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Accessing dental treatment in the NE and NC

Experiences of NHS dentistry

Tell us your experience of NHS dentistry

People have been telling us about the challenges they face getting NHS dentistry.

Using your feedback we are working with the NHS Integrated Care Board in the North East and North Cumbria to help shape future services, including planning the next phase of the NHS dental recovery plan in the region.

Across the North East and North Cumbria, the local Healthwatch network is working together to tackle this important issue.

So if you live in Northumberland or anywhere else in the North East and North Cumbria region and have recent experiences with using or trying to access dental services, then share your experiences with us.

We are the independent champion for users of health and care services in Northumberland. Your responses will inform decision-makers in the North East and North Cumbria NHS Integrated Care Board (who are funding this research), service providers and partners including Local Authority Public Health teams.

As a thank you for your time we are offering £100 of Love2shop vouchers to a lucky prize draw winner.

If you require a paper copy or have any questions please get in touch.

Please leave your feedback before Sunday 31 March 2024.

This survey has now closed

NHS dentistry in Northumberland

NHS dentistry in Northumberland

As part of our work on NHS dentistry services in Northumberland, we, along with 29 other Local Healthwatch, made a formal submission to the House of Commons Health and Social Care Committee.  The committee has now published the submissions.

The Chair of the Committee, Conservative MP Steve Brine, was interviewed on the BBC Radio 4 PM programme on 6 March. The item is at 38 minutes in, with reference to Local Healthwatch just after 42 minutes.

In the interview Mr Brine says “We’ve had hundreds of pieces of written evidence from trade bodies, professionals, charities, people working in the profession, but quite a lot of it has been from local Healthwatch and from patients themselves, telling some pretty painful stories of…DIY dentistry…home tooth extractions, people tying shoelaces to teeth…”

At the Overview and Scrutiny Committee meeting on 7 March, our Project Coordinator Derry Nugent, urged local elected members to encourage their residents to contact us for issues such as this, which can only be fixed at national level.

NHS dentistry in Northumberland continues to be difficult to access, especially in the Berwick area. If you are in pain and need to see a dentist urgently, please call NHS 111.

Please keep sharing your experiences of NHS dental care, so that we can keep making sure these are heard by those paying for services.

 

Dentistry

Dentistry myth busting

Healthwatch teams across the North East have seen a significant increase in concerns around patients getting to see their local dentist. This is also a big problem across the rest of the country.

These concerns have been made worse by some common myths and misunderstandings around how dentist practices work. Here, we take a look at some of those myths.

1. ‘Registering’ at a practice

‘I saw my dentist a few years ago and now they say they can’t see me on the NHS. Aren’t I registered?’

Dental practices are set up within the NHS in a completely different way to GP practices so there is no formal patient registration within dentistry.

A patient is only ‘registered’ with a practice while undergoing treatment. So, you are free to approach any NHS dentist for treatment at any time.

2. They only want to work with private patients

‘My dentist said they could not see me on the NHS but offered me a private consultation.’

There is no formal patient registration within dentistry – NHS dental practices are commissioned to deliver a number of Units of Dental Activity (UDA) which they spread out over the year.

The number of UDAs used per day will depend on the treatment needs of the patients who contact the practice, for example, simple treatments like fillings and extractions equate to 3 UDAs, more complex treatment like crowns and bridges: 12 UDAs.

Whilst NHS provision must be available across the practice’s contracted opening hours, demand for NHS treatment may be so great that on any given day, depending on demand and the treatment needs of the patients who contact them, they could have used up all their NHS appointments when a patient rings.

They may, therefore, offer a private option to patients as an alternative, as they will have separate NHS and private appointment books, with separate clinical staff time allocated accordingly.

In line with national guidance all dental practices are required to prioritise patients based on clinical need and urgency into their available NHS appointments – this is called Triage. It is therefore important when you contact the practice that you fully explain the nature of your dental problem so that a clinical assessment can be undertaken to determine how quickly you need to be seen.

3. They are not doing routine work such as check-ups or scale and polish on the NHS

‘It’s impossible to get a routine check-up despite the fact I’ve not had one for over a year.’

All practices are currently working to national standard operating procedures which means that they have to prioritise patients based on clinical need and urgency. Therefore, their ability to take on patients for routine treatment such as check-ups is likely to be limited with the reduced capacity they are able to deliver, because of infection prevention control guidance.

However, if you have healthy teeth and gums, a routine check-up may not be needed for up to two years between appointments.

4. They are not doing emergency appointments.

‘I broke my tooth, but my dentist wouldn’t take me as an emergency appointment to fix it.’

Lost fillings, crowns or bridges, broken teeth or braces are not usually deemed to be clinically urgent, which means you may need to wait a little longer for an appointment.

Access to NHS urgent dental appointments is based on an individual clinical assessment of need. It is therefore important that you fully explain the nature of your dental problem to the practice or NHS 111 when you call, so they can correctly triage you.

 

Download the Dentistry Myth Busters PDF

If you have any further concerns about a dental service in your area, please visit the dental section of the NHS website where you can find further advice and an official complaints procedure.

Dentistry

Healthwatch Dentistry Report

Access to NHS dental care continues to be a problem for people across England, with Healthwatch recording a 22% rise in calls and complaints about dentistry between January and March 2021.

Healthwatch England’s review of 1,375 people’s experiences found a lack of consistency across the country when it comes to accessing a dental appointment. Whilst some people were asked to wait an unreasonable time of up to three years for an NHS appointment, those able to afford private care could get an appointment within a week.

