Accessing Dentistry Services Report

Research findings from Healthwatch Thurrock | May 2022

About Healthwatch Thurrock

Healthwatch Thurrock is the independent health and social care services champion for the people of Thurrock. We gather and represent views of local residents in order to build up a picture of services that are doing well and where they can be improved.

Along with consultation work and gathering the voices of residents, Healthwatch Thurrock also provide an information, guidance and signposting service.

Residents are invited to “speak out” via an online forum as well as through targeted surveys, conversations and face to face engagement within the community. Healthwatch Thurrock presents the voices of Thurrock to aid in identifying the need for change, considerations before commissioning and to support best practice across services.

Through conversation and engagement with people actually using the services, Healthwatch Thurrock highlight and promote improvements.

We know that services are better when people are treated as individuals and are actively involved with shaping support. To do this, services need to learn from examples of real experiences, how they can be adapted and fit around local needs.

Background

Since the beginning of the COVID-19 pandemic in 2020 we saw an increase in the number of people providing feedback on dentistry services, with a fall in the proportion of positive feedback regarding dentistry. Healthwatch Thurrock created this survey in order to establish what issues people were having and whether there were any difficulties accessing dentistry services since pandemic restrictions have eased on a national level.

The survey reflected that of the national concerns and specifically sought to discern the effects on the local population and services being accessed.

Residents were contacted via telephone and during face to face engagement with the community and the survey was promoted on social media channels.

Thurrock picture

Healthwatch Thurrock serves the unitary authority of Thurrock in Essex. Thurrock has a population of 176,000 and four Primary Care Networks. Thurrock has high levels of deprivation and health inequalities with one fifth of children in Thurrock growing up in poverty.

How we did this research

Healthwatch Thurrock created a short survey to find out resident’s experiences accessing dental care. The survey was distributed to local groups and Healthwatch Thurrock staff and volunteers assisted residents to complete them when attending and hosting events. This survey was also promoted on social media. From January to April 2022, 88 residents responded to the survey.

In April 2022 Healthwatch Thurrock also undertook a mystery shopper exercise in which the 17 dental practices in Thurrock were contacted asking if they had any NHS appointments available.

Who responded

Ethnic background:

• White or white British: 79 (90%)
• Black or black British: 4 (4.5%)
• Asian or Asian British: 5 (5.5%)

Gender:

• Female: 62 (70%)
• Male: 26 (30%)

Age:

• Aged 18-44: 23 (26%)
• Aged 45-64: 37 (42%)
• Aged 65+: 28 (32%)

Key findings

50% of survey respondents reported difficulties accessing NHS appointments

Of the 88 people who responded to the survey, 44 (50%) reported difficulties registering as NHS patients or accessing NHS appointments.

Whilst practices have opened for routine appointments, residents still report difficulties in accessing routine care. People have reported struggling to access NHS dentistry because practices are not taking on new NHS patients or have no NHS appointments. Some individuals have been told to try again in a few months, whilst others have been told the surgery has had an NHS waiting list since 2021 that is unlikely to open.

Mystery shopper results

Of those surgeries that responded during the mystery shopper exercise:

• 9 said they do not have the capacity to take on NHS patients
• 5 said they are taking on new NHS patients but had waiting lists for appointments varying from 4-12 weeks
• 1 practice said they are only taking on NHS patients that have been referred to them
• 1 said they are only able to provide NHS appointments to patients already known to them
• 1 did not respond

This information was not always consistent with what was provided on the NHS website on accessing dental care.

What people told us

Availability of appointments and prioritisation of private care

People reported difficulty in accessing appointments since the pandemic with some dental services saying that they are not taking NHS patients as there is no funding. Patients that have tried to make appointments with surgeries have been told that they cannot take any more NHS patients but that they can get a private appointment straight away.

Five survey responders spoke of difficulties accessing NHS dental care since their practice closed down. However they could easily access care if they were willing to go private.

Steve, 38, said: “[My] dentist has reduced appointments to 2 days [per week] only for NHS dental care patients”

Anonymous quote: “Dentists seem to have forgotten NHS patients”

Consequences of difficulty accessing dental care

Some parents or expecting parents expressed concern over difficulties in accessing care for themselves and their children and the consequences this may then have. Respondents also raised concerns over accessibility of dental care for people with additional needs. For example it was raised that some surgeries are not accessible for patients with mobility issues due to stairs and there were concerns over dental care access for patients with cognitive needs.

Sarah, 32, said: “Both my children are ASD [autism spectrum disorder] and I feel the service for them is very poor.”

Personal story: Maternity Exemption Card

Fiona, 29, said: “Recently, I had treatment done but could not use my maternity exemption card because I could only accept weekend appointments. This is due to childcare and my partner being available to look after the baby during weekends and evenings only. I feel the dentistry services are not flexible and as a new mum, having the exemption card, I could not utilise it because I could not accept appointment during weekdays.”

Personal story: Accessing emergency treatment

Brenda, 57, said: “There are now long waits at the surgery for appointments. When I had a bad fall late on a Friday in August last year I needed emergency treatment and although my surgery was open Saturday morning I was unable to get an appointment as only private available and although I would have happily paid as I was in so much pain there were no appointments.

I did manage to see an emergency dentist via 111 but this took persistence as they did not call me back as promised and spent a very painful night before I finally managed to get someone to help me. However, my surgery did see me urgently on the Monday afternoon when the pain was so bad and again on the Tuesday.

I ended up with a long course of treatment due to the trauma and had final appointment about 10 days ago. Because of their long waiting list it was recommended that I book my 6 monthly check up for July, which I did!

While I was in the waiting room I did hear the receptionist on the phone to someone saying they were not taking on any more NHS patients at present and already had a waiting list.”

What went well?

It is important to note that 12.5% of those contacted had positive feedback about their dental care experience.

Maureen, 46, said: “I have such a brilliant relationship with my dental practice, everyone there is friendly, polite and so accommodating! Never had an issue.”

Sally, 51, said: “Very happy with service when chipped tooth, able to get seen very quickly”

What have we learnt?

Of the local residents we have spoken to, a significant proportion expressed frustration in local availability of dental care. Messages need to be consistent to patients. And an examination of whether local NHS dental provisions are sufficient to keep in line with local demand is recommended.