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Nov 2023

Last Updated: 28/11/2023

Health

Pannal dental practice stops treating adults on NHS

by John Grainger

| 28 Nov, 2023

A Harrogate dental clinic will no longer provide a full NHS service next year because it says it cannot afford to.

Pannal Dental Clinic (PDC) sent letters at the weekend to its patients to let them know of the new arrangements.

The letter, which has been seen by the Stray Ferret, said:

“As of the 1st January 2024, our team will cease to provide NHS care for adults. Instead, we will be able to provide your dental care on a private basis and to aid this transition we have introduced a patient membership plan.”

The change came as a shock to some patients, including Pannal resident Petra Turner.

She told the Stray Ferret:

“A number of Pannal and Burn Bridge residents are now finding that they have to join the PDC dental plan or stay on as a pay-as-you-go (a lot of money) patient in order to stay on their list.”

She added:

“We (a family of four) have been with this practice for 22 years. If the three adults in our family were to join the PDC basic plan, we would have to pay £750 a year. This would include two dental check-ups and two hygienist appointments per person. A very nice hourly rate.”

But Dr Greg Cadman, owner and principal dentist at PDC, said he had no choice but to reduce the NHS contract.

Under a system introduced in 2006, any dental practice working to an NHS contract must fulfil a target of units of dental activity (UDAs) set by the Integrated Care Board (ICB) that gave it the contract.

A check-up is worth one UDA, but a filling is worth three. Confusingly, multiple fillings in one visit still count as three UDAs.

Earlier this year, Parliament’s Health and Social Care Committee called the UDA system “not fit for purpose”.

Pannal Dental Clinic has failed to meet its targets in three of the last four years, and missing them carries a penalty known as a “clawback”, where the ICB can claim back the value of the underachieved units.

As a result, the practice had to pay back a large sum of money.

Dr Cadman said:

“We are not terminating our NHS contract – we are reducing it and prioritising children.

“We lost a couple of associates due to them wanting to work privately, and another went on maternity leave. With staffing levels like that, it became impossible to hit the target.

“There’s no clawback if you fulfil 90% of your UDAs, but we hit 89.7% – just 0.3% off the target – so we were hit with a full clawback of tens of thousands of pounds that had to be paid within just three months.”

He said the problem had been exacerbated by the recruitment crisis in the NHS, which had grown more acute since Brexit and the Covid pandemic. He said:

“There always used to be dentists who would take on NHS work, but now many are finding it too difficult under the current system. We’ve advertised for new NHS dentists in numerous places for six months – without a single applicant. Even dental nurses are hard to find.

“There’s definitely still a place for the NHS – it's really important, and I don’t want to see it go. But for practices like ours, working within it is very difficult.”

The reduction in PDC’s NHS contract is symptomatic of a national trend. The British Dental Association has said that NHS dentistry is facing a “genuine crisis” of access.

A YouGov survey in March 2023 found that one in five people in the UK (22%) are currently not registered with a dentist, and of these, 37% said this was because they couldn’t find an NHS dentist.

One in 10 (10%) even admitted to attempting their own dental work.

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