A crisis in recruitment
Practice owners are responding, but there also needs to be specific action from the Government
In the very early days of the pandemic – and, in fact, throughout lockdown and beyond – the British Dental Association’s website was (is) a consistent source of up-to-the-minute news, guidance and insight. Live COVID-19 related updates. News releases. Blogs.
To an outsider – a journalist, as I am – these resources gave the sense of an organisation working around the clock to keep members, and others such as the media, informed. That sense continues today. Updates … news … but, for an insight into what the profession is feeling it is
that third medium – the blog – which recently delivered
so forcefully.
This magazine has reported on the many impacts that the pandemic has had and the challenges policymakers face in responding. But the words, the experience, of a practitioner inevitably carry more force. “We have been waiting on reform for ten years now,” wrote Josephine Weir, a practice owner recently1.
“Although there is a sense of returning to normality, we are not out the other side of the pandemic and can wait no longer. Without agreed reform we cannot effectively plan our dental business model and are left sinking in a swamp of last-minute guidance and changes.”
Josephine described the Statement of Dental Remuneration (SDR) as a “treadmill, unsuitable for
modern dentistry” and with no real recognition for the additional activity that takes place in a dental practice looking after patients.
It does not consider the number of patients needing care with dementia, complex medical histories and requiring assisted communication, she said. Even before the pandemic, she pointed out, dentistry had changed in many areas – including delivery, materials, laboratory costs, patient expectations, education and training.
“The SDR model only remunerates dentists by seeing as many patients as possible in order to allocate a fee-generating income. We are left wondering what kind of care we are delivering. We need long term contract reform negotiations now, and certainty about our future,” said Josephine.
“We are faced with a mass of NHS patients who need our help, but we don’t have enough workforce”
The profession’s experience to date has not been positive, she noted: “Information has been drip-fed and poorly timed, causing additional stress. Updates often come to us on a Friday, despite guarantees this would no longer happen. The system is dysfunctional.”
There is a need for “constructive negotiations and communication together with appropriate financial measures. The instability we are facing now, has never been worse”. Young dentists face cuts in pay as they progress from a VT scheme to becoming an associate. It is pushing many to turn their backs on the NHS and focus on non-primary care treatments. At the same time, dentists aged over 50 are choosing to leave the profession.
As Josephine pointed out: “We are faced with a mass of NHS patients who need our help, but we don’t have enough workforce to deal with it.”
Last month, it was reported that some NHS patients have been deregistered from their local practice because of the recruitment crisis, caused by a combination of Brexit and the pandemic. As we report in this edition (see page 38), one corporate is taking proactive steps to counter the crisis.
But there needs to be action at a national government level as well. While work may have restarted on the reform of how NHS dentistry is provided, equal effort is required in making sure that whatever model is agreed there are sufficient practitioners in place to deliver the care.
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