NHS dental workforce data gaps

#9 —

Public Accounts Committee

Recommendation: The threadbare provision of NHS funded dental care is a further example of a failure to provide preventative or protective routine care leading to more acute health problems.24 NHS England, rather than ICSs, remains responsible for most of NHS dentistry …

Gov response: 6.1 The government agrees with the committee’s recommendation Recommendation implemented 6.2. Securing recovery of dental access is a key NHS priority. The pandemic had a significant impact on the delivery of dental services and NHS …

Accepted

#6 —

Public Accounts Committee

Recommendation: NHS funded dental care is in crisis in some parts of the country, and NHS England’s failure to ensure people can access routine dental care is leading to more acute dental health problems. NHS England, rather than ICSs, remains responsible …

Gov response: The government agrees with the committee’s recommendation 6.2. Securing recovery of dental access is a key NHS priority. The pandemic had a significant impact on the delivery of dental services and NHS England is taking …

Accepted

#31 — NHS dental workforce maldistribution creates shocking regional inequalities in access to care.

Public Accounts Committee

Recommendation: It is also clearly the case that NHS dental workforce issues are much more pronounced in some parts of England than others and that this is leading to some shocking regional inequalities in access to dental care.92 At the lowest …

Gov response: 1.5 Reforming the dental contract needs careful consideration and this will take time. In the meantime, the government is addressing the immediate challenges for patients trying to access NHS dental care by delivering 700,000 extra …

Accepted

#29 — NHS dental workforce declines, facing over 5,500 unfilled vacancies nationally

Public Accounts Committee

Recommendation: The NAO reported that in 2023–24 there were 24,193 dentists providing some NHS dental care in England, a 2% decline on the total since 2019–20.87 NHSE data outlines that there is a large workforce gap that exists in NHS dentistry, …

Gov response: 1.5 Reforming the dental contract needs careful consideration and this will take time. In the meantime, the government is addressing the immediate challenges for patients trying to access NHS dental care by delivering 700,000 extra …

Partially Accepted

#3 — Publish updated land value estimates to support effective land value capture reforms.

Housing, Communities and Local Government Committee

Recommendation: Any reforms to land value capture should also be considerate of the wider tax system, to balance public needs and equitable charges on development. To support this work, the Government should publish updated land value estimates, which were last published …

Gov response: 29. The Government is developing updated land value estimates for use in policy appraisal. The aim is to publish updated values for a range of land uses this year. Reforms to Section 106 Agreements

Position Not Stated

#28 — Current UDA-contract system unfit for purpose in NHS dental services.

Health and Social Care Committee

Recommendation: The current UDA-contract system is not fit for purpose, and urgent reform is needed to boost recruitment and retention in NHS dental services. We will return to this issue in a forthcoming inquiry into dental services.

Not Addressed

#32 — DHSC and NHSE initiatives seek to improve dental workforce numbers and distribution.

Public Accounts Committee

Recommendation: DHSC and NHSE have begun some strands of work that might usefully improve the workforce situation if they are fully implemented. For example, there is a commitment in the NHS long–term workforce plan to increase training places for dentists by …

Gov response: 6.1 The government agrees with the Committee’s recommendation. 6.2 In Spring 2024, the department ran a 6-week consultation on a ‘tie-in’ to NHS dentistry for newly qualified dentists. The department is in the process of …

Not Addressed

#17 — Limited progress and insufficient data for evaluating other dental recovery plan initiatives

Public Accounts Committee

Recommendation: In terms of the other initiatives, NHSE confirmed that it is too early to say whether the uplift to £28 minimum UDA value has had any impact.46 It said that it will only be after the year end that data …

Gov response: 2.1 The government agrees with the Committee’s recommendation. Target implementation date: Autumn 2025 2.2 NHSE is carrying out analysis of the main initiatives which were planned to result in additional appointments being delivered: the New …

Accepted

#16 — Conflicting data on new patient numbers and high cost of the New Patient Premium

Public Accounts Committee

Recommendation: NHSE did tell us that “roughly 2.7 million new patients” had come through during the year so far, which they claimed was “on track with what we would have expected” based on last year.44 However, DHSC and NHSE published information …

Gov response: 2.1 The government agrees with the Committee’s recommendation. Target implementation date: Autumn 2025 2.2 NHSE is carrying out analysis of the main initiatives which were planned to result in additional appointments being delivered: the New …

Accepted

#6 — Publish dental graduate tie-in response and outline plans to attract and retain NHS dental professionals.

