Home / Sources / Select Committees / Health and Social Care Commit… / NHS dentistry
Select committee: Health and Social Care Committee

NHS dentistry

Closed Opened 7 Dec 2022 Closed 30 May 2024 15 recommendations 11 conclusions

Health and Social Care Committee Inquiry on parliament.uk ↗

Inquiry scope (the committee's words)
The Health and Social Care Committee has launched an inquiry into dentistry following a survey that showed 90% of practices across the UK were not accepting new adult NHS patients. MPs will consider to what extent the current NHS dental contract disincentivises dentists from taking on new patients. They will look at what incentives can be offered by the NHS to recruit and retain dental professionals, also explore the role of training. They will also explore the possible impact of changes to be introduced next April to make new Integrate Care Systems and Integrated Care Boards responsible for the provision of dental services.

Where it stands

The inquiry is closed, opened 7 December 2022.

The committee has published 1 report, most recently Ninth Report - NHS dentistry on 14 July 2023.

The government's response

Published 13 December 2023. The deadline was 14 September 2023.

Summary written by Accountability Index from the government's response. It is not the government's own words.

The government states that it "accepts the majority" of the Committee's recommendations, rejects the proposal to reinstate patient registration "at this time", and says a Dentistry Recovery Plan "will be published shortly".

  • It accepts the recommendation on a public information campaign, noting NHS England is working on "a suite of public facing documents" and that practices must now update their NHS website profile every quarter.
  • On the dental contract it "partially accepts" the call for reform, stating that "there is no one perfect payment model", and says it is "working on further reforms to the 2006 contract, in discussion with the profession".
  • It "rejects" reinstating patient registration "at this time" and has "no current plans to introduce registration", saying the current model allows "greater choice and flexibility for patients".
  • On the ringfence for NHS dentistry funding, it accepts the recommendation but says it is "currently considering arrangements for 2024/25", and notes that in November NHS England confirmed ICBs could retain any underspend.

Read the government's response ↗ Report an error

Recommendations and conclusions

All 26 recommendations and conclusions

Reports

All reports

Evidence

  • 3 oral evidence sessionsLatest 19 March 2024
  • 83 written submissions
  • 17 witnesses
All evidence

Recent activity

Recommendations and conclusions 26 shown

1: NHS dentistry faces a crisis of unequal access across different regions and groups.

Conclusion · Ninth Report - NHS dentistry · Addressed to Department of Health and Social Care

Concluded (the committee's words)
We believe there is a crisis of access in NHS dentistry. Many people are unable to access an NHS dentist or are travelling significant distances to get to one. Access varies across the country and is being experienced unequally by different groups. We believe everyone should be able to access an NHS dentist when they need one, wherever they live.

Link to this item · Read this item

2: Require Government to outline timeline and strategy for universal NHS dental access

Recommendation · Ninth Report - NHS dentistry · Addressed to Department of Health and Social Care

Recommended (the committee's words)
We welcome the Government’s ambition for everyone who needs an NHS dentist to be able to access one. This ambition must ensure access within a reasonable timeframe and a reasonable distance. The Government must set out how they intend to realise this ambition and what the timeline will be for delivery. It is vital that this ambition is the central tenet of the Government’s forthcoming dental recovery plan. Once the plan has been published, we will revisit the recommendations in this report to assess it against this criteria.

Link to this item · Read this item

3: Roll-out patient information campaign to clarify NHS dental services and entitlements

Conclusion · Ninth Report - NHS dentistry · Addressed to Department of Health and Social Care

Concluded (the committee's words)
A lack of public awareness about NHS dental services and how practices operate is contributing to access issues. The Government and NHS England should roll-out a patient information campaign with the aim of improving awareness of how NHS dentistry will work and ensure the public are better informed about what they are entitled to. This should clarify common misconceptions, for example, about patient registration, recall periods, and NHS dental charges and exemptions.

Link to this item · Read this item

4: Mandate practices to adhere to NICE recall guidelines and prevent automatic patient removal

Conclusion · Ninth Report - NHS dentistry · Addressed to Department of Health and Social Care

Concluded (the committee's words)
Practices should abide by NICE recall guidelines of up to two years for most adult patients, recognising the need for more regular recall for some, but people should not automatically be removed from dentists’ registers of NHS patients without good reason. This should be monitored by NHS England to ensure it is being carried out.

