Summary
**Take Action: Urge Your Local MP to Stand Up for NHS Dentistry** is a grassroots campaign focused on addressing the long-standing crisis in NHS dental services in England. Despite significant advances in oral health since the mid-20th century, access to NHS dentistry has declined markedly over recent decades, particularly affecting socially disadvantaged and lower-income populations. Challenges such as chronic underfunding, workforce shortages, and administrative burdens have limited the availability of NHS dental care, creating a two-tier system where those unable to afford private treatment often face prolonged pain or rely on emergency services.
The COVID-19 pandemic intensified these issues by halting routine dental care for months, exacerbating waiting times and prompting many dentists to reduce their NHS commitments. Subsequent government efforts, including the 2024 Dental Recovery Plan, have aimed to improve access and service delivery but have been widely criticised by parliamentary committees and campaigners as insufficient to meet the scale of the crisis. The campaign calls on Members of Parliament (MPs) to reject punitive NHS dental targets and engage constructively with dental professionals to restore and reform NHS dentistry, emphasizing the urgent need for sustainable funding and systemic changes.
Advocacy strategies include mobilizing healthcare workers, patients, and local communities to amplify their voices, presenting detailed policy alternatives, and fostering patient involvement through storytelling to highlight the human impact of restricted dental care. Supported by a coalition of professional bodies and regulatory groups, the campaign also seeks to influence parliamentary scrutiny and legislative action by facilitating oral evidence sessions where MPs question experts and stakeholders about NHS dentistry’s challenges and potential reforms.
The campaign has attracted controversy over perceived government delays in implementing comprehensive reforms and disagreements about the adequacy of funding and policy responses. Critics warn that without fundamental contract reform and increased investment, access to NHS dentistry will continue to deteriorate, disproportionately affecting vulnerable populations and undermining the principle of equitable healthcare access. Nonetheless, the campaign remains a prominent force in maintaining public and political pressure to secure the future sustainability of NHS dental services in England.
Background
Despite significant progress in the control of oral diseases since the discovery of fluoride in the 1940s, dental caries and periodontal diseases continue to affect a substantial proportion of the population, particularly those from socially disadvantaged and lower socioeconomic groups. NHS dentistry in England aims to provide clinically necessary treatment to maintain oral health and prevent pain, forming a crucial part of the primary care system alongside general practice, primary ophthalmic services, and community pharmacies. However, the service has faced numerous challenges over recent decades, including chronic underfunding, administrative burdens, and a diminishing number of dentists willing to accept NHS patients.
The COVID-19 pandemic exacerbated existing problems by causing the wholesale closure of routine dental services for several weeks, leading to increased waiting times and pushing many patients to seek costly private care or endure prolonged pain. Surveys conducted in 2023 revealed that over half of dentists had reduced their NHS work since the pandemic began, with almost three-quarters planning further reductions, highlighting ongoing workforce retention issues. Moreover, NHS dental funding has been subject to budgetary pressures, with unspent funds being returned to central government and, following the removal of budget ringfencing in late 2023, redirected to non-dental services, worsening access inequalities.
These systemic issues have contributed to a two-tier system in which those who can afford private care access treatment more readily, while vulnerable and lower-income populations face significant barriers, often resorting to overstretched emergency departments or self-treatment. Recent reports from parliamentary committees have criticised the current dental contract as unfit for purpose, noting that current arrangements only enable about half of England’s population to see an NHS dentist within two years. The NHS has unveiled plans to address these issues through financial incentives for dentists, increased accessibility, and public health initiatives such as water fluoridation, but critics argue that fundamental reforms and sustainable funding models are urgently needed to prevent further decline of NHS dentistry.
Campaign Details
The campaign to urge local Members of Parliament (MPs) to stand up for NHS dentistry focuses on addressing the long-standing crisis within NHS dental services, which has been developing over the past 14 years. Members of Parliament have actively rallied to call for the scrapping of newly imposed NHS dental targets, describing the situation as urgent and emphasizing the need for the Department of Health and Social Care to engage constructively with the dental profession to restore services fully and promptly.
