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Publication, Part of

Dentists' Working Patterns, Motivation and Morale - 2018/19 and 2019/20

England – 2019/20

Headline Working Patterns Analysis

Table 1.1 summarises the working hours results by dental and contract type, for England in 2019/20. Results for 2018/19 are shown in the time series section.

Table 1.1: Summary table for working hours analysis by dental and contract type, England, 2019/20

Dental Type Contract Type Sample Full-Year Popln. Average
Weekly Hours NHS Weekly Hours Weeks Annual Leave   NHS  (%) Private (%)   Clinical (%) Non-Clinical (%)
Providing- GDS 950 3,704 42.3 27.3 4.2   64.6 35.4   74.6 25.4
Performer PDS 68 231 41.8 31.6 5.6   75.6 24.4   70.6 29.4
  Mixed GDS/PDS 41 159 45.0 31.1 3.9   69.1 30.9   68.3 31.7
  All 1,059 4,094 42.4 27.7 4.2   65.4 34.6   74.1 25.9
Associate GDS 2,149 11,746 34.9 26.1 4.4   74.7 25.3   84.4 15.6
  PDS 175 845 32.1 28.4 5.6   88.5 11.5   81.3 18.7
  Mixed GDS/PDS 113 626 36.9 30.7 4.5   83.1 16.9   84.4 15.6
  All 2,437 13,217 34.8 26.4 4.5   75.9 24.1   84.3 15.7
All Dentists GDS 3,099 15,450 36.7 26.4 4.4   71.9 28.1   81.7 18.3
  PDS 243 1,076 34.2 29.1 5.6   85.1 14.9   78.5 21.5
  Mixed GDS/PDS 154 785 38.5 30.8 4.4   79.8 20.2   80.6 19.4
All Dentists   3,496 17,311 36.6 26.7 4.5   73.0 27.0   81.5 18.5

Note: Further explanatory notes can be found in the glossary and Methodology section.

The Providing-Performer PDS and mixed GDS/PDS results shown in the table are based on small sample sizes (<100 by count and <75 per cent of group population).

The main findings for 2019/20 are:

  • Overall, dentists (full and part-time) reported working an average of 36.6 hours per week in dentistry in 2019/20, with 26.7 hours (73.0 per cent) devoted to NHS dental services. The remaining dental activity time – 27.0 per cent – was spent on private dentistry.
  • On average, Providing-Performer dentists worked more weekly hours (42.4 hours) than Associate dentists, at 34.8 hours. Providing-Performers reported spending 65.4 per cent of their time on NHS dentistry (27.7 weekly NHS hours); for Associate dentists, this measure was 75.9 per cent (26.4 weekly NHS hours).
  • Overall, dentists reported that their time spent on dentistry was split into 81.5 per cent on clinical work and 18.5 per cent on non-clinical work. Associate dentists spent more of their dental time on clinical work compared to Providing-Performers at 84.3 per cent compared to 74.1 per cent, respectively.

NHS/Private share

Tables 1.2 and 1.3 compare the working patterns of dentists according to their NHS/Private share.

Table 1.2: Providing-Performer dentists, summary table of working hours analysis by NHS/Private Share, England, 2019/20

NHS/Private Share Sample Full-Year Popln. Average
Age Total Weekly Hours Weeks Annual Leave   Clinical (%) Non-Clinical (%)
Mainly private (0-25%) 240 866 51.5 39.2 5.1   75.0 25.0
Mixed (>25% and <75%) 267 1,073 46.5 42.4 4.2   71.4 28.6
Mainly NHS (75-100%) 552 2,154 47.7 43.7 3.9   75.2 24.8
All Dentists 1,059 4,094 48.2 42.4 4.2   74.1 25.9

Note: Further explanatory notes can be found in the glossary and Methodology section
Table 1.3: Associate dentists, summary table of working hours analysis by NHS/Private Share, England, 2019/20

NHS/Private Share Sample Full-Year Popln. Average
Age Total Weekly Hours Weeks Annual Leave   Clinical (%) Non-Clinical (%)
Mainly private (0-25%) 285 1,405 44.9 33.1 4.9   82.0 18.0
Mixed (>25% and <75%) 452 2,504 39.5 35.6 4.6   81.2 18.8
Mainly NHS (75-100%) 1,700 9,308 39.4 34.9 4.5   85.4 14.6
All Dentists 2,437 13,217 40.0 34.8 4.5   84.3 15.7

Note: Further explanatory notes can be found in the glossary and Methodology section

The results highlight some trends when comparing dentists who spend most of their time on NHS work compared to those who spend more time on private work. Mainly NHS dentists tend to:

  • Work longer weekly hours
  • Take fewer weeks’ annual leave
  • Spend more time on clinical work in the case of Associate dentists

In addition, dentists who spend more time on NHS work tend to be younger compared to those with a higher private share.


