Public’s confusion over ‘right’ to register with an NHS dentist
We have published the first-ever research on people’s understanding of NHS dentistry and what they want from the service as the government develops its ‘Dental Rescue Plan’.
The poll, carried out in September by Savanta, reveals that most people in England have misconceptions about their 'right' to an NHS dentist and want changes to how they access dentistry.
Key findings
- Over two-thirds, 68%, of respondents mistakenly believe they have the right to register with an NHS dentist as they do with an NHS GP.
- When asked about their preference for getting NHS dental care, over half, 54% of 1,791 respondents said they want to be able to register with an NHS dentist as a permanent patient in the same way as they can with an NHS GP.
Read our poll
About NHS dental contract
People lost their right to register with an NHS dentist in 2006 when a new NHS dental contract was introduced to pay dentists per 'unit of dental activity' rather than getting paid per person registered on a list of permanent patients, combined with set fees for each treatment delivered.
The contract means a dentist has no long-term obligation to see patients on the NHS unless they are undergoing active treatment or dental work already carried out is under guarantee.
The contract is unpopular with dentists, with many cutting back NHS work and leaving people without NHS appointments, often with little warning.
Last year, Healthwatch England supported the call by MPs on the Health and Social Care Committee to reintroduce permanent registration rights for patients.
Access crisis continues
Healthwatch England’s polling shows people continue to struggle to access NHS dental appointments, despite the previous government’s efforts to improve access by introducing a new incentive payment for dentists.
A third, 33%, of respondents said they had to wait longer for their NHS dental treatment than they wanted.
One in six, 16%, said they hadn't been able to find an NHS dentist who would treat them, with 27% of those having to seek private care in the last two years.
Confusion about dental charges
As well as being confused about 'their right' to an NHS dentist, the research suggests people are also unclear about NHS dental charges.
The poll found:
- One in five, 20%, said they had difficulties finding information about NHS dental fees.
- Similarly, 19%, believed they were charged more than advertised NHS dental charges.
- One in seven, 15%, of people who had seen an NHS dentist in the last two years felt pressured to pay privately.
- Younger people, 18-34, and people from ethnic minority groups were more likely to believe they were changed more for dental care. They were also more likely to feel pressured to pay privately than other demographic groups.
Steve’s story “You either pay or are not seen at all”.
Steve, 55, from Stow-on-the-Wold, Gloucestershire, is worried that nowadays he can only get private care at local dentists’.
Steve is an NHS patient, however, in recent years he’s been asked to pay for dental treatment. He said: “There are never any NHS slots available when you try to book an appointment with a dentist. So that means you have to pay or not be seen at all.”
Louise Ansari, Chief Executive at Healthwatch England, said:
"This research is a stark reminder that people continue to struggle to access NHS dental appointments, as dentists routinely ditch working to the NHS dental contract.
"There's also confusion about the relationship between an NHS dentist and patients, with many patients mistakenly believing they can register with a dentist for life.
"It's clear NHS dentistry is not fit for purpose and that people want a new kind of solution – a GP-style system, which will allow them to register permanently with a dental practice to access ongoing appointments and check-ups easily. "
"It's now vital that government consults with the public and dental leaders to determine what kind of dental system they'll deliver to improve people's oral health now, and for future generations."
The findings come as the government develops a Dental Rescue Plan to deliver 700k extra urgent NHS dental appointments for patients in the short term. However, no details have yet been set on the rescue plan, the timetable, or the terms for a long-term reform.
We have set out recommendations for the government and NHS England:
- NHS dentistry should be reformed to give everyone a GP-style right to be permanently registered with a dental practice to get both preventative and urgent care throughout their lifetime.
- The public should be consulted on any proposals being considered for long-term reform of NHS dentistry.
- The new patient payment introduced for dentists from March 1, 2024, should be evaluated and any findings published.
- Dental practices should clearly communicate to people what they need to do to be maintained as an NHS patient.
- Public awareness of how the NHS dental system works should be improved, to help people consider or plan for alternative sources of care if their practice chooses to stop providing NHS care.