Link to this item · Read this item

5: Permanently apply ringfence to prevent diversion of NHS dental funding by ICBs

Recommendation · Ninth Report - NHS dentistry · Addressed to Department of Health and Social Care

Recommended (the committee's words)
We welcome the fact that to try and address the underspend, NHS England is applying a ringfence for 2023/24, to ensure that no ICB can divert funding away from NHS dentistry. We recommend that this ringfence applies permanently, and NHS England puts in place transparent scrutiny to ensure compliance.

Link to this item · Read this item

6: NHS England's interventions on under-delivering providers welcomed; urgent flexible funding required

Conclusion · Ninth Report - NHS dentistry · Addressed to Department of Health and Social Care

Concluded (the committee's words)
We also welcome measures by NHS England to intervene on providers who are under-delivering on contracted NHS activity. We look forward to an update on how this work is progressing. We welcome this funding being used flexibly, however there cannot be further delays in doing so.

Link to this item · Read this item

7: Urgently implement fundamental dental contract reform to address access crisis

Recommendation · Ninth Report - NHS dentistry · Addressed to Department of Health and Social Care

Recommended (the committee's words)
Fundamental reform of the dental contract is essential and must be urgently implemented, not only to address the crisis of access in the short-term, but to ensure a more sustainable, equitable and prevention-focussed system for the future. We are concerned that any further delay will lead to more dentists leaving the NHS and exacerbate the issues patients are experiencing with accessing services.

Link to this item · Read this item

8: Urgently implement fundamentally reformed dental contract, moving away from UDA system

Recommendation · Ninth Report - NHS dentistry · Addressed to Department of Health and Social Care

Recommended (the committee's words)
We welcome the Government’s recognition of the need for dental contract reform. The Department and NHS England must urgently implement a fundamentally reformed dental contract, characterised by a move away from the current UDA system, in favour of a system with a weighted capitation element, which emphasises prevention and person-centred care. This should be based on the learnings from the Dental Contract Reform Programme and in full consultation with the dental profession.

Link to this item · Read this item

11: NHS dentist headcount does not reflect actual NHS work or address access issues

Conclusion · Ninth Report - NHS dentistry · Addressed to Department of Health and Social Care

Concluded (the committee's words)
The Government states that the number of NHS dentists has increased over the past year. However, while the headcount has gone up over the past year, it has gone down over the past three years, and moreover headcount alone does not reflect how much NHS work these dentists are undertaking. We heard repeatedly that a lack of dentists and dental care professionals undertaking NHS work is the main driver behind both lack of access to appointments for patients, and the underspend in primary care dentistry.

Link to this item · Read this item

12: Commission a comprehensive dental workforce survey on NHS staffing and activity levels.

Recommendation · Ninth Report - NHS dentistry · Addressed to Department of Health and Social Care

Recommended (the committee's words)
The Government and NHS England should commission a dental workforce survey to understand how many full-time and part-time-equivalent dentists, dental nurses, therapists and hygienists are working in the NHS, and how much NHS and private activity they are undertaking, alongside demographic data such as age and location.

Link to this item · Read this item

13: Improve routine data collection on NHS dental workforce numbers, activity, and demand.

Recommendation · Ninth Report - NHS dentistry · Addressed to Department of Health and Social Care

Recommended (the committee's words)
The Government and NHS England must improve the routine data that is collected on the number of NHS dentists and the wider dental team, and the levels of NHS activity they undertake, as well as data on demand, to assist with workforce planning and identifying gaps in provision. This must be addressed in the forthcoming dental recovery plan. Until such a time, the Government should focus on statistics which show the levels of NHS dental activity.

Link to this item · Read this item

14: Introduce urgent incentives to attract and retain dentists for NHS work.

