Public’s confusion over ‘right’ to register with an NHS dentist.
Almost two decades after the public lost their right to register permanently with an NHS dentist, our new research shows two-thirds believe this right exists. Find out more about our findings and calls for dental reform.
We have published the first-ever research on people’s understanding of NHS dentistry and what they want from the service as the government develops its ‘Dental Rescue Plan’.
The poll, carried out in September by Savanta, reveals that most people in England have misconceptions about their ‘right’ to an NHS dentist and want changes to how they access dentistry.
Key findings
- Over two-thirds, 68%, of respondents mistakenly believe they have the right to register with an NHS dentist as they do with an NHS GP.
- When asked about their preference for getting NHS dental care, over half, 54% of 1,791 respondents said they want to be able to register with an NHS dentist as a permanent patient in the same way as they can with an NHS GP.
Read our poll
About NHS dental contract
People lost their right to register with an NHS dentist in 2006 when a new NHS dental contract was introduced to pay dentists per ‘unit of dental activity’ rather than getting paid per person registered on a list of permanent patients, combined with set fees for each treatment delivered.
The contract means a dentist has no long-term obligation to see patients on the NHS unless they are undergoing active treatment or dental work already carried out is under guarantee.
The contract is unpopular with dentists, with many cutting back NHS work and leaving people without NHS appointments, often with little warning.
Last year, Healthwatch England supported the call by MPs on the Health and Social Care Committee to reintroduce permanent registration rights for patients.
A GP-like dental scheme still operates in Scotland, where dentists are paid to treat each person on their list and set payments for certain procedures.
Access crisis continues
Healthwatch England’s polling shows people continue to struggle to access NHS dental appointments, despite the previous government’s efforts to improve access by introducing a new incentive payment for dentists.
A third, 33%, of respondents said they had to wait longer for their NHS dental treatment than they wanted.
One in six, 16%, said they hadn’t been able to find an NHS dentist who would treat them, with 27% of those having to seek private care in the last two years.
Confusion about dental charges
As well as being confused about ‘their right’ to an NHS dentist, the research suggests people are also unclear about NHS dental charges.
The poll found:
- One in five, 20%, said they had difficulties finding information about NHS dental fees.
- Similarly, 19%, believed they were charged more than advertised NHS dental charges.
- One in seven, 15%, of people who had seen an NHS dentist in the last two years felt pressured to pay privately.
- Younger people, 18-34, and people from ethnic minority groups were more likely to believe they were changed more for dental care. They were also more likely to feel pressured to pay privately than other demographic groups.
Steve’s story “You either pay or are not seen at all”.
Steve, 55, from Stow-on-the-Wold, Gloucestershire, is worried that nowadays he can only get private care at local dentists’.
Steve is an NHS patient, however, in recent years he’s been asked to pay for dental treatment. He said: “There are never any NHS slots available when you try to book an appointment with a dentist. So that means you have to pay or not be seen at all.”
Louise Ansari, Chief Executive at Healthwatch England, said:
“This research is a stark reminder that people continue to struggle to access NHS dental appointments, as dentists routinely ditch working to the NHS dental contract.
“There’s also confusion about the relationship between an NHS dentist and patients, with many patients mistakenly believing they can register with a dentist for life.
“It’s clear NHS dentistry is not fit for purpose and that people want a new kind of solution – a GP-style system, which will allow them to register permanently with a dental practice to access ongoing appointments and check-ups easily. “
“It’s now vital that government consults with the public and dental leaders to determine what kind of dental system they’ll deliver to improve people’s oral health now, and for future generations.”
The findings come as the government develops a Dental Rescue Plan to deliver 700k extra urgent NHS dental appointments for patients in the short term. However, no details have yet been set on the rescue plan, the timetable, or the terms for a long-term reform.
We have set out recommendations for the government and NHS England:
- NHS dentistry should be reformed to give everyone a GP-style right to be permanently registered with a dental practice to get both preventative and urgent care throughout their lifetime.
- The public should be consulted on any proposals being considered for long-term reform of NHS dentistry.
- The new patient payment introduced for dentists from March 1, 2024, should be evaluated and any findings published.
- Dental practices should clearly communicate to people what they need to do to be maintained as an NHS patient.
- Public awareness of how the NHS dental system works should be improved, to help people consider or plan for alternative sources of care if their practice chooses to stop providing NHS care.
Responding to the findings, an NHS England’s spokesperson said:
“While we know there is a lot more to do to improve access to dentistry services for patients, this should never be an excuse for dentists to require patients to join as private patients for their children to receive NHS dental care – that is completely unacceptable.
“The NHS has taken steps to improve access including incentivising dentists to work in underserved areas. And we will continue to work with the Government and the profession to reform the dental contract and deliver more appointments for patients.”
A Department of Health and Social Care spokesperson added:
“We inherited a dental sector suffering from years of neglect and it is our priority to turn it around.
“We will create 700,000 extra urgent dentistry appointments and reform the dental contract to make NHS work more appealing to dentists. We will also focus on preventing tooth decay among young children by introducing supervised brushing in schools for three to five-year-olds in areas where it’s most needed.”
I’ve been checking the Healthwatch Find NHS Dentist site in Sefton Borough for nearly 4 years and there have been none treating , accepting or registering NHS patients other than for Emergencies. Many also not accepting children, meaning early problems will be missed and turn into bigger ones.
It’s very clear that despite incentives, Dentists will no longer provide NHS Treatment unless forced to in an emergency.
In my case when the pain became too much, the Emergency Dentist, made it rudely clear that they didn’t want to treat NHS and told me to go to my GP for pain medication! The GP, of course, refused to help me. I then lost the tooth and it has led to my teeth moving out of position, which I can’t afford to get fixed.
The NHS , Health trusts, Government and local MP’s have stood by watching this happen , to the point there’s no NHS Dental Services, in reality.
It’s a complete Dereliction of Duty.
There are only two options to change this **and it needs changing soon** because too many people have been without Dental Care for the past few years.
1) Open NHS ONLY Dental Practices within existing NHS buildings, such as local hospitals, clinics, GP Practices, any suitable location.
2) Introduce emergency new legislation which ‘persuades’ Dental Practices to return to accepting NHS Patients.
My final point is, what has happened to all of the budget/ funding that has been in place for NHS Treatments in the past few years, when Dentists aren’t accepting it?
That must involve an exceptionally large amount of surplus money which surely could be used to fund NHS ONLY Dental Practices and stop relying on the Private Sector
What a terrible situation this is.
Many thanks for your comments, we will contact you privately too.
Best wishes,
Healthwatch Sefton.