NHS dental recovery plan falling short of targets

Dental Tribune International

Wed. 4. December 2024

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LONDON, England: The National Audit Office (NAO) has reported significant shortcomings in the dental recovery plan launched by the National Health Service (NHS) in February to improve access to NHS dentistry in England and address the backlog of care. Despite a target of 1.5 million additional treatments delivered by March 2025, the plan is unlikely to achieve its goal. Even if it does, the total treatments delivered annually will be 2.6 million fewer than before the COVID pandemic. These findings underscore the systemic challenges that have contributed to the crisis in access to NHS dental care.

According to the NAO’s report, access to NHS dentistry remains below pre-pandemic levels. Only 40% of adults visited an NHS dentist in the 24 months leading up to March, compared with 49% in the same period before the COVID-19 pandemic. Additionally, there are 483 fewer dentists providing NHS care since 2019/2020, exacerbating the issue. Regional disparities also persist; for example, the number of treatments per 1,000 people ranged from 382 in the rural county of Somerset to 800 in the urban county of South Yorkshire in 2023/2024.

Progress on key initiatives has been uneven. Payments for units of dental activity were increased and a new patient premium was introduced, but other measures lagged. The golden hello incentive, aimed at attracting 240 dentists to underserved areas, exemplifies the slow progress. Although 274 practices have had their applications to appoint under this programme approved, delays have meant that the first appointment was not made until October, limiting the initiative’s impact on the plan’s treatment targets. An initiative to deploy mobile dental vans has stalled entirely, no vans having been procured and progress having halted since the general election was called. Local integrated care boards, who are responsible for planning health services for their populations, must now decide whether to continue this effort.

The NAO’s findings highlight broader systemic issues within NHS dentistry. The widely criticised NHS dental contract, seen as disincentivising NHS care, remains a key barrier. Overall spending on NHS England dentistry has dropped in real terms, from £3.7 billion (€4.1 billion^*) in 2019/2020 to £3.1 billion in 2023/2024, representing a per person decrease from £65.15 to £53.88. In 2023/2024, £392 million of the NHS England dental budget went unspent. Of the £200 million allocated for the recovery plan in 2024/2025, only £57 million had been used by August.

Commenting on the report in a press release, Dr Nigel Carter, OBE, CEO of the Oral Health Foundation, said: “The Department of Health and Social Care, along with NHS England, must be completely transparent about their true plans for NHS dentistry and the funding required to implement them. The public has a right to know what the government’s strategy is and how much money they are willing to invest to address this crisis. While there are potential solutions—including a new NHS dental contract focusing on prevention and capitation—no measures can hope to be effective without real, meaningful investment and clear, achievable targets.”

In the same vein, Sir Geoffrey Clifton-Brown, chair of the Committee of Public Accounts, which oversees government expenditure to ensure transparency and accountability, said in a statement: “The Department of Health and Social Care and NHS England must take stock of what works if they are to address the serious challenges facing NHS dentistry.”

Without meaningful reforms and greater investment, the NHS dental recovery plan is unlikely to achieve its goals, leaving millions of patients without adequate access to dental care.

The report can be found here.