In this section, the percentage of dentists that chose ‘major [adverse] effect’ for each of the potential causes of low morale is compared from this and the last survey. Whilst results are shown for dentists in England, please be aware that the changes in methodology since the last survey, discussed in the Introduction, make it harder to assess genuine change in opinion as opposed to the large increase in identified Provider-Performer dentists (and corresponding drop in Associates) as outlined in table 8.1. In line with other chapters showing time series data, results from the last survey for Wales are not included in this section.
Table 8.4 shows the results for England.
Table 8.4: Percentage of dentists (%) that answered ‘major effect’ for potential cause of low morale by dental type, England, 2017/18 and 2019/20
Issue |
Providing-Performer |
|
Associate |
17/18 |
19/20 |
Diff1 |
|
17/18 |
19/20 |
Diff1 |
1. |
Admin/paperwork |
58.6 |
54.7 |
4.0 |
|
32.7 |
29.9 |
2.9 |
2. |
Complexity vs financial return |
52.2 |
54.4 |
-2.1 |
|
58.2 |
57.5 |
0.7 |
3. |
Preventative care renumeration |
53.2 |
51.7 |
1.5 |
|
48.7 |
46.1 |
2.6 |
4. |
Expenses vs Income |
70.3 |
71.1 |
-0.8 |
|
61.2 |
55.1 |
6.1 |
5. |
Litigation risk/indemnity fees |
67.9 |
70.3 |
-2.4 |
|
78.4 |
74.2 |
4.2 |
6. |
Regulations |
65.8 |
60.3 |
5.5 |
|
44.6 |
34.9 |
9.7 |
7. |
Recruitment and retention |
31.6 |
43.7 |
-12.1 |
|
19.9 |
17.8 |
2.1 |
Overall Average |
57.1 |
58.0 |
-0.9 |
|
49.1 |
45.1 |
4.0 |
1. Difference columns are calculated by subtracting 19/20 results from 17/18 results
There are some clues that the results highlight the updated methodology as much as change in opinion for dentists in England. For example, issue (7) ‘Recruitment and retention’ shows a notable increase for Providing-Performers and decrease for Associates. Results from other countries suggest that this issue is far more of a concern for practice owners and as more are now being correctly identified in England, it is no surprise to see such a shift. Likewise, Associate dentists tend to be less concerned about increasing expenses and declining income (issue 4) and their apparent improvement in this score (from 61.2 to 55.1 per cent) would also suggest the identification of dental type in England has improved with the new methodology.
Table 8.5 shows results for Northern Ireland.
Table 8.5: Percentage of dentists (%) that answered ‘major effect’ for potential cause of low morale by dental type, Northern Ireland, 2017/18 to 2019/20
Issue |
Principal |
|
Associate |
17/18 |
19/20 |
Diff1 |
|
17/18 |
19/20 |
Diff1 |
1. |
Admin/paperwork |
57.9 |
50.1 |
7.7 |
|
26.7 |
25.3 |
1.4 |
2. |
Complexity vs financial return |
57.7 |
55.7 |
2.0 |
|
57.8 |
58.3 |
-0.5 |
3. |
Preventative care renumeration |
61.1 |
50.5 |
10.6 |
|
49.4 |
58.4 |
-8.9 |
4. |
Expenses vs Income |
83.3 |
80.5 |
2.8 |
|
69.1 |
68.9 |
0.2 |
5. |
Litigation risk/indemnity fees |
65.4 |
55.8 |
9.6 |
|
82.3 |
79.7 |
2.6 |
6. |
Regulations |
73.3 |
56.0 |
17.2 |
|
38.3 |
38.0 |
0.4 |
7. |
Recruitment and retention |
36.3 |
38.5 |
-2.2 |
|
11.0 |
11.0 |
0.0 |
Overall Average |
62.1 |
55.3 |
6.8 |
|
47.8 |
48.5 |
-0.7 |
1. Difference columns are calculated by subtracting 19/20 results from 17/18 results
Table 8.5 highlights an improved ‘overall average’ score for Principal dentists in Northern Ireland, suggesting that the issues listed generally had a less damaging effect on their morale. In particular, issue (6) ‘Regulations’ dropped 17.2 percentage points and, together with a drop in issue (1) ‘Administration and paperwork’, supports the increase in clinical work (%) and corresponding drop in administration reported in the Results Across the UK section.
On the other hand, Associate dentists in Northern Ireland had roughly the same ‘overall average’ score for this survey as they did in the last. This is somewhat surprising given the drop in motivation and morale for this group discussed in earlier sections of this report, but the list of potential causes for low morale is not exhaustive and there may therefore be other contributory factors.
Table 8.6 shows the results for Scotland.
Table 8.6: Percentage of dentists (%) that answered ‘major effect’ for potential cause of low morale by dental type, Scotland, 2017/18 to 2019/20
Issue |
Principal |
|
Associate |
17/18 |
19/20 |
Diff1 |
|
17/18 |
19/20 |
Diff1 |
1. |
Admin/paperwork |
52.7 |
51.4 |
1.3 |
|
23.3 |
29.0 |
-5.7 |
2. |
Complexity vs financial return |
58.1 |
52.0 |
6.1 |
|
49.7 |
45.5 |
4.2 |
3. |
Preventative care renumeration |
48.9 |
51.0 |
-2.1 |
|
45.3 |
42.9 |
2.4 |
4. |
Expenses vs Income |
80.3 |
69.9 |
10.4 |
|
50.6 |
45.1 |
5.5 |
5. |
Litigation risk/indemnity fees |
60.1 |
57.6 |
2.4 |
|
70.1 |
65.7 |
4.4 |
6. |
Regulations |
62.4 |
46.1 |
16.3 |
|
43.8 |
33.4 |
10.3 |
7. |
Recruitment and retention |
27.2 |
30.5 |
-3.4 |
|
13.0 |
11.3 |
1.7 |
Overall Average |
55.7 |
51.2 |
4.4 |
|
42.2 |
39.0 |
3.3 |
1. Difference columns are calculated by subtracting 19/20 results from 17/18 results
Both dental groups in Scotland show a decrease in the ‘overall average’ score, which fits with their increased levels of motivation and morale since the last survey. Like results for Principals in Northern Ireland, both groups of dentists in Scotland show a marked improvement in issue (6) ‘Regulations’ compared to the last survey. Answers to issue (4) ‘Increasing expenses and/or declining income’, showed the second highest reduction as a ‘major effect of low morale’ for both groups of dentists and, taken together, these changes provide some clues to the increase in motivation and morale since the last survey.
However, there are some issues that appear to have more of a detrimental effect on dentists in Scotland, most notably issue (1) ‘Administration and paperwork’ for Associates, which scored 5.7 percentage points higher than the last survey. But, overall, this is the only issue to see a negative change for Associates in Scotland, with all others improving. Likewise, Principals in Scotland recorded two issues (3 and 7) that scored higher than the last survey but all other issues showed decreases, meaning they were less of a concern when compared to the last survey.