John Beagley

Dear Mr Wooderson, Thank you for the Regulation 28 report of 19/03/26 sent to the Secretary of State and the Department of Health and Social Care about the death of Mr John David Beagley. I am replying as the Minister with responsibility for Secondary Care. Firstly, I would like to say how saddened I was to read of the circumstances of Mr Beagley’s death and I offer my sincere condolences to his family and loved ones. The circumstances your report describes are concerning and I am grateful to you for bringing these matters to my attention. The report raises concerns over a national shortage of oral and maxillofacial (OMF) surgeons and consultants which could impact on the care of patients. The report also raised concerns that a perceived long training period for these specialists, including long elements not funded by the NHS but by the student themselves, is making this a more unattractive specialty. In preparing this response, my officials have made enquiries with NHS England to ensure we adequately address your concerns. I understand your concern about the number of OMF surgeons and how important it is to retain this workforce to appropriately support patients. The Government also recognises the unique training pathway that is required to become an OMF surgeon, with applicants needing to have both a medical and dental degree. As of January 2026, there are over 1,300 full-time equivalent (FTE) doctors working in the specialty of OMF Surgery in NHS trusts and other core organisations in England. This is over 30 (2.4%) more than in 2025, over 50 (4.2%) more than in 2021, and almost 400 (41.8%) more than in 2010.This includes over 400 FTE consultants. This is over 5 (1.4%) more than in 2025, over 30 (8.7%) more than in 2021, and almost 160 (61.8%) more than in 20101. In 2025, OMF Surgery ST1 (entry level specialist training) filled 100% of posts (16/16), indicating complete recruitment at entry level and a stable inflow into the training pipeline. 1 https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statistics/january-2026

This has increased from 75% in 2024 (12/16) and matched its 100% fill rate in 2020 (9/9)2. Competition ratios further support an increase in entry level demand. In 2025, OMFS ST1 had a competition ratio of 3.50 (77 applications for 22 posts). This has increased from 1.89 in 2024 (34 applications for 18 posts) and as of 2025, there are 147 trainees in the OMF Surgery training programme. This is 1 (0.7%) more than in 2024 and 9 (6.5%) more than in 20203. Up until 2026, there has been another application point for the specialty at ST3, which is a part of higher specialty training and requires applicants to have completed core training and relevant exams. Due to reducing fill levels at ST3, all recruitment for OMF Surgeons will be at ST1 from 2027 onwards. At ST1 level (run-through training), applicants are more likely to have both a medical and a dental degree. However, by the time resident doctors are eligible to apply at ST3 level, they are either unlikely to have both degrees (and therefore not eligible) or for various reasons they wish to work in particular region and posts may not be available where they want to work. Individual NHS Trusts and other employers are responsible for ensuring that there are sufficient and appropriate staff to provide safe care. I would expect NHS Trusts to review their staffing levels, and access to specialists where needed, to ensure that they are appropriate to treat patients who come forward seeking care. Trusts already have a duty through the Health and Social Care Act 20084 to regularly review the number of staff and range of skills needed to safely meet the needs of people using their services As your report raised, and I mentioned earlier, OMF surgeons have a lengthy training process whereby they train as both doctors and dentists before beginning the specialist training to become a fully fledged consultant in their field. There are some universities that offer a shortened 3-year postgraduate degree for qualified doctors who want to go into the OMF field and I believe the appropriate Specialty Advisory Committee within the Faculty of Dental Surgery are working with universities to expand these courses. There is a high competition ratio for places on these courses, further implying desire among medical graduates to work in OMF specialties. I fully appreciate the concerns about costs for training. The Department for Education is bringing forward a Lifelong Learning Entitlement (LLE) system which will mean an improved funding offer for individuals studying medicine or dentistry as a second degree. From January 2027, all courses funded by the current Student Finance England (SFE) system will be funded by the new LLE system. 2 https://medical.hee.nhs.uk/medical-training-recruitment/medical-specialty-training/fill-rates 3 https://gde.gmc-uk.org/postgraduate-training/postgraduate-trainees/postgraduate-trainees-summary-data 4 Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 – Regulation 18

Currently, students undertaking medicine or dentistry as a second degree are required to either partially or fully self-fund their tuition fees in study years that are not covered by the NHS Bursary. Under LLE, eligible students choosing medicine or dentistry as a second degree will be able to access maintenance support and full tuition fee loans during these years. Those who qualify will still be able to receive the NHS Bursary from year two of a graduate-entry programme or from year five of a standard 5-6 year long course. The NHS Bursary comprises non-repayable support for tuition fees and where eligible, further grants and allowances. The Government keeps the funding arrangements for all healthcare students under close review. At all times we must balance the level of support students receive with the need to deliver as much value as possible for taxpayers’ money. I hope this response is helpful. Thank you for bringing these concerns to my attention.