Tooth decay is the most common reason for hospital admission in children aged between 5 and 9 years . New figures published in February 2024 by the Office of Health Improvement and Disparities (OHID) have shown that there were just over 31,000 hospital admissions during the 22/23 financial year – equating to 119 per day.

The costs to the NHS for hospital admissions related to tooth extractions in children aged 0 to 19 years were estimated at a staggering £64.3 million, with £40.7 million specifically for decay-related procedures

This is inexcusable  and embarrassing in a developed country and must be addressed. Tooth decay is a totally preventable disease and yet remains a key reason for why children are admitted to hospital. We urge the new government to take tackle this crisis. 

Training and retaining the dental workforce

We welcome the intention set out in the NHS Long Term Workforce Plan to significantly increase dentistry training places by 24% by 2028/29 and by 40% by 2031/ 32. Increasing the number of dental professionals is a key part of improving patient access and we would encourage the new government to continue this plan.

The Plan did however lack focus on retention. This is an area that needs a real focus as once dentists have left the profession it is very hard to get them back. If the increase in those being trained is less than the number  who are leaving the profession, then we will have made little progress.

We therefore encourage the government to work with NHS England to develop a dental workforce retention strategy.

Key to this should be supporting the wellbeing of dental professionals. A recent survey of Dental Protection members found that 57% report their mental health to be worse now than it was during the pandemic, that 56% were considering their future in the dental profession due to mental wellbeing concerns, and that 50% feel pessimistic about the future. 

Supporting overseas qualified professionals

The UK dental workforce is increasingly reliant on dentists and dental care professionals who trained overseas. 

About 30% of all dentists on the GDC register qualified outside of the UK. This is increasing with 46% of new additions to the register in 2022 trained overseas.

The previous government started taking steps to ensure overseas-qualified dentists would be able to start practising in the UK as quickly as possible. We are keen to ensure that overseas trained dentists benefit from the training and supervision they need while adapting to working in a new country and in a different healthcare system. We encourage the government to work with NHS England and other stakeholders to ensure that these professionals are not seen as a way to plug gaps in a strained system but instead as part of the team that need the necessary support, supervision and development to thrive.

Enabling dental professionals to work in different ways

As well as taking the above measures to increase the size of the dental workforce, NHS contract reform is also needed in order to fully utilise the skills mix within the dental team.

Key to this will be GDS contract reform and a review of the scope of practice for each registrant group. 

82% of dental professionals who were recently investigated by the GDC said the process had a detrimental impact on their mental health. 14% quit dentistry due to the investigation, a further 38% considered leaving, and 28% said they experienced suicidal thoughts. This was revealed as part of a Dental Protection survey of 125 dental professionals who have been investigated by the dental regulator in the last five years. 

The GDC can and must introduce improvements. We recently welcomed a range of reforms including to make their communications more empathetic, the piloting of efforts to expedite simple cases, and changes to the level of detail put into the public domain for interim investigations. This progress is welcome and also shows that the lack of legislative reform cannot be used as an excuse for the lack of progress. 

The absence of government-led reform is however a significant barrier to progress.

The Dentists Act, which provides the GDC with its powers, turned 40 years old in July 2024. The Act is an anachronism, drafted for an era that has passed. In some sections, it sets out in an unnecessary level of detail how the GDC should conduct its operations. With reform to the legislation, the regulator would be more able to streamline its processes, improve efficiency, reduce the number of investigations into less serious allegations to ensure that investigations conclude more quickly.

The GDC itself has been calling for legislative reform for some years, as the current framework continues to limit its  ability to deliver functions with efficiency.  

Successive governments have however failed to deliver on substantive reform to the legislation. For too long, proposals to reform professional regulation have focused on other larger regulators such as the GMC and NMC with much needed reform to the GDC relegated to an afterthought. 

As recently as December 2023, the government confirmed its commitment to introducing reforms that would benefit the General Medical Council, Nursing and Midwifery Council and Health and Care Professions Council - with no commitment or even any reference to when GDC reform might progress.

It is time for GDC reform to be placed at the front of the queue. We urge the government to commit to delivering reforms to the professional regulators within this parliamentary term and offer and set out the timescale for how long it will take. 

We urge the government to bring forward a strategy that sets out a package of legal reforms to tackle the rising cost of clinical negligence – and in particular to ensure that the impact of claims on dentistry is central to considerations.

We suggest that this should include proposals to increase the Fixed Recoverable Costs (FRC) scheme to cover cases up to £50,000 rather than the £25,000 recently proposed. It is worth noting that the low value fixed recoverable costs scheme only relates to pre-litigated claims and we would support extending the scheme to also cover lower value claims which settle post issue of proceedings. This would supplement the Ministry of Justice’ current fixed costs process applying to matters which are allocated to the intermediate track for civil claims. We would suggest that the government review the effectiveness of the existing FRC scheme 12 months’ post implementation with specific reference to whether the same is effective in tackling the overall cost of dental claims.