NHS dentistry

Health and Social Care Committee Closed Inquiry
Opened: 7 Dec 2022 Closed: 30 May 2024 Parliament page
The Health and Social Care Committee has launched an inquiry into dentistry following a survey that showed 90% of practices across the UK were not accepting new adult NHS patients. MPs will consider to what extent the current NHS dental contract disincentivises dentists from taking on new patients. They will … Read more
15 Recommendations
11 Conclusions
1 Report
3 Oral sessions
3 Letters
3 Events
Activity timeline 11 events
22 May
2024
Correspondence
19 Mar
2024
Oral evidence
19 Mar
2024
Formal meeting (oral evidence session) · The Thatcher Room, Portcullis House
13 Dec
2023
Report published
18 Oct
2023
Correspondence
18 Oct
2023
Correspondence
14 Jul
2023
Report published
25 Apr
2023
Oral evidence
25 Apr
2023
Formal meeting (oral evidence session) · Room 6, Palace of Westminster
21 Mar
2023
Oral evidence
21 Mar
2023
Formal meeting (oral evidence session) · Room 5, Palace of Westminster
Oral evidence sessions 3 sessions
19 Mar 2024
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Dr Amanda Doyle OBE · NHS England Jason Wong MBE · NHS England Rebecca Curtayne · Healthwatch England Rt Hon Andrea Leadsom MP · Department of Health and Social Care Shawn Charlwood · British Dental Association (BDA) General Dental Practice Committee Thea Stein · Nuffield Trust
25 Apr 2023
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Chris McCann · Healthwatch England Dr Amanda Doyle · NHS England Jo York · Hampshire and Isle of Wight Integrated Care Board Neil O'Brien MP · Department of Health and Social Care Sarah Fletcher · Healthwatch Lincolnshire Sara Hurley · NHS England
21 Mar 2023
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Dr Abhi Pal · College of General Dentisty Dr Sandra White · Association of Dental Groups Ian Brack · General Dental Council Malcolm Smith · Health Education England North East Professor Nick Barker · University of Essex Shawn Charlwood · British Dental Association (BDA) General Dental Practice Committee
Title HC No. Published Items Response
Ninth Report - NHS dentistry HC 964 14 Jul 2023 26 Responded
Recommendations & Conclusions
26 results
1 Conclusion Accepted
Ninth Report - NHS dentistry
NHS dentistry faces a crisis of unequal access across different regions and groups.
We believe there is a crisis of access in NHS dentistry. Many people are unable to access an NHS dentist or are travelling significant distances to get to one. Access varies across the country and is being experienced unequally by … Read more
Government Response
The government accepts the recommendation and outlined several reforms announced in July 2022, including allowing high-performing practices to take more patients, fairer payment for complex care, and requiring NHS dentists to update their availability online. It also states a forthcoming Dentistry Recovery Plan will continue efforts to improve patient access.
Department of Health and Social Care
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2 Recommendation Accepted
Ninth Report - NHS dentistry
Require Government to outline timeline and strategy for universal NHS dental access
We welcome the Government’s ambition for everyone who needs an NHS dentist to be able to access one. This ambition must ensure access within a reasonable timeframe and a reasonable distance. The Government must set out how they intend to … Read more
Government Response
The government accepts the recommendation and highlights existing measures, such as NHS England's Patient and Public Voice group to improve patient understanding and the contractual requirement for dental practices to quarterly update their NHS website profiles. It also notes additional measures by NHS England to monitor and improve compliance with website updates.
Department of Health and Social Care
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3 Conclusion Accepted
Ninth Report - NHS dentistry
Roll-out patient information campaign to clarify NHS dental services and entitlements
A lack of public awareness about NHS dental services and how practices operate is contributing to access issues. The Government and NHS England should roll-out a patient information campaign with the aim of improving awareness of how NHS dentistry will … Read more
Government Response
The government accepts the recommendation, clarifying that there is no formal patient registration system. It supports adherence to NICE recall guidelines and details existing measures from 2022 reforms for practices to provide urgent dental care and use risk-based recalls, with NHS England monitoring compliance and sharing data with ICBs.
Department of Health and Social Care
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4 Conclusion Deferred
Ninth Report - NHS dentistry
Mandate practices to adhere to NICE recall guidelines and prevent automatic patient removal
Practices should abide by NICE recall guidelines of up to two years for most adult patients, recognising the need for more regular recall for some, but people should not automatically be removed from dentists’ registers of NHS patients without good … Read more
Government Response
The government accepts the recommendation but responds by detailing measures unrelated to NICE recall guidelines or patient registration. The response outlines NHS England's guidance on ringfencing dental allocations for ICBs in 2023/24 and measures to address underperforming contractors by rebasing contracts and recommissioning activity.
