Abstract
Introduction Studies show that changes to dental incentive structures and treatment timings impact behaviour among UK general dental practitioners (GDP). Since 1980, the British Dental Association (BDA) has conducted panel inquiries to understand the time taken to complete dental treatments, the most recent of these being the 1999 Heathrow Timings study.
Aims Given significant changes to the UK general dental service (GDS) since 1999, this research aims to gain a refreshed understanding of the time involved to complete clinical treatments in the UK and gain insight into working hours.
Materials and methods This study adopted a mixed-method research design, adapted from the BDA's Heathrow Timings study. Averages for 34 adult and 12 children's treatments were found using an online survey and group discussion with 15 GDPs.
Results Overall, GDPs worked 35.23 hours per week, at an hourly rate of £39.94. Comparison to the Heathrow study in 1999 shows an increase in time to deliver multiple treatments, including clinical examinations, root canals, extractions, composite fillings, porcelain veneers, acrylic full dentures and children's extractions.
Conclusion Overall, this study provides a current and updated insight into dental treatment times performed by GDPs in the UK and highlights a decrease in working hours and real-term earnings of GDPs over the past 20 years.
Key points
-
Provides a current and updated insight into the timings of dental treatments conducted by general dental practitioners in the UK.
-
Highlights the increased time to deliver multiple treatments currently compared to data reported in 1999 from the Heathrow Timings study.
-
Shows differences in working hours, including non-clinical/clinical hours and real-term earnings of general dental practitioners over the last 20 years.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 24 print issues and online access
$259.00 per year
only $10.79 per issue
Buy this article
- Purchase on SpringerLink
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
Data availability
Data can be provided by the corresponding author upon reasonable request.
References
Allin S, Farmer J, Quiñonez C et al. Do health systems cover the mouth? Comparing dental care coverage for older adults in eight jurisdictions. Health Policy 2020; 124: 998-1007.
Pälvärinne R, Birkhed D, Widström E. The Public Dental Service in Sweden: An Interview Study of Chief Dental Officers. J Int Soc Prev Community Dent 2018; 8: 205-211.
UK Government. The National Health Service (General Dental Services Contracts) Regulations 2005. 2005. Available at https://www.legislation.gov.uk/uksi/2005/3361/contents/made (accessed September 2023).
Welsh Government. NHS Dental Services: April 2021 to March 2022. 2022. Available at https://www.gov.wales/nhs-dental-services-april-2021-march-2022-html (accessed December 2023).
NHS Business Services Authority. How many units of activity (UDA/UOA) does a course of treatment (COT) receive? 2023. Available at https://faq.nhsbsa.nhs.uk/knowledgebase/article/KA-01976 (accessed December 2023).
NHS Business Services Authority. Units of dental activity (UDA) changes to Band 2 treatments from Friday 25 November. Available at https://www.nhsbsa.nhs.uk/units-dental-activity-uda-changes-band-2-treatments-friday-25-november (accessed December 2023).
NHS Inform. Receiving NHS dental treatment in Scotland. Available at https://www.nhsinform.scot/care-support-and-rights/nhs-services/dental/receiving-nhs-dental-treatment-in-scotland/ (accessed December 2023).
NI Direct Government Services. Health Service dental charges and treatments. Available at https://www.nidirect.gov.uk/articles/health-service-dental-charges-and-treatments (accessed December 2023).
Scottish Government. Amendment no. 162 - Statement of dental remuneration. 2023. Available at https://www.scottishdental.org/wp-content/uploads/2023/10/Amendment-No.-162-to-the-SDR-30-October-2023.pdf (accessed December 2023).
Tickle M, McDonald R, Franklin J, Aggarwal V R, Milsom K, Reeves D. Paying for the wrong kind of performance? Financial incentives and behaviour changes in NHS dentistry 1992-2009. Community Dent Oral Epidemiol 2011; 39: 465-473.
Grytten J. Payment systems and incentives in dentistry. Community Dent Oral Epidemiol 2017; 45: 1-11.
Godwin T L, Brocklehurst P, Hall B, McDonald R, Tickle M, Williams L. How and why does capitation affect General Dental Practitioner behaviour? A rapid realist review. Br J Health Care Manag 2018; 24: 505-513.
Holden A, Adam L, Thomson W. The relationship between professional and commercial obligations in dentistry: a scoping review. Br Dent J 2020; 228: 117-122.
Bearne A, Kravitz A. The 1999 BDA Heathrow Timings inquiry. Br Dent J 2000; 188: 186-194.