Individual Motivation Question Analysis

Table 1.4 presents responses to the individual motivation questions by dental type with the ‘overall average’ figure showing the average of the individual percentage scores for each response category. Please refer to the Introduction to the motivation and morale section and Annex D in the Methodology section, for more information on how the data is analysed.

Table 1.4: Percentage response (%) to each motivation question by dental type, England, 2019/20

Providing-Performer Percentage (%)
Question Strongly Disagree Disagree Neutral Agree Strongly Agree
A. I feel good about my job as a dentist 14.2 16.9 21.7 34.1 13.1
B. I receive recognition for the work I do 17.3 19.6 25.8 28.9 8.4
C. I feel my pay is fair 29.6 27.7 24.7 14.5 3.5
D. I have all the equipment and resources to do my job properly 6.5 15.2 22.7 40.7 15.0
E. My job gives me the chance to do challenging and interesting work 8.9 14.1 24.2 40.1 12.7
F. There are opportunities for me to progress in my career 12.8 19.7 32.8 25.8 9.0
Overall Average 14.9 18.9 25.3 30.7 10.3
           
Associate Percentage (%)
Question Strongly Disagree Disagree Neutral Agree Strongly Agree
A. I feel good about my job as a dentist 8.6 17.0 25.4 38.0 11.0
B. I receive recognition for the work I do 11.9 24.3 27.5 29.7 6.5
C. I feel my pay is fair 21.6 33.2 22.6 19.0 3.6
D. I have all the equipment and resources to do my job properly 6.1 21.3 26.7 37.3 8.7
E. My job gives me the chance to do challenging and interesting work 6.6 15.9 27.3 40.7 9.5
F. There are opportunities for me to progress in my career 10.7 21.0 29.8 31.4 7.2
Overall Average 10.9 22.1 26.5 32.7 7.8

Note: Dentists included in the analysis answered every motivation question

Whilst it can be hard to distinguish trends from rows of figures, it is clear that answers to question (C) ‘I feel my pay is fair’ score lowest in terms of agreement (i.e. ‘strongly agree’ or ‘agree’) for both dental types. Furthermore, over half of all dentists either ‘disagree’ or ‘strongly disagree’ when asked if they felt their pay is fair.

Table 1.5 and figure 1.1 consider the results for ‘Strongly Agree’ and ‘Agree’ combined.

Table 1.5: Percentage of dentists (%) that answered ‘strongly agree’ or ‘agree’ by question and dental type, England, 2019/20

Questions Providing-Performer Associate Difference
A. I feel good about my job as a dentist 47.2 49.0 -1.8
B. I receive recognition for the work I do 37.3 36.3 1.1
C. I feel my pay is fair 17.9 22.6 -4.6
D. I have all the equipment and resources to do my job properly 55.7 46.0 9.7
E. My job gives me the chance to do challenging and interesting work 52.8 50.2 2.5
F. There are opportunities for me to progress in my career 34.8 38.6 -3.8
Overall Average 40.9 40.4 0.5

Note: Difference column is calculated by subtracting Associate results from Providing-Performer results

Figure 1.1: Percentage of dentists (%) that answered ‘strongly agree’ or ‘agree’ by question and dental type, England, 2019/20

The results show some differences in how Providing-Performer and Associate dentists answered individual questions. The greatest difference is found for question (D) ‘I have all the equipment and resources I need to do the job properly’, with 55.7% of Providing-Performers responding ‘strongly agree’ or ‘agree’ compared to 46.0% for Associate dentists. As Providing-Performers have a responsibility to provide the necessary equipment in a practice, it is perhaps understandable that they are more satisfied than Associate dentists.

More than half of dentists of both dental types either ‘strongly agree’ or ‘agree’ with question (E) ‘My job gives me the chance to do challenging and interesting work’ whereas only a fifth said they were happy with their pay (C). Taken overall, the average figures at the bottom of table 1.5 suggest that both groups of dentists had similar levels of motivation.


Average ‘Motivation Index’

Figures 1.2a and 1.2b show distribution plots of the average ‘motivation index’ by dental type with the figures in brackets showing the overall average index for each cohort; 51.2% for Providing-Performers and 49.8% for Associate dentists. Please see the Introduction for how the average ‘motivation index’ is calculated.

Figures 1.2a and 1.2b: Distribution plots of average ‘motivation index’ by dental type, England, 2019/20

The distribution of the Associate plot appears more normal than the Providing-Performer plot which exhibits a negative skew for lower motivation columns (<50%) but also a positive skew for the 62.5<75% band, meaning both cohorts of dentists have similar levels of motivation overall, mirroring results from the preceding section.

 

Motivation band and survey responses

Table 1.6 shows results for each motivation band (described in the Introduction) against the variables of age, weekly hours of work, annual leave, NHS share (%) and clinical work (%).

