Plans to end the deepening crisis in access to NHS dental care are failing, leaving patients unable to get treatment, according to a warning from the government’s spending watchdog.
The National Audit Office’s (NAO) damning verdict on the “dental recovery plan” prompted patient groups to voice alarm that people’s struggles with decayed teeth represents “a serious public health concern”.
A pledge to provide an extra 1.5m treatments in England this year is in disarray amid falls in both the number of dentists doing NHS work and people receiving help from them.
There is “significant uncertainty” as to whether that ambition will be fulfilled because two key elements of the plan have not been achieved, an NAO investigation found. None of the promised new fleet of mobile dental vans has appeared and £20,000 “golden hellos”, to entice 240 dentists to work in areas of acute shortage, have only produced one extra dentist.
The plan, launched in February by the then Conservative government, promised that “everyone who needs to see a dentist will be able to do so” during 2024-25.
However, “based on initial analysis to date, the plan is not on track to deliver the additional courses of treatment,” the NAO concluded.
Even if the plan did provide what was promised, the NHS would still be offering 2.6m fewer treatments this year than before Covid hit in early 2020, it added.
The NHS provided 4.7m fewer courses of treatment last year than 2019-20 and only 40% of adults in England saw a dentist in the two years to this March – down from the 49% who did so pre-pandemic, the NAO found.
Louise Ansari, the chief executive of Healthwatch England, the NHS patient champion, said: “These findings underline the deplorable state of NHS dentistry.”
“The difficulty of getting NHS dental treatment is one of the public’s biggest concerns about the healthcare system generally and is a crisis that dental leaders have estimated is denying 13 million people access to NHS appointments.”
The findings were released amid huge public and political concern at the growing number of “dental deserts”, where NHS care is unavailable, and the rise in patients performing “DIY dentistry” on their own teeth because they cannot get health service-funded care and cannot afford to go private.
The two other cornerstones of the plan – a new “patient premium” and increase in payments to dentists for doing NHS work – have been put in place, the NAO added. NHS England expected the patient premium, worth up to £50 to the dentist, to yield 1.13m of the 1.5m treatments.
However, the NAO’s report notes that NHS data until the end of September shows that “fewer new patients had been seen in the first seven months of the premium than the equivalent period in the previous year”.
The report found that, so far, its findings “do not suggest that the new patient premium is on course to deliver the expected additional course of treatment by March 2025”.
NHS dental care is “broken”, said Rachel Power, the chief executive of the Patients Association.
“People are living with untreated dental issues, enduring significant pain, as well as the mental and emotional burden of decayed or missing teeth.
“Being unable to access NHS dentistry is no longer just a matter of inconvenience – it’s a serious public health concern,” she added. It is “staggering” that there are 483 fewer dentists doing NHS work compared with 2019-20 and that the NHS’s dental budget is being underspent.
Dr Nigel Carter, the chief executive of the Oral Health Foundation charity, said: “The question is no longer whether NHS dentistry can be saved, but whether the government has the will to make it a true priority before it’s too late.”
People should eat a healthy, low-sugar diet and brush their teeth regularly to reduce the risk of needing care, he advised.
Labour ministers are devising their own pan to tackle the access crisis but few details have emerged yet, though they will introduce supervised tooth-brushing for three to five-year-olds.
Stephen Kinnock, the dentistry minister, said: “We have inherited a dental service where many people are struggling to find an NHS dentist and a recovery plan that is not fit for purpose.
“This government is committed to rebuilding dentistry, but it will take time. We are working on further measures, prioritising initiatives that will see the biggest impact on access to NHS dental care.
“We will start with an extra 700,000 urgent dentistry appointments to help those who need it most, and reform the dental contract to encourage more dentists to offer NHS services to patients.”