What are the solutions to the NHS access crisis?
Featured Products Promotional FeaturesPosted by: Dental Design 21st September 2023
NHS dentistry, and the profession as a whole, has been under significant pressure for much time now. It is more important than ever that we work together, and with technology, to find solutions.
We must consider how to improve access to patients for routine and urgent care. A new approach is also needed to combat the cost-of-living crisis in order to further reduce the burden on patients. If they can see the dental team faster and access preventive care or advice, they will avoid needing more invasive and expensive treatments later down the line.
The British Dental Association (BDA) analysed data[i] published by the NHS which indicates that “more than 6 million adults tried and failed to book a dental appointment in the last 2 years”. Additionally, it is estimated that upwards of 1.1 million adults are deterred by the cost of treatment, with an estimated 600,000 people on waiting lists.[ii] While there are a wide range of causes for problems with access, it is important that we prioritise efficiency and improved care to help resolve the situation.
How is the profession reacting?
The Health and Social Care Committee recently published a report[iii] outlining the current situation with regards to the NHS dental access crisis. The report stated that “NHS dentistry is facing a crisis of access, resulting in a decline in oral health” and urged the UK government to carry out fundamental reform to ensure patients can access the care they need. The Committee recommended that this reform should include a “move away from the current system of Units of Dental Activity (UDAs)” in favour of “financial incentives for seeing new patients and those with greater dental need”. Further to this, the report advised risk-based recall periods of up to 24 months, rather than the standard 6 months.
The BDA has issued a response, outlining the key proposals which came from the Committee’s findings, these being: ‘Reform’, which must be delivered urgently in the NHS; ‘Prevention’, recommending a system which rewards dentists for maintaining and improving patients’ oral health, with a focus on long-term preventive care; ‘Funding’, in which they support the permanent ring fencing of the dental budget; ‘Integrated Care Systems’, which would require dentistry to have a voice. The BDA urges the government to implement a recovery plan for NHS dentistry urgently to minimise the impact on patients and dentists.[iv]
Whilst change is needed to improve the current situation, some people are not convinced by the above-mentioned recommendations. The relationship between NHS and private dentistry can be complex, with many dentists working in mixed practices. To fully rectify the issues faced by the profession, it’s important for governing bodies to understand these intricacies, as well as the impacts that providing urgent treatment more regularly may have on dentists. This includes the potential for a heightened risk of litigation – which could be exacerbated with the introduction of 24-month recall periods.
Easing the strain on dentistry
In response to the high demand, the General Dental Council (GDC) has increased the capacity for the Overseas Registration Exam (ORE) this year from 200 to 600 places. This will provide more opportunity for overseas dentists (who qualified outside of the UK or the EU) who wish to join the GDC register and practice in the UK to apply, ultimately designed to ease the strain on UK dentistry going forward.[v]
With the government yet to announce details of a recovery plan for NHS dentistry, it is worth considering developments which may be able to give the entire profession a boost. With dental technology constantly evolving across all areas of the profession, could new technology and artificial intelligence (AI) present opportunities for improved efficiency, as well as increased treatment acceptance and patient satisfaction?
Could technology present a long-term solution?
While hi-tech solutions are not currently accessible for every type of dental practice, the benefits of AI for enhancing efficiency in practice is undeniable, and this is already being implemented in a number of areas. This technology is still relatively new, and so isn’t always the perfect solution. However, in the years to come, it is likely to provide an opportunity for all dental settings to work more efficiently.
The only questions are: how much will it impact dentistry? And how soon could it start making a substantial difference?
AI is already being used by some across a number of areas. In diagnosis and treatment planning for example, AI algorithms can analyse patients’ records to assist the clinicians in making a more accurate diagnosis, without the need for extensive administration. This is applied to image analysis too, with AI analysing x-rays and CT/CBCT scans to more quickly and efficiently identify any abnormalities, supporting dentists by offering assistance in making informed treatment decisions.[vi]
Final thoughts
Whilst there are a number of complex factors affecting access to dentistry, be it NHS, private, or mixed, it is clear that reform is needed. This being said, it is important that change is managed effectively, minimising any further risks to patients, as well as dentists. Increasing the number of overseas dentists joining the UK dental service is a potential positive change, of which we will see the effects in the coming years, and we must consider the role that new technology and AI will play in the dental profession of the future. But will this have the desired impact? Can we develop the technology faster in order to make a difference to the profession and to patients sooner? Who should be driving the changes? If you have any thoughts to share, the conversation continues on The Digital Dental Pathway discussion page on social media.
[i] NHS England. GP Patient Survey Dental Statistics; January to March 2023, England. Accessed July 23. https://www.england.nhs.uk/statistics/2023/07/13/gp-patient-survey-dental-statistics-january-to-march-2023-england/
[ii] BDA. No sign of recovery plan as unmet need for NHS dentistry hits record high. Accessed July 23. https://bda.org/news-centre/press-releases/Pages/No-sign-of-recovery-plan-as-unmet-need-for-NHS-dentistry-hits-record-high.aspx
[iii] UK Parliament. Fundamental reform of NHS dentistry needed to end a ‘crisis of access’. Accessed July 23. https://committees.parliament.uk/committee/81/health-and-social-care-committee/news/196443/fundamental-reform-of-nhs-dentistry-needed-to-end-a-crisis-of-access/
[iv] BDA. NHS dentistry inquiry: Act now or condemn service to oblivion. Accessed July 23. https://bda.org/news-centre/press-releases/Pages/NHS-dentistry-inquiry-Act-now-or-condemn-service-to-oblivion.aspx
[v] The Dentist. Overseas Registration Exam Part 1 places to triple. Accessed July 23. https://www.the-dentist.co.uk/content/news/overseas-registration-exam-part-1-places-to-triple/
[vi] Chestnut Dental. The Future of Dentistry: How Artificial Intelligence is Changing Oral Healthcare. Accessed July 23. https://chestnutdental.com/blog/the-future-of-dentistry-how-artificial-intelligence-is-changing-oral-healthcare/
