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NHS Dentistry problems in Scotland - a thread.
Almost all practices who see NHS patients are “mixed” - we register patients as NHS but we offer private alternatives, such as white fillings and crowns on posterior teeth, implants, tooth whitening etc.
These private treatments
Almost all practices who see NHS patients are “mixed” - we register patients as NHS but we offer private alternatives, such as white fillings and crowns on posterior teeth, implants, tooth whitening etc.
These private treatments
offer an alternative income stream which is be a substantial fee towards the large overheads involved with running a dental practice.
Overheads are HUGE - rents/mortgages, wages, lab bills, material costs, insurances, utilities, courses, etc. These costs creep up all the time,
Overheads are HUGE - rents/mortgages, wages, lab bills, material costs, insurances, utilities, courses, etc. These costs creep up all the time,
while NHS fees increase by very little.
As we stand, SG is contributing 80% of NHS income to practices. On the face of it, this sounds excellent. But most practices are a split of private and NHS income. And their private income has been completely eradicated. So, for example,
As we stand, SG is contributing 80% of NHS income to practices. On the face of it, this sounds excellent. But most practices are a split of private and NHS income. And their private income has been completely eradicated. So, for example,
if you’re an 85% NHS dental practice you will currently be down to approx. 68% of usual income. Most businesses cannot survive long term on 32% reduction in their income. And there are MANY practices who are a much more even 50/50 split of NHS vs private income.
Now that we can reopen, we will still be getting the same financial support, but overheads are back up. Materials to be bought, lab bills to be paid. But with no change in the support offered. As we stand there will be many many practices who cannot survive this long term.
We have no idea when we can resume use of drills as normal. Under an NHS contract we are NOT allowed to do aerosol generating procedures. The PPE needed for these is extremely expensive so cost prohibitive for NHS work going forward.
Dental labs are in a horrific state of play and if we aren’t routinely doing crowns, bridges, dentures etc they are NOT making money. These small businesses are at severe risk.
In practice we can’t run at capacity and no idea when we will be able to do so again - most think we won’t be anywhere near business as normal this side of Christmas. As such we’re running skeleton staff. Some practices will be faced with the difficult decision of cutting staff.
This situation is horrific for everyone, but I feel dentists are being left behind out of the other healthcare professions and I can’t help but feel it’s because of the public negativity towards dentistry in general. People “hate” the dentist. People think we’re money grabbing.
People think we’re out to get them. I can assure you for the vast majority of dentists we are all nice, normal, hard working people who want to do our best by our patients. We worked hard to get into our degree, to achieve our degree, to keep our skills up to date.
Insurance costs, registrations costs etc are high for us. Dentistry is a stressful profession with one of, if not the, highest suicide rate going. We often feel unsupported and I’ve never felt this moreso.
Many of us would make a lot more money, and have a lot more respect from the general public, if we worked overseas. I’d never want to do that. I also wouldn’t want to leave the NHS, despite it’s problems. But we have been devalued and demonised for so long.
So please, be kind to your dentist in the coming months. We want to do everything we can to help you. We don’t want our patients to suffer. We are under a hell of a lot of pressure from all sides. We have no idea where we’ll be in the next year.
It’s going to be some time before dentistry is back to anywhere near normal. In the meantime, please brush your teeth, watch your sugar intake, and be kind.
Another thing I was unaware of, as I don’t have kids - apparently dentists and dental nurses not been given key worker status. I know many couples who are both dentists with children and most of our dental nurses have children. How are these people to get childcare to go to work?
