The BDA has welcomed the move from inspectors at the Care Quality Commission (CQC) to make the growing crisis in patient access the headline of its keynote report on the quality of patient care.
The State of Care report identified high street dental and GP services as areas in which "patients struggle to access non-urgent services", with knock-on effects on secondary care.
The report examined official data, showing that while the population has continued to grow, commissioning of NHS dental services has failed to keep pace. The CQC has found fewer Units of Dental Activity (UDAs) are now being commissioned per person, with 1.67 UDAs per person in 2012, falling to 1.56 per person in 2019.
This is the first time since the CQC started collecting data on primary healthcare services in 2011, that reports have placed such a heavy focus on access. Throughout that period the regulator has consistently reported that dental practices, when compared with other health providers, present a lower risk to patient safety.
Of the 1,033 dental practices inspected in 2018/19, the CQC found that 85% complied with the regulator's five key tests: Are healthcare providers safe, effective, caring, responsive and well-led. 100% of inspected practices met the tests for 'caring' and 'responsive' to their patients' needs and preferences, while 98% were found to be 'effective' in achieving good health outcomes; 95% were found to be safe, and 85% were considered to be well led.
The BDA has described this performance as a remarkable achievement and a testament to the hard work and commitment of staff in the face of funding pressures and mounting recruitment problems. The service is operating on a budget lower in cash terms than it was in 2010, and continues to operate a widely discredited target driven contract system, which funds care for little over half the population.
Access problems are growing thanks to underfunding, and as recruitment problems mount. Recent BDA surveys indicate 75% of practices are struggling to fill vacancies, with 59% of dentists stating their intentions to reduce or end NHS work. Problems are greatest among practices with the highest NHS commitment.
Mick Armstrong, Chair of the BDA, said: "It should send a message to Whitehall when health inspectors lead on access problems. Sadly, it's the inevitable result of a 'do more with less' mantra, that's pushed NHS dentistry to breaking point.
"Dentists have managed to deliver the very best for patients, without a penny of new investment, and in the face of growing recruitment problems. It's a remarkable achievement, from a service with no more to give.
"We can take pride in what we've achieved, in spite of everything. The real risk families face when it comes to their dental care is being unable to secure an appointment."