As the biggest reforms NHS dentistry in Wales has seen in a generation kick in, it is clear the Welsh Government’s failure to heed the concerns of this profession will leave a ‘difficult legacy’ for the next administration, warns the British Dental Association (BDA).
Described as ‘utterly untested’, the BDA fears said the contract is a source of deep concern on the frontline and has been dogged by poor communication with both the profession and with patients. And dental labs, which are key to the NHS supply chain, have been kept completely in the dark.
“Many already struggling practices are unclear if the new system offers a sustainable future for them and have handed back their NHS contracts,” the BDA said in a statement.
“The success of the first year of operation will be crucial to ensure more do not follow.
“We pushed hard for conditions to allow for a learning year, and not a year where practices may suffer penalties due to an untested system.”
Whoever forms the next administration in Cardiff Bay will inherit a service on the very brink. They will need to put together a rescue package if NHS dentistry in Wales is going to have a future
The BDA said some health boards have seen 10% or more of their contract allocations returned to them by practices quitting the NHS. And the remaining NHS capacity may be hard pushed to improve the situation.
“Reforms will mean rationing of care, with less-frequent appointments for many patients,” the statement reads.
“At present recalls for healthier ‘green’ patients are already at 12 months with existing contract reform measures. And new reforms will mean pushing this out for these patients to 18 or even 24 months.
“The reforms will also see NHS dental charges increase by a large margin in many cases.
“With recent increases in the cost of living, these new charges could be unaffordable for many.
“A simple examination for a new patient will be going up from £20 to £27.21 – a 36% increase. And an urgent appointment for a new patient will increase from £30 to £37.50 – a 25% increase.
“A patient with poor gums and high plaque scores in need of a periodontal package will first have to sufficiently reduce these scores themselves before they will be offered the care package at circa £48.
We need a decisive break from chronic underfunding, protections for the most-vulnerable patients in Wales, and a wholesale change of tone from a new administration
“While a simple restorative package at £36 is well below the current band 2 charge of £60, an extensive restorative package is £68.75 – an increase of 14.5%.
“Patient charges will continue to be collected by dental practices for the foreseeable future.
“The Welsh Government has delayed indefinitely bringing in a promised new system to relieve practices of the administration burden – they will need to continue to act as tax collectors at a cost to their bottom line.”
The BDA is calling for ‘much-clearer communication about how the system will work’, criticising the delay in publishing a promised patient information leaflet.
“We have published our own manifesto at what it is a ‘make or break’ moment for the service in Wales,” it states.
The BDA’s Welsh General Dental Practice Committee chair, Russell Gidney, added: “A safety net is now needed to make these reforms sustainable for struggling practices, including a pause on full implementation until 2027 while a package of needed improvements is worked up.
The risk all now face is that utterly-untested reforms will push more practices out of the NHS, taking the access crisis from bad to worse
“We also need a decisive break from chronic underfunding, protections for the most-vulnerable patients in Wales, and a wholesale change of tone from a new administration.
“This is not a negotiated contract, with any meaningful dialogue over the final package ending over 16 months ago.
“From today, many patients across Wales will have to get used to more-costly, less-frequent dental care.
“But the risk all now face is that utterly-untested reforms will push more practices out of the NHS, taking the access crisis from bad to worse.
“Whoever forms the next administration in Cardiff Bay will inherit a service on the very brink. They will need to put together a rescue package if NHS dentistry in Wales is going to have a future.”