My Solution for NHS Dentistry

[Kendodd]

As I understand it dentists are all private businesses that do some or all NHS work. I think the NHS should set up its own dental practices employing dentists directly on a salary. A good salary with promotion opportunities.

They could buy old Debenhams/Woolworths/etc sites that are still sitting empty after many years (so should be cheap). Turn the upper floors into flats for the staff (low rent) and ground floors for treatment space. I know there are difficulties with these conversations but they're not insurmountable.

Parking may be an issue on site but city centres always have car parks nearby and are well served by public transport. This plan would also bring more life back to the high street.

This plan may take years to come to fruition, buying sites, converting them etc. This time could be used to massively expand training new dentists.

The biggest hurdle I could see in this plan is one the screams of 'no money' (so shortsighted) and dentists unions might block it.

So a therapist who earns more than a young dentist , has less debt, less indemnity will not have to pay an extra tax of £1800 ish a year to provide dentistry?
The young dentist will take a pay cut and still not hit their treatment targets , in what way will that encourage them to stay in NHS dentistry? The average young dentist earns £35,000 a year so you are expecting them to take a 5% pay cut on top of the pay cuts that have happened every year in the past decade ? In what way is that securing the future of dentistry?
How are any of these young dentists ever going to buy a house, practice or even pay off their £80,000 student loans?

Why do you propose dentists pay it? I already carry out NHS dentistry- I'm regularly working for nothing when someone needs extensive treatment. I sometimes get the pleasure of a large lab bill too. Please give me an examples of other professions that are expected to regularly work at a loss.

If a dentist averages 30 UDA per day and works 45x5 = 225 days that is 6,750 UDA per year. If the payment for each UDA was increased by 50p from the levy then an NHS dentist would receive £3,375 more each year. With a levy of £2,400 this would be a net increase of £975/year.

No it isn't.
Unless you are a practice owner (over 74% of dentists do not own a practice ) then you pay a large proportion (from 50 to 70% ) of your UDAs to the practice to cover the cost of running the practice. As said before the NHS fees do not come anywhere near covering costs of running a practice.

So you are still asking dentists to pay even more for running a dental NHs service than they do now. £1687 for 50% split minus £2400 now only paying £713 a year , lucky dentists . Paying even more if they are on a smaller split.

did you read the part of my post where I said:
This of course is completely unenforceable😬 ?

40% of new patient NHs dental appointments are missed

I assume you have a source for this figure, @Lollygaggle - but I just can't get my head around this...

Almost daily we read that people are desperate for NHS dentist services, to the extent that hundreds queue up overnight to get on lists. And yet 40% - forty percent!! - of new appointments are missed?

What on earth is going on? Why would someone miss an appointment when they've finally found a dodo an NHS dentist?

As i said, the BDA aren't & even if they were, since when has a Tory Govt taken any notice of what a union wants??

So what does your £18 per month Denplan offer? 1 filling a scale and a polish?

Cheapest full plan i could see was £40 per month per person (as a min) for me, its £75 per month.

In general around 10% to 35% of all dental appointments are missed https://www.gov.wales/over-100000-extra-dental-appointments-year-missed-appointments-continue-bite
https://pubmed.ncbi.nlm.nih.gov/31980785/
https://www.nature.com/articles/sj.bdj.2014.766

new patients appointments are worse and the problem has become worse in England since 2006 as dentists are no longer allowed to charge for NHs no shows.

The people missing most appointments are children, males 21 to 30 and those who don't pay for dental treatment.

New patient appointments are the worst because of many reasons, fear , money ,and the fact that most new patients are irregular attenders coming in to get a problem fixed which might have resolved itself.

It's a big problem because unless someone comes in a practice doesn't get paid but still has to pay its bills. It also will not hit its treatment target and will have to repay money at the end of the year.

