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Trends and inequalities in realised access to NHS primary care dental services in England before, during and throughout recovery from the COVID-19 pandemic

British Dental Journal (2023)Cite this article

Abstract

Introduction The COVID-19 pandemic triggered unprecedented disruption to NHS dental services in England. This work describes changes in realised access to NHS primary care dental services between 2019 and 2022, with a particular focus on geographic and deprivation-based inequalities.

Methods Data from the NHS Business Services Authority and Office for National Statistics were combined to calculate the proportion of resident populations utilising NHS primary care dental services. These data were compared over multiple six-monthly time periods between 2019 and 2022, across several levels of geography and by quintiles of area-level deprivation.

Results The proportion of the England population utilising services fell substantially after the start of the COVID-19 pandemic, recovering to 75-80% of pre-pandemic levels in the first half of 2022. Substantial geographic variation was observed in the pre-pandemic time points and re-emerged as the recovery period progressed. Deprivation-based inequalities in service use were persistently present, although these were consistently greater in child than adult populations. While inequalities for children increased in the initial post-pandemic period, this pattern returned almost to pre-pandemic levels by 2022.

Conclusions Socioeconomic inequalities and geographic variations in the use of NHS primary care dental services, seen before the COVID-19 pandemic, have re-emerged afterwards.

Key points

  • This paper presents trends in realised access to NHS primary dental care services in relation to the COVID-19 pandemic in England.

  • It describes levels of realised access up until the first half of 2022 and thus throughout a key period of service recovery following significant pandemic-related restrictions. It shows the re-emergence of pre-pandemic patterns of geographic and deprivation-based inequalities in realised access.

  • The data generated from this work are to be used to inform local commissioning of dental services. To support this, the data have been uploaded onto an online geographic information system dental commissioning tool, available to dental commissioning and dental public health teams across England.

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Acknowledgements

The authors thank the Dental Insight team at NHSBSA for providing the dental claims data.

Author information

Authors and Affiliations

  1. Speciality Trainee in Dental Public Health, NHS England North East and Yorkshire, United Kingdom

    Rhiannon O´Connor

  2. Consultant in Dental Public Health, NHS England North East and Yorkshire, United Kingdom

    David Landes

  3. Professor of Dental Public Health, Institute of Population Health, University of Liverpool, United Kingdom

    Rebecca Harris

Authors
  1. Rhiannon O´Connor
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  2. David Landes
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  3. Rebecca Harris
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Contributions

Rhiannon O'Connor contributed to conception, conducted the data analysis, drafted the manuscript and approved the final version. David Landes and Rebecca Harris contributed to conception, edited and revised the manuscript and approved the final version.

Corresponding author

Correspondence to Rhiannon O´Connor.

Ethics declarations

Professor Rebecca Harris is also Deputy Chief Dental Officer for England and advises on dental clinical policy matters.

According to guidance from the NHS Health Research Authority (www.hra-decisiontools.org.uk/ethics), this work does not constitute research as the participants in the study were not randomised to different groups, the study protocol did not demand changing treatment/patient care from accepted standards, and the findings were not generalised. Ethical approval was therefore not required. Participant consent was not required as this work utilised routinely collected, aggregated and anonymised patient data.

The datasets generated and analysed during the current study are available from the corresponding author on reasonable request

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O´Connor, R., Landes, D. & Harris, R. Trends and inequalities in realised access to NHS primary care dental services in England before, during and throughout recovery from the COVID-19 pandemic. Br Dent J (2023). https://doi.org/10.1038/s41415-023-6032-1

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