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Accessing dental treatment in the NE and NC

Experiences of NHS dentistry

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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

Dentistry

Dentistry in Northumberland since March 2020

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The COVID-19 crisis has affected many areas of the NHS both locally and nationally. One significant issue that people have raised nationally is about access to dental care.

Data from the Department of Health highlights that almost 1,000 dentists working in 2,500 roles across England and Wales left the NHS last year. This is having an adverse effect on members of the public being able to see a local dentist for both regular check-ups and when emergency treatment is needed. Not only has this been frustrating, but many people have been left in pain or discomfort as a result. Some individuals have been offered the option of having private treatment, but this is not affordable for many.

Without improved access to NHS dental care, not only do people risk facing greater dental problems in the future, pressure will increase on overstretched hospitals and GPs. Untreated dental problems can lead to pain, infection and the exacerbation of other health conditions such as heart and lung disease and stroke. This national picture is echoed in Northumberland, and throughout the second half of 2021 we received feedback from the public that accessing NHS dental services was very difficult, whether registering with an NHS dentist or getting treatment.

With the need to now have lull time in the consulting room between patients, due to COVID-safe guidelines, there is no longer the capacity within NHS dental services to meet their targets, let alone deal with the backlog of appointments that didn’t go ahead due to the lockdown.

Following an initial meeting between Healthwatch Northumberland, Healthwatch North Tyneside, Healthwatch Newcastle, Healthwatch Gateshead and Healthwatch South Tees, the opportunity to work collaboratively with local Healthwatch partners across the North East was offered to all local Healthwatch. Collectively we agreed that there is a need for better access, to NHS dental services, but that this needed surveying and reporting both locally and on a regional basis.

Three other local Healthwatch joined the group: Healthwatch Hartlepool, Healthwatch Stockton-on-Tees and Healthwatch Darlington. These eight teams from the North East and North Cumbria Healthwatch Network agreed to undertake a joint project to understand the concerns of their respective local communities.

The aim of the study was to determine whether accessing NHS dental services is being raised by a small number of people having a problem or whether it is a more widespread issue. If it is a widespread issue, then to use our findings to:

  • Influence the North East and North Cumbria Integrated Care System (NE&NC ICS), local service providers, and NHS England to improve access to NHS dentistry.
  • Inform the national picture through sharing our findings with Healthwatch England who are calling for reform of the NHS dental contract alongside the British Dental Association (BDA).
  • Support improved information for patients regarding NHS dentistry.

Read our findings and recommendations below:

Experiences with dentistry in Northumberland since March 2020

Dentistry

Dentistry myth busting

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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.

NHS Dental Services

NHS dentistry services

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We know that some people have struggled to access the dental care they need during the pandemic. We want to hear about your experiences of trying to use NHS dentistry services since March 2020. Tell us what worked well for you and what could be better so we can help providers improve their services.

Due to strict infection control measures in place in dental practices, fewer appointments have been available causing a backlog of patients. We have been hearing that some people are unable to find an NHS dental practice which is taking on new patients while others aren’t sure where to go for urgent dental care.

We would like to hear about your experiences of accessing NHS dentistry since the start of the first lockdown.

The survey will run from Monday 29 November 2021 until Friday 7 January 2022. We will then combine our findings with colleagues at other local Healthwatch to build a regional picture of NHS dentistry services in the North East.

NHS Dentistry Survey

More information about finding an NHS dentist and what to do if you need urgent dental care is available on the NHS website:

How to find an NHS dentist

Get in touch with our Information and Signposting Service

 

This survey is now closed.

Dentistry

Healthwatch Dentistry Report

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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.

Public concerns about dentistry continue

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New data gathered by Healthwatch England shows access to NHS dentistry remains a huge problem for the public amid the COVID-19 pandemic.

Healthwatch continues to hear concerns about dentistry which were highlighted at the end of last year in the Dentistry and the impact of COVID-19 report after a 452% rise in calls and complaints over the summer (July – September).
In a follow-up review, Healthwatch looked at 1,129 people’s experiences of accessing dental care received between October and December 2020 and found:
  • Access to dentistry was difficult for more than seven in 10 people (72%), with some people actively seeking dental treatment being told they would have to wait anywhere between a few months to, in one case, two years for an appointment.
  • Access to urgent NHS treatment was difficult for people with painful teeth, with patients being told that dental pain was not considered an “emergency”, and for those who were prescribed multiple courses of antibiotics by NHS 111 without being provided any further treatment.
  • Examples of the extreme lengths some people went to, to get treatment, include calling over 40 practices to find an NHS dentist, and pulling their own teeth out when they couldn’t bear the pain.
  • When dentists couldn’t offer an appointment, they advised people to buy dental repair kits to treat themselves.