Public Accounts Committee

Recommendation: Without a workforce sufficiently supported to deliver NHS dental care, there will be no future for NHS dentistry and DHSC and NHSE have not yet done enough to address workforce issues. The total number of dentists delivering some NHS dental …

Gov response: The government agrees with the Committee’s recommendation. dentists is a key part of the government’s ambition to reform the dental contract. This work is underway but will take time. Whilst the new dental contract is …

Accepted

#3 — Explain how DHSC and NHSE will strengthen dental analytical capabilities and implement business-critical changes in practice.

Public Accounts Committee

Recommendation: DHSC and NHSE’s modelling of what might be achieved, and how much this would cost was wrong and it took too long to identify the error, raising wider concerns about the quality assurance processes in place for such plans. DHSC …

Gov response: The government agrees with the Committee’s recommendation. analytical work supporting the modelling of dental contract changes and reform. In addition, NHSE are undertaking a lessons learnt exercise to fully understand the key causes of the …

Accepted

#10 —

Public Accounts Committee

Recommendation: However, NHS England was unable to tell us how many more dentists it expected these reforms to produce, or by when they would appear. It told us that a sustainable solution required further engagement with the dental profession on the …

Gov response: 6.1 The government agrees with the committee’s recommendation Recommendation implemented 6.2. Securing recovery of dental access is a key NHS priority. The pandemic had a significant impact on the delivery of dental services and NHS …

Accepted

#13 —

Petitions Committee

Recommendation: Free dental care is an important benefit that most pregnant and new mothers have been unable to access as the result of the pandemic. The Government should extend maternity dentist provision for new and expectant mothers affected by the pandemic …

Gov response: Routine dentistry during COVID-19 requires the correct social distancing measures and personal protective equipment to be in place. That’s why, routine dentistry was suspended with the outbreak of coronavirus. Dental practices are working hard to …

Response Not Attributed

#27 — Significant pay gap between NHS and private dentistry causes under-provision of care

Public Accounts Committee

Recommendation: DHSC told us that even with these uplifts to UDA rates, there is still a large gap between what dentists are earning through NHS work compared with the larger amounts they can make in the private sector.80 It described this …

Gov response: 6.5 The government agrees with the Committee’s recommendation. 6.6 Incentivising dentists to carry out more NHS work and improving the retention of NHS dentists is a key part of the government’s ambition to reform the …

Not Addressed

#25 — NHS dental contract uses Units of Dental Activity to measure treatment complexity

Public Accounts Committee

Recommendation: Under the current NHS dental contract, dentists are contracted to deliver a certain number of Units of Dental Activity (UDAs). Based on current treatment bands, there are six different levels of UDAs that a treatment can attract depending on the …

Gov response: 5.1 The government agrees with the Committee’s recommendation. 5.2 The government is conducting analysis on the ‘actual costs’ of providing dental care and engaging with the BDA on this work, which the government expects will …

Not Addressed

#22 — Integrated Care Boards hold delegated responsibility and flexibilities for local dental service commissioning

Public Accounts Committee

Recommendation: Responsibility for commissioning dental services was delegated to integrated care boards (ICBs) in April 2023.62 Within the national dental contractual framework, ICBs have some flexibilities that NHSE says should help them to tailor services to meet specific population needs.63 This …

Gov response: 4.1 The government agrees with the Committee’s recommendation. Recommendation implemented: April 2025 4.2 Whilst NHSE sought to engage ICBs and regional colleagues in the development of the Dental Recovery Plan (DRP) NHSE acknowledge that there …