Dentist here!
This is never going to be resolved until the government and patients understand that dentists are highly skilled professionals. And should be regarded and paid as such, along with Surgeons,GPs, Lawers, Bankers etc…
We belong in a group with one of the highest rates of suicide and work related illness and stress. Yet for some reason we seem to have been completely devalued. I think/hope this current crisis will make people reconsider what we truly offer our patients and therefore society as a whole. At the moment we’re in a position of the government won’t pay, the patients don’t want to pay…….. So I’m honestly looking at moving into finance! I’ve been offered a wonderful position it’s double what I earn now, no stress of angry stressed, late patients ( making me run late for the rest of my day!). No unpredictably of will it snap/ bleed/ hurt/ will the patient move….. but if I leave my village will be left with no one.
I haven’t been in dentistry for decades but I’m disillusioned. And for those patients blaming their dentist, don’t. We’re humans, highly trained, specialists, trying to do our best. Blame the successive governments for failing to see our worth, for failing to train enough of us, and for failing to educate everyone about the importance of our dental health

I hope you have made contact with one of the support groups for dentists to support you at a difficult time .

Unfortunately we all know colleagues who have committed suicide or have become very unwell , including some very well known names in the profession . You are not alone, reach out for support and a listening ear.

Denplan might well start at £18 pcm but every year it goes up, and the more work you have done, the more your premium increases. I have crappy teeth (filings, gum disease, wisdom teeth removed, root canals and crowns) and my Denplan is now £44 a month.

Alongside the links above , this week a colleague worked a day on EDS ( emergency dental service) where patients with urgent needs are referred by 111.
In one day 3 1/4 hours were wasted because patients did not turn up. The worst thing is no one was surprised it's par for the course.

I work in a practice with 2 empty surgeries and we have a dentist that would love to join our practice. Our principal dentist has been asking for a bigger contract for 18 months to enable us to take new patients.
Pretty much every email has been ignored.
With the extra UDA’s (units of dental activity) we would be able to employ the dentist and take on some of the patients on our never ending waiting list.

Our health board has had a policy for years not to hand out new or increased contracts except as a non recurring contract. What dentist or practice is going to work somewhere where funding is only guaranteed for a year?

The money from returned contracts / undelivered contacts/ clawback is used to prop the rest of the health service up.

Can we have a fast track queue in this new building for people who brush their teeth twice a day and floss regularly?

E.G People like me that try their best get fast tracked and make gross unhygienic folk queue in the slow lane.

Won't be a long queue
only one in twenty in the U.K. floss
the average U.K. child eats 7 times a day
the average U.K. adult eats double the daily sugar recommendation
the average 4 year old eats 2 1/2 times recommended daily sugar
36% of adults don't brush their teeth twice a day
3% of adults don't brush their teeth every day
62% children brush their teeth in the morning
58% children brush their teeth at night.

Its a real bug bear of mine when highly educated and skilled professionals are compared to people who are not.

Having had extensive RC work done at a dental school and seen the dedication by both students and supervisors, i think you are all worth as much or more than any of the professions you mention.

The present dental contract is absolute rubbish and we shouldn't be handing out tax cuts until dentistry is fixed.

There will always be time wasters and non attendees but thats no reason not to fund dentistry.

To fund the required amount of NHS dentists or any other increase in NHS medical specialists will require us to pay more tax. There’s a finite amount of money available and so many services require funding.

Exactly, we are not valued

Increasing numbers of us cannot afford to pay for private dentistry. There’s got to be an argument that leaving a significant portion of the population without care is going to cost more in the long term. More oral cancers, dental pain, heart disease….

Yes that’s a situation no one wants to see. But it is down to the government, not individual dentists.

And for a lot of us, paying more tax is the best solution. It’s convenient and takes the worry away about covering the basics.

I agree.

Is anyone fighting for this in parliament? It’s an area I know little about but I would write to my MP if there is a campaign.

I may be a little jaded but this has been a situation which has been brewing for decades. Governments have known about it and chosen to ignore it as dentistry isn’t a vote puller!
I really believe that it’s been the intention of successive governments to privatise dentistry, but to blame the dentists!

I work in a city where we know for a fact several practices have handed back their contracts. Like you say though the money isn’t ringfenced for dentistry any more.
Noises we’re made that they were going to share out the handed back contracts but so far..nothing.