Publication of Family Practitioner Services General Dental Statistics for Northern Ireland 2021/22

The Health and Social Care’s Business Services Organisation (BSO) has today published its Family Practitioner Services General Dental Statistics for Northern Ireland 2021/22.

This National Statistics report contains high level summary information on activity and payments in relation to General Dental Services. Information is provided at NI level with further breakdowns presented at both Local Commissioning Group (LCG) and Local Government District (LGD) level.

The publication is available on the Business Services Organisation’s website at www.hscbusiness.hscni.net/services/3173.htm

Key Points

From March 2020, General Dental Services were significantly restricted with the onset of the Covid-19 pandemic. This had a major impact on GDS Items of Service (IOS) activity levels and the number of patients seen over the last two financial years. As such individual contractors were provided Financial Support Scheme (FSS) payments to stabilise their IOS payments in 2020/21 and 2021/22. The rebuilding of dental services commenced in phases from 8 June 2020. From 20 July 2020, routine dental care could be offered and Aerosol Generating Procedures (AGPs) provided in general dental practice.

The key points from the 2021/22 report are:

Dental Services

• In Northern Ireland, there were 365 dental practices with 1,146 dentists registered to carry out health service treatments at the end of March 2022. The number of dentists registered has increased by 13% over the last decade although it has remained reasonably stable over the last 2 years.
• At Northern Ireland level, 94% of the population live within five miles of a health service dental practice, with at least 88% of the population living within three miles in more urban LGDs.
• The number of female dentists exceeds males, currently making up 59% of the workforce. In particular, the majority of new dentists are female, with 71% of dentists aged under 35 being female while the reverse is true in the older age groups with 63% of dentists aged 50 and above being male.
• 67% of the population is registered with a health service dentist including 72% of children. Whilst the overall registration rate has increased by 3 percentage points since March 2020, the proportion of children registered has fallen by the same percentage during this period.
• Fermanagh and Omagh LGD has a significantly lower proportion of the adult population registered (49%) compared to all other LGDs, however its registration rate of 73% for children is in line with the regional average of 72%.
• Females are more likely to be registered with a dentist (70% compared to 64% of males); this difference is particularly striking in the 18-44 age group with 77% of females registered compared to just 62% of males.
• Looking at individual ‘Item of Service’ treatments, almost 347,000 Examinations were performed on adults, an increase of 79% on 2020/21 which can be explained by the relaxation of restrictions put in place due to Covid-19. This still represents a drop of 61% when compared to the pre-pandemic levels of 2019/20.
• Almost 76,000 children received dental treatment in excess of the basic treatments, an increase of 47% on last year, but this figure is still down by 37% when compared to the pre-pandemic activity levels.
• Fillings increased by 90%, and extractions by 44%, compared to 2020/21, but still represent significant reductions of 47% and 21% respectively, compared to the most recent pre-pandemic year.
• During 2020/21, the latest year for which comparative figures are available, NI dentists filled more teeth (almost 13,000) per 100,000 population than any of the other UK regions. Since 2013/14, NI has consistently had the highest number of fillings per head of population of the four regions. Government initiatives and differential uptake of private dentistry may help explain some of the observed inter-country differences.   
• The Gross Cost of Dental Services was £143.8 million, with Covid-19 payments making up £43.7 million of this. Patient contributions (also included in the gross total) rose from £7.1 million in 2020/21 to £13.1 million in the latest year.
• The average cost (GDS Fees) per head of child population was £67 in 2021/22, up from £55 in 2020/21, whilst for adults, the cost per head (including patient contributions) was almost £27 in 2021/22, up from £18 in the previous year. These costs, however, exclude payments made to practices in relation to the Financial Support Scheme and provision of Personal Protective Equipment (PPE), as well as other adjustments which cannot be assigned to adults or children. 

Notes to editors: 

1. This is the third year that General Dental Services Statistics for Northern Ireland has been released as a standalone report.  This information was previously included as part of the FPS compendiums published in 2017/18 and 2018/19. This report was produced by the Health and Social Care’s Business Services Organisation (BSO) which was specified as an Official Statistics producer body under the Official Statistics Order (Northern Ireland) 2012. It provides the definitive source of figures on BSO FPS General Dental Services activity and finalises the provisional quarterly figures which have been released over the course of 2021/22.

