Dentist denied more NHS work despite hiring staff

A dental practice claims it is being denied the chance to take on more NHS appointments, despite having the staff to do so.

Dr Michael Frain Ltd, which runs practices in Wiltshire and Bristol, recently hired an orthodontist who takes NHS patients at its Hathaway practice in Chippenham and believes it could give 50 more children braces before April.

The company reduced its NHS contract in April 2025 after several dentists left, but believes commissioners should be able to arrange a new contract quickly to allow for this.

In response, NHS Bath and North East Somerset, Swindon and Wiltshire said it had already recommissioned services after the practice decided to reduce its annual contract.

The care board added it must keep NHS dental access stable across local communities and that Chippenham had not lost any NHS provision.

NHS dental contracts are agreed annually, and there is no quick way to move units of dental activity - how NHS work is measured - between practices when demand changes.

Dr Keith Garber, director at Dr Michael Frain Ltd, explained that the NHS provision the practice could provide was stable, but its contract had to be reduced last year because several dentists who saw NHS patients left the Chippenham practice.

"We advertised for some new dentists for about nine months, but had no applicants at all, so we were faced with a decision of what we do for these surgeries.

"So we reluctantly gave back a chunk of our NHS contract, advertised to recruit private dentists and had about nine applicants within a short space of time, which tells you the story I'm afraid."

He added: "Everybody thinks it's greedy dentists going privately to earn more money - it's not a case of that.

"It's a case of we either stay in business or don't stay in business a lot of the time, and if we're asking for more [NHS]work to be done, how frustrating is it that we actually get turned down by the local team."

Referring to the Chippenham practice, NHS Bath and North East Somerset, Swindon and Wiltshire Integrated Care Board (ICB), said: "In April last year, one of our dental contractors, decided to significantly reduce their contract to provide units of NHS dental activity, from April 2025.

"As the commissioners of NHS dental care in Bath and North East Somerset, Swindon and Wiltshire, our role is to ensure access to NHS dental appointments remains stable, in the areas where the dental contracts are handed back, or significantly reduced.

"We therefore recommissioned alternative services with other dental providers in Chippenham and Melksham to fill the gaps left."

The practice has also sought the help of Chippenham's Liberal Democrat MP, Sarah Gibson.

She says she recently met with the chair of the ICB, Rob Whiteman, about provision of NHS dental care in the area and the ability of practices to pick up extra NHS appointments at short notice.

"I raised this issue with him very strongly, and asked that he look into it," she said.

"He's come back and said he will do that, and he is trying to find a solution locally."

She added: "We also need the government to do what Wes Streeting said he would do right at the beginning, which is to overhaul the entire system and set up a contracting system for dentistry, that works for the patient and for the dentist."

Industry leaders have also called for longer term change.

As it stands, dental practices are awarded NHS contracts following a tendering process, so they cannot just be awarded suddenly without a more complex process taking place.

The chair of the British Dental Association (BDA), Eddie Crouch, told BBC West: "The sadness of that is that if someone has capacity, and other dentists in the area are actually reducing, that money can't just be simply transferred across."

He added: "It's a stupid system but sadly it's the system we're working to at the moment.

The government is set to introduce changes to the NHS dental contract in April 2026, which will see an emphasis on emergency care and support for people with complex needs.

The current system of commissioning is set to remain in place.

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