Dental deserts loom for North Wales as reformed contracts worsen service crisis

WITH Betsi Cadwaladr Health Board back in special measures again, this is the news that has hit the headlines recently but another crisis is also unfolding as dentists report how perilously close to breaking point they are when treating NHS patients across the north.

A British Dental Association survey published recently revealed that almost half of Welsh dentists have found the last six months extremely stressful, with many facing complete burnout. A huge 83.1% of respondents reported going to work, despite not feeling mentally well enough. Worryingly, almost half had done so for more than 10 days.

Dentists from the north of Wales and from Arfon are included in the all-Wales survey and additionally the North Wales Local Dental Committee has undertaken a survey of local members .

They say that some dentists who have run long-standing NHS General Dental Practices have already handed back their NHS contracts, and many others have held discussions with a view to handing back or drastically reducing their NHS commitments going forward.

This will inevitably lead to a reduction in NHS provision in Arfon with more and more dentistry services open only to those who can afford it. Many who cannot access NHS treatment will need emergency treatment when they reach crisis point.

Many of the problems have been exacerbated by the new contract which sets new targets as dentists complain that the targets are not realistic and not flexible enough and that practices are not allowed time to understand and adapt to new ways of working.

The reformed contract consists of targets for meeting historic patient demand (40%), a forced provision for providing access to new patients (25%), an element of Units of Dental Activity (25%), provision of Fluoride

Varnish (5%) to more than 80% of children and high needs adults and that no more than 20% of low-risk patients should re-attend within a 12-month period (5%).

It is important to note that no evidence was forthcoming at the time around how the contract targets had been developed and this evidence is still yet to be provided.

It is recognised that Welsh

Government has indicated that it will begin contract negotiations for 2024/25 and beyond and this is welcomed.

But according to the North Wales Local Dental Committee, the fear is that after another year of the contract, many will have walked before this happens leaving large swathes of the north of Wales as NHS dental deserts.