NHS DENTISTRY: Only half the expected NHS work being done in Wales since April shake-up, dentists warn

If you have spent this year ringing round trying to get on an NHS dentist’s list, there is a figure that goes some way to explaining why.

The British Dental Association, which represents dentists across the UK, says NHS dental activity in Wales is running at only around half of expected levels under the new contract that came in on 1 April.

The same reforms raised charges and lengthened the gap between routine check-ups, both written into the new system rather than a side effect of it.

The BDA also warns that more practices could hand back their NHS work altogether before the Welsh Government’s review of the contract later this year.

What you can actually do about it

The main official answer is the Dental Access Portal. Anyone looking for an NHS dentist can register their details on it, and Mabon ap Gwynfor, the Cabinet Minister for Health and Care, is urging people to do so.

Registering does not book you an appointment. The Welsh Government’s stated purpose for it is to show health boards where demand is, so that future investment is aimed at the areas generating the most registrations.

There is some movement locally. A new NHS practice is due to open in Neath town centre early next year, and a health board report earlier this summer set out how the reforms are changing access across Swansea Bay.

If you are already with a dentist and stuck waiting for specialist treatment, it is worth asking what they can do directly. A child in the Hywel Dda area who had waited nearly two years for orthodontic treatment was seen within days once her dentist used a rapid specialist advice service.

Why it is worse in some places than others

The minister acknowledged what people in rural Carmarthenshire have been saying for years, referring to “dental deserts” and to rising numbers of patients either going without treatment or paying to go private.

His answer for those areas is salaried dentists employed directly by health boards, more dental provision in community hubs, and another look at mobile clinics.

He has also backed a proposal from Bangor and Aberystwyth universities for a new Welsh dental school, on the basis that training people in rural Wales makes them likelier to stay. A dental school would take years to build and years more to produce qualified dentists, so it does nothing for anyone currently on a waiting list.

The row behind the waiting list

The Welsh Government, which runs NHS dentistry in Wales, defends the new contract as the most significant change in almost twenty years, and says it has scrapped the Unit of Dental Activity target dentists complained about for years and is already delivering more preventative care.

Dentists are not convinced. The BDA wrote to the minister in June setting out the problems it says are already emerging, and asked for an urgent meeting. It says that meeting has not happened.

Dr Russell Gidney, who chairs the BDA’s Welsh General Dental Practice Committee, said the new dental school “won’t work if the contract in place means the next generation can’t see a future for themselves in the NHS”.

“Sadly, a Plaid administration appears to be recycling Labour soundbites,” he said. “It might be ‘the most significant change’ in 20 years, but this new, untested system now risks pushing more dentists out of the service.”

The BDA also says practices are struggling with extra administration, IT failures and contractual complexity, and that higher charges are changing what treatment people agree to.

The run-up was rough too. In February, dentists said they had been given a weekend to decide whether to stay in the NHS, after key contract documents were published months later than promised.

The Welsh Government’s review of the contract is due later this year and a long-term NHS Wales workforce strategy is promised for the autumn. Until then the options open to patients are the ones already on the table: register on the portal, ask your own dentist what they can escalate, and wait.