NHS dentistry disaster as Rishi Sunak’s ‘restoration plan’ formally made the scenario worse

Fewer new patients are accessing NHS dental care after a botched Tory “recovery plan”.

A damning report by a Government watchdog has concluded that every month since Rishi Sunak launched the plan in February has seen fewer new patients treated than the same month the previous year. The National Audit Office is the external body which scrutinises the effectiveness of government spending and it found one in every 50 dentists has stopped doing any NHS work since 2019/20. Others have decided to treat fewer NHS patients and do more private work.

The review shows government spending on NHS dentistry in England has dropped by half a billion during the period and there are 483 fewer dentists providing some NHS care. It comes after the Mirror launched the Dentists for All campaign and a cross-party committee of MPs is now calling on Labour to “take stock of what works” to tackle the “crisis”.

Sir Geoffrey Clifton-Brown, chair of the Committee of Public Accounts, said: “NHS dentistry is in a state of crisis. People across the country are struggling to access NHS dentists, particularly in rural areas. The roll out of dental vans and ‘golden hello’ bonuses to under-served communities has been slow and the Dental Recovery Plan is now unlikely to deliver its ambitions for 1.5 million extra treatments. The Department of Health and Social Care and NHS England must take stock of what works if they are to address the serious challenges facing NHS dentistry.”

Unmet need for NHS dentistry is estimated at over 13 million – or one in four of England’s adult population. The NAO found one in ten adults live more than six miles from a dental practice listed on the NHS website as accepting new patients “when availability allows”. It comes after a Mirror probe showed more than four fifths of those listed as such are still not currently taking new NHS patients .

The NAO concluded the Tory “recovery plan” will not achieve its pledge of an extra 1.5 million NHS dental treatments by the end of the financial year. Shortly after the plan was announced then-health minister Andrea Leadsom was forced to admit its key pledge “has a high likelihood of not being reliable” during an appearance before the Health Select Committee.

The plan included the “new patient premium” which was expected to deliver 1.13 million of the additional 1.5 million courses of treatments promised. It saw dentists offered a bonus of between £15 and £50 for treating someone who had not had a check up for two years. However fewer courses of treatment for new patients were completed in every month than in the equivalent month in the previous year. The NAO does not explain why this could be.

The total number of dental appointments in England fell from 38.8 million in 2019/20 to 12.3 million in 2020/21 during the pandemic, before recovering to 34.1 million in 2023-24. This is still 4.7 million fewer dental appointments than before the pandemic.

The NAO also said that even if the 1.5 million goal was reached by its target date, it would still be 2.6 million fewer treatments per year than pre-pandemic levels. It said: “Patients who do not already have a relationship with a dental practice struggle to get accepted, as practices are not obliged to accept new patients.”

The Labour government is currently reviewing the package of measures set out in the recovery plan – which also included so-called “golden hellos” for dentists moving to under-served areas, mobile dental vans.

The report cites “ministerial disagreement” on locations contributed to delays with the first dentist hired using a ‘Golden Hello’ payment in October. Not a single dental van has been procured to date. It concluded: “Fewer new patients had been seen in the first seven months of the premium than the equivalent period in the previous year.”

At the time the British Dental Association said the Tory plan would not work and was an attempt to “kick the issue into the long grass” until after the General Election. Shawn Charlwood, the BDA’s chair of its general practice committee, said: “We warned at the outset that this Recovery Plan was unworthy of the title. Unfunded, unambitious policies failed to make a dent in a crisis hitting millions. A new Government must show it is willing to learn from its predecessor’s mistakes.”

The report comes as the BDA warned that dentistry in the UK is in “crisis” as it urged the UK Covid-19 Public Inquiry to specifically examine the impact of the pandemic on dental services. The Association said that dentistry saw a “collapse in capacity seen nowhere else in the health service” and is “yet to recovery to pre-pandemic levels of activity”. The BDA said in a submission to the pandemic probe: “Dentistry faced major problems before lockdown, but the pandemic proved a catalyst, and turbocharged them into a genuinely existential threat to the service.”

The outgoing government spent £555 million less in real terms on primary care NHS dentistry in 2023/24 compared with 2019/20. However how much, if any, extra funding Labour are willing to commit to rectify the situation remains unclear.

Lib Dem health spokesperson Helen Morgan said: “Whole regions of our country are now Dental Deserts. Too many people are finding it impossible to even register with an NHS dentist let alone get an appointment. The previous Conservative government wrecked NHS dentistry and it is patients who have borne the brunt of this failure, with many left in terrible pain. The new government must urgently grip this situation and show the ambition necessary to deliver these promised appointments, end dental deserts and the awful practice of DIY dentistry.” Close to £500 million of the NHS dental budget for England was left unspent in 2022/23 as practices struggled to recruit and retain staff, missing targets set in their “flawed” NHS payment contracts. These funds were not ring fenced under the outgoing Tory government so have been largely lost from the dentistry front line.

The BDA says all these funds – around a sixth of the total NHS dental budget – should have already been earmarked to expand access for millions of patients by keeping NHS practices sustainable.

total budget for England has already seen a £1 billion real terms cut over the last decade due to inflation and has remained flat despite population growth. The BDA estimates the budget is only enough to fund care for half the population.

Health Minister Stephen Kinnock 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. Prevention is better than cure, so we will also introduce supervised tooth brushing for three to five-year-olds.”