Foreword

The 2016 dental workforce report is the latest in a series of biennial dental workforce reports that aim to inform workforce planning for dental services in Scotland and has been supported by NHS NSS and the Health Workforce directorate of the Scottish Government Health and Social Care directorates.

The report examines past trends in the supply of dentists and DCPs to inform estimates of the supply of dental services. Estimates of the demand for dental services are informed by past trends in access to dental services. These past trends are used to inform forecasts of the supply of and demand for dentists and dental services in the future.

These past trends and forecasts indicate that the capacity of the system to deliver dental services to the people of Scotland is greater than ever before and is forecast to increase in the future.

Executive summary

This report is the latest in a series of biennial dental workforce reports that aim to inform workforce planning for dental services in Scotland.

Dentists

  • There continues to be considerable demand for BDS places relative to supply.
  • Almost all students who start a BDS course in Scotland graduate within six years.
  • The reductions in intake targets that began in academic year 2013-14 will result in reductions in the number of graduates from Scottish dental schools from June 2018 onwards, in the number of DVT places from 2018-19 onwards and in the inflow to the dental workforce from 2019 onwards.
  • The number of VTNs issued to EEA dentists has decreased during recent years and the number likely to be issued in the future is uncertain.
  • The number of dentists that were registered with the GDC and had a Scottish postcode continues to increase but at a much slower rate than in the past.
  • The number of dentists in NHSScotland continues to increase but at a much slower rate than in the past as a result of lower inflows rather than higher outflows.
  • Real taxable income of dentists decreased considerably between financial years 2008-09 and 2014-15.

Dental Care Professionals

  • The ratio of applications to accepted places has increased since 2008 indicating increasing demand for OHS places.
  • The 45 students starting OHS courses each year is likely to result in about 40 OHS graduates each year.
  • The number of DCPs that were registered with the GDC and had a Scottish postcode continues to rise and at a faster rate than registrants without a Scottish postcode.
  • The number of DCPs employed in the HCHS decreased slightly in 2014 and 2015 as a result of relatively large reductions in the number of technicians, relatively small reductions in the number of nurses and relatively large increases in the number of therapists.
  • Median gross hourly pay for dental nurses decreased between 2014 and 2015 both in real terms and relative to other comparable occupations.

Access

  • NHSScotland registration rates continue to increase and in September 2015 were at record levels.
  • There is variation in the registration rate between NHS boards but the lowest registration rate was almost 75%.
  • Younger dentists register more patients than older dentists and male dentists register more patients than female dentists.
  • People are visiting a dentist more frequently and are more likely to see an NHS dentist when they do.

Forecasts

  • The projected changes in the size and composition of the population are forecast to increase the demand for dental services during the forecast period.
  • Based on the current number of registered patients per dentist the forecast increase in the demand for dental services increases the demand for dentists.
  • Based on a series of estimates and assumptions, the supply of dentists is forecast to exceed the number required to maintain current registration rates.
  • There is considerable uncertainty over the inflows from other, typically non-UK, sources that have an immediate impact on the number of dentists in Scotland.

1 Introduction

This report is the latest in a series of biennial dental workforce reports that aim to inform workforce planning for dental services in Scotland.

The supply of dental services depends on the supply of dentists. The report examines trends in the education, training and labour markets for dentists from application to undergraduate BDS courses, through BDS courses, registration with the GDC, through DVT, into the dental workforce, specialty training and admission to GDC specialty registers.

The supply of dental services also depends on the supply of Dental Care Professionals. While there is less routinely collected information on DCPs than on dentists, the report examines trends in the education of dental hygienists and therapists, the number of DCPs on the GDC register, their employment in the HCHS of NHSScotland and the earnings of dental nurses.

A key dimension of the demand for dental services is access. The report examines trends in access measured by NHSScotland registration rates, the frequency of visits to public and private dental services and registration with Denplan.

The duration of education and training for dentists and DCPs means that workforce planning involves making forecasts of the future demand and supply of dental services. These forecasts draw on current trends in the supply of and demand for dental services that are presented throughout the report.

The report is intended to complement other sources of information on dental services including those on participation, fees and treatments and the oral health of children and adults. These other sources of information show that: an increasing number of patients are seeing an NHS dentist within two years; the oral health of adults as measured by the percentage of adults with at least some natural teeth improved between 2008 and 2015; and the oral health of P7 children with no obvious decay continues to improve.

2 Dentists

2.1 BDS courses

2.1.1 Background

Each year the Chief Dental Officer writes to the SFC with a recommendation for the number of students taken into BDS courses in Scotland. The SFC announces these intake targets and the total number of FTE students it will fund during the academic year. If there are either too many or too few FTE students compared to the number of SFC funded students then universities may have to transfer money back to the SFC.

Intake targets for dental schools in Scotland are set to ensure that the right number of people are in the right place at the right time as set out in the Scottish Government’s 2020 Workforce Vision. In recent years the intake targets for EU students have decreased. The reduction in the intake targets for EU students has a direct effect on the revenue of universities and the intake targets for non-EU students have increased to allow universities to offset the reduction in revenue from EU students.