Many would think that the capital of England would not have issues with accessing NHS healthcare with it's wealth of workforce, hospitals and medical/dental schools. That certainly was the case when I first qualified in 2014 and moved down to London. My first job as an associate took several months to secure, even though I was going out of my way to get a role that would involve weekend work. There were countless job ads in BDJ jobs and when going for interviews, it was common to be part of a cohort of candidates in double digits. 

Fast forward to the present day and things couldn't be more different. I am seeing this in my role in a tertiary care hospital: patients being admitted with life threatening dental sepsis because there weren't able to find an NHS dentist to treat their dental infection, long waiting lists of patients referred from other sectors of healthcare, patients who cannot have their life-saving heart operations because they are awaiting a dental check. 

There is also huge variation across London. In some boroughs such as Tower Hamlets, the borough where I had my first ever job as a dentist, only 25% of adults and 33% of children have accessed a dentist in recent years. This is compared to 60 % of children seeing an NHS dentist in Hounslow. 

The access crisis is affecting all sectors of NHS dentistry as general practice is the base level of the pyramid of dental care. Without an adequate service, the whole pyramid falls down. 

I called on him to:

The plan has lacked a lot of fine detail and it seems like as time goes on, elements of the plan will be more well defined and this is now all on the timeline of a July 4th election. So there is a risk with a new government which may be elected in the Summer, that the plan may be scrapped/adapted/repurposed. 

But so far, here's some of the details not quite so obvious initially in the plan.

1. The new patient premium - this is reliant on providers passing the patient premium to their performers, and also isn't any additional UDA allowance - therefore technically practices will make up their UDA target faster. So some practices might have a risk of 'running out' of UDAs before their financial year is up. This could be good for those practices who previously found it difficult to hit their UDA targets. There is also the question about how do you assess whether a patient hasn't seen a dentist in 2 years... is that an NHS practice, does that exclude out of hours services, how will that be verified? 

2. The Golden Hellos - this will be limited to the first 240 dentists who apply and will be staggered over 3 years. So in year 2 and 3 this amounts to an extra £5000 a year - when you consider the costs of moving this isn't a lot! And it also is just moving a recruitment crisis from one area of the country to another...

3. Mobile dental vans - there is currently a market engagement exercise ongoing about this that will confirm what the offering for this would be, but 13 coastal/rural ICBs of dental need have been identified and commissioners are already calling for options of 'non-van' solutions as there really aren't that many mobile dental units about...

4. Minimum UDA value - this only affects 700 of the 8000 practices that hold an NHS dental contract

The whole of the dental profession is eagerly awaiting the finer details of the plan, but from what is being heard we don't think that what has been announced is good enough. While change is welcome, the real call from the profession is to abolish the UDA and we've been calling for this pretty much as long as it has been in existence!

I've been a dental consultant for coming up to a year now, and while my team were very kind in letting me find my feet and settling in, I am well and truly past the honeymoon stage of a Consultant post! I am seeing the most complex patients I have ever seen in my career, in a challenging environment of long waiting lists and stretched NHS resources with healthcare staff strikes, increasing patient needs and a NHS dental access crisis. So no wonder I have barely time to breathe!

My role as a Consultant takes me out of the main dental hospital to community clinics and our district general hospital and I love these clinics seeing patients locally and setting up/building on spoke services. But this does mean when I am at work I juggle the workloads of my CDS patients, my district general patients and my dental hospital patients which takes some organisation. 

On top of that my role at Dentaid the Dental Charity is becoming increasingly busy as our team is expanding and with our first partnership with an NHS ICB to deliver a huge number of clinics in a area where patients are facing difficulties in accessing care. And my role within the British Dental Association as Young Dentist Committee Chair means squeezing in meetings left right and centre with the access crisis becoming evermore prominently in the public eye and debated in parliament. 

I often get asked on social media and when speaking at events, how do I fit it all in?! I used to really see that as a compliment and I do still value having a portfolio career and fingers in a few pies, but the past few months have seen me reflecting on what I am currently doing. 

I have been a dentist for almost 10 years and have built up various experiences across sectors. I now think it is time to really decide what I enjoy doing and refocusing on what I really enjoy. Particularly now I have a family, there is only so many hours in the week and I don't want to work myself to death. 

I think it is hard for mothers and working parents to really say they have a balance between work and personal life. I enjoy going to work as I feel like 'me' not just 'a mum', and even when I am at home with my little one I find myself thinking how can I squeeze a few emails in or a meeting. The result is yes productivity and getting stuff done, but at the end of the day I cannot tell you how tired I feel! So that is why an evening blog post has been pushed down to the bottom of the priority list for the past few months.

So is there a future for this blog? I am so proud of what I've achieved with over 9 years of typing away on this site. I still feel that glow when someone says to me they read my blog, particularly when they say it's really helped them with an aspect of their career. 

And so I will continue to make space to blog and post on here. It might to be as often as 5 years ago and I might change direction a little, but A Tooth Germ is here to stay! And of course I will continue to offer my platform to those who wish to write something themselves. I have always meant my blog to share ideas and education across Dentistry and support those coming through their careers - and even though I'm almost 10 years a dentist and a Consultant, I would still consider myself to be a Tooth Germ....