High cost of dental care

Whilst some people were charged £400 to get one tooth out, an individual reported being asked to pay over £7,000 for their dentures privately. But private treatment is not an option for everyone, with many people now struggling to pay even for NHS treatment. A poll of 2,019 adults commissioned by Healthwatch England found 61% of respondents felt that NHS dental treatments were expensive. The poll, which looked at people’s experiences of NHS dentistry during the pandemic and how it has impacted their future habits, found the following:

People’s experiences of NHS dental charges

  • Over a quarter (27%) of respondents said they either struggle to pay or avoid dental treatments altogether because they cannot afford the costs.
  • About one in three (30%) have reported they felt pressured into paying private fees to get all the dental treatment they needed. And nearly two in five (39%) reported that they had been charged extra for their NHS treatments.
  • Almost a quarter (23%) feel they will now visit the dentist only when they need treatment, despite clinical guidelines recommending regular dental check-ups to keep people’s mouths healthy.
  • Demographic groups who have been affected the most by the lack of NHS dental appointments and NHS dental fees include people on low incomes and those from ethnic minority groups – the same groups who have been worst hit by the COVID-19 pandemic.
  • Calling for equitable and affordable dental care

Reform of dentistry has been underway since 2009. Earlier this year, it was announced that NHS England would be taking over the process from the Department of Health and Social Care, but reform plans have yet to be announced.

In a recent report on the future of the NHS, the Lancet Commission stressed ‘an absence of affordability is a major barrier to dental care’ and suggested an abolition of patients’ co-payments to access and receive dental care.

We call for greater ambition and urgency from NHS dental reform plans to create more equitable and affordable dental care.

Imelda Redmond CBE, National Director of Healthwatch England, said “The twin crisis of access and affordability hitting NHS dentistry means many people are not able to access timely care – and the poorest are hardest hit. Those human stories show that oral health is a social justice and equity issue.

Reform of dental contracts needs to be a matter of urgency for this government. New arrangements should include making access to NHS dental services equal and affordable for everyone, regardless of where people live, their income and ethnicity. Failing to act now will result in long-term harm for thousands of people, putting even greater pressure on the already overstretched healthcare system.”

Income and regional disparities

Almost twice as many people from lower socio-economic groups (SEG) D and E struggle or can’t afford to pay NHS dental charges (37%) than people from the higher socio-economic group, A, (19%). As a result, people from SEG D and E are also twice as likely to avoid dental care due to affordability issues.

People living in the North East of England are the most likely to avoid NHS dental treatment due to costs (13%), compared with just one in 30 (3%) who live in the South West. Despite this, people in the North East have been charged for NHS dental treatments the most (29%), while people in the South West were charged the least (13%).

People from ethnic minority groups

Just over a quarter of people from ethnic minority communities (26%) reported they would go to the dentist for regular check-ups, compared to two in five (41%) of White people.  The survey also found that people aged over 55 from ethnic minority groups who are on low incomes were six times more likely to report avoiding dental treatments due to costs than their White counterparts.

 

If you would like to tell us your experiences of dental care over the last 12 months please get in touch.

Covid-19 and NHS dental care

Healthwatch England is calling for action to address widespread issues with access to NHS dental care following an unprecedented surge in concerns. Healthwatch experienced a 452% increase in feedback on the issue in the second quarter of the year, with continuing accounts of people being left in pain, resorting to ‘DIY’ repair methods and in some cases even extracting their own teeth.

The review of 1,300 people’s experiences of accessing dental care found that:

  • More than 7 in 10 people (73%) found it difficult to access help and support when they needed it.
  • Access issues were caused by dentists not taking on NHS patients, as well as conflicting advice from different parts of the NHS about what help is available.
  • Many people were offered treatment if they went private, despite research indicating that 40% of people would struggle to afford private dental care.
  • The impact of not being able to access care led many people to experience pain, discomfort and further complications.

The increase in feedback comes after the British Dental Association reported that treatments delivered by NHS dental services in England are at a quarter of pre-COVID levels, with over 14.5 million fewer procedures taking place.

Laura Floyd, from West Berkshire, was part-way through significant dental treatment when it was cancelled due to the lockdown in March. The new mother explained: “As we went from April to May, I had an abscess develop on the tooth which was still awaiting treatment. I did receive care over the phone and a course of antibiotics which helped ease some of the pain and swelling but this never fully went away, I just lived with it as cautiously as I could. Sadly my eight-month-old wasn’t as cautious when reaching out and grabbing my face!”

Laura, who was entitled to free NHS dental care for 12 months after the birth of her child, did then receive some emergency treatment for a further painful cavity but is still waiting for her main treatment to be completed a year on from her initial diagnosis.

Sir Robert Francis QC, Chair of Healthwatch England, said: “The COVID-19 crisis has impacted on many areas of NHS support but, problems in dental care appear to be particularly acute.

“Even before the pandemic, people were telling us about problems in accessing NHS dental appointments but since the start of the summer these reports have hugely increased.

“If we don’t improve access to NHS dental care, not only do people risk facing far greater dental problems in the future but it also puts pressure on overstretched hospitals and GPs. Untreated dental problems can lead to pain, infection and the risk of long-term harm, which is comparable with other medical conditions.

“Health and care services are working hard to deal with the pandemic, but we believe the Government and the NHS should give more attention to resolving both long-standing and COVID-related issues in dentistry.”

While the report accepts that the overall treatment backlog caused by the pandemic will take time to clear due to limited industry capacity and COVID-related restrictions, it makes several recommendations including:

  • providing more accurate and up-to-date information for patients
  • providing clarity over NHS dentists’ obligations relating to patient registration
  • making more resources available to improve patient access to
    dental care and;
  • reviewing the overall cost to patients of NHS dental care, particularly with a 5% price increase set to take effect before Christmas.

Healthwatch is also calling for people on low incomes who are forced to travel long distances to access dental care to be reimbursed.

Read more on the Healthwatch England website

If you would like to tell us about your experience of accessing dental care during the pandemic you can tell us your story here.