There is “no short answer” to fixing Nottingham’s shortage of NHS dentist appointments, a senior care manager has warned.
Caroline Goulding, deputy director of primary care and public health for NHS England, said the service had been badly affected by the pandemic, and was still struggling to cope with demand.
She addressed the ongoing shortages during a Nottingham City Council meeting on November 17.
Members of the Labour authority’s health scrutiny committee heard the pandemic has had a “significant” impact on how available dental services are in the city.
The council had invited local dentistry professionals to its meeting to explore what is being done to improve access to NHS and community dental services in the city.
According to the online NHS dental service finder, just one Nottingham city practice is currently listed as accepting new NHS patients without a referral.
Listings for all the rest say practices are either not accepting NHS patients or have not updated their status for some time and should be contacted directly.
Dentistry is one of the few NHS services where patients pay a contribution
towards the cost of NHS care at the point of treatment – but some councillors raised concerns that this could fall by the wayside during the cost of living crisis.
Committee chair Councillor Georgia Power said: “People’s priority isn’t going to be paying for the dentist, it will be heating their homes and feeding their children.”
The committee also heard there are problems with recruiting new dentists, partly due to the current NHS dental contract which was introduced in 2006.
Ms Goulding said during the meeting: “Being very open and transparent, dentistry services have been significantly impacted since the pandemic.
“It was a challenged service before the pandemic.
“During the pandemic dental surgeries were supported to close while we got to know the virus and how we could work with it.
“Following that, we opened services gradually but it does mean procedures take longer than they did before and dentists have to take far more precautions which slows down the number of patients they can see.”
Councillor Maria Joannou (Lab) said her experience of accessing a dentist has been “horrendous”.
She said: “Dentists are leaving because of the stress they are under.
“How are we going to get more NHS dentists and make it more accessible?”
Ms Goulding responded: “There isn’t a short answer to this.
“We are hoping the dental contract reform will provide a platform for dentists that have moved from the private back into the NHS.
“On a positive note, Nottingham city hasn’t had the level of contract terminations we have seen in other parts of the East Midlands.”
She added that an extended hours urgent care site is being rolled out in Nottingham city from January 2023.
Dr Rami Khatib, local dental network chair for Derbyshire, said: “There is a lot of work going on to reform the contract but there is a long way to go.
“Some steps have already taken place which will come into effect at the end of this month hopefully.
“Recruitment is extremely difficult. We do have enough dentists in the country but many have chosen not to work in the NHS because they feel the pressures and the contract are too difficult.
“Dental nurses have left the profession in significant numbers.”
Dr Pavni Lakhani, local dental network chair for Nottinghamshire, said that an increase in families using food banks could have an impact on the condition of people’s teeth.
She said: “Dental decay is the biggest reason for children’s admission in hospital for general anaesthetic.
“During the pandemic, we have seen an increase in families going to foodbanks and we have seen a change in their nutritional intake.
“We are likely to see an impact on the oral health of children if their diet has changed significantly.”
She added that considerations for a mobile dental unit are in place for those who find it difficult to visit the dentist.
“It does seem very related to poverty, its something we see time and time again.
“We are very concerned about availability and access. A mobile unit might be helpful.
“We are seeing real standout issues for those who already have barriers.”
Speaking after the meeting Cllr Power said: “I think they were honest which is always a good start, but it’s clear there is a lot of work to do. This is a national issue but there is also a real issue here in Nottingham.
“I am pleased it is being brought into commissioning locally through the Integrated Care Board in April next year, I think that will be helpful.
“Ultimately the government needs to tackle this. They’ve been talking about changing the NHS dental contracts for decades.”
