Watchdog report: Just one NHS dentist per 10,000 people in Harrogate district

A health watchdog has laid bare the shocking lack of provision of NHS dentists in the Harrogate district in a new report published today.

NHS Dentistry in North Yorkshire: A Review of Public Feedback 2020-2021 found there was just one NHS dentist practice per 10,000 people in the district.

The report, published by Healthwatch North Yorkshire, also revealed that no Harrogate district dental practices were currently taking on new patients.

With so few dentists and so many patients, the report said many patients faced either long waits or high bills through private treatment.

Healthwatch North Yorkshire also highlighted how confusing it can be for someone attempting to find an NHS dentist.

In most areas across the county there are dentists listed on the NHS Choices website which do not actually provide an NHS service.

Volunteers from Healthwatch North Yorkshire called all of the practices listed on the NHS website in the county to ask if they were taking on new patients.

Three of the 19 in the Harrogate district said they were not NHS practices.

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This means there are 16 NHS dentist practices in the Harrogate district for an estimated 160,500 people. None are taking on new patients.

Healthwatch North Yorkshire received 176 calls from the public in the last year about NHS dentists. The vast majority — 84% — were negative.

Some of the complaints from Harrogate residents:

Anonymous email, December 2020, Harrogate:

“I needed an emergency filling at the beginning of the first lockdown. I was offered a temporary DIY kit which worked for all of two days.

“Weeks go by. I finally got my appointment, only to find that they still can’t fix it because they can’t use all equipment without the correct PPE.

“God knows how many months later and I’ve still only got a temporary fix.”

Anonymous website feedback, April 2021, Harrogate:

“I have been trying to obtain an NHS dentist for my 10-year-old daughter, myself and my husband.

“One dentist in Knaresborough said they could add us to a list that had a three year wait for an appointment.

“Another told me that the only way that my daughter could be seen would be if myself and my husband took a private place at a cost of £75 for an initial consultation each.

“This is disgraceful and holding people ransom for their children to be able to access basic dental treatment.”

Anonymous telephone call, April 2021, Harrogate:

“Caller rang about their partner. They have a hole in their tooth. Rang 111 to arrange an emergency appointment because of the pain – it took a week and a half to get an appointment.

“The dentist charged £90, and gave antibiotics. Told them to come back two days later for further treatment, bill to be £1,600.

“I tried finding NHS dentists elsewhere, none anywhere. Partner can’t pay that as they have been unemployed for the past six months.”

What can be done to fix the problem?

Ashley Green, chief executive of Healthwatch North Yorkshire, said:

“The lack of access to and availability of NHS dentists has severely affected the health and wellbeing of people across North Yorkshire, from Scarborough to Selby, from Craven to Harrogate.

“The impact of coronavirus has only acted to exemplify a dental system already under enormous strain and challenge.

“We feel it is now time to act – and to use upcoming changes to NHS and social care reforms, specifically the emergence of integrated care systems to fuel this change.

“We hear on a weekly basis the struggles of people and families unable to be seen by an NHS dentist, but also the desire by NHS dentists to see and treat their patients more effectively.”

‘Extremely urgent’ action required to tackle NHS dentist shortage

Health bosses have insisted they are doing everything possible to attract NHS dentists to set up in North Yorkshire after admitting there is a growing backlog of patients awaiting treatment.

After grilling NHS bosses responsible for dentistry across the region, North Yorkshire’s scrutiny of health committee concluded the health service needs to take “extremely urgent” action to address dire access to services.

It comes as the Stray Ferret revealed in March that just two NHS dentists in the Harrogate district were accepting new patients — and both have a waiting time of at least two-and-a-half years.

At the time, Cllr John Ennis, chair of the health scrutiny committee for North Yorkshire, described the findings as “shocking”.

‘Residents demand explanations’

The health committee meeting heard that over the past 12 months, practices in North Yorkshire had started handing back NHS contracts and others had been terminated for failing to provide contracted services.

Of the 100 remaining dentistry NHS contracts in the county, some only take children as NHS patients if their parents pay for private treatment and others that do take adult NHS patients report waiting lists of more than 8,000 patients.

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Cllr Tony Randerson told the meeting that residents were demanding explanations as to why parents were having to take children as young as six to places such as Middlesbrough and face bills of £100 for check-ups.

He called on the county council to put pressure on the government to improve access to NHS dentistry.

Cllr Randerson said:

“The government has got a responsibility to look after not only the small few that can afford private treatment, but everybody. It is a duty of care.

“It’s absolutely criminal that these people are having to travel as far away as Hull or Leeds if they are fortunate enough to get an appointment, and not necessarily NHS appointments. This cannot be allowed to go on.”

The meeting heard access to NHS dentistry had been grave in some areas for many years.

NHS dentistry commissioner Debbie Pattinson said that due to nationally imposed pandemic restrictions practices were continuing to operate at about 60 per cent capacity. 

She emphasised practices had been asked to prioritise those in need of urgent care.

Ms Pattinson said: 

“We’ve got a growing backlog, a growing number of people who want a regular check up and cant get one.

“It is unprecedented. We’ve not known anything like it in North Yorkshire with the contracts coming back.”

Managing perceptions

However, she added NHS bosses were working to manage “public perceptions”. 

