The UK Government has announced significant expansion of routes to registration for overseas qualified dentists. It is seismic change to the dental workforce, but it feels like a quick fix.
There will be a tenfold increase in Licence in Dental Surgery (LDS) exams and an increase of a thousand plus in places for the Overseas Registration Exam (ORE). Clearly, it is right to address the scandalous backlogs here, but taken together it does not form a coherent response to the current crisis in the NHS and could leave applicants facing both uncertainty and exploitation.
The policy will see the total number of dentists potentially joining the UK dental register through any route rising from around 2,100 to up to 4,200 per year from 2028, with a potential for up to three quarters joining through international routes.
Overseas qualified dental professionals make a huge and welcome contribution to the sector, and applicants will need wrap-around support to enable them to deliver NHS care. We certainly do not have an immigration policy that offers real certainty these dentists can build a future here.
Recent proposals to change the immigration and settlement rules will inevitably make it much harder for these dentists to stay in the UK long term, which suggests this does not represent a sustainable approach. We have opposed these proposals as wrong in principle and in practice. This inevitable insecurity over long-term status in the UK will open these dentists up to far greater risk of exploitation.
Clearly there will be no automatic boost to the supply of NHS dentists, as registration alone is not enough to be able to work in the NHS. Any new registrants will need to get on the NHS performers list or equivalent, to assess the individual applicants' knowledge, skills and experience, and most likely some time with in-practice support.
At the end of the day overseas qualified dentists are no more willing to work within England’s failed, underfunded NHS dental system. Any credible solution to the current crisis rests on meaningful reform, underpinned by sustainable funding, together with a long term, genuinely sustainable approach to workforce planning.
In England, the funding allocated to NHS dentistry is now nearly all being spent on care. Therefore, if there is to be any additional NHS care provided by new registrants, it will require further investment that the Government has so far been unwilling to provide. Otherwise, there will be no NHS work for these dentists to perform.
The changes also include a rather modest increase to UK dental student numbers – which will not start to impact until 2032 – but we have also expressed concern that there needs to be the academic workforce within UK dental schools and NHS training places to support this expansion. It will be challenging to upscale to address all these issues for both UK students and overseas qualified dentists.
While this policy is technically ‘England only’ we know it will have implications UK-wide.
Clearly, this is a radical break from approaches taken to every other health profession. More new dentists will come through this pipeline than will graduate from UK dental schools.
But ultimately, it does not matter whether a dentist qualifies in Manchester or Mumbai. We will not keep talent working within a failed, underfunded NHS system without real change.