Department of Health and Social Care
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5 Recommendation Acknowledged
Ninth Report - NHS dentistry
Permanently apply ringfence to prevent diversion of NHS dental funding by ICBs
We welcome the fact that to try and address the underspend, NHS England is applying a ringfence for 2023/24, to ensure that no ICB can divert funding away from NHS dentistry. We recommend that this ringfence applies permanently, and NHS … Read more
Government Response
The government partially accepts the recommendation, stating they need to build on existing contractual changes but do not commit to making the dental funding ringfence permanent. They are working on further reforms to the 2006 contract in discussion with the profession.
Department of Health and Social Care
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6 Conclusion Rejected
Ninth Report - NHS dentistry
NHS England's interventions on under-delivering providers welcomed; urgent flexible funding required
We also welcome measures by NHS England to intervene on providers who are under-delivering on contracted NHS activity. We look forward to an update on how this work is progressing. We welcome this funding being used flexibly, however there cannot … Read more
Government Response
The government explicitly rejects a recommendation to introduce patient registration, which was not made in this conclusion. The response then outlines existing information on patient choice and practice availability, and commits to commissioning a dental workforce survey by early 2024 and publishing monthly data on local NHS dental activity.
Department of Health and Social Care
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7 Recommendation Accepted in Part
Ninth Report - NHS dentistry
Urgently implement fundamental dental contract reform to address access crisis
Fundamental reform of the dental contract is essential and must be urgently implemented, not only to address the crisis of access in the short-term, but to ensure a more sustainable, equitable and prevention-focussed system for the future. We are concerned … Read more
Government Response
The government partially accepts the recommendation for fundamental reform, committing to build on existing contractual changes and work on further reforms to the 2006 contract, though they rejected a previously piloted capitation model due to its identified shortcomings.
Department of Health and Social Care
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8 Recommendation Accepted in Part
Ninth Report - NHS dentistry
Urgently implement fundamentally reformed dental contract, moving away from UDA system
We welcome the Government’s recognition of the need for dental contract reform. The Department and NHS England must urgently implement a fundamentally reformed dental contract, characterised by a move away from the current UDA system, in favour of a system … Read more
Government Response
The government partially accepts the recommendation for urgent reform, stating they will build on existing contractual changes and work on further reforms to the 2006 contract, but reject moving to a weighted capitation model based on previous pilot evaluations.
Department of Health and Social Care
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9 Conclusion Accepted
Ninth Report - NHS dentistry
Patient registration under capitation-based contract will improve dental access
We believe patient registration under a reformed capitation-based contract will better enable those patients who currently can’t access a dentist to be able to do so.
Government Response
The government partially accepts, detailing existing and planned measures like a 5.13% uplift to NHS dental contracts and guidance for Integrated Care Boards on 'Flexible Commissioning' for local initiatives. They are also exploring tie-ins for new dentists and developing a career pathway including apprenticeships through the Advancing Dental Care review.
Department of Health and Social Care
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10 Conclusion Deferred
Ninth Report - NHS dentistry
Reinstate requirement for patients to be registered with an NHS dentist
We uphold the recommendation from our predecessors’ 2008 report into Dental Services, that the Department should reinstate the requirement for patients to be registered with an NHS dentist. (Paragraph 55) Workforce
Government Response
The government reinterprets the recommendation to be about making best use of the wider dental team's skills, citing July 2022 guidance to enable dental therapists and hygienists to open treatment courses and a completed consultation on allowing them to supply/administer certain medicines without a prescription. They do not address the recommendation to reinstate patient registration.
Department of Health and Social Care
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11 Conclusion Accepted
Ninth Report - NHS dentistry
NHS dentist headcount does not reflect actual NHS work or address access issues
The Government states that the number of NHS dentists has increased over the past year. However, while the headcount has gone up over the past year, it has gone down over the past three years, and moreover headcount alone does … Read more
Government Response
The government accepts the importance of efficient processing for overseas dentists, confirming they are working with the GDC to clear the registration backlog. They highlight specific GDC actions to triple ORE Part 1 capacity and increase Part 2 sittings to address demand.
Department of Health and Social Care
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12 Recommendation Accepted
Ninth Report - NHS dentistry
Commission a comprehensive dental workforce survey on NHS staffing and activity levels.
The Government and NHS England should commission a dental workforce survey to understand how many full-time and part-time-equivalent dentists, dental nurses, therapists and hygienists are working in the NHS, and how much NHS and private activity they are undertaking, alongside … Read more
Government Response
The government accepts the recommendation, stating that NHS England introduced a new biannual dental workforce survey in October 2023, which will collect comprehensive data on the dental team and NHS activity, with initial data expected by early 2024.
