A dentist and a dental nurse carry out a procedure on a patient. Photo: Leon Neal/Getty Images
Healthwatch in Greater Manchester has produced a new report on NHS dentistry, based on the experiences of patients across the city-region trying to access the health service, particularly during the Covid-19 pandemic.
It says that calls to Healthwatch organisations have shot up and the vast majority of those relate to problems with accessing the NHS.
While acknowledging that the health service has faced colossal challenges with coronavirus, Healthwatch in Greater Manchester is echoing calls for change by the national body Healthwatch England.
Throughout 2020 and 2021 Healthwatch England has been collecting data relating to NHS dentistry from local organisations, including the 10 Healthwatches in Greater Manchester.
At the same time Healthwatch in Greater Manchester was drawing up its own report on dentistry in the city-region.
In May 2021 Healthwatch England published a briefing on the topic, with Greater Manchester organisations fully supporting its recommendations.
Now the city-region’s Healthwatches have published a supplementary report with all the local data in it.
What did Healthwatch in Greater Manchester find?
The period of the Covid-19 pandemic coincided with a six-fold increase in calls to Healthwatch organisations in Greater Manchester regarding NHS dentistry.
There were 102 enquiries on the topic in 2019-20.
In 2020-21 this then jumped massively to 650.
A whopping 97.7% of these enquiries were about the accessibility of NHS dentistry.
The highest proportion of enquiries (38.3%) were in the fourth quarter of 2020-21, during the longest and most recent lockdown in England.
Healthwatch in Greater Manchester says it is reasonable to believe the pandemic and the volume of enquiries about accessibility are correlated, given how Covid-19 has forced organisations to alter their ways of working.
What did people say about accessing NHS dentists?
The report includes a selection of enquiries made to the local Healthwatch teams during 2020-21 about dentistry.
“I have got toothache and I have rang 14 dentists and none of them are taking on NHS patients. I looked on the internet and it said to contact you,” one person told their local Healthwatch.
Another said: “I need to find a dentist please can you help. I am in receipt of ESA and cannot afford the private costs. I am in pain and need help .”
Other reports included patients baffled by being unable to see a dentist even though they were registered and those struggling to find a dentist taking on new NHS patients.
What does Healthwatch in Greater Manchester say?
The report groups the issues into four main problems:
- People making multiple calls and having to spend hours on the phone,
- people turning to Healthwatch for help because they are unable to navigate the system,
- the NHS websites being out of date or not up to date,
- and misunderstandings of the concept of ‘registration’.
There were examples of informal carers searching for access for housebound adults, women in pregnancy seeking access, specialist cancer centres advising patients that they need a dental assessment before commence of treatment for their cancer, and children or those with a disability being unable to have access to timely dental attention.
The report concludes that the problem is that there is simply not enough capacity in the system to meet the needs of the public.
The report is scathing about the functions on NHS websites for finding dentists, saying these signposting services online are quite simply “not fit for purpose”.
And it highlights the desperate position of those who cannot even afford enough credit on their phones to ring surgeries, saying they are at the sharp end of the issue of health inequalities.
Healthwatch in Greater Manchester says it fully sympathises with the difficulties coronavirus has caused the health system.
However, it also stresses that simply getting back to normal is not going to solve the issues, as there is evidence that there are not enough NHS dentists in the city-region going back five years and more.
What does Healthwatch England say?
The England-wide look at dentistry has come up with four recommendations, which are fully backed by local teams.
These are: Rapid and radical reform of the way dentistry services are commissioned and provided, tackle the twin crises of access and affordability as part of the commissioning overhaul, provide better information about NHS dentistry and look at using dental practices to support people’s general health.
What do the authorities say?
The Greater Manchester Health and Social Care Partnership told Healthwatch that Covid-19 had brought “unprecedented challenges”, with practices operating at significantly reduced capacities.
It said that despite the city-region having devolved powers for health and care it still had to keep within the constraints of the money given out by NHS England.
It is working hard to support practices to increase capacity while longer-term solutions are found.
And it said innovative projects are being worked on and rolled out in the region to tackle health inequalities.
A network of 92 urgent dental centres across Greater Manchester, set up at the start of the pandemic, are also still running to help practices that may be struggling due to staffing levels and offer urgent care to people who do not have a regular dentist.
Patients can access the centres by referral from their dentist or via the Greater Manchester NHS Dental Helpline on 0333 332 3800, 8am to 10pm, seven days a week.
The Local Dental Committees, which represent dentists in the NHS, also responded to the report.
They said that Covid had vastly reduced care provision and that dental care was operating within NHS constraints.
They also explained that patients do not register with a dentist but are examined, treated and then discharged with a recommendation of when further examination is appropriate.
As most practices accept patients back for years, this can make it seem like people are registered to an individual dentist.
The body also said there was an urgent need for more dentistry services to be commissioned.
An NHS Digital spokesperson said: “ In 2018, NHS Digital introduced new functionality on the NHS website which ensures that only dentist availability information updated or validated by providers within the last 90 days is displayed.
“Providers now receive an email reminder when their information requires updating or validating, and they can validate this information through a link within the email.
“This work has increased the percentage of dental practices displaying up-to-date availability information (defined as updated within the past 90 days) to 45%. In February 2021, 3,704 of 5,749 practices routine care dental practices updated their information within this timeframe.
“We are working hard to further improve the coverage by making it easier for practices to update their information through a new profile editor app. Due to be launched in early 2022, the new profile editor app will work on tablet and mobile devices - making it more convenient for providers to keep their information up-to-date.
“We are working closely with the Department of Health and Social Care and NHS England and NHS Improvement to further improve dental information for patients on the NHS website.”