Lack of NHS dental appointments widens health inequalities
A new survey of public attitudes to NHS dentistry shows that half of the adults in England find dental charges unfair amid escalating living costs. In Cheshire and many other areas, few dentists are taking on new NHS patients.
Healthwatch England says NHS dentistry is in desperate need of reform ahead of new regional health bodies taking over control next year.
Healthwatch England warns that health inequalities are widening as people in every part of the country are struggling to pay for dental care.
A representative poll of 2,026 adults based in England found nearly half (49%) of respondents felt NHS dental charges were unfair.
What are people saying?
The poll, which looked at people’s experiences of NHS dentistry, including costs associated with dental care, found the following:
- 41% of respondents said they found it difficult to book an NHS dental appointment, whilst one in five (20%) couldn’t access all the treatments they needed.
- One in four (24%) respondents said they had to pay privately to get all the treatment they required.
- One in six (17%) reported they felt pressured to pay privately when they booked their dental appointment. Similar numbers (17%) said their NHS dentist didn’t explain the costs before starting their treatment.
- More than one in 10 (12%) reported that their NHS dentist charged more for the treatments than the advertised NHS charges.
- Almost a third (29%) said lack of access to dental care led to more serious problems, making them feel anxious. Others said lack of timely dental care made it hard to eat or speak properly (16%); and made them avoid going out (14%).
Widening health inequalities
The shortage of NHS appointments has hit people on low incomes hardest, meaning they are less likely to have dental treatment, compared with those on higher incomes. The poll suggests that people from social economic group (SEG) A are six times more likely to be able to pay for private dental care if they can’t find an NHS dentist to treat them than people from SEG E (48% and 8%, respectively).
The new data also reveals a significant North-South divide when it comes to affordability of dental care. While one in five people (20%) living in the South said they can afford private dental care if they can’t find an NHS dentist, in the North, just seven per cent said they could afford private treatment.
Overall, 38% of the respondents feel they are less likely to visit a dentist, despite clinical guidelines recommending regular dental check-ups to keep people’s mouths healthy.
Fewer NHS dentists
The findings come as more than 2,000 dentists quit the NHS last year, according to new data obtained by the Association of Dental Groups under freedom of information laws, suggesting a growing trend towards private provision.
Healthwatch England has repeatedly raised concerns over the last two years as the twin crisis of access and affordability has continued to grow. Between October 2021 and March 2022, the Healthwatch network heard from 4,808 people about their experiences of dental care, many of whom were struggling to access timely care.
Healthwatch is therefore making renewed calls on NHS England and the Department of Health and Social Care to put a reformed dental contract in place before formal responsibility for dental services passes to the 42 new Integrated Care Systems in April 2023.
Louise Ansari, national director at Healthwatch England said:
“Access to NHS dentistry has been one of the most significant issues people have raised with us in the last two years. There is now a deepening crisis in dental care, leaving people struggling to get treatment or regular check-ups on the NHS.
“The shortage of NHS appointments is creating a two-tier dental system, which widens inequalities and damages the health of the most disadvantaged communities. With millions of households bearing the brunt of the escalating living costs, private treatment is simply not an option and even NHS charges can be a challenge. This needs urgent attention if the Government is to achieve its levelling up plan and tackle health disparities.
“We are once again calling on the Department of Health and Social Care and NHS England for greater ambition and urgency from NHS dental reform plans to create a fair and inclusive dental service. We strongly recommend that a new dental contract is in place before Integrated Care Systems take on formal responsibility for dentistry from next April.”
What you’ve told us
Healthwatch Cheshire have published two reports based upon what people have been telling us about accessing dentistry, the most recent of which can be viewed here.
Since June 2020, Healthwatch Cheshire has received increasing numbers of enquiries asking for details of local dental practices taking on new NHS patients across Cheshire. Issues have included inaccurate information listed on the NHS England website, a lack of NHS appointments or treatment available, long waits or having to register with a dentist outside of Cheshire, concerns about the Cheshire and Merseyside Emergency Dental Helpline, and people being unable to access a dentist due to them being deemed inactive.
These reports, along with all comments and feedback received, was shared with the individual dental providers, and NHS England who commission dentistry services. Healthwatch Cheshire have held regular meetings with the NHS England dentistry team in the North West, to raise the concerns shared with us by the public. The reports were also presented at the Cheshire West and Chester Council Health Overview and Scrutiny Committee and shared with the Cheshire East Council Public Health team. We have attempted to assist people through signposting and advice where appropriate, and have also been circulating NHS extra dental help leaflets to members of the public when on engagement activity so that they are aware what support is available. Our findings and reports are fed into Healthwatch England to help build up a national picture of the situation. We have held meetings with the NHS England dentistry team in the North West, to raise the concerns shared with us by the public,
Cheshire residents who’ve been in touch with us have said:
- “I have today contacted 45 dental practices within a 10 mile radius (from the NHS website) but to no avail… all saying they only have a small NHS contract & therefore not taking on at present but would be happy to accept me as a private patient which is ironic… I am desperately seeking an NHS dentist simply because not only is it my right but also because I can’t afford private treatment prices… I am in considerable pain with what I believe to be both a broken tooth and a cracked filling…”
- “I am trying to find a dentist in Crewe, Nantwich or even Sandbach that are taking on NHS patients. Not one person, unless I go private which I can’t afford.”
- “I’m looking to register myself, partner and our two children (both under two years of age) with a local dentist. I’ve called everywhere in Sandbach, Alsager, Holmes Chapel and Crewe and have been told by everyone that they are not accepting NHS patients at the moment and it could be the end of the year/beginning of next year when we could possibly register. Some practices will take the children on under the NHS but as adults we have to wait or pay for costly treatment as private patients. We are on a low income as I am currently on maternity leave so we cannot afford this. My partner has had to have emergency dental treatment twice during lockdown and has had to take unpaid time off work because of his dental problems.”
Please keep continuing to share your experiences of trying to access NHS dental treatment with us. Your continued feedback helps us to keep raising access to NHS dental treatment as an urgent priority with NHS England. You can leave your comments on our online Feedback Centre, by calling 0300 323 0006, or by emailing info@healthwatchcheshire.org.uk.
About the poll
Yonder Data Solutions polled 2,026 adults (aged 18+) based in England in February 2022.
Key findings from this polling are available on the Healthwatch England website.