Dental practices across the southwest of England are facing ongoing challenges in providing NHS dental services, even as many try to expand their offerings to meet growing community needs. Dr Michael Frain Ltd, which oversees dental surgeries in Wiltshire and Bristol, recently hired an orthodontist at its Hathaway practice in Chippenham with hopes of providing more NHS appointments. However, despite having the necessary staff, the company reports that it is unable to take on additional NHS work because existing contracts prevent rapid increases in NHS service provision.
This situation arose after the practice was forced to reduce its NHS contract in April 2025 due to several dentists leaving. Attempts to recruit new NHS dentists went unsuccessful for months, prompting the company to hire private dentists instead. Director Dr Keith Garber explained that there are often misconceptions about dentists prioritizing private work for higher income, but he emphasized that the choice is often one of survival. He said, “We either stay in business or don’t stay in business a lot of the time, and if we’re asking for more NHS work to be done, how frustrating is it that we actually get turned down by the local team.”
The NHS Bath and North East Somerset, Swindon, and Wiltshire Integrated Care Board addressed the issue, stating that they had already recommissioned alternative services with other providers to make sure access to NHS dental appointments remained steady after the contract was reduced. NHS dental contracts, which are reviewed annually and awarded through a tendering process, make it difficult to quickly adjust levels of NHS care in response to surges in demand.
Local politicians have also become involved, with Chippenham’s Liberal Democrat MP, Sarah Gibson, meeting with the care board to push for more flexible arrangements allowing practices to swiftly take on extra NHS appointments. Gibson highlighted the need for broader reform, referencing a call for a new contracting system that works both for patients and dentists. Industry leaders agree, with Eddie Crouch, chair of the British Dental Association, criticizing the current system for being unable to easily transfer funding between practices with varying capacity.
Amid these challenges, some organizations are striving for long-term improvements. Smile Together, operating throughout Cornwall, focuses on reducing oral health inequalities and invests in training, mentoring, and sustainable dental careers for its workforce. This approach aims to serve both NHS and private patients while building a resilient dental workforce. The government plans new changes to NHS dental contracts set to begin in April 2026, emphasizing emergency care and support for patients with complex needs, though the central commissioning system will remain in place. Many in the industry hope these efforts will lead to more accessible and equitable dental care for communities across the region.
Tags: dental care