This grassroots movement, part of a broader effort to ‘Save Our NHS,’ involves mobilizing healthcare professionals, patients, advocacy groups, and local communities to amplify their impact and advocate effectively for policy reforms. The campaign encourages community organizing as a vital strategy to influence healthcare policies and highlights the importance of presenting detailed, costed, and viable alternative choices to policymakers. Suggestions for potential policy alternatives include raising user charges, limiting NHS dental offers, introducing means-tested eligibility, exploring social insurance models, and engaging private providers.
The campaign also recognizes the importance of patient and carer involvement, with teams actively seeking to capture personal stories related to care and treatment within NHS dental services. This approach aims to provide a platform for patients, carers, family members, and friends to share their experiences through various formats such as audio recordings or video diaries, fostering greater public engagement and awareness.
Furthermore, the campaign is supported by a collaborative advisory group comprising representatives from professional and regulatory bodies such as the British Dental Association, College of General Dentistry, British Society of Dental Hygiene and Therapy, Healthwatch, and others. This group provides guidance and clarifies regulatory positions on direct patient care by dental therapists and hygienists within NHS primary dental services, thereby contributing to informed policy development.
To strengthen parliamentary scrutiny, the campaign is associated with efforts by committees conducting oral evidence sessions. These sessions involve MPs questioning experts, government officials, and campaigners to gain deeper insights into the NHS dentistry sector and inform legislative action. Together, these elements form a comprehensive campaign strategy aimed at ensuring equitable access to NHS dental care and addressing the systemic issues faced by underserved communities, including those in rural and coastal areas.
Methods of Advocacy
Advocacy efforts to improve NHS dentistry encompass a variety of approaches aimed at influencing policymakers and raising public awareness. One key method involves direct campaigning, where grassroots movements mobilise healthcare professionals, patients, and local communities to collectively call for better funding and services within NHS dental care. These campaigns often urge Members of Parliament (MPs) to “act now” in addressing the patchy and under-funded state of NHS dental provision, highlighting urgent concerns through reports and public statements.
Another important advocacy method is engaging with parliamentary processes. The House of Commons Health and Social Care Committee plays a significant role by conducting oral evidence sessions that include experts, government officials, and campaigners. These sessions allow MPs to question witnesses and gain a deeper understanding of the challenges facing NHS dentistry, informing their recommendations to the government.
Lobbying efforts are also central to advocacy, particularly through professional bodies representing dental practitioners. These organisations negotiate better pay and working conditions, lobby for favourable legislation, and campaign on public health issues to uphold high standards of dental care. Presenting politicians with detailed, costed, and viable alternatives is critical in these lobbying activities, especially given limited public finances. Suggested options include raising user charges, adjusting NHS dental service eligibility, or exploring social insurance and partnerships with private providers.
In addition to these formal strategies, patient involvement through storytelling has emerged as a powerful advocacy tool. NHS Trusts often use anonymised or recorded patient stories to share real experiences with staff and policymakers, fostering service improvements. Special projects aim to make this process accessible to diverse patient groups, including those with learning disabilities or communication challenges, enabling their voices to contribute to advocacy efforts.
Together, these methods—community mobilisation, parliamentary engagement, professional lobbying, and patient storytelling—form a multifaceted approach to urging local MPs and government bodies to prioritise and strengthen NHS dentistry services.
Impact and Outcomes
The ongoing challenges in recruitment and retention (R&R) of dental professionals have had a significant impact on the delivery of NHS dental care, affecting not only dentists but the entire dental workforce. These workforce issues have contributed to reduced capacity and limited access to dental services, particularly in England’s rural and coastal areas. The COVID-19 pandemic and Brexit have exacerbated these problems, further restricting workforce availability and access to care.
Efforts to reform NHS dentistry, including the 2009 Steele Review and subsequent contract reform pilots, have sought to improve access, focus on prevention, and introduce new payment models such as capitation-based systems. Despite these initiatives, the existing dental contract has been widely criticised as unfit for purpose, with only about half of England’s population able to access an NHS dentist over a two-year period. The Dental Recovery Plan, introduced in February 2024 with the aim of increasing NHS dental treatments and appointments, has been described by MPs and the Public Accounts Committee as failing to improve access, with vulnerable patients continuing to suffer disproportionately.
