The British Dental Association (BDA) has urged the government to set out a clear roadmap for reform and relaxation of COVID-19 restrictions as new survey data points to an exodus from the service as the access crisis continues with nearly 30 million appointments lost since the first lockdown.
According to a new survey of dentists in England, 47% of dentists indicate they are now likely to change career or seek early retirement in the next 12 months should current restrictions remain in place. The same proportion says they are likely to reduce their National Health Service (NHS) commitment as well.
Also, working in high-level personal protection equipment (PPE) mandated under current infection control procedures is having a devastating effect, the BDA said, with 88% indicating it is having a high impact on their morale.
Additionally, 78% say financial uncertainty is having a high impact on their ability to provide pre-pandemic levels of care. Two-thirds cite hitting NHS targets imposed by the government on January 1, 2021. Since the new year, the BDA said, the workforce has reported the highest levels of stress compared to any point since the onset of the pandemic.
Nearly two-thirds of NHS dentists estimate they won’t meet imposed targets and will face penalties for not hitting 60% of their pre-pandemic activity levels. Those that have made progress say that they have done so unsustainably.
Meanwhile, 62% say their practice had to invest in new ventilation equipment without any government support, 41% say they were forced to refocus on routine over urgent appointments, and similar numbers say they have reduced private work or reduced or eliminated annual leave.
England remains the only nation in the United Kingdom where the government has not committed to or embarked on exploratory work to provide capital funding for ventilation systems to enable practices to increase patient numbers while meeting infection control restrictions, the BDA added.
While securing new equipment has been the number one strategy deployed by dentists to meet NHS activity targets, the BDA said, nearly 70% of practices say they now face financial barriers to further investment.
Finally, the BDA said, 47% of dentists lack confidence in terms of the business outlook for their practice should current standard operating procedures remain unchanged.
The BDA’s analysis of Freedom of Information data indicates that nearly 70% of appointments, or 28 million courses of treatment, that would have been delivered in NHS services in England in the year since March 2020 have been missed. The BDA estimates the figure to have grown to exceed 30 million.
While some ministers of Parliament had expressed concern in January that the current interim system of targets would prioritize volume over need, the BDA said, urgent treatment delivered has fallen since the start of 2021.
Dental leaders have welcomed recent government commitments to reform the widely discredited activity-based contract at the heart of NHS dentistry, the BDA said, but they also have warned that needed change could be fatally undermined by further reductions in capacity through colleagues leaving the service or reducing their NHS commitment.
The BDA believes that contractual and legislative change needs to be in place before April 1, 2022, which is the beginning of the next NHS financial year.
With the vaccination program making real headway, the BDA said, the organization added that it also has underlined the need for a clear timetable for revising high-intensity infection prevention and control procedures, including heavy-duty PPE and maintaining lengthy gaps between appointments, given the huge impact on both productivity and the workforce.
“The pandemic has wiped out access for millions and taken a hammer blow to the workforce, with many now looking for the exit. Practices have managed to hit punitive targets but at a terrible cost. Churning through appointments against the clock in heavy-duty PPE now risks an exodus from this service,” said Shawn Charlewood, chair of the BDA’s General Dental Practice Committee.
“Fixing NHS dentistry will be impossible if dentists are left unwilling to work in it. We need a clear roadmap that lifts restrictions, provides needed support to all practices, and makes a decisive break with a broken contract,” Charlewood said.
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