Early career ideals may draw dentists into the NHS – but building pressure around the NHS contract and finances are pushing many away.
This is according to a new study that looked into the motivations for working in NHS dentistry in England.
Published in the British Dental Journal (BDJ), the report found that the main motivation among GDPs in England for working within NHS dentistry were patient-centred. This included moral obligation, helping the community and some favourable terms of work.
However, findings showed that over time, push factors – particularly the dental contract and financial pressures – ‘heavily’ outweighed others, leading to low morale and burnout. ‘The conflict between doing the right thing for the patient and the cost of doing so to them as the dentist was a strong burden for many,’ the study concluded.
It added: ‘For the majority of respondents, there was a desire to stay working within NHS dentistry and providing care to patients; however, the financial viability of doing so has become difficult, ultimately surpassing their motivations for wanting to stay.’
Ella Buckland is an author in the study. Since graduating from the University of Bath with a master’s in chemistry, Ella (left) has worked within healthcare research for eight years, with the last four of these spent as a research analyst at the British Dental Association
Change to the NHS contract
When it came to pull factors, several participants expressed feeling it was their duty to give back to the community. They reported that working for the NHS allowed them to treat patients who would struggle to afford private care costs.
Treating vulnerable, high-needs patients and flexible working, however, were cited as both push and pull factors for participants. With the former, clinicians felt motivated to treat the patients but felt the current NHS contract does not adequately remunerate for the time and care needed to treat them.
Around half of respondents reported they were originally drawn to medicine as a career – but chose dentistry due to the perception of a more enhanced work-life balance. Respondents said the flexibility of being self-employed drew them to NHS dentistry. However, self-employment was also mentioned as a push factor by some, with participants citing additional admin, conditions and lack of benefits compared to being employed.
The majority of respondents felt the current NHS dental contract is not fit for purpose and does not allow GDPs to practise dentistry as they would like. There were several participants who reported the need for the current system to change to allow better patient care. The majority also expressed that the current NHS dental contract does not fairly remunerate GDPs.
For those who relied less heavily on NHS income due to being close to retirement or not the main household earner, personal finances were reported as less of a pressure. These respondents said they were willing to personally take the financial hit and provide the care needed to patients, even taking their time as necessary.
For example, one of these respondents said: ‘I am at that age where I do what I want. My debts are paid off, I’m just trying to run the practice and keep the revenue, so it gets me out of here. I don’t particularly need to earn a lot of money at the moment, and I’m not earning a lot of money, I am taking the time that I need, but I don’t feel dentists in general are able to do that.’
You can read the full study here.
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