NHS reform 'left dentists behind'

By Nick Triggle
Health reporter, BBC News

A new contract for dentists was introduced in 2006

NHS dentistry has been left behind in the drive to improve the health service, dental leaders say.

The British Dental Association said while hospitals and GPs had largely solved access problems, the issue was still dogging dentistry in England.

A report by the union said there was so little information available on local people that they did not know who they needed to focus their efforts on.

NHS dentistry has been a long-running problem for the government.

Ministers sought to improve access by introducing a new contract in 2006 to entice more dentists into NHS work - unlike GPs they have significant portfolios of private patients.

We just do not know who wants to see a dentists and can't. Without this information we can't target people Professor Chris Drinkwater, report author

But it made little impact. In fact, in the two years immediately following the start of the new system 1m fewer patients saw an NHS dentist.

The government has already agreed to another reform of the system after commissioning a review of dentistry by independent experts.

Pilots will be starting soon looking at whether linking income to the number of patients registered with a practice will improve access.

But the BDA, while welcoming that move, said dentists needed more help in reaching out to their local populations.

Latest figures suggest about half of the population do not access NHS dentistry on a regular basis.

However, what is not known is whether these people are being treated privately or going without care completely.

Professor Chris Drinkwater, a Northumbria University health policy expert who was the lead author of the BDA's report, said dentistry was being "left behind" and was not being made a "high priority".

"We just do not know who wants to see a dentist but can't. Without this information dentists can't target people."

'Bridging the gap'

His report said local health managers held the key to bridging the gap by compiling data on who needed support accessing care and who was in the most desperate need because of the poor condition of their teeth.

This is done in GP care by carrying out surveys of patients and compiling detailed data on their health during checks-ups, a process which is underpinned by an integrated IT system.

Dr Susie Sanderson, chairman of the BDA's executive board, urged the government to take heed of the warning.

She said the BDA report should complement the changes that are going to be piloted.

"What's important now is that government, dentists and the commissioners of care work together constructively to improve the delivery of care to patients."

But a Department of Health spokesman said improvements were being made.

He said extra funds had already been invested in the service and pilots of the new system recommended by independent experts would begin in the spring.

He added: "The tide is turning and access to NHS dentistry has been increasing steadily over the past year."