Partially Accepted

#20 — Additional dental recovery plan costs deemed affordable due to significant budget underspends

Public Accounts Committee

Recommendation: The £200 million assumed cost of the dental recovery plan was to be drawn from expected underspends in the dental budget for 2024–25.57 As there was an under–spend of £392 million in 2023–24, NHSE and DHSC said that this additional …

Gov response: 5.1 The government agrees with the Committee’s recommendation. Recommendation implemented: June 2025 5.2 The government is conducting analysis on the ‘actual costs’ of providing dental care and engaging with the BDA on this work, which …

Not Addressed

#13 — The 2024 dental recovery plan introduced four distinct headline initiatives

Public Accounts Committee

Recommendation: The 2024 dental recovery plan included four headline initiatives, which aimed to provide an additional 1.5 million courses of treatment at a cost of £200 million in 2024–25.34 Funding for these initiatives would be drawn from anticipated underspends in the …

Gov response: 2.1 The government agrees with the Committee’s recommendation. Target implementation date: Autumn 2025 2.2 NHSE is carrying out analysis of the main initiatives which were planned to result in additional appointments being delivered: the New …

Not Addressed

#1 — Committee heard evidence on NHS dentistry and the dental recovery plan.

Public Accounts Committee

Recommendation: On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department for Health and Social Care (DHSC) and NHS England (NHSE) on NHS dentistry and the dental recovery plan.1

Gov response: The government agrees with the Committee’s recommendation. the main underlying drivers of ill-health and tackling persistent inequalities in health. This includes a shift from sickness to preventing illnesses before they happen. As a first step …

Accepted

#17 — Department's further education workforce data collection is incomplete, undermining projection reliability.

Public Accounts Committee

Recommendation: The Department has overseen further education colleges since July 2016 with further education colleges reclassified into the public sector in November 2022. Its further education workforce data collection started in 2020, and while this was able to cover 94% of …

Gov response: 2.6 Strengthening the evidence base remains a key priority especially in FE where the department’s data and therefore its understanding of the workforce is less developed. The FE Workforce in England data publication plays a …

Accepted

#18 — Publish local authorities' Infrastructure Funding Statements on the national CIL map.

Housing, Communities and Local Government Committee

Recommendation: The Ministry must review its guidance to local authorities on IFSs, to ensure all local authorities have a clear, up-to-date IFS which sets out how CIL receipts will be used locally, and when they will be pooled to deliver larger …

Gov response: 57. Planning practice guidance includes clear information on what should be included within IFSs. Further guidance is available on the PAS website. Initial PAS guidance was published in 2020, and this was updated in 2023 …

Position Not Stated

#15 — Publish an interactive map of CIL coverage and charging rates for local authorities.

Housing, Communities and Local Government Committee

Recommendation: The Ministry must publish an interactive map of CIL coverage on its website, updated quarterly to include the rates charged in each local authority in England. Publishing a national map would support the housing sector to navigate different charging schedules …

Gov response: 54. CIL is a locally-set rate, and charging authorities must publish a charging schedule on their website which sets out their CIL rates. The Government considers these the most appropriate information sources for CIL. 55. …

Position Not Stated

#13 — Publish indicative benchmark land values to inform viability assessments on Green Belt land.

Housing, Communities and Local Government Committee

Recommendation: The Government must continue to develop its proposal to publish indicative benchmark land values to inform viability assessments on Green Belt land across England. The Government must publish different benchmark land values for each region of England, to reflect variation …

Gov response: 51. In 2024, the Government consulted on setting indicative benchmark land values for land released from or developed in the Green Belt. The Government does not believe a national benchmark land value would sufficiently account …

Position Not Stated

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

Health and Social Care Committee

Recommendation: 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 …

Gov response: Partially Accept ICBs are responsible for undertaking oral health needs assessments to support commissioning priorities for investment. While all ICBs are at different stages of maturity and not all may be complete by the end …

Partially Accepted

#25 — ICBs' delegated responsibility for dental services offers opportunities for local improvement.

