NHS 10-Year Plan “Rings Hollow”

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BDA and BSPD respond differently to NHS 10-Year Plan

The British Dental Association (BDA) has expressed disappointment that despite a heavily trailed focus on both primary care and prevention, the government has failed to outline a coherent strategy for dental services within its 136-page NHS 10-Year Plan.

The Plan makes reference to supporting dental services via its Starting Well initiative, claiming it supports 24,000 dentists across England to “see more children from a young age to form good oral health”. In reality the programme is not receiving any new investment; and is active in a handful of wards in just 13 English local authorities. References are also made to addressing oral health needs of care home residents and children with learning difficulties.

The PM launched her plan in Liverpool’s famed Alder Hey paediatric hospital. Tooth decay remains the number one reason for child hospital admissions, with official data showing that in Liverpool alone 4,000 children have undergone hospital extractions in the last five years, costing up to £1 million a year.

There were 45,077 extractions of multiple teeth in under-18s across England in 2017/18 at a cost of £38.9 million, according to NHS spending data. No children in Merseyside will currently benefit from the government scheme.

Since taking office Health Secretary Matt Hancock has consistently pledged to put prevention at the heart of NHS strategy – but has failed to invest in public health activity or make any tangible commitment to dentistry.

“Put the Mouth Back in the Body”

The Westminster Government's spend per head on NHS dentistry has fallen by £4.95, from £40.95 to £36, in the last five years. Academic research has pointed to significant pressures placed on both GP and A&E services, in part thanks to NHS charges pushing large volumes of dental patients to other parts of the health system.

The plan also failed to address the NHS’s workforce issues, including the growing recruitment and retention crisis in the dental profession, fuelled by the discredited NHS dental contract. The system, based on hitting tough activity targets for curative treatment, has helped fuel access issues across England and stifled prevention. BDA surveys have estimated that 65% of practices who tried recruiting in 2017 experienced difficulties filling vacancies, leaving patients without access to NHS care.

BDA Chair Mick Armstrong said: “Warm words on prevention will ring hollow as the government fails to acknowledge the challenges facing 24,000 NHS dentists.

“The Prime Minister launched her strategy at a paediatric hospital, serving a city that spends £1 million a year extracting rotten teeth from children. We have faced year on year cuts, a recruitment and retention crisis, and have patients travelling over 50 miles to secure access to basic services. Now a single unfunded scheme is being offered as a substitute for proper resources and a coherent plan.

“If government really intends to put the mouth back in the body they need to work with this profession on implementation. The alternative is to keep treating dentistry as an afterthought, and let the NHS pay the price.”

BSPD Welcomes 10-Year Plan

The inclusion of children’s oral health in the NHS Long Term Plan – published Monday 7th January – has been welcomed by the British Society of Paediatric Dentistry which has been campaigning for oral health to be recognised as a marker for general well-being and a priority for prevention.

Although the Plan contains no chapter or even paragraph heading for oral health, the BSPD reasons that the fact it is mentioned in the context of holistic care for children represents significant progress, considering that it has been excluded from earlier strategies for the NHS.

The document states that local areas should design and implement models of care that will “support health development by providing holistic care across local authority and NHS services, including primary care, community services, speech and language therapy, school nursing, oral health, acute and specialised services.”

Dentistry is also included in references to children with learning disabilities. The NHS plan commits towards investment to ensure that this cohort of children have needs met in relation to eyesight, hearing and dental services.

Claire Stevens, spokesperson for BSPD, commented: “It’s really good to see recognition for oral health in the NHS Long Term plan. I am delighted that there is a mention for Starting Well, the prevention programme launched in 2017 in high priority areas. We would like to see this extended into other areas where there are high levels of dental decay. “