer concerns must be addressed when the Dentist Contract comes up for renewal next year.”
Statement from NHS Choices:
"NHS Choices provides every NHS dentist with the opportunity to tell local people about their services, including an indication of whether they are currently accepting NHS patients for new courses of treatment. Whenever we hear from the public or bodies such as Healthwatch England that information is not up to date for a particular practice, we contact the practice. This is our opportunity to help and encourage them to provide accurate information.
Each dentist’s page on NHS Choices has a facility for the public to alert us if they see a problem with the information we have published. This is a very valuable in helping us fix any problems. We urge both the public and Healthwatch England to provide us with detail of any errors via the website or by emailing firstname.lastname@example.org."
Healthwatch case studies
Significant numbers of patients are struggling to find an NHS dentist for routine NHS treatment, but are consistently being given misleading information about the availability of NHS dentists by local services and NHS Choices, leaving them confused and frustrated.
Fundamentally though, the current NHS dental contract in Kirklees is too inflexible, and is largely based on historical demand not an objective assessment of need. This is causing particular issues around need for dentures and the ageing population.
One patient said:
“I’m a 65 year old pensioner, I called up my dentist for new dentures. I was told that that I was “no longer on our computer”. They advised me to call them every month to check if they were taking NHS patients, but they were only taking on private patients. In the end I had to go private and pay £760 for new dentures and I am on pension credits. It’s degrading ringing up lots of people, I shouldn’t have to jump through hoops to get new dentures”
“I have been looking for a dentist for over 3 months and have still not found one. I have rung the dentist but they keep advising me to call back after 2 weeks. I am now in extreme pain. I have contacted all local dentists but they are all saying that they will only take on private patients. I don't want to be going to A&E but the problem is getting worse, if I had been seen 3 months ago then I might not be in the pain that I am in today.”
According to the General Dental Council, NHS England, Local Commissioners and NHS Choices people do not need to be 'registered' with a dentist and can access dental services from any NHS dental provider. However the myth of registration continues in both the minds of patients and practice managers.
For example Healthwatch Bolton has collected evidence that those who miss an appointment are being struck off dentists’ registers. Whilst it is recognised that missing appointments causes delays and additional costs, there are occasionally times in our lives when it is unavoidable but such individual circumstances are not being taken in to account. For example:
- Ms S was experiencing domestic violence when she missed a dental appointment. She visited her dental practice with relevant police protection documents as evidence of her reasons for missing the appointment. The dental practice told Ms S ‘sorry, that’s not a valid reason.’
- Mrs X missed a dental appointment while her husband was in hospital receiving cancer treatment. She was subsequently deregistered.
In June this year, Healthwatch Leicester conducted a survey and found that just 18 of the 58 dentist surgeries across the city were currently accepting new NHS patients, leaving some areas of the city without any provision what so ever.
When they raised this issue locally, the NHS England Local Area Team responded by saying that access wasn’t an issue but that people may have to travel further to access services. This sadly ignores the barriers to access that will be experienced by those reliant on public transport in particular.
It also overlooks the fact that one particular practice in the city recently told the local Healthwatch that it was not taking on any new NHS patients as they had no funding. When asked why not, they said that the funding they did have was concentrated on existing patients. Local Healthwatch raised this with NHS England Local Area Team who advised that all practices say they have no funding when they are not taking on new patients. This causes huge frustration to those looking to register for NHS treatment and also to existing patients who are waiting for further treatment.