Sir, on 8 June 2020, practices in the UK reopened after the lockdown precipitated by the pandemic. Since then, dentists have rejigged their practices at some expense to maintain full cross-infection control and social distancing in line with a series of standard operating procedure guidelines issued by the Department of Health and Social Care (DHSC). In time, output ramped up so that most practices are currently working at what they consider to be a safe speed commensurate with a safe environment, something around 20% of pre-COVID levels.

The profession was dismayed to learn in December 2020 that, as of 1 January 2021 and with only a few days' notice, the DHSC was demanding that output was to be increased to 45%. This figure would be accompanied by a return to the invidious UDA as a measure of output along with a complex set of bands which determined levels of clawback if targets were not reached.

Regrettably, the Department has not listened to and, in reality, has completely ignored the arguments of the GDPC that this target was untenable for a number of reasons, these being:

  • Practices are currently working to capacity, taking into account high levels of cross-infection control, limited patient capacity, patient flow within the practice and the need for enhanced cleaning of surgeries after each patient, including the now revised fallow time after aerosol generating procedures

  • Any increase in throughput will, in the opinion of the profession and the BDA, increase the risk to health and safety procedures to dentists, staff, and above all, to the welfare of patients as dentists attempt to cut corners to increase throughput.

In the 1970s, around 95% of all dental treatment in the UK was done under the NHS. By June 2018, this had fallen to around 50%.1 If the Department continues with its current policy, there is a real danger that more dentists will leave the NHS, or at least reduce their commitment to NHS dentistry even further, and the NHS dental services, once the envy of the developed world, will wither on the vine.

Finally, it has not escaped the profession's eye that clawback will further hazard the financial stability of practices, already reeling from the hit of vastly reduced throughput (affecting both the NHS and private sectors) and exorbitant PPE costs. There is a real risk that practices in socially deprived areas where the only option is to work within the NHS may find themselves financially unviable.

The profession urges the Department to rescind the 1 January orders with immediate effect and enter into real and meaningful negotiations, not diktat, with the profession's representatives, the GDPC, without delay. Otherwise, patients' safety will be put at risk and the NHS primary dental services will continue to wither on the vine. This government will go down in history as the one that finally destroyed it.