Ganbavale S G, Aukett J W, Gallagher J E. Timings and skill mix in primary dental care: a pilot study. Br Dent J 2019; 227: 907-913.
Wanyonyi K L, Radford D R, Harper P R, Gallagher J E. Alternative scenarios: harnessing mid-level providers and evidence-based practice in primary dental care in England through operational research. Hum Resour Health 2015; 13: 78.
Bannister C, Cope A L, Karki A et al. Time to complete contemporary dental procedures - estimates from a cross-sectional survey of the dental team. BMC Oral Health 2023; 23: 926.
McColl E, Jacoby A, Thomas L et al. Design and use of questionnaires: a review of best practice applicable to surveys of health service staff and patients. Health Technol Assess 2001; 5: 1-256.
UK Research Integrity Office. Code of Practice for Research. 2023. Available at https://ukrio.org/wp-content/uploads/UKRIO-Code-of-Practice-for-Research.pdf (accessed September 2023).
UK Government. Health matters: Health economics - making the most of your budget. 2018. Available at https://ukhsa.blog.gov.uk/2018/07/27/health-matters-health-economics-making-the-most-of-your-budget/ (accessed October 2023).
NHS England. The NHS Long Term Plan. 2019. Available at https://www.longtermplan.nhs.uk/publication/nhs-long-term-plan/ (accessed November 2023).
Wanless D. Securing our Future Health: Taking a Long-Term View. London: HM Treasury, 2002.
McKee M, Dunnell K, Anderson M et al. The changing health needs of the UK population. Lancet 2021; 397: 1979-1991.
Steele J, O'Sullivan I. Adult Dental Health Survey. London: The Health and Social Care Information Centre, 2011.
NHS England. Guides for commissioning dental specialties - Special Care Dentistry. 2015. Available at https://www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2015/09/guid-comms-specl-care-dentstry.pdf (accessed June 2024).
Office for National Statistics. Living longer: how our population is changing and why it matters. Available at https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/ageing/articles/livinglongerhowourpopulationischangingandwhyitmatters/2018-08-13 (accessed November 2023).
Hellyer P, Radford D R. An evaluation of defensive dentistry: w(h)ither the profession? Br Dent J 2017; 223: 885-888.
Holmes R D, Burford B, Vance G. Development and retention of the dental workforce: findings from a regional workforce survey and symposium in England. BMC Health Serv Res 2020; 20: 255.
Gallagher J E, Scambler S. Reaching A Female Majority: A Silent Transition for Dentistry in the United Kingdom. Prim Dent J 2021; 10: 41-46.
NHS Digital. NHS Dental Statistics: 2022-23 Workforce. 2023. Available at https://view.officeapps.live.com/op/view.aspx?src=https%3A%2F%2Ffiles.digital.nhs.uk%2F94%2FE54172%2Fnhs-dent-stats-22-23-workforce.xlsx&wdOrigin=BROWSELINK (accessed February 2024).
Newton J T, Buck D, Gibbons D E. Workforce planning in dentistry: the impact of shorter and more varied career patterns. Community Dent Health 2001; 18: 236-241.
Murphy T C, Parkin N A, Willmot D R, Robinson P G. The feminisation of the orthodontic workforce. Br Dent J 2006; 201: 355-357.
Puryer J, Patel A. The career intentions, work-life balance and retirement plans of dental undergraduates at the University of Bristol. Br Dent J 2016; 220: 183-186.
Collin V, O'Selmo E, Whitehead P. Psychological distress and the perceived impact of the COVID-19 pandemic on UK dentists during a national lockdown. Br Dent J 2021; DOI: 10.1038/s41415-020-2592-5.
NHS Digital. Dentists' Working Patterns, Motivation and Morale - 2018/19 and 2019/20. 2020. Available at https://digital.nhs.uk/data-and-information/publications/statistical/dental-working-hours/2018-19-and-2019-20-working-patterns-motivation-and-morale/england (accessed October 2023).
Kelly E, Stoye G, Warner M. Patterns of less-than-full-time working by NHS consultants. 2023. Available at https://ifs.org.uk/sites/default/files/2023-05/IFS-R258-Patterns-of-less-than-full-time-working-by-NHS-consultants.pdf (accessed June 2024).
Gallagher J E, Colonio-Salazar F B, White S. Supporting dentists' health and wellbeing - workforce assets under stress: a qualitative study in England. Br Dent J 2021; DOI: 10.1038/s41415-021-3130-9.
NHS Digital. Dental Earnings and Expenses Estimates, 2021/22. 2023. Available at https://digital.nhs.uk/data-and-information/publications/statistical/dental-earnings-and-expenses-estimates (accessed October 2023).