Department of Health and Social Care
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13 Recommendation Accepted
Ninth Report - NHS dentistry
Improve routine data collection on NHS dental workforce numbers, activity, and demand.
The Government and NHS England must improve the routine data that is collected on the number of NHS dentists and the wider dental team, and the levels of NHS activity they undertake, as well as data on demand, to assist … Read more
Government Response
The government accepts the recommendation, stating that NHS England introduced a new biannual dental workforce survey in October 2023 to improve data collection on the dental team and NHS activity, with initial data expected by early 2024. They also highlight existing monthly publications of NHS dental activity data.
Department of Health and Social Care
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14 Recommendation Accepted in Part
Ninth Report - NHS dentistry
Introduce urgent incentives to attract and retain dentists for NHS work.
Any contract reform now will almost certainly be too late for those dentists who have already left the NHS or are considering doing so in the near future. The Government must urgently introduce incentives to attract and retain dentists to … Read more
Government Response
The government partially accepts the recommendation, rejecting some specific incentives listed but committing to explore other measures, such as a tie-in for new graduates. It also agrees with the importance of a sustainable careers framework and is working with NHSE to develop a career pathway for dental professionals.
Department of Health and Social Care
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15 Recommendation Accepted
Ninth Report - NHS dentistry
Ensure reformed dental contract fully utilises skills of the entire dental team.
The Government, NHS England and ICBs must ensure that the reformed contract ensures that full use is made of the skills of the whole dental team. (Paragraph 73) NHS dentistry 35
Government Response
The government accepts the recommendation, having already published guidance in July 2022 to facilitate dental therapists and hygienists opening treatment courses, and completed a consultation on changes to human medicines regulations to expand their scope of practice, with a response due shortly.
Department of Health and Social Care
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16 Conclusion Accepted
Ninth Report - NHS dentistry
Advancing Dental Care Review shows potential but immediate incentives needed for supply and demand.
We support the implementation of the work of the Advancing Dental Care Review. Centres for Dental Development could have the potential to change how we approach training dentists in the UK to meet the needs of the populations who most … Read more
Government Response
The government partially accepts, stating that Integrated Care Boards are responsible for undertaking oral health needs assessments to support commissioning priorities and are working towards having these assessments in place by July 2024.
Department of Health and Social Care
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17 Conclusion Accepted
Ninth Report - NHS dentistry
Unacceptable backlog of Overseas Registration Exam applications hinders NHS dentist numbers.
The backlog of applications for the Overseas Registration Exam is unacceptable and resolving this represents an opportunity in the short term to increase the number of dentists working in the NHS, and therefore create more appointments to enable patients to … Read more
Government Response
The government accepts the recommendation, detailing that it is working with the GDC to clear the backlog by tripling ORE Part 1 exam capacity and increasing Part 2 sittings for 2024. Additionally, it has streamlined processes for overseas-qualified dentists, including unilateral recognition of EEA qualifications and new regulations to reduce performers list application times.
Department of Health and Social Care
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18 Recommendation Accepted
Ninth Report - NHS dentistry
Work with GDC to clear Overseas Registration Exam backlog and speed up international registration.
The Government must work with the General Dental Council to ensure the backlog of applications for the Overseas Registration Exam is cleared in a timely manner, and to speed up changes to the process of international registration for new applicants … Read more
Government Response
The government accepts the recommendation, detailing GDC's increased ORE exam capacities from August 2023 and 2024, and listing specific measures already taken to streamline international registration processes for overseas-qualified dentists to work in the NHS.
Department of Health and Social Care
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19 Conclusion Acknowledged
Ninth Report - NHS dentistry
Absence of dental contract in Workforce Plan reflects lack of priority for reform.
We are concerned that the absence of explicit mention of the dental contract in the Long Term Workforce Plan reflects the lack of priority given by the Government and NHS England to contract reform. We believe it indicates a lack … Read more
Government Response
The government acknowledged the committee's concern that the absence of explicit mention of the dental contract in the Long Term Workforce Plan reflects the lack of priority given by the Government and NHS England to contract reform.
Department of Health and Social Care
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20 Recommendation Accepted in Part
Ninth Report - NHS dentistry
Ensure full consultation with professionals on potential graduate NHS dental tie-in policy.
