The must-read stories and debate in health policy and leadership.

By all accounts dentistry is in crisis, with whole regions of the country without access to NHS care and grim stories of desperate patients taking matters into their own hands.

Yet HSJ has revealed that a staggering £400m – more than 10 per cent of the NHS dental budget – is likely to go unspent this year.

The record underspend comes as dentists increasingly shun NHS work, claiming that financial arrangements do not cover the costs of carrying out health service work. It has prompted calls for a “fundamental rethink” of the much-derided NHS dental contract, introduced back in 2006.

Data shared with HSJ reveals dentists are still well below their targets for NHS work. As British Dental Association chair Eddie Crouch put it: “It’s not because there’s any lack of demand for dentistry, it’s simply that practices are working to a failed contract and can’t fill vacancies.”

Charity Healthwatch, which described the underspend as an “absolute scandal”, said dental access concerns were one of the top reasons for people contacting the charity.

Away from the doom and gloom, it’s quids in for NHS England: finance bosses have already said they will siphon the cash away to plug gaps in other budgets.

Even more Epic

Say the words “EPR implementation” and it’s enough to make many chief executives shudder.

Going live with a new electronic patient record is often more complicated and troublesome than first thought, with many senior managers left scarred by the transformation.

There have been some notable horror stories of NHS trusts struggling for years after EPR implementations, with Cambridge University Hospitals Foundation Trust’s travails with Epic being the most famous.

Therefore, the decision by Guy’s and St Thomas’ FT to delay its own implementation of the Epic EPR looks a sensible one.

The trust told HSJ it had pushed back go-live from April to autumn, probably October, following concerns that the system could not yet be implemented “safely”. In other words, more preparation is needed to ensure as smooth a transition as possible.

HSJ reported last month how three other trusts have all faced performance and data quality issues after going live with Epic, though of course some benefits have also been accrued.

With GSTT suffering an IT nightmare last summer when its data centres failed amid a heatwave, the last thing anyone at the trust wants is another digital disaster.

Also on today

In Mental Health Matters, Emily Townsend looks at the reaction to last week’s warnings by coroners about failing services for adults with eating disorders, and in news we report that the NHS has awarded an American healthcare giant a £20m contract to provide a new national infection control surveillance system.