Written evidence submitted by the Dental Schools Council (RTR0030)


The Dental Schools Council is the authoritative voice of the dental schools within universities across the United Kingdom and Ireland. Its Chief Executive is Dr Katie Petty-Saphon.

  1. What are the main steps that must be taken to recruit the extra staff that are needed across the health and social care sectors in the short, medium and long-term?

Dentistry in the UK is in a precipitous state due to three interacting factors:

(1) The effect that Covid 19 has had on the provision of dentistry in the UK and access to NHS dental care. Prior to the Pandemic there was already a significant problem with access to NHS Dentistry – this has been further exacerbated over the past 22 months.

(2) The dual impact of Brexit and the fact there have been no allowances for delays in taking the General Dental Council’s Overseas Registration Examination during the Covid Pandemic has resulted in a drop in the number of overseas qualified dentists being able to join the UK dental register. This is now substantially impacting on access to NHS dental care for patients.

(3) Early retirements and drop in GDC registration. This year dentist registrations with the GDC fell by 961 registrants compared to last year. This is due to both the impact of the pandemic and the fact that dentists identify NHS dentistry’s working conditions as unsustainable. Compounding this are the limitations related to pension accrual and potentially punitive tax charges as a result.

To reverse the impact of these three factors and others, the Department of Health and Social Care must invest in and bolster the current training provision of dentists and the wider Dental Team in the UK. The 10% number cut in 2013 in England to dentists’ training numbers must be immediately reversed and further opportunities should be offered for the Dental Schools to expand their student numbers both nationally and internationally. The latter is possible by lifting the cap on international student numbers and is consistent with the Government’s expressed desires post-Brexit to create a global Britain and brand.

The HEE-provided NHS undergraduate tariff associated with Dental Therapy and Hygiene Training (currently) at NMET level is woefully inadequate and must be increased to parallel the Dental Undergraduate Tariff in dentistry. Without this increase, there will be little of the necessary diversification of the workforce as institutes simply cannot afford to increase training places for dental hygiene and therapy. This is due to the fact that there is an up to £30,000 deficit per capita for each dental therapy student trained when comparing the costs of their clinical education and the remuneration provided by HEE through undergraduate tariff.

  1. What is the best way to ensure that current plans for recruitment, training and retention are able to adapt as models for providing future care change?

DHSC must work together with the UK Dental Schools to optimise recruitment and training of the future team. All schools will be able to offer opportunities around this.

The training and funding of training for the Dental Team must be increased including:

Dental Nurses

Dental Hygienists

Dental Therapists

Clinical Dental Technicians

Orthodontic Therapists



  1. What is the correct balance between domestic and international recruitment of health and social care workers in the short, medium and long term?

Please see our response to question one. International recruitment has reached a crisis point through the pandemic following Brexit and the failure to run the Overseas Registration Examination for over 2 years.

  1. What can the Government do to make it easier for staff to be recruited from countries from which it is ethically acceptable to recruit, with trusted training programmes?

Work with the UK Dental Schools via Dental Schools’ Council to explore opportunities to be able to help with training and recruitment. This might involve being able to accredit more fully the prior learning of dental colleagues trained overseas.

  1. What changes could be made to the initial and ongoing training of staff in the health and social care sectors in order to help increase the number of staff working in these sectors? In particular:

Needs to increase the training numbers of dentists and all members of the Dental Team

  1. To what extent is there an adequate system for determining how many doctors, nurses and allied health professionals should be trained to meet long-term need?

All current markers point to a crisis in recruitment of Dentists and the Dental Team to the NHS. The Dental team must be optimised to allow delivery of NHS care by making the most of all the skills sets available within Dentistry.

The current and future model for the education, training and employment of the dental workforce is not clear. Over the past thirty years, there has been an emphasis on developing the role of the Dental Team particularly with the expansion of numbers of dental hygienists and therapists. However, there remain barriers to how fully these highly trained individuals are able to employ the full range of their skills in the workplace.

  1. Do the curriculums for training doctors, nurses, and allied health professionals need updating to ensure that staff have the right mix of skills?

Current UK Dental Schools have the capacity to train all that is required. Funding of Dental Hygiene, Dental Therapy, Clinical Dental Technicians and Orthodontic Therapists needs to be increased to make the training of these vital groups viable.

  1. Could the training period for doctors be reduced?

There are opportunities with Dental Apprenticeships to offer flexible training and also opportunities to offer accelerated opportunities for Dental Therapist and Dental Hygienists to upskill. These could be used to rapidly increase the provision in line with national oral health requirements.

  1. Should the cap on the number of medical places offered to international and domestic students be removed?

Yes, as long as they are appropriately funded – as the Dental Students will be treating NHS patients. The Dental Undergraduate Tariff is unique in that it includes service provision and care for NHS patients – but this is not explicitly renumerated.

  1. What are the principal factors driving staff to leave the health and social care sectors and what could be done to address them?

Poor NHS renumeration, poor working conditions and the continual ask for more for less. Staff should be paid appropriately for the work they do.

DHSC need to review the funding system for NHS Dentistry.

All Team members should be able to access the necessary systems, for example, under current NHS regulations Dental Therapists are unable to open or sign off a course of treatment.

  1. Are there specific roles, and/or geographical locations, where recruitment and retention are a particular problem and what could be done to address this?

There are recruitment problems throughout the UK. Issues are particularly prominent in rural and coastal communities.

DHSC needs to invest in current UK Dental Schools so they can increase their reach and training in underserved areas. DHSC should work with the current UK schools to allow them to expand and increase their reach.

  1. What should be in the next iteration of the NHS People Plan, and a people plan for the social care sector, to address the recruitment, training and retention of staff?

Review of current NHS Dentistry funding and structure.

  1. To what extent are the contractual and employment models used in the health and social care sectors fit for the purpose of attracting, training, and retaining the right numbers of staff with the right skills?

Current contractual and employment models used in the NHS for dentistry are not fit for purpose and these need urgent review and reform.

Funding levels for Dental Undergraduate Training are not appropriate and need to be reviewed and increased. This is true both for dental and dental therapy undergraduate tariff. Both tariffs are not fit for purpose and the recent review has not addressed this as there is a fixed quantum which hasn’t been adjusted for inflation in at least the last 7 years (since 2015).

  1. What is the role of integrated care systems in ensuring that local health and care organisations attract and retain staff with the right mix of skills?

Dentistry needs to feature higher up the agenda, or in some cases even on the agenda, for Integrated Care Systems. ICS’ need to properly consider the unique opportunities and challenges facing the dentistry sector to ensure that the Dental Team that we need for the future is appropriately developed and trained.




January 2022