Dental Workforce Survey 2024
1 Introduction
NHS Education for Scotland were asked to run a workforce census data as part of the annual QI cycle for 2024.
This survey would collect data on the Headcount and total hours worked of 9 groups of staff working in a practice in the week ending Saturday 30th March 2024.
These groups were:
- Principal Dentist
- Associate Dentist
- Assistant Dentist
- Vocational Dental Practitioner
- Dental Hygienist
- Dental Nurse
- Dental Therapist
- Dental Technician
- Clinical Dental Technician
Data on the percentage of time the practice worked on NHS work in the past year and the percentage of the time they expected to in the next year was also collected.
2 Methods
A list of main contacts at each dental practice was received from Practitioner Services Division (PSD) in NHS National Services Scotland (NHS NSS). A survey link was then sent using the QuestBack survey email distribution system. Within Questback, each link was attached to a specific practice, allowing for meta-data to be added without collecting known information twice.
A description of the data quality can be found in Appendix 1.
3 Response Rate
There were a total of 1,021 eligible distinct practices, including PDS practices.
Of these 1,021 practices, 1,003 were General Dental Service (GDS) practices. 829 GDS practices responded giving a response rate of 80.9%.
4 Dentists and DCPs Headcount and WTE
The response rate for each board was used to weight the headcount and WTE.
This weighting does not take into account the size of the practices that did or did not complete. As larger practices were more likely to complete than the smaller practices, and some roles are more common in larger practices, the weighted total may over estimate the total numbers of some roles.
A full time of 37.5hours a week has been used.
4.1 General Dentist Service
The NHS General Dental Services (GDS) are usually the first point of contact for NHS dental treatment.
People registered with a dentist can receive the full range of NHS treatment available under GDS.
The majority of GDS is provided by independent dentists who have arrangements with NHS boards.
These are also referred to as high-street dentists.
Notes:
- Totals given here may double count staff who work in multiple practices or NHS Boards.
- This survey only collected information on staff working within GDS and PDS locations. It will therefore be an underestimate of the total workforce of some roles, particularly Dental Technicians and Clinical Dental Technicians, the vast majority the vast majority of whom work in commercial dental laboratories.
4.2 Public Dental Service
The main role of the Public Dental Service (PDS) is to provide dental services for people who cannot access care from an independent dentist.
This includes patients:
- with special care needs, such as mental health conditions or physical disabilities resident in long-stay care
- referred for specific treatment
The data for these PDS practices were collected through the survey but were typically collated centrally in each board prior to submission. We have therefore not weighted the Headcount and WTE of the roles working in the PDS service.
The Principal Dentist, Dental Associate and Assistant Dentist roles are reported in a combined category for PDS.
Notes:
- Totals given here may double count staff who work in multiple practices or NHS Boards.
- This survey only collected information on staff working within GDS and PDS locations. It will therefore be an underestimate of the total workforce of some roles, particularly Dental Technicians and Clinical Dental Technicians, the vast majority of whom work in commercial dental laboratories.
4.3 VDPs
New or recent graduates from UK dental schools must complete a one-year Vocational Dental Programme (VDP) to allow them to work as a an Associate or Principal in General Dental Practice in NHS Scotland.
4.4 Percent Clinical Time
In addition to the questions on the workforce, practices were asked to record the percentage of time that was spent on NHS work in the past year, and the percentage that they planned in the following year.
The chart below compares the two, with the 45degree line showing those who are not planning to change, those above the line showing the practices planning on increasing their NHS time, and those below the line showing the number planning on reducing their NHS time.
5 Further Information
More information on the dental workforce, including training and forecasts can be found in the Dental Workforce section of the Turas Data Intelligence website.
6 Appendix 1 - Data Quality
6.1 Locations
There were challenges at the initial stage of the process in getting the correct list of contact details and this had impacts later on.
A list of main contacts at each dental practice was received from Practitioner Services Division (PSD) in NHS National Services Scotland (NHS NSS). A survey link was then sent using the QuestBack survey email distribution system. In the background, each link was attached to a specific practice, however there was very little information in the survey questions that asked what practice the survey being filled out was for. It did ask for the main List Number of the practice.
When this was initially tested the email came directly into test recipients email accounts, however when the survey was sent out to ~1000 dental practices, the nhs mail system automatically redirected the emails into the “Other” mailbox, which staff rarely check. This is not quite spam, but designed for correctly sent large mail drops.
When the communications were sent out letting dental practices know that the links had been distributed, some practices forwarded their copy to others. This meant that when the second practice filled out the survey, the data was then attached to the initial recipient and disentangling the two surveys was then challenging.
Using several different sources of data, using list numbers, manually checking names etc. many of these duplicates were fixed and the survey for a practice was linked with the correct details for that practice, but this was not always possible.
There were 186 duplicate surveys for 73 practices, One of these was for a practice were all 14 member of staff completed the survey identically. 55 practices had 2 surveys and the vast majority of these were simply corrections to the initial one.
To simplify the analysis and to avoid over counting the latest survey for each practice was taken. There may have been a small number of practices which submitted a survey using a another practices data and because they weren’t the latest their data has not been included in this analysis.
To get a denominator for the number of eligible practices, two sources of data were used, the list of practices to which emails were sent (from a list provided by Practitioner Services Division (PSD)), and the list of practices that according to our Official statistics employed at least one Dentist on the 31st of March.
If an email was recorded as having been sent to a practice, however there was no response or any record of a practice existing in our official statistics that practice was excluded. If an email was sent to a practice, and there was no response, and there was no record of that practice in our official statistics, that practice was also excluded.
6.2 Headcount and Hours
To reduce the number of errors, validation was set for the headcount and hours to ensure only numbers could be entered, however there were still some errors that crept in.
In 58 Practices for 98 staff across all roles, (including 40 Principal Dentists), no hours were entered. This could have been an error in entering the data, the person completed missed the question, or it could have been due to misunderstanding the question and those dentists were working in the practice, but did no hours in the survey week in question.
In 2 practices no headcount or hours were entered for Dentist roles.
7 Appendix 2 - Sensitivity
7.1 Response rate of total GDPs
A second way of measuring the response rate is comparing the total headcount that was reported in the survey to that of the total headcount reported in the Official Statistics.
One challenge in this comparison is that the number reported in the Official statistics has been deduplicated at the Health Board level, meaning any dentists working across two practices will be counted twice in the survey, and only once in the Official Statistics. This deduplication has not been performed in this analysis so these numbers will not match exactly to that reported in the publication.
There were 3,091 Dentists reported in the survey. The total dentists in the data used for the official statistics was 3,732. This is a total completion rate of 82.8%. This is slightly higher than the response rate indicating a slightly higher response rate among larger practices.
7.2 Comparing individual practices headcount
Of the 787 practices that we have linked with data from the Official stats, we can compare the headcount between the two.
80.3% of the practices reported the same headcount as the official stats data shows.
7.3 PDS Dentists
Comparing the Public Dental Service headcount to the Official Statistics, we can see that these match quite closely, with the exception of NHS Lothian, where the NHS Lothian service reported 69 Dentists compared to the 44 dentists in the Official Statistics.
The NHS Lothian PDS headcount reported that there was a total of 40.02 hours across the 69 dentists, this is presumably a data entry issue. NHS Western Isles also had data quality issues with hours, where the hours were entered as 1020 hours for 10 Dentists. These have been excluded from WTE calculations.