NHS Dental Payment Reform: Fairer Scotland Duty Summary

The Fairer Scotland Duty Summary considers the potential impact of NHS Dental Payment Reform on socio-economic inequality.

NHS Dental Payment Reform - Fairer Scotland Duty summary

Title of policy, strategy or programme

NHS Dental Payment Reform

Summary of aims and expected outcomes of strategy, proposal, programme or policy

From 1 November 2023 payment reform will be implemented with the main aim to sustain NHS dental services by offering higher fees to incentivise NHS treatment and improve access to NHS dental services. The reform will therefore benefit both the sector by improving the NHS offer, and patients, with increased NHS provision.

The new model reduces bureaucracy, provides greater clinical freedom to NHS dental teams and reflects modern dentistry. It is intended as the first step towards a truly modern NHS dental service which appropriately assesses, responds to and supports the oral health needs of every patient in Scotland.

Summary of evidence

Evidence showed that people from deprived areas are more likely to have decayed teeth, poor oral hygiene and higher levels of periodontal disease and therefore have a greater clinical need for dental treatment. Furthermore, patients living in the lowest SIMD areas are more likely to have no (or less) natural teeth compared with people living in the least deprived areas, and will therefore be impacted by the increased cost of laboratory based items (such as dentures) to a greater extent.

Summary of assessment findings

To the extent that people in lower SIMD areas have a greater treatment need, sustaining access to NHS dental services will have a disproportionate benefit on this group.

To the extent that people from lower SIMD areas require additional dental treatment they will be impacted by higher NHS costs.

Our overall view is that the net effect is positive on this group of patients. The main objective of payment reform is to sustain access to NHS dental services. To the extent that reduced access to NHS dental services has a disproportionate effect on patients in the most deprived areas and recourse to private dentistry, then payment reform in preserving NHS services has a disproportionate benefit for these patients.

We already have existing mitigations in place in which patients who have difficulty paying for NHS dental services may be exempt from NHS charges and those patients will continue to receive free NHS dental care and treatment. For those not exempt from NHS dental charges but on a low income, financial support is available via the NHS Low Income Scheme.

Sign off

Name: Tom Ferris

Job title: Deputy Director for Dentistry, Optometry and Audiology


Email: nhsdentistry@gov.scot

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