The findings come after some MPs and the British Dental Association called on the Government to scrap its new targets for NHS dentists, which require them to deliver 45% of their pre-pandemic levels of dental activity.

There are concerns this is likely to push practices into prioritising appointments such as check-ups over emergency or more complex longer treatments.

Healthwatch’s findings also suggest that patients are being told that although NHS appointments are not available, they can be treated privately. This creates a real barrier for everyone, and in particular for people on low income, to receive vital treatment.

Tell us about your experience of dental care during the pandemic here or text 07413 385275 and one of our friendly team will call you back.

Covid-19 and NHS dental care

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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.

Quarterly Report October – December 2019

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Introduction

As a listening organisation working across Northumberland, Healthwatch Northumberland wants to hear what people like about health and social care services and what can be improved. We act on what people are saying, sharing their views with those who have the power to make change happen. We also help people find the information they need about services in their area and record this as ‘signposting’.

We receive feedback from people living in Northumberland about their experiences throughout the year. This report shares a summary of the feedback collected from October to December 2019.  The next report will cover January – March 2020.

 

This quarter we received feedback and enquiries from:

  • Telephone calls, emails and social media (31%)
  • Postal surveys and feedback forms (12%)
  • Talking to people at local engagement events (27%)
  • Through a meeting (27%)
  • Through a third party (4%)

Areas of Focus

We are open to all feedback about health and social care services. Responses to our Annual Survey helped us to identify three specific Areas of Focus which we are prioritising in 2019/20:

  1. General Practitioner Services (GP Services)
  2. Mental Health Services, including dementia care
  3. Access to Services

Aims

The report aims to increase understanding of:

  • Who Healthwatch Northumberland is hearing from
  • What people are saying
    • The general sentiment of comments
  • What people are experiencing
    • What is working well?
    • Where there are areas for improvement?

Feedback

Between October and December 2019, we received 26 pieces of feedback through talking to people at local engagement events, telephone calls, emails, our website, surveys and feedback forms and other sources. Alongside this, we signposted 17 people to services. Altogether we had 39 different recordable interactions this quarter.

This report explores who Healthwatch Northumberland is hearing from across the county, presenting a summary demographic information of those who got in touch. Demographic information includes location, gender, age, and whether the respondent is sharing their own health and social care experience or speaking on behalf of a friend or relative.

We also look at whether the feedback is negative or positive, with specific reference to the service type (e.g. primary care, secondary care, mental health, social care), as well as whether the feedback relates specifically to quality of care or access to services.

Read the Quarterly Report for October to December 2019

Events

Share your experiences – join our online forum

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As we will be unable to get out and about across the county to meet with and listen to people for a while, we’re holding some public online forums, and we’d like you to join us. If you are unable to take part but would like to tell us about your experiences of these services, Caroline and Lesley will be available by phone, text and email each Wednesday between 3.00pm and 4.00pm to listen, answer any questions and help with providing information about services.

The forums will take place via Zoom. Read our guide on how to use Zoom.

Whilst some of our forums are on specific issues and services, this one is a chance to tell us about any health or social care service you’ve used in the last 12 months. That could be hospitals, GPs, care homes, NHS 111, mental health services, maternity services or dentists and pharmacies.

If you would like to take part please contact Laura Kane: laurak@healthwatchnorthumberland.co.uk, or call 03332 408468.

Find out more about our other online forums

 

Dental check up

Dental Services in Rothbury – Listening Event

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Following the closure of the Coquetdale Dental Surgery we are holding two events jointly with NHS England to understand the impact the closure has had for people in the different areas covered by the practice and to help with the development of services in the future. Please come along and talk to us if you can.

We are also holding an event in Hadston on Thursday 5 April at the Youth and Community Centre, between 10.00am and 1.00pm.

 

If you cannot attend one of these events and would like to leave feedback about dental services in these areas please contact us.

Dental check up

Dental Services in Hadston – Listening Event

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Following the closure of the Coquetdale Dental Surgery we are holding two events jointly with NHS England to understand the impact the closure has had for people in the different areas covered by the practice and to help with the development of services in the future. Please come along and talk to us if you can.

We are also holding an event in Rothbury on Monday 9 April at the Jubilee Hall, between 1.00pm and 3.00pm

 

If you cannot attend one of these events and would like to leave feedback about dental services in these areas please contact us.