She said: 

“Dentistry isn’t free. It is a subsidised service.”

Ms Pattinson said finding replacement practices was proving difficult as due to covid restrictions “nobody wants to take on more activity”.

Nevertheless, she said the NHS hoped to have commissioned some out of hours urgent care appointments on Saturdays at a number of different clinics in bigger towns across North Yorkshire by the beginning of October.

To target inequality, North Yorkshire and Humber Local Dental Network chairman Simon Hearnshaw said the NHS was looking at introducing a dentistry programme for children linking a practice to a school, supporting supervised brushing, increasing fluoride, and supporting access to care.

He added the NHS was “trying extremely hard” to improve provision, which included examining incentivising practices to set up in areas of county with no NHS dental cover.

Harrogate dentist drops plans to stop NHS services

A Harrogate dentist has dropped plans to stop providing NHS services after patients raised concerns.

Chatsworth House Dental Clinic proposed in August transferring NHS patients to Starbeck Dental Centre.

The provider never made a formal approach to the NHS and has now confirmed it has no intention to stop the service.

The owners of Chatsworth House Dental Clinic said in a statement to the Stray Ferret:

“At the time, the practice was merely seeking opinion from our patient base about the possible merging of NHS services with another practice in the locality.

“We decided not to pursue this any further after feedback from our patients and the logistics of such a proposal.

“We have no intention of ceasing NHS services and the practice is fully committed to providing NHS services for the long-term future at its current location.”

The decision surprised the management team at Starbeck Dental Centre, which was set to take on the NHS contract.

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Jonathan Campbell, group operations manager at Starbeck Dental Centre, said:

“I can confirm that the transfer to Starbeck Dental Centre is not happening following the unexpected withdrawal from the owners of Chatsworth House Dental Clinic.

“At Target Dental Group our aim is to provide the best possible care to the patients to both NHS and private patients of Harrogate and surrounding areas.”

Investigation into NHS dentist provision in Harrogate district

It comes after an investigation by the Stray Ferret found that just two NHS dentists in the Harrogate district are currently accepting patients and they have a waiting list of at least two-and-a-half years.

We looked into the availability of free NHS services at the 18 district dental practices listed on the NHS website.

Many have not updated their information for years. But they all fall into one of three categories: they have a long waiting list; they have such a long waiting list that they are not taking on new patients; or they no longer hold an NHS contract.

Of the 18 practices, only MyDentist in Knaresborough and AW Jones Dental Practice in Boroughbridge are taking patients — with waiting times of two-and-a-half years and three years respectively.

Harrogate dentists prioritise emergency patients

Dentists in Harrogate have been hit hard by lockdown restrictions and some fear that social distancing measures at surgeries will be place for a long time to come.

Dr Tim Doswell, who is a dentist at the Raglan Suite in Harrogate, said dentistry will not be able to “go back to normal” and that surgeries will have to prioritise emergency procedures.

He said non-essential areas, such as cosmetics, will have to be seen as less important and appointments may remain limited for some time to come.

Meanwhile, patient appointments may have to be spaced out which means some dentists will be forced to remain open longer in order to see them.

Dr Doswell said the industry will have to adjust to life after the coronavirus pandemic.

“The problem with dentistry there is a lot of aerosol-generating procedures and it has been shown that this can stay in the environment in the surgery for up to three hours, so this then puts the next patient at risk,” he said.

“So in the new world when we do go back to work it’s going to be very different until we get a vaccine.

“Appointments will have to be spaced out which is going to limit availability, so non-essential dentistry is going to be very limited for a long time as dentists will have to prioritise emergencies.”

At the moment, dentists can only see patients for emergency appointments.

This includes life threatening infections, trauma caused by accidents, severe pain that cannot be controlled by pain killers or a fractured tooth which has exposed the nerve.

Other patients are triaged over the phone and offered advice or prescribed medicine, such as pain killers or antibiotics.

Anne Benson, who works as a carer for St Margaret’s, told the Stray Ferret that she would not have been able to get back to work without the swift work of her dentist:

“The day after the lockdown came into place I started to have really bad toothache. After a few courses of antibiotics prescribed by my dentist did not seem to be doing the trick he booked me in for another appointment. He carried out an x ray and then drained the abscess. He was in full PPE along with his assistant the whole time, it was absolutely brilliant. If I didn’t get the care from my dentist then I would not be able to do my job looking after vulnerable people.”

WATCH: Harrogate Dentist using 3D printers to make protective visors

 

Dentists and technicians from the Raglan Suite Dentistry Laboratory in Ripon have developed a protective visor from 3D printers normally used for dental work.

So far they have provided almost 2,500 visors free of charge to local care homes, hospitals and other key workers that need them.

Steven Campbell, Dental Technician at the Raglan Suite and MD of Nexus Dental Laboratory, told The Stray Ferret:

“Dentistry is on pause, so we wanted to make use of our 3D printing machines that usually make night guards, liners and dentures. I was shocked at the lack of PPE available so we have managed to come up with the perfect design to create these essential visors. It is brilliant to be able to provide  PPE equipment to our local area.”

The technicians have also been making 900 ear savers each day to make the visors more comfortable for people to wear for long periods of time.

There has been industry funding for the production of these and there is also a go fund me page where people are able to donate towards the making of them.