Given the varying views expressed regarding a tie-in for new graduates into NHS dentistry, we urge NHS England and the Government to ensure full consultation with professionals and representative bodies, as they seek to explore the potential merit of such … Read more
Government Response
The government partially accepts, committing to explore incentives like a tie-in as part of the NHS Long Term Workforce Plan and agreeing on the importance of a careers framework. They are working with NHSE to develop a career pathway and have implemented other dental system improvements and remuneration uplifts.
Department of Health and Social Care
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21 Recommendation Accepted in Part
Ninth Report - NHS dentistry
Ensure dental profession representation on Integrated Care Boards for informed decision-making.
The dental profession should be represented on Integrated Care Boards to ensure they have the necessary expertise to inform decision-making around contracting and flexible commissioning. This should include wider engagement with the profession locally, for example through Local Dental Committees … Read more
Government Response
The government partially accepts, stating that while they have not changed their stance on mandatory representation, existing legislation allows ICBs the discretion to appoint additional members, including dental professionals, where locally deemed necessary. DHSC will continue to work with NHS England and ICBs to ensure current arrangements are effective.
Department of Health and Social Care
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22 Recommendation Accepted in Part
Ninth Report - NHS dentistry
Gather and review ICB membership data, assessing representation and policy effectiveness for NHS dental services.
We contest the Department’s rejection of the recommendation in our ‘Integrated Care Systems: autonomy and accountability’ report, and reiterate that they should centrally gather information relating to the membership of ICBs, including the specific role of members and their area … Read more
Government Response
The government partially accepts, stating that NHS England has published guidance on effective clinical leadership and ICBs are asked to ensure diverse professional integration. However, the government has not changed its stance on centrally gathering and reviewing ICB membership information itself, noting that ICBs already publish this data and can appoint additional members as needed.
Department of Health and Social Care
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23 Recommendation Accepted
Ninth Report - NHS dentistry
Provide evidence on the effectiveness of initiatives for commissioning local dental services to ICBs.
We welcome the initiatives outlined by the Chief Dental Officer to help ICBs commission dental services in a way that best meets the needs of their local populations. NHS 36 NHS dentistry England should provide evidence of the effectiveness of … Read more
Government Response
The government accepts the recommendation, stating that NHS England published guidance in October 2023 with commissioning options for ICBs, and will release a further publication in 2024 providing practical examples of services and commissioning options to spread best practice.
Department of Health and Social Care
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24 Recommendation Accepted
Ninth Report - NHS dentistry
Provide clarity to ICBs on commissioning flexibilities for NHS dental services and resource targeting.
In light of the current national contracting arrangements, NHS England must provide clarity to ICBs about what flexibilities they have with regard to commissioning NHS dental services and targeting resources according to the needs of their populations. Read more
Government Response
The government accepts the recommendation, stating that NHS England published guidance in October 2023 to provide ICBs with clarity on commissioning flexibilities within the national dental contractual framework, and will issue further guidance with practical examples in 2024.
Department of Health and Social Care
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25 Conclusion Acknowledged
Ninth Report - NHS dentistry
ICBs' delegated responsibility for dental services offers opportunities for local improvement.
ICBs have been delegated responsibility for commissioning dental services by NHS England. They offer an opportunity to improve access locally, better integrate services around patients and address inequalities.
Government Response
The Government acknowledges that the transfer of responsibility for commissioning NHS dentistry services to ICBs provides a greater opportunity to tailor services around the needs of the local population.
Department of Health and Social Care
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26 Recommendation Accepted in Part
Ninth Report - NHS dentistry
Mandate all ICBs to complete oral health needs assessments by July 2024 with NHS England support.
By the end of July 2024, every ICB should have undertaken an oral health needs assessment, in consultation with service users, patient organisations and the profession. NHS England should provide support to ICBs to undertake this, including sharing examples of … Read more
Government Response
The government partially accepts the recommendation, acknowledging that not all ICBs may complete oral health needs assessments by the July 2024 deadline due to varying maturity. However, it confirms that all ICBs are working towards having these assessments in place with support from NHS England.
Department of Health and Social Care
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Government Response AI assessment · 26 of 15 classified
Accepted 13
Accepted in Part 7
Acknowledged 3
Deferred 2
Rejected 1
Total 15 recs + 11 conclusions
Correspondence 3 letters
22 May 2024 Parliamentary Under Secretary of Sate for Public Health on plans to recover and reform NHS Dentistry 10.05.24
Parliament page
18 Oct 2023 Correspondence from the Chair to the Secretary of State, Steve Barclay MP, on the Department's response to the NHS Dentistry report 20.09.23
Parliament page
18 Oct 2023 Correspondence from the Parliamentary Under Secretary of Sate for primary Care and Public Health,Neil O'Brien MP, regarding the Committee's dentistry report 26.09.23
Parliament page