Recommendation · Ninth Report - NHS dentistry · Addressed to Department of Health and Social Care

Recommended (the committee's words)
Any contract reform now will almost certainly be too late for those dentists who have already left the NHS or are considering doing so in the near future. The Government must urgently introduce incentives to attract and retain dentists to undertake NHS work. These should include, but not be limited to, the reintroduction of NHS commitment payments, incentive payments for audit and peer review, and the introduction of late career retention payments. The development of a careers framework should be considered, including on-going education, supervision and support. This should form part of a wider package, accompanied by a communications drive, to entice professionals to return to NHS dentistry.

Link to this item · Read this item

16: Advancing Dental Care Review shows potential but immediate incentives needed for supply and demand.

Conclusion · Ninth Report - NHS dentistry · Addressed to Department of Health and Social Care

Concluded (the committee's words)
We support the implementation of the work of the Advancing Dental Care Review. Centres for Dental Development could have the potential to change how we approach training dentists in the UK to meet the needs of the populations who most require care. However, these are in their early stages and their outputs will need to be assessed. We also recognise that incentives are required in the short-term to address the immediate challenges with supply and demand.

Link to this item · Read this item

17: Unacceptable backlog of Overseas Registration Exam applications hinders NHS dentist numbers.

Conclusion · Ninth Report - NHS dentistry · Addressed to Department of Health and Social Care

Concluded (the committee's words)
The backlog of applications for the Overseas Registration Exam is unacceptable and resolving this represents an opportunity in the short term to increase the number of dentists working in the NHS, and therefore create more appointments to enable patients to access much-needed services.

Link to this item · Read this item

18: Work with GDC to clear Overseas Registration Exam backlog and speed up international registration.

Recommendation · Ninth Report - NHS dentistry · Addressed to Department of Health and Social Care

Recommended (the committee's words)
The Government must work with the General Dental Council to ensure the backlog of applications for the Overseas Registration Exam is cleared in a timely manner, and to speed up changes to the process of international registration for new applicants seeking to work in the NHS.

Link to this item · Read this item

19: Absence of dental contract in Workforce Plan reflects lack of priority for reform.

Conclusion · Ninth Report - NHS dentistry · Addressed to Department of Health and Social Care

Concluded (the committee's words)
We are concerned that the absence of explicit mention of the dental contract in the Long Term Workforce Plan reflects the lack of priority given by the Government and NHS England to contract reform. We believe it indicates a lack of recognition of the urgent need for reform before any other workforce initiatives can be implemented.

Link to this item · Read this item

20: Ensure full consultation with professionals on potential graduate NHS dental tie-in policy.

Recommendation · Ninth Report - NHS dentistry · Addressed to Department of Health and Social Care

Recommended (the committee's words)
Given the varying views expressed regarding a tie-in for new graduates into NHS dentistry, we urge NHS England and the Government to ensure full consultation with professionals and representative bodies, as they seek to explore the potential merit of such a policy, although its success depends on fundamental contract reform, and should be accompanied with a careers framework.

Link to this item · Read this item

21: Ensure dental profession representation on Integrated Care Boards for informed decision-making.

Recommendation · Ninth Report - NHS dentistry · Addressed to Department of Health and Social Care

Recommended (the committee's words)
The dental profession should be represented on Integrated Care Boards to ensure they have the necessary expertise to inform decision-making around contracting and flexible commissioning. This should include wider engagement with the profession locally, for example through Local Dental Committees and Local Dental Networks.

Link to this item · Read this item

22: Gather and review ICB membership data, assessing representation and policy effectiveness for NHS dental services.

Recommendation · Ninth Report - NHS dentistry · Addressed to Department of Health and Social Care

Recommended (the committee's words)
We contest the Department’s rejection of the recommendation in our ‘Integrated Care Systems: autonomy and accountability’ report, and reiterate that they should centrally gather information relating to the membership of ICBs, including the specific role of members and their area of expertise. We also recommended the Department should review that information with a view to understanding whether the policy of keeping mandated representation to a minimum is the right one and whether any specialties are especially under-represented. We believe this is particularly relevant in the case of NHS dental services.

Link to this item · Read this item

23: Provide evidence on the effectiveness of initiatives for commissioning local dental services to ICBs.

Recommendation · Ninth Report - NHS dentistry · Addressed to Department of Health and Social Care

Recommended (the committee's words)
We welcome the initiatives outlined by the Chief Dental Officer to help ICBs commission dental services in a way that best meets the needs of their local populations. NHS 36 NHS dentistry England should provide evidence of the effectiveness of these initiatives, so that ICBs can see for themselves which options they could most usefully pursue and best practice is spread.

