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Sector Dispatch - Dental services

Dentistry review increases uncertainty in the dental services sector

The dental services sector is currently dealing with a number of key changes that will affect the way both NHS and private practitioners operate. Ongoing problems with the NHS dental service over the past few years, particularly regarding access in some areas, have driven many patients - and dentists - towards the private sector.

Dentists are classed as either a 'performer only' dentist or a 'providing performer' dentist depending on the way they contract and perform work. The Health and Social Care Information Centre explains the differences:

'Primary Care Trusts (PCTs) hold contracts with providers to deliver an agreed level of dental service. A provider who sub-contracts all the dental activity on a contract to other performers and does not perform NHS dentistry on the contract themselves is classed as 'provider only'. A provider may also act as a performer and deliver dental services themselves; this type of dentist is classified as a 'providing performer'. Other dentists will be 'performers only' and will deliver dental services but not hold a contract with the PCT themselves (ie they will be working for a ‘provider only' or 'providing performer' dentist).'

According to figures from the 'NHS Dental Statistics for England: 2008/09' report, published in August 2009, 32% of dentists were 'providing performer', accounting for over 6,700 dentists. This is a drop of 7% on the 2007/08 figures. The remaining 68% dentists were 'performer only', which is a fall of 7.7% on the 2007/2008 figures.

In June 2009, the Government published an independent review of the NHS dental service in England, and the findings of the review are still being digested and discussed. The review, led by Professor Jimmy Steele, highlighted two key areas of concern - a lack of communication in the commissioning process, and a variation in the provision of services.

"There are some practices delivering outstanding services at really good value for money, but there are problems," said Professor Steele as he introduced the review's early findings. "Some patients are not able to access care. The services that are available are highly variable. At the worst they are inappropriate."

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