No out-of-hours dental pain clinic in Western Trust

The Western Trust does not provide an out-of-hours facility for dental pain patients, similar to all other Trusts in the North.

In addition, the Trust had the lowest number of dental practices and dentists per 100,000 people in the North in 2023.

There was a 10.4% drop in the number of dental practices in the Western Trust  per 100,000 people between 2014 and 2023. This was the second biggest drop of all the Trusts and was significantly bigger than the North’s 8.7% average.

NHS dentists unobtainable in Derry

'Improved access needed to NHS dentistry' - Sinead McLaughlin MLA

In the same time period, there was a drop of 1.9% in the number of dentists per 100,000 people in the Western Trust.

This was in marked contrast to all other Trust areas, which saw increased dentist numbers per 100,000 people. Belfast Trust, for example, saw an increase of 5.5% in its dentist numbers per 100,000 people in the same period.

These shocking statistics were revealed in the Family Practitioner Services General Dental Statistics for Northern Ireland 2022/23 report, published this week by the Department of Health.

Speaking to Derry Now, local NHS-committed dental practice owner, Meabh Owens highlighted the additional “challenge” of the Western Trust’s failure to provide an out-of-hours facility for dental pain patients. 

Dr Owens said: “At every other Trust, except for the West, there will be an emergency dental care clinic, where dentists are paid a sessional fee to go in and they are there for three of four hours and whoever shows up, they get them out of pain, so unregistered patients have somewhere to go. This is where patients here are getting really let down.”

Dr Owens said that  all dentists are “under pressure” at the minute but dentists in the Western Trust were facing “a unique set of circumstances which makes the situation for dentists and patients here much more difficult than any other Trust”.

She added: “Patients simply cannot get registered anywhere. Most of us have quite a big list when we work in the Health Service, a lot of patients to look after. And, in order to make the Health Service work, dentists are seeing between 20 to 30 patients a day, which is a huge volume of patients and there really isn’t any wriggle room to take on any additional patients, considering the amount of dental disease that has ramped up over covid

“Dentists were already working at capacity before covid but it made things worse. On a Monday, my practice would take on average between 20 and 22 calls from unregistered patients that are ringing around trying to  get in somewhere because they are in pain.

“On any other day of the week it could average between 10 and 12 and that is only my practice. There is a large volume of people who need dental health and can’t access that at the moment.

“As a result of having no space in the diary to take on patients’ long-term care, we also have an issue with recruitment. Personally, I have had an advertisement in for an associate dentist for the last four months and I have not had one CV and I know two other practices in Derry that are the same.”

Dr Owens added that dentists had had the ear of Ministers and had been saying for a long period of time, ‘We’re in trouble here and there is worse to come down the tracks and your need to do something now’. 

“However, they have stripped Health Service Dentistry of everything. The British Dental Association has calculated we have had a real-time pay cut of 50% in the last 10 years. 

“Within the last 10 years, they have taken away Practice Commitment, which was a commitment payment to dentists who would continue to practise heavily within the Health Service. 

“And I think it is also worth saying, there is a board of management to structure the Health Service and there is no dentist or dental representative on it and I think that speaks volumes of where we are going in the Health Service. If we are not represented, I think it doesn’t bode well for us for the future.”

Foyle MLA Sinéad McLaughlin (SDLP) said the statistics “highlighted the challenges in dentistry for patients in the Western Trust”.

She added that she regularly heard from clients struggling to access appointments with NHS dentists.

“I know that some people have been forced to go private as a result, but many more simply do not have that option,” said Ms McLaughlin.

“These statistics show how the Western Trust area is particularly badly affected by the challenges facing dental practices, given the drop in the number of practices here over the last nine years and the ratio when it comes to the number of dentists.

“None of these issues is the fault of our hard-working dentists. Instead, it’s the fault of a system which has de-prioritised patient access to healthcare and created a two-tier service, where those who can afford to pay get seen much faster.

“When I recently contacted the Permanent Secretary at the Department of Health on this issue, he outlined a number of steps that are being taken in relation to supporting dental practices. 

“While there is clearly a lot of good work taking place, it will come as cold comfort to the dentists who cannot make ends meet and the patients who are struggling to get an appointment.

“The massive funding gap in the Department of Health is also likely to exacerbate this crisis and unfortunately, I fear more dentists are going to think about leaving the profession altogether.”

Speaking to Derry News a spokesperson for the British Dental Association said: “These figures count heads not commitment, so a dentist doing one NHS check-up a year carries the same weight as an NHS full timer.

“Underneath the surface real movement is taking place, as dentists reduce the amount of NHS work they do.

“Many dedicated NHS dentists can see no future in a service where they are having to deliver NHS care at a loss. It’s not sustainable. Patients across Northern Ireland will pay the price if the powers that be fail to step up.”

The BDA spokesperson explained that the “broken low margin/high volume model used in NI dentistry was incompatible with working through the pandemic, and is incapable of underpinning the recovery”.

They added: “With surging prices dentists now face the reality of delivering NHS treatments, particularly those that require laboratory work, like dentures, at a loss.”

“[In addition] most dentists operate in a ‘mixed’ economy, providing a combination of NHS and private care.

“That means we cannot read too much into most official figures. However there is a clear movement taking place, that we’re seeing UK wide, of dentists reducing their NHS commitment.”