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The UK government’s new system of NHS targets can have negative financial and contractual consequences for dentists who fall below certain levels of activity. (Image: DC Studio/Shutterstock)

NHS dental activity targets continue to attract controversy

By Brendan Day, Dental Tribune International
February 17, 2021

LONDON, UK: Since being implemented on 1 January, the UK government’s new system of NHS targets has drawn its fair share of detractors from both inside and outside the dental profession. Now, a member of parliament (MP) has accused mydentist, the UK’s largest dental chain, of advising its members to “prioritise routine check-ups over treatments in order to meet the new targets”.

The NHS targets were outlined in the seventh letter of preparedness for primary dental care late last year, which informed dental professionals that their practices must deliver 45% of their pre-pandemic dental activity for the period 1 January–31 March. Those who fall beneath 36% of these activity targets will face financial penalties, as well as potential breach of contract consequences.

According to the British Dental Association (BDA), providing this level of service has proved to be difficult, particularly since England is currently experiencing its third national lockdown. The trade union said that its own survey data revealed that 79% of dental practices in the UK had seen an increase in cancelled or missed appointments in the first few weeks of 2021, whereas around 41% of practices are operating below the 36% activity threshold.

On 9 February, Judith Cummins, MP for Bradford South, told the UK’s House of Commons that she had been contacted by an unnamed whistle-blower at mydentist. He or she provided Cummins with an internal memo that indicated that the dental provider, which runs over 600 practices throughout the UK, had instructed its workforce to prioritise volume over need in terms of patient treatment.

“An imposed system is limiting the options for the very people who need us most”
— Dr Shawn Charlwood, BDA

“It is now clear that the newly imposed NHS dentistry targets are in fact actively undermining patient access to urgent treatments during the pandemic as I warned they would,” Cummins noted.

A spokesperson for mydentist rejected Cummins’ accusations, telling the Yorkshire Post that the claims were “untrue” and that the company would be “asking her to correct the record”.

“The briefing that has been referred to was based directly on NHS guidance to explain the activity targets in England and to support clinicians in growing capacity and managing their diaries in order to meet them,” the spokesperson added.

In a statement, Dr Shawn Charlwood, Chair of the BDA’s General Dental Practice Committee, noted: “This isn’t about the conduct of any one company, but the result of failed policy that places government targets ahead of patient need.”

“An imposed system is limiting the options for the very people who need us most. These targets must be abandoned,” Charlwood concluded.

Issues with dental access remain systemic

According to the BDA, over 19 million NHS dental appointments were missed in England in 2020 alone. A recent report from the independent statutory body Healthwatch England shed further light on this issue, outlining how some patients actively searching for dental treatment had been told that they might have to wait up to two years for an NHS appointment.

Sir Robert Francis, QC, chairman of Healthwatch England, informed the BBC that the COVID-19 pandemic had “exacerbated the human impact of years of structural issues in NHS dentistry and is now pushing it to crisis point”.

He added: “All efforts should be made to treat those in need of urgent care and provide more accurate and up-to-date information to help people find and access NHS dental care.”

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