Health and Social Care Committee

Recommendation: ICBs have been delegated responsibility for commissioning dental services by NHS England. They offer an opportunity to improve access locally, better integrate services around patients and address inequalities.

Gov response: The transfer of responsibility for commissioning NHS dentistry services from NHS England to Integrated Care Boards (ICBs) on 1 April 2023 provides a greater opportunity to tailor services around the needs of the local population …

Not Addressed

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

Health and Social Care Committee

Recommendation: 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.

Gov response: Accept Following the delegation of primary care commissioning functions to ICBs on 1st April 2023, local commissioners are understandably seeking to explore new opportunities to commission dental services and support partnerships to prevent poor oral …

Accepted

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

Health and Social Care Committee

Recommendation: 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 …

Gov response: Accept Following the delegation of primary care commissioning functions to ICBs on 1st April 2023, local commissioners are understandably seeking to explore new opportunities to commission dental services and support partnerships to prevent poor oral …

Accepted

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

Health and Social Care Committee

Recommendation: 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 …

Gov response: Partially Accept NHS England have published implementation guidance on effective clinical and care professional leadership within ICBs. As part of the development of local frameworks and wider governance arrangements, system leaders were asked to commit …

Partially Accepted

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

Health and Social Care Committee

Recommendation: 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 …

Gov response: Partially Accept NHS England have published implementation guidance on effective clinical and care professional leadership within ICBs. As part of the development of local frameworks and wider governance arrangements, system leaders were asked to commit …

Partially Accepted

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

Health and Social Care Committee

Recommendation: 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 …

Gov response: Partially accept The Department partially accepts this recommendation. While we want to encourage all professionals to commit more of their time to NHS work, and to work in areas of the country with low provision …

Response Not Attributed

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

Health and Social Care Committee

Recommendation: 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 …

Gov response: 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 …

Not Addressed

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

Health and Social Care Committee

Recommendation: 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 …

Gov response: Accept The Department accepts this recommendation. We agree that efficient processing of applications for the Overseas Registration Exam (ORE) is vital and are working with the GDC to identify the most efficient measures to clear …

Partially Accepted

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

Health and Social Care Committee

Recommendation: 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 …

Gov response: Accept The Department accepts this recommendation. We agree that efficient processing of applications for the Overseas Registration Exam (ORE) is vital and are working with the GDC to identify the most efficient measures to clear …

Accepted

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

Health and Social Care Committee

Recommendation: 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 …

Gov response: Partially accept The Department partially accepts this recommendation. While we want to encourage all professionals to commit more of their time to NHS work, and to work in areas of the country with low provision …

Response Not Attributed

#15 — Ensure reformed dental contract fully utilises skills of the entire dental team.

Health and Social Care Committee

Recommendation: The Government, NHS England and ICBs must ensure that the reformed contract ensures that full use is made of the skills of the whole dental team. (Paragraph 73) NHS dentistry 35

Gov response: Accept We accept the Committee’s recommendation to make best use of the skills held by the wider dental team and have already taken steps with NHSE to embed this approach within contract reform and to …

Position Not Stated

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

Health and Social Care Committee

Recommendation: 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 …

Gov response: Partially accept The Department partially accepts this recommendation. While we want to encourage all professionals to commit more of their time to NHS work, and to work in areas of the country with low provision …

Partially Accepted

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

Health and Social Care Committee

Recommendation: 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 …

Gov response: Accept The Department accepts these recommendations. In October 2023, NHSE introduced a new workforce survey which will be repeated biannually. This data collection will incorporate the whole dental team and will include information on retention …

Accepted

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

Health and Social Care Committee

Recommendation: 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 …

Gov response: Accept The Department accepts these recommendations. In October 2023, NHSE introduced a new workforce survey which will be repeated biannually. This data collection will incorporate the whole dental team and will include information on retention …

Accepted

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

Health and Social Care Committee

Recommendation: 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 …

Gov response: Accept The Department accepts these recommendations. In October 2023, NHSE introduced a new workforce survey which will be repeated biannually. This data collection will incorporate the whole dental team and will include information on retention …

