Health managers say some NHS dentists are prioritising patients with simpler dental problems because treating complex cases is not financially worthwhile under the current system.
Dental practices receive the same level of NHS funding whether a patient needs a routine check-up or several fillings. As a result, patients with more serious dental issues often struggle to secure appointments.
Charmaine Hawker, director of primary care commissioning and contracting for the Herefordshire and Worcestershire Integrated Care Board (ICB), said the situation is linked to the national dental contract, which has seen limited reform since it was introduced in 2006.
She told councillors the ICB had gone “above and beyond” national requirements by paying practices more per “unit of dental activity” than the standard rate set by the government.
Hawker was speaking during a health overview and scrutiny committee meeting, where commissioners were questioned by local councillors about access to NHS dental care.
Councillor Peter Turner said many residents have reported difficulty finding an NHS dentist.
“I’ve heard various stories that trying to get an NHS dentist is proving quite difficult and it’s not worthwhile for practitioners to take on NHS patients because it’s not financially prudent,” Turner said.
Hawker acknowledged the problem. She said Worcestershire ranked at the bottom of the West Midlands for NHS dental access last year but has since moved up three places.
“What we’re finding is many practices are seeing patients with less complex needs, because the contract does not reward them for seeing patients with complex needs,” she said.
Changes to the contract are expected to take effect in April. Under the new rules, dental practices will be required to reserve 8% of treatment capacity for urgent cases.
Commissioners have also been given greater authority to remove NHS contracts from underperforming practices and redirect the funding to other providers.
Satinder Bell, Worcestershire County Council’s cabinet member for health, said schools are helping educate children about better dental hygiene, but dental practices could also play a stronger role in prevention.
“Dental work is all about prevention, and here it is a Catch-22,” Bell said.
“They’re not seeing you to do the majority of work, which is preventative work to keep your teeth healthy. Then it becomes a complex problem, and they’re not going to see you anyway.”