Written evidence submitted by Healthwatch Northumberland (DTY0021)
1.1. Healthwatch Northumberland is the local health and social care champion for Northumberland. We’re here to listen to the issues that really matter to people in Northumberland and to hear about their experiences of using local health and social care services.
1.2. As an independent statutory body, we have the power to make sure NHS leaders and other decision makers listen to local feedback and improve standards of care. We can also help Northumberland residents to find reliable and trustworthy information and advice.
1.3. Healthwatch Northumberland is part of a network of over 150 local Healthwatch across the country. Last year, the Healthwatch network helped nearly a million people to have their say and get the support they needed.
1.4. We are entirely independent and impartial, and anything residents share with us is confidential.
2.1. Northumberland is a large, predominantly rural county in the northeast England that borders Scotland and has an area of 5,013 km2.
2.2. It is sparsely populated with a population of 320,274 (census data 2021) with half the population living in the urbanised southeast of the county. The remaining 49% are scattered across the county although the most live in the towns of Hexham, Haltwhistle and Prudhoe in the west of the county; Morpeth and Ponteland in the middle of the county; and Berwick-upon-Tweed and Alnwick in the north of the county.
2.3. The population density is 64 people/km2, which is the lowest in England.
3.1. In March 2022 we published a report on the state of NHS Dentistry in Northumberland and people’s experiences of NHS dentistry between March 2020 and November 2021.
3.2. We found that there seemed to be great difficulty, with finding an NHS dentist as it seemed to be almost impossible to be ‘registered’ as a new patient.
3.3. It appeared that the dental practices were struggling to cope with their existing patients and had no further capacity to accept new patients, due to the constraints imposed by being Covid-safe and problems recruiting staff.
3.4. There also seemed to be some dissatisfaction with the dental contract.
3.5. Part of the research we did for this report was to approach dental practices in Northumberland. The feedback we received from dentists included these comments, “In Northumberland difficult to recruit new dentists due to rural area – [there’s a] shortage of practitioners - therefore difficult to cover the demand” and, “NHS dental contract needs reviewing as unattainable.”
4.1. Since then, despite the Covid restrictions having been eased, we have still been receiving regular complaints about accessing NHS dentists.
4.2. Between July and December 2022 20% of our feedback was complaints to do with accessing NHS dentists - second only to complaints about GP practices, who comprised 29% of our feedback.
4.3. The issues to do with accessing NHS dentistry are not being resolved and are likely to get worse in the foreseeable future.
5.1. The situation has been exacerbated by the closure in September 2022 of one the three remaining NHS Dentists’ practices in Berwick-upon-Tweed/Tweedmouth (population 13,170 – 2021 census) which served both the town itself and also the surrounding villages in North Northumberland.
5.2. This was a planned closure, with plenty of notice given to the patients on the practice’s books, but since July we have had a constant litany of complaints with the subject either being the most, or second most, frequently cited issue every month.
5.3. People of all age groups report that they cannot find an NHS dentist locally who will take them on with the few patients who have been successful in registering with another NHS dentist having to travel long distances to access treatment.
5.4. For example, we have heard of two Berwick upon Tweed residents successfully registering with a new NHS practice that had opened in Kelso, which is a 40-minute drive away or a 1-hour bus journey, and is in Scotland so under a different healthcare system.
5.5. Judging from the feedback we have received, most Berwick residents, however, have not been successful in finding another NHS practice who will take them on, and some have resorted to treating themselves.
5.6. In December we had feedback from member of the public who attended one of our engagement events in Berwick. They complained that there is no NHS dentist in the Berwick area after their dentist had closed. They have had to get private dental care for their 11-year-old son but recently had their own dental problem with tooth pain and a dental abscess. They popped this abscess themselves as they could not find a dentist to treat it on the NHS. They had called NHS 111 for emergency appointment, but NHS 111 said to call local dentists instead and could not access any help. They felt they had no choice but to treat themselves directly.
5.7. On 11 January 2023 we were notified that another NHS dentist in Berwick is planning on closing its practice, with effect from 31 January 2023.
5.8. The reason given for this closure in a letter by the practice to their patients is, “a result of difficulties experienced in recruiting dentists and ongoing running costs, which have prevented the practice from operating sustainably.”
5.9. This will leave no NHS dentists in Berwick itself, with the sole remaining NHS dentist in the immediate area being across the river in Tweedmouth.
5.10. The next nearest NHS dentist in Northumberland listed on the NHS ‘Find a Dentist’ website is in Alnwick, which is a 60-mile round trip from Berwick, but they are not currently accepting new NHS patients. The nearest NHS dentist in Northumberland which is currently accepting new NHS patients is in Bedlington, in the southeast of the county (a 110-mile round trip from Berwick-upon-Tweed).
6.1. Problems accessing NHS dental care aren’t just confined to the north of the county, in and around Berwick.
6.2. We have had many complaints of Northumberland residents struggling to access even basic check-ups with NHS dentists from across the county.
6.3. Complainants regularly noted that the practices they contacted were not able to offer NHS appointments but were able to offer private appointments at the practice. Unfortunately, a lot of complainants reported that they cannot afford to pay for private treatment and, consequently, question the dentists’ commitment to NHS’ ethos.
6.4. Even getting NHS appointments for children, who are supposed to be a priority, has been an issue. We heard from a resident in the middle of the county who had moved to Northumberland 15 months prior to contacting us and had had no success with finding an NHS dentist for their 4-year-old child.
6.5. One practice had even said to them that if the parent registered as a private patient with them then they would take the child on as an NHS patient.
7.1. We believe that these access problems are due to the dearth of NHS dentists in Northumberland who can take on new patients.
7.2. At best, between July and December 2022, there have been a maximum of three dental practices in the whole county who are accepting new NHS patients: one in Hexham (a 165-mile round trip from Berwick-upon-Tweed, cf para. 5.3 above) and another sister branch in Prudhoe (140-mile round trip from Berwick); and one in Bedlington, as previously mentioned in para. 5.10.
7.3. For a population spread over a large geographical area, this is inadequate and there needs to be a better provision of NHS dentists both in the number of practices and the geographical distribution.
7.4. Although there have been some changes to the NHS dental contract since the pandemic, which has improved the contract terms for dentists, the whole contract system needs a full review as it is still failing to entice enough dentists to set up as NHS providers in the county nor does it appear to cover running costs of existing NHS dental practices.