The Government has acknowledged the severity of the access crisis and accepted most recommendations from parliamentary committees, committing to make improvements and laying the groundwork for reform. However, concerns remain that the planned changes may not go far enough, and there is frustration over delays in publishing a comprehensive dental recovery plan.
Additional measures aimed at boosting NHS dentistry include increased funding allocations, contract changes to encourage prevention and efficiency, and calls for better public information campaigns to improve patient awareness of NHS dental entitlements. Greater utilisation of the full dental team’s skills, including therapists, hygienists, and oral health educators, is also emphasised as a way to enhance service delivery.
Advocacy and grassroots campaigns urging local MPs to prioritise NHS dentistry have helped maintain the issue’s prominence on the political agenda, contributing to sustained public and parliamentary pressure for reform. Patient stories and involvement initiatives have further highlighted the human impact of restricted access, helping to inform and motivate policy responses.
Barriers to Accessing NHS Dentistry
Access to NHS dentistry has become increasingly problematic over the past decade, with reports highlighting a widespread “crisis of access” that disproportionately affects certain regions, ethnic groups, and socioeconomic classes. One significant barrier is the existence of a two-tier dental care system where individuals from lower socioeconomic backgrounds often have no access to NHS dental treatment. Those unable to afford private care may endure untreated dental pain, seek help from overstretched Accident & Emergency departments, or resort to self-treatment.
Geographical factors also contribute to disparities in access. Studies assessing access through various methodological approaches note that patients frequently face difficulties in securing appointments within their local area, partly due to the limitations of current metrics that assume demand and provision occur within the same geographic neighborhood—a condition that does not hold true for NHS dentistry services. Additionally, waiting lists and registration procedures create further hurdles. Patients may be placed on waiting lists before receiving appointments and are sometimes unable to secure ongoing NHS care at the same dental practice after initial registration.
Workforce challenges exacerbate these barriers. A significant backlog in the Overseas Registration Exam has delayed the onboarding of internationally trained dentists, limiting the supply of NHS dental practitioners and appointment availability. Efforts to address these issues include short-term financial incentives to attract dentists and long-term strategies to improve service accessibility and oral health promotion.
Barriers also extend beyond structural and logistical factors to include issues in preventive care. Despite oral health education being a standard part of dental services, the persistent high demand for restorative treatments suggests that preventive advice and care are hindered by systemic challenges, which have likely worsened with the ongoing crisis.
Case Studies and Patient Experiences
Patient experiences play a crucial role in understanding the challenges faced within NHS dentistry and in driving improvements to services. Within the Trust, Patient Story videos are frequently used to share firsthand accounts from patients with staff. These narratives provide valuable insights, enabling healthcare professionals to learn from patient feedback and implement changes that enhance care quality. Patient Stories are presented across various Trust forums, including the Trust Board and the Patient Experience Sub-Group, facilitating broad dissemination and discussion of patient perspectives.
A survey conducted by eight local Healthwatch organizations across North East England between November 2021 and January 2022 gathered responses from 795 individuals regarding their experiences accessing NHS dental services. This comprehensive collation highlighted ongoing difficulties faced by patients, emphasizing the need for targeted action to improve availability and quality of dental care.
Further evidence of regional disparities in NHS dentistry access is documented by the National Audit Office (NAO), which found significant variation in treatment rates per capita across England. For instance, Somerset recorded substantially fewer NHS dental treatments compared to areas like South Yorkshire during 2023-24. Despite government initiatives such as the deployment of dental vans and offering ‘golden hello’ bonuses to encourage dentists to serve under-represented communities, the roll-out has been slow, and challenges persist in increasing equitable access.
Financial pressures have also impacted dental practices, many of which serve both NHS and private patients. The COVID-19 pandemic exacerbated these difficulties, with some practices struggling to maintain operations. This situation has serious implications for patients requiring regular and ongoing dental care, particularly those with high needs. Delays of 12 to 18 months in receiving treatment have led to worsening oral health conditions among vulnerable groups, underscoring the critical importance of timely access to NHS dentistry.
Role of Advocacy and Awareness Campaigns
Advocacy and awareness campaigns play a crucial role in addressing the challenges faced by NHS dentistry. These campaigns mobilize diverse groups, including healthcare professionals, patients, advocacy organizations, and local communities, to highlight issues such as underfunding and limited access to dental services. By raising public and political awareness, campaigns urge policymakers to take immediate and effective action to improve NHS dental provision.