Office for National Statistics. RPI All Items Index: Jan 1987 = 100. 2023. Available at https://www.ons.gov.uk/economy/inflationandpriceindices/timeseries/chaw/mm23 (accessed October 2023).
British Dental Association. 40% drop in dentists' incomes over a decade. 2021. Available at https://www.bda.org/news-centre/latest-news-articles/Pages/40-per-cent-drop-in-dentists-incomes-over-a-decade.aspx (accessed October 2023).
Nuffield Trust. Chart of the week: Pay has fallen in real terms for most NHS staff groups since 2010. 2022 Available at https://www.nuffieldtrust.org.uk/resource/chart-of-the-week-pay-has-fallen-in-real-terms-for-most-nhs-staff-groups-since-2010 (accessed October 2023).
Kay E J, Lowe J C. A survey of stress levels, self-perceived health and health-related behaviours of UK dental practitioners in 2005. Br Dent J 2008; 204: 622-623.
Collin V, Toon M, O'Selmo E, Reynolds L, Whitehead P. A survey of stress, burnout and well-being in UK dentists. Br Dent J 2019; 226: 40-49.
Virdee J, Thakrar I, Shah R, Koshal S. Going electronic: an Epic move. Br Dent J 2022; 233: 55-58.
O'Selmo E. Dental corporates abroad and the UK dental market. Br Dent J 2018; 225: 448-452.
House of Commons Library. The Care Quality Commission. 2020. Available at https://researchbriefings.files.parliament.uk/documents/CBP-8754/CBP-8754.pdf (accessed February 2024).
General Dental Council. Standard for the dental team. 2019. Available at https://www.gdc-uk.org/standards-guidance/standards-and-guidance/standards-for-the-dental-team (accessed February 2024).
NHS Digital. NHS Dental Statistics: 2021-22 Annex 1 - Index to tables and charts. 2022. Available at https://digital.nhs.uk/data-and-information/publications/statistical/nhs-dental-statistics/2021-22-annual-report (accessed February 2023).
HSC Business Services Organisation. FPS General Dental Services Statistics for Northern Ireland 2021/22. 2022. Available at https://bso.hscni.net/directorates/operations/family-practitioner-services/directorates-operations-family-practitioner-services-information-unit/general-dental-services-statistics/previous-general-dental-services-publications/ (accessed February 2023).
StatsWales. NHS Dental workforce by local health board, age group, gender, contract type and dentist type. 2022. Available at https://statswales.gov.wales/Catalogue/Health-and-Social-Care/General-Dental-Services/Current-Contract/nhsdentalworkforce-by-localhealthboard-agegroup-contracttype-gender-dentisttype-year (accessed February 2023).
NHS Education for Scotland. NHS Scotland workforce statistics. 2022. Available at https://view.officeapps.live.com/op/view.aspx?src=https%3A%2F%2Fturasdata.nes.nhs.scot%2Fmedia%2Flqifqv1s%2Fdentists_s2022_public.xlsx&wdOrigin=BROWSELINK (accessed February 2023).
UK Government. Delivering better oral health: an evidence-based toolkit for prevention. 2021. Available at https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention (accessed June 2024).
Acknowledgements
Thank you to the BDA Trust and the Shirley Glasstone Hughes Trust for funding this research, and all of those who participated.
Funding
BDA Trust, Shirley Glasstone Hughes Trust [Buckland, Barnett, King, Pabary].
Author information
Authors and Affiliations
Contributions
Overall, Ryan Barnett and Ella Buckland lead the project and contributed fully in equal parts. Ryan Barnett, Ella Buckland, Tom King, and Shiv Pabary contributed to the conception and design of the overall study. Ryan Barnett and Ella Buckland conducted the surveys, facilitated discussions, conducted subsequent analysis and drafted the manuscript.
Corresponding author
Ethics declarations
The authors declare no conflicts of interest.
The Wimpole Timings study was reviewed using the Health Research Authority Decision Tool, which indicated the study did not require NHS Research Ethics Committee review. The answers provided to the questions within the tool indicated that NHS ethics approval was not needed, and therefore exempt. The Health Research Authority Decision Tool form for this study is available, subject to request. Written informed consent was obtained from each participant and they were given the opportunity to withdraw their data at any point. Participation was voluntary and all data was anonymised.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Barnett, R., Buckland, E., King, T. et al. Wimpole Timings study. Br Dent J (2024). https://doi.org/10.1038/s41415-024-7521-6
Received:
Revised:
Accepted:
Published:
DOI: https://doi.org/10.1038/s41415-024-7521-6