NHS patients of a dental practice in Swansea have been sent letters this month telling them they will no longer receive state-funded treatment from April 1, this year. A letter from Crescent Dental Care in Uplands informed patients they would have to join a private membership scheme if they wanted to remain at the practice.
A spokesperson for Swansea Bay University Health Board said they were "surprised and very disappointed" to see the letter had been sent out to patients and said they had "serious concerns" over the accuracy of some of its contents.
The practice will still offer NHS care for children, but only if their parents are signed up privately. The letter stated that significant changes to NHS dentistry by the Welsh Government did not allow staff at the Uplands dental practice to prioritise loyal patients who wanted to visit regularly. You can read more stories about Swansea here.
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While current NHS patients at the practice have been urged to join a private membership plan to guarantee continued dental care with the practice, places are limited to just a third of the current NHS list, according to the letter, in order to provide "the best possible care". Prices for Crescent Dental membership range from £9.95- £29.95 a month. The cheapest plan includes one dental health examination, one hygiene appointment, small x-rays and "many" discounted treatments, according to the practice website.
The letter advised that anyone who did not wish to sign up to the private plan should de-register and call 111 to speak to the NHS helpline and get support with finding another NHS dentist.
The health board spokesperson said it was currently in discussion with Crescent Dental Care over the management of its NHS dental services contract, as the practice had recently made it aware of ongoing workforce challenges at there. However, the letter had not been shared with the health board before it was sent to patients, the spokesperson said.
"We have some serious concerns over the accuracy of some of its content which could cause unnecessary alarm and confusion to patients," the spokesperson added. They said that while the health board continued to speak to Crescent Dental Care about management of its NHS contract, patients were urged not to follow the advice in the practice's letter to call 111 to find another dentist.
"This is not necessary at this stage, and given the current unprecedented pressures on NHS services it will add to delays in 111 calls being answered," the spokesperson added. "NHS patients at the practice who have an urgent dental need should continue to contact the practice directly who will advise them."
The letter from Crescent Dental Care said rising costs and a nationwide recruitment crisis had made NHS dentistry unstainable: "We no longer believe we can provide the level of care you have come to expect under these conditions," it said, adding: "Like many NHS practices across the UK, we are having to make difficult decisions to ensure our practice survives."
It has been sent just two months after the health board announced around 28,000 new patients would be offered appointments at dental practices in Swansea Bay by April this year, to help with backlogs of patients waiting to get an NHS dental appointment. You can read more about that here. According to the health board, updated contracts signed by dental practices last year had meant those on the programme had agreed to see new NHS patients as part of the reformed contract introduced by the Welsh Government.
But Crescent Dental Care's letter said changes made to the NHS contract in April, 2022, required it to invite patients who had previously received treatment back after 12 months, rather than the current six. It said this would "likely lead to even longer intervals between NHS examination appointments".
The health board said changes to NHS dental contracts in Wales over check-up intervals were in line with well-established guidance from the National Institute for Health and Care Excellence. This guidance focused on providing care and treatment to patients who needed it rather than the "outdated" practice of recalling everyone for check-ups twice a year, said the spokesperson.
"Rather than routine six-monthly check-ups, dentists are now encouraged to consider each patient individually and create a personal care plan just for them. In some cases this could mean patients being seen more regularly than six months if they have ongoing oral care needs," the spokesperson added.
Joining the contract reform programme was not compulsory, as NHS dental providers could continue to stay on their existing contract requirements, explained the spokesperson. "However, the Welsh Government has reported that across Wales more than three-quarters of dental practices which have NHS patients have signed up to it, including this one," the spokesperson added.
On the guidelines around check-up intervals that Crescent Dental attributed as likely to lead to further delays, a Welsh Government spokesperson said the guidelines on the frequency of dental check-ups were issued by the National Institute for Health and Clinical Excellence (NICE) in October, 2004.
“The guidelines state the recommended interval between recall appointments should be determined specifically for each patient and tailored to meet their needs on the basis of an assessment of disease levels and the risk of or from dental disease," the Welsh Government spokesperson added. “Routine visits to the dentist every six months are not necessary for everyone, largely because the oral health of the nation has improved dramatically over the last few decades," said the spokesperson.
A spokesperson from Crescent Dental Care said: "All the information as to why we have had to make the decision to reduce NHS provision can be found within the letter sent out to patients this week. We have run as a majority NHS practice for many years but rising operating costs, a national recruitment crisis in dentistry and new contract reform targets have made this unsustainable for us and we can not meet the needs of our historic patients. As stated in the letter to patients there will be no changes until 1st April 2023."
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