7,000 patients face 'disaster' after dental practice ordered to close by NHS

Thousands of NHS patients face 'disaster' after a dental practice was ordered to close by the NHS.

Sefton Dental Centre is based on Stanley Road in Bootle and supports over 7,000 registered NHS patients. The practice services one of the most deprived areas in the country and includes vulnerable patients with complex needs. It has now been ordered to close.

Many residents have expressed 'fears for the future' of their health and said the closure of dental services in Bootle would have a 'detrimental' impact on the area and accused the NHS of abandoning vulnerable people.

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Smart Dental Care is the managing agent for Sefton Dental Centre and its problems began in May last year when an NHS commissioning team conducted a spot check and discovered the practice did not employ enough clinicians to deliver its contracted services. This was defined by Cheshire and Merseyside Integrated Care Board (ICB) (the body which manages NHS dentists in Sefton) as 'non-compliance' and they issued a remedial notice.

Soon afterwards, the practice was told it had 'failed to take the required action by the stated deadline' and was informed the ICB would be seeking to terminate its contract. Smart Dental Care dispute this claim.

Suken Shah is the Managing Director of Smart Dental Care and said the firm took over the Bootle practice during early 2020, just as the covid pandemic was starting to hit the country. Mr Shah also cites the fallout from Brexit as adding an extra layer of difficulty during this time in charge as practices struggled to recruit dentists from abroad to fill a labour shortfall.

Previously, qualified dentists from the EU would have to undertake a three week administrative process to be granted the right to work in the UK. Mr Shah said this timeframe increased to 18 months after Britain left the European Union in January 2020.

Mr Shah believes Brexit and the pandemic created a 'perfect storm' which meant dental practices were finding it impossible to recruit dentists - a 'storm' which was exacerbated by the end of the covid lockdown.

He said: "In 2022 after covid, Sefton Dental Care like almost all NHS practices struggled with the national dental recruitment crisis. 157 out of 318 NHS dental contracts across Cheshire and Merseyside could not deliver their NHS commitment as a result."

Mr Shah further explained that a backlog of need had built up between 2020 and 2022 and many of the patients were presenting with high needs and deteriorating dental health. He believes the level of high need and the availability of better paid work abroad depleted the supply of clinicians on the labour market - a situation many dental practices are still struggling with today.

Nevertheless, Smart Dental Care believed the NHS was acting in good faith when it issued the termination notice and vowed to put its case forward during mediation. This entailed an explanation of why the practice was one dentist short and how it had now recruited the extra dentist to meet full compliance with the contracted NHS services.

However, at a meeting with the NHS, Mr Shah claims he was informed Cheshire and Merseyside ICB was 'not interested' in mediation and doubled down on its commitment to terminating the contract with Smart Dental Care. Mr Shah wanted to know why.

A response to a Freedom of Information (FOI) request submitted by Mr Shah to the NHS Cheshire and Merseyside ICB shows the ICB manages 318 NHS dental contracts of which 157 were deemed to have 'underperformed' during the financial year 2022/23. Discounting Smart Dental Care, none of the other 'underperforming' 150+ dental providers were issued with a termination notice.

Furthermore, the response to the FOI also reveals NHS Cheshire and Merseyside ICB 'clawed back' over £27m worth of Units of Dental Activity (UDA) during 2022/23 and recommissioned zero new UDAs for 2023/24.

Mr Shah said: "Closure will disadvantage thousands of children, disabled, vulnerable and elderly patients who are currently being seen in our practice, for no reason."

The impact on patients is difficult to quantify but a survey conducted by the Bootle practice showed 91% of patients feared losing access to dental services in the event of the practice closing - with the majority stating their inability to travel outside their area. What area that would be is yet to be determined as no alternative service has yet been presented.

In the survey, patients expressed a number of concerns including the belief it would be 'disastrous' and 'detrimental to the area' if Sefton Dental Centre was closed.

Mr Shah said: "You have parents of disabled children who see this as a safe haven and elderly patients who have no other possibility of getting to a dentist outside the area. The bureaucrats never get to see patients and they do not understand the impact on people who do not have access to a dentist."

A spokesperson for NHS Cheshire and Merseyside said: “During 2022 it became clear that five practices managed by Smart Dental group were not delivering the contracted level of NHS care. In response, a nationally agreed process was followed but, as the situation remained unresolved, a decision was taken to issue termination notices in August 2023.

“This process remains ongoing and patients at impacted practices should continue to use services as normal. In any situation where there is a change to service provision, we always signpost patients to alternative local providers and, where a contract comes to an end, we work with local practices to ensure no reduction in the overall level of care.”

The notices served on five practices managed by Smart Dental Care include their Bootle branch, one in Chester, one in Wallasey and two other locations in the Picton area of Liverpool.

Responding just to the notice served on Bootle, Mr Shah said: "I know that there simply is no capacity in other local practices to take on 7000 patients that are being cared for at our practice in Bootle! The NHS should be able to answer exactly where these thousands of patients will be accommodated if Sefton closes."

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