Access to NHS dental care and the existing Dental Contract was debated in the House of Commons yesterday (18 January 2022).
The existing contract which was commissioned in 2006, remunerates dentists purely on activity, known as Units of Dental Activity (UDAs). These measure a practice’s activity, which are used to ensure that the correct amount of patient charges is collected. The 2006 contract effectively pays dentists per course of treatment, regardless of how many items are provided in it. The number of UDAs is related to the treatment bands which are laid out in the patients’ charges regulations.
The British Dental Association, which acts as a trade union and professional body representing all fields of dentistry has been pushing for reform of the 2006 NHS contract in England and Wales; advising that their members feel as if they are on a ‘treadmill’ with the focus of the contract on meeting targets as opposed to patient care. They have also found strong evidence that working under the contract is associated with stress and burnout amongst dentists.
Derek Thomas, MP for West Cornwall and the Isles of Scilly, raised the increasing difficulties his constituents face in trying to seek dental care;
“Right across Cornwall, there are vast numbers of children and adults that cannot get access to an NHS dentist", he said. "It’s not about funding, it’s not about Covid, it’s not even about the lack of dentists. It is just that the contract that they currently work with is no longer fit for purpose.
“Now next year, the responsibility of dentistry comes into Cornwall. Can we hear something from the Minister, maybe a statement, about how they are going to reform this contract which no longer works and holds dentistry away from the people that need it.”
In response, Minister Maria Caulfield MP for Lewes and Parliamentary Under-Secretary for the Department of Health and Social Care said, “Can I thank my Honourable Friend because he gets to the nub of the problem.
“The 2006 contract was introduced under the last Labour government, which is dependent on Units of Dental Activity, has perverse disincentives that dentists take on NHS work, and it is something we have already started work on reforming.”
Posting on Twitter yesterday, the BDA thanked Derek Thomas MP for highlighting the current crisis faced by so many dental patients across England. It noted, “Failure to make a decisive break from a discredited NHS contract will further impact millions of patients already unable to access care.”
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