Credit: James Goldman
The unprecedented public health event of the coronavirus pandemic is taking its toll on almost every aspect of life and dentistry has also been affected to a large extent with all routine, non-urgent treatment being halted and new collaborative urgent dental centres being created.
In the midst of such upheaval, the dental recruitment market has been hit significantly with many posts put on hold, but the people at the heart of the market believe dentistry will bounce back after the pandemic is under control and could be in line for boom times.
The BDJ Jobs website has seen its traffic fall by 26% from February to March of this year – a good indication of a temporary decline of interest in recruitment.
Prior to the virus and the government’s restrictions, in January and February of this year, the website saw a 158% growth in job postings, 54% growth in job views, and 27% rise in applications, when compared with the same months in 2019. However, since March, job applications have fallen by 29% compared to March of 2019.
The impact that the pandemic and subsequent restrictions on life in the United Kingdom has had are significant with many practices having to close temporarily and the BDA seeking clarification on what type of financial support from the government will be available to practices whether NHS, mixed or purely private.
The latest advice1 from England’s Chief Dental Officer Sara Hurley says: ‘This is the time for a collaborative, collective and concerted effort to re-direct our talents and to help support our fellow NHS primary care colleagues when they are at their most stretched.’
Dentists have been advised that all routine, non-urgent dental care including orthodontics should be stopped and deferred until advised otherwise.
In addition, all areas have been advised to establish a remote ‘urgent care service’, providing telephone triage for their patients with urgent needs during usual working hours, and whenever possible, treating with advice, analgesia, or antimicrobial means if appropriate.
Some patients are having to be referred to the appropriate part of their local urgent dental care system to manage urgent dental care needs only.
Hurley adds: ‘We appreciate that these are significant changes that will have major implications on your personal and professional lives and will bring about new ways of working locally and nationally.’
BDA Associate Director of Advisory Services James Goldman says these are extraordinary times for the profession so the union has ensured it is providing daily updates and guidance2 for its members.
‘There is a lot of worry, anxiety and uncertainty at the moment,’ he says. ‘That will change as we have more information. It is affecting dentists’ livelihoods.
‘Some NHS dentists and mixed practices will probably be relatively okay but private practices are likely to suffer. The BDA is working very hard to change that. We hope not, but you can’t rule out some practices going down.
‘I’ve heard stories of practice owners saying to associates who have got contracts signed they will delay the start of their contract.’
Goldman believes recruitment has mostly been paused completely apart from the centres that are being set up to provide urgent treatment for patients.
‘Clearly, for practices now is not the time to be bringing new people in because they’ve got nothing for them to do,’ he explains. ‘If you’re an associate and you’ve got a job, you probably want to keep it especially if it’s got NHS content.
‘This will have a small, long-term impact but at the end of all this, people are still going to need to be able to go to a dentist. It might impact on the less essential dentistry and we might see a drop in aesthetics, tooth whitening, and maybe implants, but I don't think it's going to be massive.’
Paul Holborn, director at Blue Sky People Ltd recruitment agency, admits recruitment is being hammered at the moment, saying: ‘We’ve been impacted by the virus situation. We are seeing practices effectively being mothballed for the time being.
‘The problem with all of this is the unknown. There's no fixed end date to this, so it’s the uncertainties of what's the landscape going to look like, how many jobs are going to be lost in the economy, what is the economic impact of this, and what’s going to be the economic strength of dental businesses if this goes on for three, four or five months?
‘We’ve spoken to our clients who are able to take a medium term view to recruiting. They still require a pipeline of candidates who will be ready to hit the ground running later in the year once their practices are able to reopen. Until then, we’ve taken the decision to shut our advertising down, while assisting our clients on their workforce planning in the meantime.’
Boom times ahead?
Kelly Saxby, managing director of Green Apple Dental Recruitment Limited also admits the situation is having an impact on the recruitment market but says she is optimistic about the future.
‘I am an optimist and I think that we're going to see a boom in the job market following this with more job seekers being more open to NHS dentistry because patients are going to be looking to budget as best as possible,’ she says.
‘From a patient perspective, I think that people are going to appreciate more that they need to focus on better oral hygiene, better care, attend more check-ups and get treatment completed when it’s needed instead of putting it off.
