As the biggest reforms NHS dentistry in Wales has seen in a generation kick in today, it is very clear the Welsh Government’s failure to heed the concerns of this profession will leave a difficult legacy for the next administration.
Utterly untested, the new contract is a source of deep concern on the frontline and has been dogged by poor communication with both the profession and with patients. Dental labs - key to the NHS supply chain - have been kept completely in the dark.
Many already struggling practices are unclear if the new system offers a sustainable future for them and have handed back their NHS contracts. The success of the first year of operation will be crucial to ensure more do not follow. We pushed hard for conditions to allow for a learning year, and not a year where practices may suffer penalties due to an untested system.
Some health boards have recently seen 10% or more of their contract allocations returned to them by practices quitting the NHS. The remaining NHS capacity may be hard pushed to improve the situation.
Reforms will mean rationing of care, with less frequent appointments for many patients. At present recalls for healthier ‘green’ patients are already at 12 months with existing contract reform measures. New reforms will mean pushing this out for these patients to 18 or even 24 months.
The reforms will also see NHS dental charges increase by a large margin in many cases. With recent increases in the cost of living, these new charges could be unaffordable for many. A simple examination for a new patient will be going up from £20 to £27.21 – a 36% increase. An urgent appointment for a new patient will increase from £30 to £37.50 – a 25% increase. A patient with poor gums and high plaque scores in need of a periodontal package will first have to sufficiently reduce these scores themselves before they will be offered the care package at circa £48. While a simple restorative package at £36 is well below the current band 2 charge of £60, an extensive restorative package is £68.75 – an increase of 14.5%.
Patient charges will continue to be collected by dental practices for the foreseeable future. Welsh Government has delayed indefinitely bringing in a promised new system to relieve practices of the administration burden - they will need to continue to act as tax collectors at a cost to their bottom line.
Both the profession and the public have emphasised the need for much clearer communication about how the system will work. In an approach that we believe is indicative of the whole process, a long-awaited patient information leaflet which has been in production since last autumn has not yet been published.
We have published our own manifesto at what it is a ‘make or break’ moment for the service in Wales. A safety net is now needed to make these reforms sustainable for struggling practices, including a pause on full implementation until 2027 while a package of needed improvements is worked up.
We also need a decisive break from chronic underfunding, protections for the most vulnerable patients in Wales, and a wholesale change of tone from a new administration. This is not a negotiated contract, with any meaningful dialogue over the final package ending over 16 months ago.
“From today, many patients across Wales will have to get used to more costly, less frequent dental care” says Welsh General Dental Practice Committee Chair Russell Gidney.
“But the risk all now face is that utterly untested reforms will push more practices out of the NHS, taking the access crisis from bad to worse.
Whoever forms the next administration in Cardiff Bay will inherit a service on the very brink. They will need to put together a rescue package if NHS dentistry in Wales is going to have a future.”
We are committed to ensuring our members will get the wrap around advice and support they need. And we will continue to campaign to ensure the struggles you face remain at the forefront of the media and high on the political agenda. We urge all dentists in Wales to reach out to their candidates.
