BDA: Covid inquiry ignoring biggest hit and weakest recovery in healthcare
NewsPosted by: Dental Design 27th November 2024
The British Dental Association has warned the mistakes made by the last UK Government during the pandemic – that have left millions unable to access dentistry – risk being repeated, given the UK Covid Inquiry’s unwillingness to consider the sector.
In new evidence put to the Inquiry, analysis by the professional body shows the pandemic had an impact on dentistry with no parallel anywhere in healthcare, with the sharpest single fall in capacity, and the weakest recovery. [1]
The BDA stress dentistry was made an outlier, losing a third of all NHS capacity (33.3%) from 2020/21-2023/24, compared to 1.9% for outpatient care, 7% for Finished Consultant Episodes and 5.9% for A&E admissions. GPs have more than made up on lost patient contacts since lockdown. [2]
The BDA say the choices made by the former Government – on suspension and restoration of services and the recovery – left dentistry lagging behind other parts of healthcare. This gulf has been sustained and eclipses even those parts of secondary care that have been subject to widespread industrial action. In total over 52 million NHS dental appointments have been lost since lockdown in England, the equivalent of well over a year’s worth of dentistry in normal times. [3] This is having an ongoing impact on patient care. BDA analysis of Government data indicates unmet need for NHS dentistry in England stands at 13 million – or 1 in 4 of the adult population. [3] Recent ONS data indicates 97% of new patients who try to access NHS care are unsuccessful. [4]
The BDA say dentistry was treated like an ‘optional extra’ at lockdown, with all routine face to face care in England suspended, a decision motivated at least in part by PPE shortages, a problem which also dogged the resumption of care.
Dentist leaders say the pandemic proved a catalyst for the current crisis, making the discredited target-based contract NHS dentists work to impossible to deliver. The previous Government failed to make any significant breaks from it. The new administration has pledged fundamental reform, but the BDA stress urgency and ambition are now required.
Just two references to dentistry have been made by the UK Covid Inquiry to date. The first is correspondence that underlines that dentistry is not an “important” part of the process for Module 3, which covers the impact of the pandemic on healthcare systems. [5] The second to simply confirm the CV of Scotland’s former National Clinical Director of Healthcare Quality and Strategy, Professor Jason Leitch. [6]
BDA Chair Eddie Crouch said: “No part of the health service took such a hit during the pandemic, and none has seen such a limited recovery. Yet dentistry isn’t even on the menu at this Inquiry. At lockdown, dentistry was treated like an optional extra. Subsequent failure to deliver needed reform turbocharged existing problems into a genuinely existential threat to the service. The crisis millions now face is the result of political choices. If lessons are not learned we will see more collateral damage to core parts of our health service.”
References
[1] Activity delivered across primary and secondary care, by quarter as a proportion of pre-Covidlevels from 2018/19.
Data rebased to a proportion of 2018/19 levels, from NHS Dental statistics, Provisional Monthly Hospital Episode Statistics for Admitted Patient Care, Outpatient and Accident and Emergency data, Hospital Admitted Patient Care Activity, and Appointments in General Practice.
[2] Activity lost in sectors in England. Estimates based on comparing activity delivered since Q1 2020/21 against average delivery for 2018/19.
NHS Dental statistics, Provisional Monthly Hospital Episode Statistics for Admitted Patient Care, Outpatient and Accident and Emergency data, Hospital Admitted Patient Care Activity, and Appointments in General Practice.
*GP services rapidly recovered lost ground, with total gains of 153m in total appointments across 2020-24 over pre-Covid norms. The pre-pandemic level was 281.2m total count of appointments in 2018/19. The total count of appointments in 2023/34 was 352.6m.
[3] BDA analysis of the GP Survey by Ipsos, 2024. Unmet need for NHS dentistry in England now stands at 13m, or well over 1 in 4 of the adult population (28%). This includes an estimated 5.6m adults who tried and failed to secure an appointment in the last 2 years. Nearly as many have given up trying with 5.4m not attempting to make appointments as they didn’t think they could secure care. The cost of care pushed 1.25m away, and around 780,000 indicated they were on waiting lists. While there has been some methodological change, with the survey moving online-first approach, this is clear growth from last year, when total figures stood at around 12m.
[4] Experiences of NHS healthcare services in England: 10 October 2024
[5] Correspondence from Rt Hon Baroness Hallett DBE, Chair, UK Covid-19 Inquiry, 16 February 2023. “Dental healthcare systems… are part of the healthcare systems of the United Kingdom, but are not an important aspect of the matters within the scope of Module 3.” https://covid19.public-inquiry.uk/wp-content/uploads/2023/02/2023-02-16-Dental-Alliance-Determination-of-CP-application-Module-3-Decline.pdf
[6] Transcript of Module 2A Public Hearing on 22 January 2024
