Written evidence submitted by The Royal College of Surgeons Edinburgh (DTY0049)

Response Proforma

The Health and Social Care Committee has launched an inquiry into dentistry following a survey that showed 90% of practices across the UK were not accepting new adult NHS patients.

MPs will consider to what extent the current NHS dental contract disincentivises dentists from taking on new patients. They will look at what incentives can be offered by the NHS to recruit and retain dental professionals, also explore the role of training.

They will also explore the possible impact of changes to be introduced next April to make new Integrate Care Systems and Integrated Care Boards responsible for the provision of dental services.    

More information can be found at NHS dentistry - Committees - UK Parliament



Please provide your answers to the following questions in the boxes below.



  1. What steps should the Government and NHS England take to improve access to NHS dental services? 


DHSC and NHSE should engage positively with General Dental Practitioners to be able to deliver a safe, effective and affordable NHS dental service. There should be consultation with the BDA and relevant Royal Colleges to understand the obstacles and ultimately further investment in dentistry will be required.

This is a very complex issue and there will be no simple solutions – there are huge changes in healthcare provision and its delivery since COVID and there needs to be a change in emphasis to prevention rather than repair to manage the change in dental health needs in the 21st century.

With resources tight and demand high there needs to be additional resource ploughed into education, rather than reallocation of funds from the frontline. There needs to be a wholesale culture change at all levels, including government, so that education is seen as core business rather than an add-on that is done when there is time to do it.


  1. What role should ICSs play in improving dental services in their local area? 

The role of ICS’s in bringing partner organisations together should be supported and they should be simplified. This means they should be minimally bureaucratic and become enabling organisations to provide the funding that dentists require to deliver NHS dental care.

Whilst different areas will have different needs there should be a core set of themes that are consistent for all ICS’s and areas. These should not however be overwhelming.

We await the recommendations of the Hewitt Review into this with interest.


  1. How should inequalities in accessing NHS dental services be addressed? 

The social gradient and inequalities are increasing due to the failure of the UK government to address the fundamental financial crisis affecting NHS dentistry.

The options are either to provide a much reduced list of treatments, only those which are necessary to secure oral health which are free at the point of delivery or to reform the current disastrous quota system with adequate funding. Contracting has not been a successful model.

In addition to better funding across the board, there needs to be incentives in place to encourage practitioners to set up in areas with low levels of service.



  1. Does the NHS dental contract need further reform? 

Yes. It requires far greater involvement from dentists, and needs to be adequately resourced.


  1. What incentives should be offered by the NHS to recruit and retain dental professionals, and what is the role of training in this context? 

Incentives need to include a combination of financial, life style and job security factors.

AN adequate skills escalator for dentists and Dental Care Practitioners (DCPs) should be outlined, in conjunction with the relevant Royal Colleges to deliver the range of training and skills that the dental industry requires. Different levels of training and broader skill mixes should be available to DCPs.

The concept of an apprenticeship for dentists is viewed with scepticism and we are concerned that it has the potential to lead to a two-tiered system of dental training.

Jan 2023