The National Audit Office (NAO) has released an investigation into the NHS Dental Recovery Plan, pinpointing major challenges and progress in enhancing dental services in England, particularly underlining the acute struggles faced by rural areas. The investigation report emphasises the rural-urban disparities in service provision and the tailored responses needed to address these inequities.

The investigation highlights a dramatic decrease in accessibility to dental services, with rural areas particularly disadvantaged. The number of treatments provided through NHS dentistry dropped by 4.7 million in 2023-24 compared to 2019-20, and only 40% of the adult population in rural England had seen an NHS dentist in the 24 months up to March 2024, down from 49% before the pandemic. This decline is more pronounced in rural regions, where distances and travel times to the nearest dental clinics exacerbate accessibility issues.

Additionally, the financial commitment to primary care NHS dentistry has seen a real-term decline, impacting rural areas significantly due to their often-higher operational costs and lower patient density. The under-utilisation of dental budgets, with a reported £392 million underspend in the NHS dental budget in 2023-24, signals a missed opportunity for bolstering rural services, where such funds are desperately needed.

The NHS and the Department of Health & Social Care's £200 million Dental Recovery Plan aims to enhance access by adding over 1.5 million additional treatments by 2024-25. Key components such as mobile dental vans are particularly relevant for rural communities, aiming to mitigate the lack of fixed dental practices in these areas. However, the implementation has faced hurdles, including delays in deploying these mobile units, critical for extending reach in underserved areas.

Early indicators suggest that the plan is not meeting its intended goals, with significant implications for rural populations. As of October 2024, while some initiatives like new patient premiums and adjustments in UDAs have been rolled out, essential components like mobile dental vans have not been fully realised. This shortfall is troubling for rural areas, which benefit significantly from such flexible service delivery models.

The report calls for a comprehensive evaluation of what works, especially in the context of rural service delivery. There's a pressing need for the NHS and DHSC to refine their approach, considering the unique challenges faced by rural areas, such as geographic isolation, fewer healthcare resources, and higher operational costs. Improving engagement with Integrated Care Boards (ICBs) and local practices and ensuring that reforms address the specific needs of rural communities, are critical for making NHS dental services more equitable across England.

For those seeking a deeper understanding of the NHS Dental Recovery Plan’s impact on rural areas and its broader implications, the full report is accessible here.

Lee Summerfield, Report Director, summarises the findings in this video: