As any health professional will you tell you, recruitment, retention and access are intimately linked.
We want this profession to succeed, and to deliver the very best for its patients. It's why each year we ask our members for their feedback on pay and on morale.
Well the results are in. We have just submitted your evidence to Review Body on Doctors' and Dentists' Remuneration (DDRB), the body tasked with providing recommendations on pay.
And sadly, it looks like many colleagues have had their fill.
1) A recruitment crisis is brewing…
Feedback from members across the UK points to an emerging crisis, and services that cannot be maintained because practices simply cannot fill vacancies. In the wake of a 35% real terms pay cut in the last decade we are seeing less than one applicant for every GDP vacancy advertised outside of London, with 63% of practices now saying they are experiencing difficulties.
The Community Dental Service isn't immune, with problems developing especially for specialist posts. And, tellingly, for the first time ever the majority of CDS dentists say they are dissatisfied about pay. Of course this will be old news to dental academia – where there has been a permanent 10% vacancy level amongst Senior Clinical Lecturers, the backbone of clinical undergraduate teaching.
2) It shouldn't be a case of more NHS = Lower morale (but it is)
Half of respondents seem ready to opt out of a treadmill of targets and pay cuts. We have colleagues settling on five year plans that boil down to getting out of NHS General Dental Practice, and patterns point to lowest levels of morale where NHS commitment is highest.
The key challenge for NHS dentistry is recruiting and retaining dentists. Morale and motivation are vital. It's not rocket science. High street dentists need to be valued, and want to stay in practice.
Instead we are losing staff as they reduce their NHS commitment, seek to retire early or leave the profession entirely. This situation is driving recruitment issues in general dental practice, community services and secondary care across the UK.
3) These problems carry consequences for patients
We know the contractual arrangements in England and Wales are hurting morale and effectively capping patient numbers.
We've worked with The One Show to highlight the situation in West Yorkshire, where charities are having to step in. When a government funds care for half the population, takes clawback and doesn't reinvest, you will find there isn't always enough dentistry to go around.
And in Plymouth we have the flip side. There may be the UDAs, but there aren't always the staff to deliver it. The result is 9,000 strong waiting lists, public health officials writing begging letters to Whitehall for action, and patients facing 70 mile drives down the A38 in search of an appointment.
Sadly, government claims of an ever-growing number of dentists amount to denial, as the evidence shows more and more colleagues are going part time.
4) These problems are solvable
Pay restraints amount to pay cuts, which is having a deleterious impact on the service. Below inflation uplifts must end, and clawback must be kept in the dental budget to help meet demand.
The re-introduction of NHS commitment payments in all four countries would throw a lifeline to NHS associates, who generally have a higher NHS commitment and form the vast majority of the workforce.
There is now a compelling case for NHS support for skyrocketing costs of indemnity to encourage retention.
As The One Show concluded the charities are just "temporary fixes" that fail to tackle underlying problems.
NHS access won't be solved by patients using half a tank of petrol. Nor will recruitment problems be solved by health officials sticking their heads in the sand.
What it needs is commitment from government. We need real reform, real support and real progress on contracts.
And as long as we're left waiting we will use your evidence, to keep this debate going in Parliament and in the press.
Vice Chair, British Dental Association
Dentists’ pay: What we do for you
Each year we use our evidence to fight for a fairer pay for associates, practice owners, community dentists (PDS in Scotland), and we call for pay parity for dental clinical academics.
We work across England, Northern Ireland, Scotland and Wales, and provide evidence to the Governments on your behalf.
We want an end to the public sector pay cap for doctors and dentists – we believe the continued decline in income for dentists is affecting not just the profession, but the access to care dentists can provide for patients.