2. The UK Statistics Authority designated these statistics as National Statistics on 11 May 2022. National Statistics status means that official statistics meet the highest standards of trustworthiness, quality and public value. All official statistics should comply with all aspects of the Code of Practice for Statistics. They are awarded National Statistics status following an assessment by the Authority’s regulatory arm. The Authority considers whether the statistics meet the highest standards of Code compliance, including the value they add to public decisions and debate. These statistics were considered as part of a wider assessment of the BSO Family Practitioner Services statistics.

3. On 18 March 2020, general dental practitioners were informed to restrict the provision of aerosol generating procedures (AGPs). On 23 March 2020, they were instructed to cease all AGPs and routine dental treatments were postponed. From that date the provision of face-to-face treatment within general dental practice was restricted to urgent and emergency dental conditions that could not be managed remotely and in which a non-AGP could address the patient’s dental need. The rebuilding of dental services commenced in phases from 8^th June 2020. From 20 July 2020, routine dental care could be offered and AGPs provided in general dental practice. The impact of COVID-19 restrictions on dental practices in turn has had an impact on General Dental Service (GDS) item of service (IOS) activity levels and the number of patients seen over the last financial year. As such individual contractors were provided financial support scheme (FSS) payments to stabilise their IOS payments in 2020/21 and 2021/22. These additional support payments were made each month to cover the shortfall in GDS payments in 2020/21 and 2021/22 for Item of Service Fees and Patient Contribution fees compared with payments made in 2019/20. Dental Practitioners were also with provided personal protective equipment (PPE) payments. All other payments such as registration, capitation and other allowances were paid as normal.

4. Family Practitioner Services (FPS) is responsible for annual payments to primary care contractors including GP Practices, Dentists, Opticians and Community Pharmacists on behalf of the former Health and Social Care Board (HSCB), now Strategic Planning and Performance Group (SPPG) within the Department of Health. In 2021/22 this figure was almost £950 million, and included additional support to contractors related to the covid-19 pandemic.

5. The data relate to BSO’s General Dental Services payment and volumes claimed and have been sourced from administrative systems. It is important to note that, unless otherwise stated, figures relate to the year in which a payment claim was processed by BSO and this may not necessarily coincide with when the actual activity took place (i.e., some claims from a previous year may be processed in the current year whilst, conversely, some claims relating to activity in the current year may not be processed until a later year). Dental activity figures do not cover private work or secondary care activity.

6. Primary care statistics on the number of dental practitioners are taken from lists of performers registered to provide these services. The lists maintained by BSO provide a headcount rather than full-time equivalent figures so takes no account of differences in hours worked or changes to practitioner working patterns over time.

7. Whilst a number of UK comparisons have been included in the report, there can be important differences in how services are delivered between countries that can impact on the figures. The relative size of the private sector in the delivery of primary care services within each country will be a particularly important factor in this regard so care needs to be taken when interpreting any inter-country differences in HSC activity levels.

8. The cost of primary care dental services is based on the annual assurance information supplied by the BSO to the former HSCB for each financial year.

9. The report itself presents high level summary information with all of the detailed data tables consigned to the accompanying Excel appendices. The figures are prepared and released by independent NISRA statisticians working within BSO’s FPS Information Unit.

10. Quarterly updates for 2022/23, for key report tables, will be released on a provisional basis on the FPS section of the BSO website www.hscbusiness.hscni.net/services/3173.htm. These will be added to the historic quarterly series. The timetable for the release of the quarterly updates will also be published on the BSO website and all publications, both quarterly and annual, will be formally announced on the UK.Gov release calendar www.gov.uk/government/statistics/announcements

11. Electronic copies of the Bulletin and associated Excel tables are available free of charge from: www.hscbusiness.hscni.net/services/3173.htm

12. National Statistics - This is a National Statistics publication and therefore follows the Code of Practice for Statistics.  You can find further information about the Code of Practice at: www.statisticsauthority.gov.uk/code-of-practice/

13. For further information please contact:
    Information Unit
    Family Practitioner Services
    Business Services Organisation
    2 Franklin Street
    Belfast BT2 8DQ

14. For media enquiries please contact the DoH Press Office by email pressoffice@health-ni.gov.uk.
15. Follow us on Twitter @healthdpt.
16. The Executive Information Service operates an out of hours service For Media Enquiries Only between 1800hrs and 0800hrs Monday to Friday and at weekends and public holidays. The duty press officer can be contacted on 028 9037 8110.

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