Table 1.6: Relationship between ‘motivation band’ and variables from the Dental Working Patterns Survey by dental type, England, 2019/20

Dental Type Motivation Band Full-Year Popln.   Average
Count (%)   'Motivation Index' (%) Age Weekly Hours Leave NHS     (%) Clinical (%)
Providing-Performer Very Low 712 17.4   14.4 46.9 47.0 3.5 80.3 73.4
Neutral & Low 1,333 32.6   40.9 48.3 42.3 4.1 71.1 75.3
High 1,618 39.5   64.6 48.7 41.6 4.5 56.0 74.9
Very High 431 10.5   88.3 48.4 38.3 4.8 45.3 77.0
All 4,094 100.0   50.7 48.2 42.4 4.2 64.0 75.0
Associate Very Low 1,815 13.7   16.0 41.3 35.8 4.4 83.9 82.6
Neutral & Low 4,883 36.9   41.0 40.1 35.2 4.4 79.9 85.0
High 5,351 40.5   64.1 39.7 34.1 4.7 72.0 85.3
Very High 1,167 8.8   88.0 39.2 35.7 4.5 62.1 84.6
All 13,217 100.0   51.1 40.0 34.8 4.5 75.7 84.8
All Dentists   17,311 100.0   51.0 42.0 36.6 4.5 72.9 82.4

Note: NHS share (%) and clinical work (%) do not take account of the weekly hours of work of individual dentists but just the percentage values recorded in the DWP Survey. This methodology differs to that used in Working Hours Results chapters and these figures may differ.

The full-year population counts in table 1.6 show that for both dental types nearly 75% of dentists lie in the central motivation bands (i.e. ‘neutral & low’ or ‘high’) with the remaining dentists either in the most or least motivated bands (i.e. ‘very high or ‘very low’). The results suggest relationships between the motivation bands and some of the measured variables. For example:

  • Both groups of dentists appear to show a strong relationship between NHS share and average ‘motivation index’; dentists with a higher ‘motivation index’ do less NHS work compared to those with a lower ‘motivation index’.
  • Providing-Performer dentists appear to show a relationship between weekly hours of work, annual leave and the ‘motivation index’; those dentists who work longer hours and take less annual leave report a lower ‘motivation index’ compared to other colleagues.

Such potential relationships are more easily visualised when considered graphically.

Figures 1.3a and 1.3b: Providing-Performer dentists, plot of average working pattern variables by motivation band, England, 2019/20

Figures 1.4a and 1.4b: Associate dentists, plot of average working pattern variables by motivation band, England, 2019/20

Note: Error bars for some variables have been omitted to aid interpretation (as they would overlap making the chart more difficult to read). The omitted error bars are the same length as those shown. Please see table 1.6 for source data.

Figures 1.3a and 1.3b illustrate that for Providing-Performer dentists there appears to be a relationship between their ‘motivation index’ and their average weekly hours of work, their NHS share and the amount of annual leave taken.

Of these three variables, only NHS Share appears to show a relationship for Associates, as seen in figure 1.4a. Clinical work (%) and age seem to have a weaker relationship with the ‘motivation index’. The error bars (displaying 95% confidence intervals) allow estimation of the statistical significance of observed changes.


Multivariate Analysis (Multiple Linear Regression Results)

Table 1.7 shows multiple linear regression results by dental type for the average ‘motivation index’. Variable results that are not statistically significant are in italics in the table.

Table 1.7: Parameter estimates1 for ‘motivation index’ by dental type using multiple linear regression, England, 2019/20

Dental Type Sample Intercept1 Weekly Hours NHS% Clinical% Leave Age
Providing-Performer 1,059 64.09 -0.18 -0.23 0.07 0.96 -0.01
Associate 2,437 66.37 -0.09 -0.20 0.08 0.47 -0.14

1. Please see Annex E and F of the Methodology for descriptions of parameter estimate and intercept as well as all significance and adjusted R2 values relating to this table.

The positive or negative values of the variable results indicate the relationship between each variable and the average ‘motivation index’. For both sets of dentists an increase in annual leave correlates with an increase in motivation, whereas increases in weekly hours of work or NHS share (%) have the opposite effect and lower motivation.

This type of analysis allows the individual relationships between each measured variable and the ‘motivation index’ to be assessed. For example, the statistical model predicts that if all other working patterns remained unchanged, but dentists switched from all private to entirely NHS work (from 0% to 100% NHS share) the ‘motivation index’ of Providing-Performers would decrease by 23.2 percentage points and by 20.4 for Associate dentists.

