The start of a trend back to NHS dental practice?
Promotional FeaturesPosted by: Dental Design 28th October 2024
In August this year, a surprising set of statistics was released by NHS Business Services Authority (NHSBSA).[i] Instead of confirming a continuation of the downward trend reported by Nuffield[ii] and others[iii] last year, the new figures indicate that in 2023-24, NHS dentistry in England experienced a small but significant rise on the previous year.
Although it may be too early to celebrate this, the increase in UDAs, and NHS courses of treatment (COTs), as well as an increase in dentists offering NHS treatment is interesting, and worth monitoring to consider the impact on the overall dental market.
The statistics
There were 24,300 dentists who performed NHS dental activity in 2023/24, a slight increase of 0.4% compared to 2022/23. This is 500 more than in 2021-22. With a possible caseload of 2000 per individual dentist, this small increase could represent potential dental care for 1million patients. With the addition of a further 400 dentists with NHS activity, numbers could equal those of 2019-20.
The story continues with 34 million NHS courses of treatment (COTs) delivered, representing a 4.3% increase in the previous year. COTs increased for both adult and child patients, by 2.2% to 23 million, and 9.0% to 11.2 million respectively.
Income from NHS treatment also increased last year. In 2023-24, the total patient revenue was £774 million, 2.7% more than in 2022-23. Although at 72 million, the total value of UDAs is still 9.1% lower than the 79.7 million total in 2019/20, the figure has increased by 3.4% since 2022/23.
Why this is surprising
2000 dentists left the NHS in 2021-22, potentially affecting 4 million patients.[iv] Filling this gap has not been an easy task, and there has followed a recruitment and retention crisis in many regions of the UK.[v]
Low morale, resulting in dentists choosing to leave NHS practice, was reported by the BDA[vi] as recently as June 2024. The report cited heavy workloads, rises in practice costs, continuing problems with recruitment and retention, and fear of complaints among the reasons dentists were choosing to leave.
So why are NHS numbers now increasing?
The dental profession – like many others – has begun to embrace different ways of working to make treatment more accessible. Improvements in communications through digital technology, as well as the introduction of telephone and online appointments have been shown to enhance patient engagement. Empowering multidisciplinary team members to deliver certain treatments has been identified as a factor in improving provision figures in the medical arena,[vii] and it may be that a similar strategy is already working to relieve pressure in NHS dental practices.
Encouraging though new increases in NHS dental treatment will be for many, numbers are not increasing equally across England, and seem to be dependent on the commissioning strategies in each region as well as other variables. The overall average percentage of adults accessing NHS dental care in England over the last two years was 40.3%, but this extended to 55.7% in the South Yorkshire Integrated Care Board (ICB), and was as low as 29% in Cambridgeshire and Peterborough ICB.
Children fared better across England, with an average of 55.4%, but had a similarly wide regional variance. 63.6% were seen by a dentist in South Yorkshire ICB, and in the lowest – this time Somerset ICB – 42.8% of children received NHS dental treatment.
What increased NHS dental activity means for the dental market
Exclusively NHS practices can be highly profitable, and achieve strong multiples in some regions of England. In fact, there is emerging evidence that the NHS contract can be a key driver for practice growth. Profitability trends between NHS and private practices already show similarities with the latest interim goodwill report produced by Dental Elite showing the average mixed practice sold to an Independent operator for nearly 100k more than other income compositions, and this could further change in favour of the NHS market as investment in services increases.
Fully private practices still achieve a higher gross income, but an increase in NHS activity could potentially affect figures.[viii] Some private practices are also reporting the slow appearance of more white space so it could be that mixed practices are now falling back more on NHS activity. Further still, changes in the recognition of UDAs may be making it easier than it was to achieve a higher volume of UDAs which may be inflating the appearance of volume of NHS delivered.
Dental Elite has been keeping a keen eye on market trends for 14 years, using the specialist team’s collective experience to directly benefit clients through its bespoke services. Whether you are looking to buy, sell or enhance your practice before going to market, Dental Elite’s team of experts will guide you every step of the way.
There is clearly much work to do to recover pre-pandemic levels of NHS dentistry – never mind returning to numbers reported in 2013. However, the latest statistics suggest that predictions of the total demise of NHS dentistry in England may yet be premature.
For more information on Dental Elite visit www.dentalelite.co.uk, email info@dentalelite.co.uk or call 01788 545 900
About the Author:
Luke Moore is one of the Founders and Directors of Dental Elite and has overseen well in excess of 750 practice sales and valuations. With over 19 years working in the dental industry, Luke has extensive knowledge in both dental practice transfers and recruitment and understands the complexities of NHS and Private practices.
References:
[i] Dental statistics – England 2023/24. NHSBSA August 2024. Available at: https://nhsbsa-opendata.s3.eu-west-2.amazonaws.com/dental/dental_narrative_2023_24_v001.html Accessed October 2024
[ii] Bold action or slow decay? Nuffield Trust. December 2023. Available at: https://www.nuffieldtrust.org.uk/sites/default/files/2024-01/Nuffield%20Trust%20-%20NHS%20dentistry%20policy%20briefing_WEB_Jan.pdf Accessed October 2024.
[iii] Evans D, Mills I, Burns L, Bryce M, Hanks S. The dental workforce recruitment and retention crisis in the UK. Br Dent J. 2023 Apr;234(8):573-577. doi: 10.1038/s41415-023-5737-5. Epub 2023 Apr 28. PMID: 37117357; PMCID: PMC10141865.
[iv] England’s Dental Deserts: The urgent need to “level up” access to dentistry. Association of Dental Groups. May 2022. Available at: https://www.theadg.co.uk/wp-content/uploads/2022/05/ADG-Report_The-urgent-need-to-level-up-access_April-2022_V3.pdf Accessed October 2024.
[v] Evans D, Mills I, Burns L, Bryce M, Hanks S. The dental workforce recruitment and retention crisis in the UK. Br Dent J. 2023 Apr;234(8):573-577. doi: 10.1038/s41415-023-5737-5. Epub 2023 Apr 28. PMID: 37117357; PMCID: PMC10141865.
[vi] https://www.bda.org/news-and-opinion/blog/supporting-you-during-declining-morale-in-dentistry/
[vii] https://www.rcgp.org.uk/representing-you/key-statistics-insights
[viii] https://dentalelite.co.uk/benchmarking-report/
