A dental clinic in Wiltshire is raising concerns over access to NHS dental services after being unable to secure additional NHS appointments, even though it recently hired staff to expand its capacity. Dr Michael Frain Ltd, which operates in Wiltshire and Bristol, employed an orthodontist at its Chippenham location, believing this could allow up to 50 more children to receive braces before April. Despite these changes, the practice cannot increase its NHS work due to limitations with its current contract.
Last year, the clinic reduced its NHS contract following the departure of several dentists who handled NHS patients. The clinic says it spent months searching for new dentists, but had no luck with applicants for NHS positions. Instead, it received several applications for private roles, leading to a shift in the way the clinic operates. Dr Keith Garber, one of the directors, explained that the reduced contract was not driven by profit, but was instead a move to keep the business running.
The NHS Bath and North East Somerset, Swindon and Wiltshire Integrated Care Board responded to these concerns, stating that services were recommissioned with other providers to account for contract changes. The Board emphasized its role in keeping access to NHS dental appointments stable in local communities, confirming that Chippenham had not experienced a decrease in NHS services.
Dental contracts with the NHS are negotiated annually and measured by units of dental activity. Because the system is based on a tender process, it is not possible to quickly reallocate NHS work between clinics if demand changes, which can be frustrating for those able to provide extra care. The British Dental Association has described the current system as flawed, saying more flexibility is needed when practices have the capacity to do more NHS work.
Local Liberal Democrat MP Sarah Gibson has taken up the issue, calling for system reform and improved contracting arrangements that work for both patients and dentists. Government plans to update the NHS dental contract in April 2026 are underway, aiming to prioritize emergency care and help patients with complex needs, though many believe broader reforms are necessary for lasting improvement.