Response Not Attributed

#10 — Reinstate requirement for patients to be registered with an NHS dentist

Health and Social Care Committee

Recommendation: We uphold the recommendation from our predecessors’ 2008 report into Dental Services, that the Department should reinstate the requirement for patients to be registered with an NHS dentist. (Paragraph 55) Workforce

Gov response: Reject The Department rejects this recommendation at this time and has no current plans to introduce registration. NHS dental practices are only contracted to deliver a course of treatment, which means that dental patients are …

Accepted

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

Health and Social Care Committee

Recommendation: 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 …

Gov response: Partially accept The Department partially accepts this recommendation. We accept the Committee’s recommendation that we need to build further on the contractual changes we announced in July 2022, to further support and incentivise Dental Practices …

Partially Accepted

#7 — Urgently implement fundamental dental contract reform to address access crisis

Health and Social Care Committee

Recommendation: 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 …

Gov response: Partially accept The Department partially accepts this recommendation. We accept the Committee’s recommendation that we need to build further on the contractual changes we announced in July 2022, to further support and incentivise Dental Practices …

Response Not Attributed

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

Health and Social Care Committee

Recommendation: 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 …

Gov response: Accept The Department accepts this recommendation. We agree that patients need to be well informed about how NHS dentistry works and the care they are entitled to. NHS England has created a new group of …

Accepted

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

Health and Social Care Committee

Recommendation: 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 …

Gov response: Accept The Department accepts this recommendation. We want to ensure that every adult and child who needs an NHS dentist can access one, regardless of where they live. The package of reforms we announced in …

Accepted

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

Health and Social Care Committee

Recommendation: 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 …

Gov response: Accept The Department accepts this recommendation. We want to ensure that every adult and child who needs an NHS dentist can access one, regardless of where they live. The package of reforms we announced in …

Response Not Attributed

#9 —

Health and Social Care Committee

Recommendation: We are concerned that there does not appear to be a plan for the restoration of dental services in England. We recommend that Sara Hurley (Chief Dental Officer for England) sets out her assessment of the challenges facing dentistry services …

Gov response: The Chief Dental Officer for England’s remit extends to clinical policy and does not cover operational delivery or contracting, which sits with the Department of Health & Social Care and the NHS. This assessment has …

Not Addressed

#6 —

Health and Social Care Committee

Recommendation: The NHS responded quickly and strongly to the demands of the pandemic, but compared to other health systems it “runs hot”—with little spare capacity built in to cope with sudden and unexpected surges of demand such as in a pandemic.

Gov response: The government accepts this recommendation. Since the beginning of the pandemic, the NHS has been under significant pressure. There were 390,000 general and acute beds available in 1987, but there are now around 141,000. The …

Accepted

#6 —

Health and Social Care Committee

Recommendation: The NHS responded quickly and strongly to the demands of the pandemic, but compared to other health systems it “runs hot”—with little spare capacity built in to cope with sudden and unexpected surges of demand such as in a pandemic.

Gov response: The experience of the demands placed on the NHS during the COVID-19 pandemic should lead to a more explicit, and monitored, surge capacity being part of the long term organisation and funding of the NHS.

Under Consideration

#63 —

Health and Social Care Committee

Recommendation: The NHS responded quickly and strongly to the demands of the pandemic, but compared to other health systems it “runs hot”—with little spare capacity built in to cope with sudden and unexpected surges of demand such as in a pandemic. …

Gov response: The experience of the demands placed on the NHS during the COVID-19 pandemic should lead to a more explicit, and monitored, surge capacity being part of the long term organisation and funding of the NHS.

Under Consideration

#9 — Patient registration under capitation-based contract will improve dental access

Health and Social Care Committee

Recommendation: We believe patient registration under a reformed capitation-based contract will better enable those patients who currently can’t access a dentist to be able to do so.

Gov response: Reject The Department rejects this recommendation at this time and has no current plans to introduce registration. NHS dental practices are only contracted to deliver a course of treatment, which means that dental patients are …

Response Not Attributed