Link to this item · Read this item

24: Provide clarity to ICBs on commissioning flexibilities for NHS dental services and resource targeting.

Recommendation · Ninth Report - NHS dentistry · Addressed to Department of Health and Social Care

Recommended (the committee's words)
In light of the current national contracting arrangements, NHS England must provide clarity to ICBs about what flexibilities they have with regard to commissioning NHS dental services and targeting resources according to the needs of their populations.

Link to this item · Read this item

26: Mandate all ICBs to complete oral health needs assessments by July 2024 with NHS England support.

Recommendation · Ninth Report - NHS dentistry · Addressed to Department of Health and Social Care

Recommended (the committee's words)
By the end of July 2024, every ICB should have undertaken an oral health needs assessment, in consultation with service users, patient organisations and the profession. NHS England should provide support to ICBs to undertake this, including sharing examples of best practice and learnings from other ICBs. NHS England must also ensure each assessment is sufficient to meet its intended purpose.

Link to this item · Read this item

Reports

1 report

Oral evidence sessions

3 sessions

On smaller screens, scroll horizontally to read every column. Keyboard users can focus the table region and use the arrow keys.

Date Session and witnesses Source
19 Mar 2024
Oral evidence session
Dr Amanda Doyle OBE · NHS England, Jason Wong MBE · NHS England, Rebecca Curtayne · Healthwatch England, Rt Hon Andrea Leadsom MP · Department of Health and Social Care, Shawn Charlwood · British Dental Association (BDA) General Dental Practice Committee, Thea Stein · Nuffield Trust 		View ↗
25 Apr 2023
Oral evidence session
Chris McCann · Healthwatch England, Dr Amanda Doyle · NHS England, Jo York · Hampshire and Isle of Wight Integrated Care Board, Neil O'Brien MP · Department of Health and Social Care, Sarah Fletcher · Healthwatch Lincolnshire, Sara Hurley · NHS England 		View ↗
21 Mar 2023
Oral evidence session
Dr Abhi Pal · College of General Dentisty, Dr Sandra White · Association of Dental Groups, Ian Brack · General Dental Council, Malcolm Smith · Health Education England North East, Professor Nick Barker · University of Essex, Shawn Charlwood · British Dental Association (BDA) General Dental Practice Committee 		View ↗

Written evidence

83 submissions recorded

Submission metadata is shown here; use the source links to read the evidence on Parliament’s website.

Showing the latest 50 of 83 recorded submissions. Written evidence in the activity timeline uses this same preview. Browse the inquiry on Parliament.

On smaller screens, scroll horizontally to read every column. Keyboard users can focus the table region and use the arrow keys.

