No extra funding for government’s urgent appointment pledge

The Department for Health and Social Care has today said that each ICB was being set a minimum target of additional urgent appointments from April, based on estimates of unmet need in each system.

It said it was “delivering on the government’s manifesto pledge”. Labour’s manifesto said it “will tackle the immediate crisis with a rescue plan to provide 700,000 more urgent dental appointments”. It attached a £125m cost to its “dentistry package”.

However, an NHS England letter to ICBs today said: “This is to be funded from within dental allocations.”

HSJ revealed a draft NHSE letter last year suggesting there would be no new funding for the pledge, but officials and government claimed no final decision had been made.

In recent years, ICBs have routinely underspent dental budgets, and used them to cover other overspending, but the level of expected shortfall in 2024-25 is not yet known.

The DHSC said they were being targeted at “dental deserts”, citing the East of England and particularly Norfolk and Waveney. NHS England has calculated the ICB targets (see table below) based on the share of those who reported in the GP patient survey they had failed to get a dental appointment; the share of appointments which are urgent; and the level of activity they are already managing to deliver.

ICBs must increase their number of urgent appointments by their target level, over and above the level delivered in the 12 months to June 2024, running up to the general election. However, this has not yet been calculated. 

Commissioners can buy the extra appointments through new or recommissioned contracts or modification of existing contracts, and/or using “flexible commissioning”, but neither approach is mandated, NHSE said.

Despite the targeting, ICBs with large populations have the biggest targets, with the largest at North East and North Cumbria (57,559). Coventry and Warwickshire ICB has the smallest target, at 2,740.

Both the British Dental Association and NHS Confederation said wider changes to dentistry, including access to routine treatment, are needed.

Labour’s general election manifesto also promised to “reform the dental contract, with a shift to focusing on prevention and the retention of NHS dentists”, but the BDA last month told HSJ that even preliminary negotiations had not yet begun.

Minister Stephen Kinnock said in today’s announcement that wider reforms “will take time”.