Grassroots movements have been particularly effective in drawing attention to specific concerns, such as the increase in performance targets that many in the dental profession oppose. Campaigners have called on the Department for Health and Social Care to abandon these targets and instead work collaboratively with dental professionals to restore services fully and sustainably. Community organizing efforts, such as mobilizations in regions like Suffolk, demonstrate the power of local engagement in advocating for systemic change.
Effective advocacy involves presenting detailed, costed, and viable alternatives to current NHS dental policies, allowing politicians to make informed decisions despite financial constraints. This strategic approach, combined with persistent dialogue between campaigners and representatives like the British Dental Association, aims to improve access to NHS dental care and incentivize the workforce to deliver more services. Such collaborative efforts between grassroots organizations and policymakers exemplify successful strategies for influencing healthcare policy and ensuring the future sustainability of NHS dentistry.
Criticism and Controversies
The campaign to urge local MPs to stand up for NHS dentistry has faced criticism primarily related to the government’s response to key recommendations made by oversight bodies. The House of Commons Health and Social Care Committee has expressed disappointment that the Government has not fully accepted calls for fundamental reform of the contract that pays dentists for NHS work. Despite assurances from the Secretary of State that the Government has “begun laying the foundations of change,” there remains frustration over the lack of a clear timeline for publishing the dental recovery plan, which has been a point of ongoing concern for the Committee.
Furthermore, there is criticism regarding the accessibility of NHS dentistry services. The Government has acknowledged the need to improve access for all patients, and the new Secretary of State has committed to making “real improvements.” Nevertheless, campaigners and committee members highlight that without substantive reforms, many people will continue to experience pain and distress due to inadequate access to NHS dental care.
In addition to institutional critiques, some analyses of grassroots movements related to NHS advocacy have noted gaps in public understanding. For example, discussions about the ‘Save Our NHS’ movement emphasize the importance of community organising in mobilising diverse stakeholders, such as healthcare professionals, patients, and advocacy groups. However, some commentators have pointed out that the absence of clear definitions and explanations of grassroots movements can limit broader engagement and comprehension among the public.
The campaign involves active engagement through oral evidence sessions where MPs question experts, Government officials, and NHS representatives to gather deeper insights into NHS dentistry challenges. These sessions, while valuable for informing policy, have also highlighted ongoing tensions between parliamentary committees and Government commitments on NHS dental reform[35
Related Campaigns and Movements
Several grassroots campaigns and movements have emerged alongside efforts to improve NHS dentistry, reflecting broader concerns about the future and accessibility of NHS services. One prominent example is the ‘Save Our NHS’ movement, which actively campaigns to protect and enhance the National Health Service as a whole. This movement emphasizes issues such as better pay and working conditions for healthcare professionals, including junior doctors, and more sociable working hours. It also highlights public opposition to the privatisation and Anglo-Americanisation of healthcare, which many see as threats to the NHS’s founding principles.
The ‘Save Our NHS’ movement exemplifies how community organising plays a crucial role in healthcare activism by bringing together healthcare professionals, patients, advocacy groups, and local communities. Such coalition-building can amplify the voices calling for policy reform and greater investment in NHS services. Understanding the successes and challenges faced by this movement offers valuable insights into strategies that may be effective for campaigns focused specifically on NHS dentistry.
Additionally, parliamentary scrutiny has underscored the urgent need for reform within NHS dental services. Reports by MPs reveal significant disparities in dental care access, particularly impacting deprived areas where patients have resorted to extreme measures such as self-extraction of teeth due to lack of available treatment. These findings have fueled calls for increased investment and systemic change, paralleling the broader aims of related NHS advocacy movements.
In response, the Department of Health and Social Care has committed to substantial reforms aimed at supporting dental teams to address treatment backlogs and improve service delivery. The NHS Long Term Workforce Plan includes training record numbers of dentists, dental therapists, and hygienists, with an annual investment exceeding £3 billion in dentistry to expand access and care quality. These efforts resonate with the goals of grassroots campaigns that seek to strengthen NHS dentistry as a vital component of public health provision.
The content is provided by Jordan Fields, Lifelong Health Tips
