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LONDON, UK: The British Dental Association (BDA) warned in early January that hundreds of dental practices would be put out of business if the government did not abandon NHS targets for patient volumes during the national lockdown. New polling has since revealed the extent to which UK residents are cancelling or avoiding dental treatment altogether, and Dr Dave Cottam, the BDA’s chair of the General Dental Practice Committee, says that when the facts change, so must the policies.
The seventh letter of preparedness for primary dental care—sent to UK dental professionals on 22 December—stated that dental practices must deliver 45% of contracted (pre-pandemic) units of dental activity for the period 1 January–31 March. Those that do not will face financial penalties. In a statement on 4 January, in light of the third national lockdown that was set to come into effect two days later, Cottam called the targets imposed by the government on NHS dentistry “impossible to justify”.
A 14 January BDA statement said that data from YouGov polling collected on 7–8 January had found that 46% of adults in England were likely to cancel a routine dental appointment if they had one booked during the lockdown. Close to half (45%) of the respondents said that the lockdown meant that they would be less likely to seek routine dental care, and one in six (16%) said that they would be less likely to seek dental care for urgent problems such as acute pain. The BDA said that its own data supported the YouGov polling figures. BDA survey results showed that, so far in 2021, 79% of dental practices had witnessed an increase in cancelled or missed appointments, and 43% had reported higher no-show rates.
The BDA said that the target meant that dentists were being forced to prioritise non-urgent care in order to keep patient volumes up, and it has called on the government to abandon the targets so that dental teams can focus on urgent cases without fear of financial penalties.
“As COVID rates surge to new levels, so are cancellations. A critical number of dental staff are also sick, self-isolating or struggling to secure childcare” – Dr Dave Cottam, BDA
In a letter sent to Secretary of State for Health and Social Care Matt Hancock and England’s Chief Dental Officer, Dr Sara Hurley, the British Orthodontic Society (BOS) said that the rationale behind the target was at odds with the lockdown measures that aimed to keep people indoors. The BOS said that, whereas it appreciated that emergency, urgent and high priority orthodontic care was permitted, “it is hard to argue that in the vast majority of cases it is urgent for treatment to start during what is widely regarded as the most dangerous phase of the pandemic to date, especially with transmission of the new COVID variant”.
The BDA stated in a press release that the two-fifths of practices that are currently operating below 36% of their targets are “facing a ‘cliff edge’ and the potentially ruinous return of the majority of their NHS funding for the period 1 January to 1 April 2021.”
Cottam wrote on the BDA blog that dental practices were open during the lockdown, but that patients were voting with their feet. He said: “As COVID rates surge to new levels, so are cancellations. A critical number of dental staff are also sick, self-isolating or struggling to secure childcare. So, we’ve gathered the evidence, on where the public stand and what our members are seeing at the coal face to show that the government must change tack on targets.”
He added: “NHS Targets that were always hard to justify now look impossible to deliver, leaving scores of dedicated practices set to go to the wall. All practices—NHS and private—need support, now more than ever.”