ReferenceDateSubmitter
DTY0106 26 Mar 2024 Department for Health and Social Care
DTY0105 26 Mar 2024 Healthwatch England
DTY0104 11 Jul 2023 Department of Health and Social Care
DTY0103 19 Apr 2023 National Audit Office
DTY0034 14 Mar 2023 Mr Michael Furminger
DTY0074 10 Mar 2023 Professor Paul Batchelor, UCLan
DTY0072 10 Mar 2023 Healthwatch Bolton
DTY0071 10 Mar 2023 Denplan (Simplyhealth - WA Communications)
DTY0070 10 Mar 2023 Healthwatch Lincolnshire
DTY0069 10 Mar 2023 Plymouth Community Dental Services Ltd
DTY0068 10 Mar 2023 Healthwatch Richmond
DTY0067 10 Mar 2023 Healthwatch Isle of Wight
DTY0066 10 Mar 2023 Newcastle University School of Dental Sciences
DTY0065 10 Mar 2023 Oral Health Foundation
DTY0064 10 Mar 2023 The Challenging Behaviour Foundation
DTY0063 10 Mar 2023 Faculty of Dental Surgery, Royal College of Surgeons of England
DTY0073 9 Mar 2023 LDC Confederation
DTY0015 7 Mar 2023 Healthwatch East Riding of Yorkshire
DTY0014 7 Mar 2023 Mr Vijay Sudra, Shard End Dental Pactice
DTY0009 7 Mar 2023 Mr Martin Turver, Licensee
DTY0008 7 Mar 2023 Mr Philip Martin, Whitehouse Dental Surgery
DTY0005 7 Mar 2023 Robert Barker, Private
DTY0002 7 Mar 2023 Dr Eurico Martins, Self employed
DTY0003
Full text not held
 7 Mar 2023 Anonymised
DTY0006
Full text not held
 7 Mar 2023 Anonymous
DTY0030 7 Mar 2023 Healthwatch Hertfordshire
DTY0029 7 Mar 2023 The Dental Defence Union (DDU)
DTY0028 7 Mar 2023 Gill Furniss, UK Parliament
DTY0027 7 Mar 2023 Healthwatch Liverpool
DTY0024 7 Mar 2023 Bupa Global & UK
DTY0023 7 Mar 2023 Birmingham Local Dental Committee
DTY0021 7 Mar 2023 Healthwatch Northumberland
DTY0020 7 Mar 2023 Mr R Bannister, Swan Dental Practice
DTY0016 7 Mar 2023 Healthwatch Middlesbrough & Healthwatch Redcar and Cleveland (Healthwatch South Tees)
DTY0045 7 Mar 2023 West Yorkshire Joint Health Scrutiny Committee
DTY0043 7 Mar 2023 Dr Andrew Bell, John G Plummer and Associates
DTY0041 7 Mar 2023 Healthwatch Derbyshire
DTY0040 7 Mar 2023 Parliamentary and Health Service Ombudsman
DTY0039 7 Mar 2023 Healthwatch Southend
DTY0038 7 Mar 2023 Association of Dental Groups
DTY0037 7 Mar 2023 Healthwatch Worcestershire
DTY0036 7 Mar 2023 Jan Cuerden
DTY0033 7 Mar 2023 Dental Protection
DTY0032 7 Mar 2023 Healthwatch Cambridgeshire and Peterborough
DTY0031 7 Mar 2023 Healthwatch Staffordshire
DTY0058 7 Mar 2023 Hertfordshire Local Dental Committee (LDC)
DTY0057 7 Mar 2023 Healthwatch North Lincolnshire
DTY0055 7 Mar 2023 Healthwatch Norfolk
DTY0053 7 Mar 2023 Healthwatch Sheffield
DTY0052 7 Mar 2023 Healthwatch North East Lincolnshire

Who gave evidence

17 witnesses

On smaller screens, scroll horizontally to read every column. Keyboard users can focus the table region and use the arrow keys.

WitnessOrganisationSessions
Shawn Charlwood · Chair British Dental Association (BDA) General Dental Practice Committee 2
Chris McCann · Director of Communications, Insight and Campaigns Healthwatch England 1
Dr Abhi Pal · President College of General Dentisty 1
Dr Amanda Doyle · National Director for Primary Care and Community Services NHS England 1
Dr Amanda Doyle OBE · National Director for Primary Care and Community Services NHS England 1
Dr Sandra White · Clinical Director Association of Dental Groups 1
Ian Brack · Chief Executive and Registrar General Dental Council 1
Jason Wong MBE · Interim Chief Dental Officer NHS England 1
Jo York · Managing Director Hampshire and Isle of Wight Integrated Care Board 1
Malcolm Smith · Chair, HEE's Advancing Dental Care Review and Dental Education Reform Programme, and Postgraduate Dental Dean Health Education England North East 1
Neil O'Brien MP · Parliamentary Under-Secretary of State for Primary Care and Public Health Department of Health and Social Care 1
Professor Nick Barker · General Dental Practitioner and Professor of Oral Health Science University of Essex 1
Rebecca Curtayne · External Affairs Manager Healthwatch England 1
Rt Hon Andrea Leadsom MP · Parliamentary Under-Secretary of State (Minister for Public Health, Start for Life and Primary Care) Department of Health and Social Care 1
Sara Hurley · Chief Dental Officer NHS England 1
Sarah Fletcher · Chief Executive Officer Healthwatch Lincolnshire 1
Thea Stein · Chief Executive Nuffield Trust 1