‘With regard to recruitment, we still have some practices that are actively recruiting permanent dentists. Many practices have put locum recruitment on hold or are delaying potential start dates into May or June, so for us as a company, we are updating our adverts where we think they still want somebody but will want to delay it.
‘Practice owners don’t want to lose candidates it took such hard to work to find. Permanent dentist start dates are being pushed back, but we have not had any cancelled.’
While practices are inactive during the coronavirus restrictions, the focus has turned to the government’s call for areas to set up urgent dental care centres or clinics, which are the result of collaboration across the profession, including general dental, hospital dentistry, and community dentistry services.
The BDA says that dentists across the country are signing up to work in these centres and in Northern Ireland, for example, four times the 100 dentists required to work in the new centres volunteered in the first week.
Richard Graham, chair of the BDA’s NI General Dental Practice Committee, says: ‘This is a very stressful time for everyone, dental teams included, so we are very proud of colleagues who are in the forefront of finding a solution for people in dental pain.
‘Routine check-ups are off the menu for now, and we want to ensure that every patient has access to advice, pain relief and emergency care when they need it.’
Goldman says that, as of 14 April 2020, only about half of the 160 centres envisaged are up and running but England is lagging behind the other three nations in setting up these services, meaning that many parts of England are without effective urgent care.
‘Setting these things up from scratch is never going to be something that happens overnight,’ he says.
On the issue of suggestions from the government that dentists may be asked to treat patients outside of their normal dental competencies, Goldman says: ‘If it stays a relatively small pandemic, which at the moment it is because people are doing what they're supposed to be doing, then dentists hopefully will be required to do some dentistry and that's it.
“If this mushrooms, it may be there’s a bigger call to arms in which case, dentists may be asked to do other things. At the moment, it’s too early to say what those other things might be, but the hope is that the public will behave themselves and the virus will be largely contained so dentists can concentrate on teeth and leave others to concentrate on
more Covid-19 related illnesses.’
Once life starts to return to normal, the dental market could be left with some permanent changes to practices and professionals, says Holborn, who believes peoples’ attitudes will change.
‘I think businesses will start looking at where they have been ploughing along, head down, just getting through the work and not really looking strategically at what their business needs to look like,’ he says.
‘It is contingent on what happens in the wider economy, but as things stand, I hope healthcare will be one of those sectors that will bounce back reasonably quickly.’
There may also be an impact on the locum market, as he adds: ‘We've seen a big increase in locum dentists moving around. I think perhaps these big shocks that have come to the marketplace will have an impact on people's thinking that some security and bedding down in a practice may be a positive thing rather than constantly able to pick up locum work ad hoc whenever you feel like it.
‘I hope it might also encourage people to consider working in some of those slightly more remote locations and less populous areas as well.’
Saxby is similarly positive, saying: ‘When we get through this, NHS dentistry is going to be booming compared with private and dentists are going to look at wanting to work more days a week, which is going to be fantastic for practices because they're going to get more continuity and coverage.
‘We think that dentists are going to consider permanent options more. We're always going to have locums, but for people who have always thought ‘I'll just work three months there, as and when’, more of them are going to want more stability and know they’ve got a longer-term option.
‘That could lead to people being a little bit more flexible with regard to what they’ll look at with contracts and locations. They’re going to want to get back into some stability and continuity with regard to income.
‘Practices will still have to look at making sure they provide professional, nurturing, supportive and caring environments. I think the dentistry market is going to be really busy when this ends.’
Advice for the future
Despite the current fears and uncertainties, the BDA is advising the profession and the market to remain calm and have confidence that dentistry will return to a healthy state.
Goldman says: ‘My advice to dentists just now is to be patient, be calm, and see the bigger picture. I would plea for dentists to make sensible commercial arrangements with each other in practice.
‘Don't take advantage and we are going to be looking to help dentists, especially associates, where their practice owners are acting unreasonably in terms of redeployment. Keep an eye on the news and make sure you follow the best guidance. We will get through these things by not panicking.’
- NHS England. Preparedness letter for primary dental care. (25 March 2020) https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/issue-3-preparedness-letter-for-primary-dental-care-25-march-2020.pdf
- British Dental Association. Coronavirus Guidance. https://bda.org/coronavirus