The model also predicts that weekly hours of work have a weaker relationship with the ‘motivation index’ of Associates compared to Providing-Performers. However, over a third of Associate dentists work part-time (<35 weekly hours), which is likely to affect the result and when these dentists are removed from the analysis the coefficient score changes from -0.09 to -0.31. The results suggest that choosing to work part-time actively limits the negative relationship between motivation and weekly hours of work, which may be one reason that some dentists make this work-life choice.

Finally, it is important to note that whilst regression analysis provides evidence for the existence of relationships between variables, it does not provide measures of causality. In other words, although there may well be a relationship between, for example, weekly hours of work and motivation, it is not possible to determine if longer working hours demotivate staff or whether demotivated staff tend to work longer hours.


Effect of Different Dental Populations

Table 1.8 compares multivariate results for the average ‘motivation index’ for Providing-Performer and Associate dentists. The first rows (‘All’) repeat results from table 1.7, with the subsequent rows showing results for different cohorts of dentists. Variable results that are not statistically significant are in italics in each table.

Table 1.8: Parameter estimates1 for ‘motivation index’ by split populations using multiple linear regression by dental type, England, 2019/20

Dental Type Population Sample   Intercept Weekly Hours NHS% Clinical% Leave Age
Count (%)  
Providing-Performer All 1,059 100.0   64.09 -0.18 -0.23 0.07 0.96 -0.01
<35 Hours 229 21.6   53.07 0.19 -0.16 0.01 1.13 -0.03
≥35 Hours 830 78.4   71.71 -0.33 -0.25 0.07 1.10 0.00
Mainly NHS 552 52.1   94.12 -0.31 -0.47 0.03 0.71 0.03
Mainly Private 240 22.7   65.08 0.11 -0.41 0.13 1.06 -0.30
Male 764 72.1   54.24 -0.21 -0.24 0.12 0.99 0.11
Female 295 27.9   76.33 0.01 -0.24 0.01 0.57 -0.19
Associate All 2,437 100.0   66.37 -0.09 -0.20 0.08 0.47 -0.14
<35 Hours 1,065 43.7   62.67 0.01 -0.17 0.01 0.76 -0.07
≥35 Hours 1,372 56.3   76.40 -0.31 -0.24 0.13 0.25 -0.16
Mainly NHS 1,700 69.8   74.23 -0.14 -0.28 0.07 0.58 -0.11
Mainly Private 285 11.7   62.36 0.15 -0.52 0.13 0.05 -0.19
Male 1,110 45.5   60.35 -0.14 -0.21 0.15 0.21 -0.08
Female 1,327 54.5   68.60 0.03 -0.20 0.02 0.69 -0.17

1. Please see Annex E and F of the Methodology for descriptions of parameter estimate and intercept as well as all significance and adjusted R2 values relating to this table, respectively.   2. ‘Mainly NHS’ and ‘Mainly Private’ percentages will not sum to 100% due to the omission of the ‘Mixed’ NHS/Private cohort.

There are some interesting results when dentists are split into different cohorts. For example, both Providing-Performer and Associate dentists who work full-time (≥35 hours) exhibit a statistically significant negative relationship between ‘motivation index’ and weekly hours of work, whilst their part-time colleagues (<35 hours) do not. This is also the case for male compared to female dentists, with the former showing a negative relationship between motivation and weekly hours. However, the fact that female dentists tend to work fewer weekly hours on average (43.4 compared to 39.9 hours[1]) may have an effect.

It is also noticeable, that unlike any other variable, NHS share (%) exhibits a statistically significant and negative relationship with ‘motivation index’ for all cohorts of dentists.

 

[1] More detailed working pattern results are presented in a separate interactive report which accompanies this report and can be found under 'Resources' on the Overview page


Morale of Dentists

Table 1.9 and figure 1.5 show how dentists answered question (H) ‘How would you rate your morale as a dentist?’. 

Table 1.9: Level of self-reported morale (%) by dental type, England, 2019/20

Dental Type Full-Year Popln. Percentage (%)
Very Low Low Neither High Very High
Providing-Performer 4,094 28.2 27.7 23.3 14.9 5.8
Associate 13,217 16.8 29.5 28.1 19.5 6.0


Figure 1.5: Level of self-reported morale (%) by dental type, England, 2019/20

Note: Please see table 1.9 for source data

Figure 1.5 shows that Associate dentists report higher levels of morale compared to Providing-Performers with 25.6% choosing ‘very high’ or ‘high’ morale compared to 20.7%. Furthermore, 56.0% of Providing-Performers report their morale as either ‘low’ or ‘very low’ compared to 46.3% for Associates. These results are in contrast with earlier sections that show Providing-Performer and Associate dentists with similar levels of motivation and may reflect increased levels of responsibility that Provider-Performers face when running their practices.

2012/13 to 2019/20 Time Series, Motivation and Morale shows how the morale and motivation of dentists have changed since these measures were first collected in the Dental Working Patterns Survey.


Last edited: 21 June 2021 3:45 pm