Majority of UK dental practices closed to new NHS patients

Percentages of dental practices with NHS contracts not accepting new patients, by UK nation

Of those closed to new adult patients, nearly one in five said the waiting time to join their patient list would be a year or longer.

READ MORE: What's happened to NHS dentistry? 

The findings follow warnings from the profession that providing NHS care is becoming unaffordable.

The vast majority of dental practices in Scotland are mixed, providing both NHS and private care.

The last official figures show that, as of February this year, the number of NHS dental treatments being carried out in Scotland remained 28% below pre-pandemic levels.

The number of NHS dental treatments - counted as the number of claims reimbursed per month - in February 2022 remained 28 per cent lower than February 2019, even counting treatments such as 'telephone triage' which were not on the list of NHS items dentists could claim for pre-Covid

In April, infection control measures were de-escalated in a bid to increase the number of patients being seen, with a temporary "multiplier" payment system seeing dentists reimbursed 170 pence for every £1 of NHS treatment claimed.

Interim statistics suggest that NHS dental activity doubled in April-June, compared to the first three months of the year.

However, the Scottish Government cut the multiplier to 130% in July, sparking criticism from the profession that increased costs of staffing, electricity, and materials would leave practices making a loss on NHS work.

The British Dental Association called for the 170% rate to remain while talks continue on a revised fee model, with warnings that struggling dentists will simply opt to retire, go fully private, or sell their practices.

David McColl, chair of the BDA's Scottish Dental Practice Committee, urged ministers to "bring forward the reforms and resources we need to deliver for patients across Scotland".

He added: “The Scottish Government promised free NHS dentistry for all, but the public are now living with the harsh reality. 

“You can’t run a health service on soundbites and slogans."

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It comes as figures show that dozens of dentists a year in Scotland are quitting the NHS early, amid calls for "urgent" pensions reforms to tackle the treatment backlog.

Figures obtained from the Scottish Public Pensions Authority (SPPA) by the Scottish LibDems show that only 14 of the 249 dentists who have retired in Scotland since 2015 waited until the state pension age to do so.

Separate data on family doctors shows that 127 out of the 136 GP retirements since 2015 were early retirements.

There are growing concerns about the ability of the NHS to clear waiting lists if too many senior clinicians abandon the health service.

The total number of high street NHS dentists in Scotland has fallen by over 5% since the onset of Covid.

Alex Cole-Hamilton, health spokesman and LibDem leader, said: “Dentists I speak to tell me that engaging with the Scottish Government over current funding levels is worse than pulling teeth.

"There is a real risk that we see the death of NHS dentistry in Scotland unless the Health Secretary is prepared to change course.

“These figures show that even before the present crisis, hundreds of experienced professionals were taking early retirement every year.

"A shortage of dentists creates stress for patients and increases the workload for those who remain."

READ MORE: Why doctors are angry at their 4.5 per cent 'pay rise' 

The figures also come after health leaders in England last week appealed to chancellor Nadhim Zahawi to make “urgent changes” to pension tax rules for clinicians, stressing that current arrangements are "preventing senior medical staff from carrying out the additional work that the NHS desperately needs them to undertake".

The rules, which are set by the Treasury and also apply to NHS Scotland's top earners, mean that senior doctors and dentists with pension pots worth over £1.07 million incur charges running into tens of thousands of pounds if their NHS income exceeds a yearly "allowance".

The problem is being worsened by inflation, due to the way the consumer price index is factored into pensions growth.

Clinicians can reduce their risk by cutting their hours or retiring early.

Figures published for England show a steady increase in the proportion of consultants, GPs and dentists who took voluntary early retirement. The figures were published by the Doctors' and Dentists' Pay Review Body, but no equivalent breakdown for the other UK nations was provided (Source: DDPRB)

A report in July by MPs on the Commons Select Committee called for “swift action” to remedy a “national scandal” of doctors reducing their hours to avoid pension tax bills at the same time as the NHS faces record waiting list backlogs and the "greatest workforce crisis" in its history.

A Scottish Government spokeswoman said: “We are continuing to provide additional funding to the dental sector and remain in a position of relative strength in terms of workforce numbers and capacity.

"There has been a 32% increase in the number of dentists providing NHS services in Scotland in the past 15 years, meaning we now have 54 NHS dentists per 100,000 of the population, compared with 42 per 100,000 in England.

“We have supported NHS dental teams with an additional £50 million of financial support (on top of their normal earnings before the pandemic) and £35 million of PPE.

"A new system of interim dental support payments was introduced in April to support dentists to see more patients and to avoid the cliff edge of financial uncertainty for the sector.

"We continue to engage with dentists to develop a future payment system that reflects the challenges of modern dentistry and ensures patients’ needs are at the heart of our NHS dental services.”