The Greater Manchester borough which lost one in four NHS dentists in a year

A Greater Manchester borough has lost one in four NHS dentists in the space of a year, shocking data shows.

Statistics analysed by the BBC Shared Data Unit showed a dramatic 25% reduction in the number of dentists working for the health service in Bolton between 2020 and 2021.

Three other local authorities in the city-region have seen numbers fall by 10% or more in a year.

Unions have warned that in some parts of the country NHS dentistry is “hanging by a thread”, while local authorities have said that service provision has remained the same over the past couple of years despite the number of people providing it changing.

What does the data show?

The data shows that there have been significant reductions in the number of NHS dentists over the past couple of years.

NHS Bolton CCG was the second-worst affected in the country, losing a staggering quarter of its health service dentists in the space of 12 months.

There were 190 in 2020 and 142 in 2021, a fall of 25%.

Other Greater Manchester boroughs were severely affected too, with an 18% drop in Oldham in the space of a year (180 in 2020 to 148 in 2021).

There was a 12% drop in NHS Bury CCG and 11% falls in both Trafford and Salford.

These areas have also seen a drop in the number of NHS dentists over the past five years, though not by quite such dramatic amounts.

NHS Bolton CCG, for example, had a 5% fall in the number of dentists working in the health service over the longer time-period.

How does NHS dentistry work?

Dentists can decide whether to take on NHS work, private work or a mix of the two.

Practices receive funding from the NHS to take on health service work under the NHS Dental Contract.

The 2006 NHS Contract introduced a system of Units of Dental Activity (UDAs) to England and Wales.

UDAs are used to measure a practice’s activity. Courses of treatment - for example, a check up or a filling, are banded into UDAs.

Practices are set targets of UDAs to achieve, and if that target is missed, the contract holder and the practice can be forced to pay back money - known as ‘claw back’.

During the pandemic, the NHS has reduced the target percentage for UDAs, acknowledging that dentists cannot physically see the same amount of patients as before due to social distancing and hygiene restrictions.

The British Dental Association (BDA) is now concerned that this reduced target could be increased before dentists are back to full capacity - leaving hundreds of practices facing claw back costs.

The UDA system is controversial with dentists, who claim it disincentivises preventative care.

Another criticism is the amount of work that goes into completing UDAs. The BDA pointed out that treating a patient for one filling will fulfil the same amount of UDAs as treating the same patients for 12 fillings, despite the extra work and time involved.

What has been said about the data nationally?

With fewer NHS dentists available to do work Healthwatch England said that two-year waits for routine check-ups were now not unheard of.

The British Dental Association (BDA) said unhappiness with the NHS dental contract was a key factor in both dentists leaving the health service and practices struggling to fill vacancies.

The union warned dentistry in the NHS was “hanging by a thread”.

What has been said about NHS dentistry in Greater Manchester?

Health bosses in the city-region said that despite changing staffing levels over the past few years the service for patients had broadly remained the same.

They also paid tribute to the efforts of NHS workers during the Covid-19 pandemic.

Laura Browse, director of primary care at Greater Manchester Health and Social Care Partnership, said: “The level of NHS dental care provision in Greater Manchester has remained the same for the past two years, even though the number of dentists delivering it has changed.

“Dentists take on varying amounts of NHS dental activity, alongside any private patients.

“Over the past 10 years, the number of dentists delivering NHS care in Greater Manchester has increased by 18%, compared to a national rise of 4%.

“We recognise that the past two years have been a very challenging time for dentistry, along with other parts of the NHS. We are extremely grateful to dental teams for all their hard work during the pandemic.

“We have recently invested in additional health and wellbeing support for staff across primary care, including dentistry.”