Swanage and Purbeck is close to becoming a dental desert as access to a NHS dentist continues to get harder and the travelling distance gets longer.
Residents in Swanage already face a three hour, 140-mile round trip to Portsmouth in Hampshire – the nearest dentist taking new NHS patients. This is approaching the definition of a dental desert where whole regions are without provision for new NHS patients.
The shortest route from Swanage to a new NHS dental practice in Portsmouth is a three hour round trip by car
The site of the newly opened Portsmouth dentist which is now the nearest to Swanage accepting new NHS patients. Inset, Dr Nadeem Harunani who runs the business.
Swanage patients have had to join a Surrey practice
Any adult in Swanage wanting to register with an NHS dentist on Friday 7th July 2023 would have found that the closest surgery where they could register was in the centre of Portsmouth.
But since the new Portsmouth practice opened on a retail park in April 2023, demand has been so high there is now a waiting list for appointments for those who register, believed to be around six months at present.
The next nearest available dentist to Swanage which will take new adult NHS patients is a four hour round journey away in Aldershot, on the Surrey border with Hampshire.
All dentists in Purbeck have closed their doors to new NHS patients, taking on private clients only, and the picture is repeated in Poole, Bournemouth, Christchurch, Dorchester, Weymouth and even further afield.
Already residents in Swanage and Wareham have admitted to joining practices in Surrey because they couldn’t afford the cost of private treatment for major dental work, but could not find any NHS practices closer to Purbeck.
Of Swanage’s two dental practices, Smile Dental Care is only taking NHS patients under the age of 14 but does have spaces for adults on a private plan, while Regency Dental is fully private but with spaces available; a 30 minute appointment to register and for a full checkup is £142, with subsequent routine appointments costing from £56.50.
Debby Monkhouse, left, during a campaign to save Swanage’s ambulance car
“Nye Bevan would be turning in his grave”
Councillor Debby Monkhouse, who leads the Swanage Town Council’s emergency services working party said:
“On the 75th anniversary of the NHS, Nye Bevan would be turning in his grave to see what has become of it and we need to look at the failure of central Government to fund it properly.
“We should not be blaming or criticising dentists, who will find it very hard to make a living out of providing NHS dentistry when it is so critically underfunded by a government which does not support the public sector.
“The bottom line is funding, whether that’s for the NHS, the police or our county, where Dorset’s £80 million rate support grant has been cut to zero.
“Funding is all being continually cut and as long as people carry on voting for those who make the cuts, things will carry on getting worse.”
Swanage’s Smile Dental Practice in Kings Road West is only taking new NHS patients under the age of 14
“Can’t recruit our way out of retention crisis”
Although the NHS long term workforce plan is to expand training places by 40 percent in the next decade, the British Dental Association (BDA) says the problem is that more than half of all practices have cut their NHS commitments since the Covid pandemic.
BDA chair Eddie Crouch said:
“Failed contracts and underfunding are fuelling an exodus from this service. There’s little point training more dentists who don’t want to work in the NHS.
“This workforce plan is government’s latest attempt to fill a leaky bucket, but the case for meaningful reform has never been clearer. We cannot recruit our way out of a retention crisis.
“We also have fundamental concerns that the plan is looking to tie dental graduates to this failed NHS system, with no tangible plans to deliver needed reform.
“Ministers need to make the NHS a place young dentists would choose to work, not handcuff the next generation to a sinking ship.”
According to NHS Digital, up to 7 million people in England may be struggling to find a dentist
“On your own unless you want to pay more”
One Swanage resident took to Facebook to say that after her dentist first in Swanage and then in Wareham had gone private, she and her husband had been left without dental care unless they took out a private care plan.
It had been suggested that she look on the gov.uk site to find a dentist which was still taking on adult NHS patients, but the closest she had been able to find was a practice in Surrey.
“So now as I head towards old age and when I might need a dentist more, I have basically been told that you’re on your own unless you want to pay more.”
Swanage’s Regency Dental private only practice is a sign of the times
Dental deserts refuse to take on new NHS patients
The underlying problem is that if dentists treat patients on the NHS, they lose money, because the state funding package does not cover their costs.
Since 2006, dentists have worked for the NHS under a contract where they are paid according to ‘units of dental activity’ (UDA), which bear no relation to the costs of treatment.
Until 2022 dentists received the same payment from the NHS for a patient who required a dozen fillings as for a patient who required one. Treating a patient earned three points, regardless of the length or expense of the procedure.
Critics say there is no incentive to practise preventive dentistry, while it actually benefits dentists to exclude the patients with the greatest needs – all at a time when fuel costs, laboratory bills and dental materials are soaring.
Recruitment problems, coupled with the fact that dentists are effectively fined by government if they deliver less than 96 percent of the UDAs they are contracted to carry out, has led to ‘dental deserts’ – whole regions where dentists are refusing to take on new NHS patients.
South Dorset MP Richard Drax says that the current situation is unacceptable
“I did not realise how shocking the situation was”
Local MP Richard Drax said:
“In my seat of South Dorset there are only 10 dental practices, in Swanage, Weymouth and Portland. None of them are NHS only, one is now private, and none were accepting new NHS patients when contacted by Healthwatch six months ago.
“There are only two surgeries in Swanage – my constituents write to me regularly on this issue, and I am ashamed to say that I did not realise how shocking the situation was until we started to look into it.
“One of my constituents said after telephoning 14 practices ranging from Wareham and Poole to Castle Cary in Somerset, he was met with 12 straight negative replies and two offers of being placed on very slow moving waiting lists or private treatment offers. That is completely unacceptable.”
According to the British Dental Association, NHS dentistry is facing a real threat
300 Dorset children waiting for dental surgery
It is reported that about 300 children in Dorset have been waiting for months, not just for treatment but to go to Dorset County Hospital to have an operation under general anaesthetic because their dental problems are so severe.
Richard Drax added:
“The British Dental Association has said – and I agree, from what I am learning – that NHS dentistry is facing an existential threat.
“It shocked me to discover that before the pandemic there were only sufficient funds for dentistry to look after 50 percent of the population – even before the pandemic, only half the population had their teeth looked after. That is extraordinary.”
Soaring costs of dental materials and electricity are helping to push dentists away from NHS contracts
“Improving access to dental services is a priority”
A spokesperson for NHS Dorset said:
“We are aware that some people are experiencing challenges to access an NHS dentist in Dorset. Improving access to dental services is a national priority, and NHS Dorset Integrated Care Board is working with NHS England South West on this.
“In Dorset, there is a lack of dentists in the area, which, along with additional pressures on the system, has led to less appointment availability.
“NHS Dorset ICB has recently taken on responsibility for commissioning dentistry in Dorset and is engaging local dental clinicians and Healthwatch to offer practical support to enable dental practices to take on more NHS dentistry in the area.
“There are several other measures we are putting in place to increase dental access for people. As of June 2023, we have 96 NHS dental practices in Dorset and recently secured additional capacity in Poole, providing an additional 3,000 dental appointments.”
People can call NHS 111 to access urgent dental care appointments which are provided Monday to Friday during normal contracted hours. Currently in Dorset, this service provides 35 face-to-face appointments per week.
If people are experiencing a significant dental emergency, such as rapid facial swelling, uncontrolled bleeding, or facial trauma, this can be treated at accident and emergency departments in Poole or Dorchester.
- More about the dentistry crisis on the British Dental Association website