Are more dentists now working in the NHS?

“As a result of the new reformed NHS dentistry contract, there are now more NHS dentists across the UK with more funding, making sure people can get the treatment they need.”

“The facts are there are no new dentists, no new contract and no new money.”

During Prime Minister’s Questions last week, Rishi Sunak claimed that following reforms to the NHS dentistry contract “there are now more NHS dentists across the UK with more funding”.

This statement was challenged by the British Dental Association (BDA), which said Mr Sunak had made a “wholesale misrepresentation of the crisis facing NHS dentistry”.

In a statement, BDA chair Eddie Crouch said: “The facts are there are no new dentists, no new contract and no new money.”

Since the pandemic NHS dentistry has been facing significant difficulties, with many patients across the country struggling to get appointments or register with an NHS dentist.

We asked Number 10 to confirm the figures Mr Sunak was referring to and what his claim was based on, but we haven’t had any response. The BDA has provided us with some more information about its comments. We’ve looked at how the conflicting claims stack up below.

Are there more dentists working in the NHS?

If Mr Sunak was referring to figures for the last financial year, he is correct that the number of dentists in the UK doing some NHS work has increased. 

In 2021/22 there were 30,438 dentists working across the NHS in England, Wales, Scotland and Northern Ireland—an increase of 447 compared with the previous year. However, in all countries but Northern Ireland, and across the UK as a whole, overall numbers remain lower than before the pandemic.

It’s worth noting that although Mr Sunak spoke about dentists “across the UK”, health is a devolved matter, and the UK Government is only responsible for health services in England. In 2021/22 there were 24,272 dentists who undertook work in the NHS in England— an increase of 539 compared with the previous year.

However, as the BDA told us, this is still lower than the number of dentists working in the NHS in England before the pandemic, and is in fact the lowest number of dentists recorded as working in the NHS in England since 2016/17, with the exception of 2020/21.

When we contacted the BDA about its claim that there are “no new dentists”, it also pointed out that the government’s figures only refer to the number of dentists who have done “some” NHS work over the year, and does not show whole/full-time equivalence (WTE) for NHS work.

It added that the majority of dentists do some combination of NHS and private dentistry, and that “feedback from frontline suggests an ongoing shift away from NHS work, which has accelerated owing to the pandemic”.

Full Fact has been unable to find data on the number of WTE NHS dentists in England. Official figures do show that the number units of dental activity per dentist in the NHS in England had been falling prior to the pandemic, and remained below pre-pandemic levels in 2021/22, though this could be due to a number of different factors.

What about funding?

The BDA also criticised Mr Sunak’s claim that NHS dentists had received “more funding”, claiming that there has been “no new money”.

Number 10 hasn’t given any explanation for Mr Sunak’s claim, which means we don’t know exactly what figures or time period he was referring to. But in January 2022, the government announced a £50 million one-off funding injection intended to help NHS England dental services return to pre-pandemic levels. Mr Sunak may have been referring to this.

That extra funding was for the 2021/22 financial year, but the most recent year for which we’ve seen complete funding figures is 2020/21. Those figures show that in 2020/21 some £3.031 billion was spent on NHS dentistry in England, up slightly from £2.958 billion the previous year. 

The BDA told us its claim that there has been “no new money” was based on a long-term fall in spending on NHS dentistry across the UK in real terms.

Although there are different ways of measuring this, it does appear there’s been such a fall in the longer term. Looking only at spending on NHS dentistry in England, for which the UK Government is responsible, in 2009/10 the cost of providing dental services was around £2.7 billion and in 2020/21 was around £3 billion. Using a GDP deflator, we estimated this as a fall, in real terms, of roughly 10%.

Some of these costs are covered by patient fees and charges, but most of the cost is borne by the health service.

Are workforce and funding changes due to contract reforms?

Mr Sunak claimed that an increase in the number of dentists in the NHS and in funding was “a result of the new reformed NHS dentistry contract”.Without Downing Street having explained the basis of his claim, it’s hard to say for sure if there’s a connection. But the latest published figures for the number of NHS dentists and funding predate recent contract reforms coming into effect.

Although the process of reforming NHS dental contracts in England began in 2021, the first reforms were not announced until July 2022, and only took effect in November 2022, after the period covered by the latest published workforce and funding data.

The reforms included increased payments for dentists treating more complex cases, and a legal requirement for dental practices to update the NHS website with details on availability of appointments.

In a statement following the implementation of the reforms in November, health minister Neil O’Brien said: “Our new contract rewards dentists more fairly for taking on high needs patients and delivering treatments to those who need it most.”

However the BDA has taken issue with the contract changes being described as a “new contract”. Shawn Charlwood, chair of the BDA's General Dental Practice Committee, said last November: "Ministers have done little more than rearrange the deckchairs. These minor tweaks will not end the access crisis or give demoralised dentists any reason to stay in the NHS.”

Image courtesy of No 10 Downing Street