Articles, Dentistry

Reading into the HSCIC NHS dentistry report

Media interest in the annual statistics from the Health and Social Care Information Centre (HSCIC) on NHS dentistry in 2013/14 has focused on access to NHS dentistry.

This is understandable as this is where public and political interest is focused.

But there is more to the report than this aspect.

It covers data on the number of courses of treatment (CoT), units of dental activity (UDA) and orthodontic activity (UOA), prescribing patterns and clinical treatments, patient charge revenue and the dental workforce.

Most data is for the year 2013/14, although some comparisons are made with the year of the new dental contract, 2006/07.

Patients seen

The measure of ‘patients seen’ is those who have attended a dentist at least once in the previous 24 months.

It now stands at nearly 30 million, compared with 28 million in 2006.

Although more patients have been seen since 2006, there are more people in the country.

Thus, the percentage of the population seen has remained static and stands at 55.9%, compared with 55.6% in 2006.

There are differences in the proportion of adults and children seen since 2006.

For adults the percentage seen has risen from 51.5% to 52.3%; for children it has fallen from 70.2% to 69.2%.

There are also regional variations.

The increase in the number of patients seen since 2006 has been most notable in the south of England, 10.9%.

As a percentage of the population, the increase in the south was 2.5% and in the north 1.4%.

The latter was the only region where the percentage of children seen has increased.

Courses of treatment

A total of 39.8 million courses of treatment were delivered in 2013/14, compared with 35 million in the first year of the contract.

The proportion of different bands has remained similar since 2006, with band one at 54.5%, band two at 29.7%, band three at 5.6% and urgent 9.7%, although there has been a small increase in band three and urgent.

The report notes some difference between treatments given to change-payers and exempt patients.

Non-paying adults account for more than half of band three treatments despite accounting for less than one quarter of all courses.

The authors say this may be due to 'a lower standard of dental health among these patients.’

There is also a difference in treatments for patients in London.

The percentage of band one treatments in London at 44.7%, is 9.8% lower than the national figure.

Paying adults account for 40.7% of courses of treatment in London, which is considerably lower than the national figure of 50.5%.

The figure for non-paying adults at 30.3% is higher than both the national average and the other three regions.

There were 88.7 million UDAs completed during 2013/14, a rise of 594,000 (0.7%) from the previous year.

There were 4.2 million UOAs carried out in 2013/14, a decrease of 155,000 (3.5%) from the previous year.

Clinical treatments

Excluding examinations, which all patients have, scale and polish remains the most frequently delivered treatment for adults with 44.7% (12.8 million) of courses of treatment having this.

For children, the most common treatment is fluoride varnish, with over a quarter (2.7 million) having this.

Permanent fillings and sealant restorations were the second most common treatment given to both adults and children during 2013/14 with a total of 7.7 million (26.7%) and 2.3 million (20.8%) delivered respectively.

Patient charge revenue

Patient charge revenue rose by £27m (4.2%) to £685m; in 2006/07 it was £475m, so it has increased by 38% since then.

Workforce

There are 23,723 dentists providing NHS treatment, an increase of 3,563 (17.7%) since 2006/07.

Last year there were 4,413 dentists with an NHS contract, making up 18.6% of the workforce.

The remaining 81.4% are associates, an increase from 62.4% in 2006/07.

If we take the age of 45 as roughly the mid-point of a dentist’s career, roughly a third (36.2%) are still working in the NHS above this age.

A similar proportion (38.8%) are below 35.

Women dentists account for 46.1% of the profession, up from 38.8% eight years ago.

Women are in the majority among the under 35-year-olds (56.5%) and just in the majority among the 35-44 year olds (50.5%).

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