NHS Dental Statistics for England - 2019-20 Annual Report

NHS Dental Statistics for England annual report brings together information on NHS dental activity for the 12-month period to 31st March 2020 and information on the number of patients seen by an NHS dentist up to 30th June 2020. Data about courses of treatment, clinical treatments and dental workforce are included to provide insight into NHS dental activity in England. This data is summarised at national and regional level in annex 1 and annex 2 of the publication and practice level information can be found in annex 3.

On the 25^th March 2020, dental practices were instructed to close and defer routine, non-urgent dental care including orthodontics and establish remote urgent care services to limit the transmission of COVID-19. The restrictions included:

•        Cease all routine dental care (including orthodontics) (UK-wide)

•        Cease all aerosol generating procedures (UK-wide)

•        Offer patients with urgent needs appropriate advice and prescriptions over the phone (UK-wide)

•        Cease all face-to-face urgent care (England, Scotland)

Due to the COVID-19 restrictions the number of FP17 and FP17W claim forms and therefore, the totals regarding activity, patient numbers, finances and  treatments, will be much lower than traditionally expected for the final quarter of 2019/20 and the months leading into 2020/21. It is anticipated the number of children patients will be impacted the most. Dental practices could commence opening from 8th June 2020 for all face to face care, including non-urgent treatment and where practices assessed they had the necessary safety requirements in place. Information about instructions from NHS England can be found online.

The reduction in dental services through the pandemic is captured in with the NHS Dental Statistics for England publication, from March 2020 to 30^th June 2020 within the measure Patients Seen. This report will outline the estimated impact of COVID-19 using the data at national level for NHS dental practices and explain the caveats where they are applicable.

Patients seen shows the number of adult patients who received NHS dental care in the previous 24 months, where their last course of treatment started within the past 24 months. For children, the measure shows the number who received NHS dental care in the previous 12 months, where their last course of treatment started within the past 12 months. The time periods are aligned with the recommended longest interval between dental checks in the Oral and Dental Health NICE guidance.

Each patient is counted only once even if they have received several episodes of care over the period. Unique patients are identified by using surname, first initial, gender and date of birth, although inevitably there will be some duplication and omissions. For more information about data quality for this measure, please read our guidance. Please note, due to the different time frames covered, this supplementary report will consider adults and children separately and focus on the number of adult patients seen.

The measure is collected monthly and reported quarterly in the Annex 1 summary of the annual publication. Each value is the number of adult patients who received NHS dental care in the previous 24 months up to the specified date. Figure 1 depicts the change of the time period covered. The data does not include the number of patients seen within a month therefore all calculations are an estimate. When analysing the reduced number of patients seen, it is important to remember the difference between patients seen at 31^st March 2020 and 30^th June 2020 is comparing the number of patients seen in a different 24 month periods.

Analysing previous years against 2019-20 displays the impact of COVID-19 and how the data differs. 2017-18 and 2018-19 are similar showing linear trends with little variation however 2019-20 had a lower number of adult patients seen in the last 24 months in each quarter with a decrease between March-June. This is indicates the number of patients seen in the previous 24 months was impacted by the closures for COVID-19 in England. There will be other factors which may impact the number of patients seen in the previous 24 months, shown by the fluctuations within the data before the decrease in March 2020.

Similarly, in March 2020 there is a decrease in number of adult patients seen in the previous 24 months when analysing the data reported monthly released in the publication

To estimate the difference in Patients Seen over the COVID-19 period in England, the number of adult patients seen in the previous 24 months from February 2020 (before COVID-19 closures) will be used as a baseline. This would approximately be the expected Patients Seen if the dental practices were not instructed to close.

The actual number of adult patients seen for each month affected by COVID-19 closures (March 2020 to June 2020) was subtracted from the number of patients seen up to 29th February 2020 to calculate the difference in the number of adult patients who were seen in the previous 24 month time period. The table below shows the Patients Seen for the months affected by COVID-19 closures and the calculated difference and percentage difference to February 2020.

June 2020 is the most recent data included in the publication and will reflect the patients unable to be seen during the previous months. Therefore, to the 30^th June 2020, it is estimated approximately 876,000 (4%) fewer adult patients were seen in the previous 24 months to receive NHS dental treatment.

The analysis can be used to calculated the estimated number of children seen in the previous 12 months in England. The chart shows the number of child patients seen in the previous 12 months for each month in this release.

The number of child patients seen in the previous 12 months up to 29th February 2020 (before COVID-19 closures) = 7,057,756

Using the actual number of child patients seen in the previous 12 months to 30^th June 2020, it is estimated approximately 758,000 (10.7%) fewer child patients were seen to receive NHS dental treatment.

Dental practices were instructed to close and limit treatment to urgent only to reduce the risk of transmission of COVID-19 between the 25^th March and 8^th June 2020. By  comparing the Patients Seen during the months affected by the COVID-19 closures from the Patients Seen in February 2020, the difference in the number of patients who were seen by an NHS dentist in England can be calculated.

To the 30^th June 2020, it is estimated approximately 876,000 (4.0%) fewer adult patients were seen in the previous 24 months to receive NHS dental treatment compared to 24 months previous to February 2020.

To the 30^th June 2020, it is estimated approximately 758,000 (10.7%) fewer child patients were seen in the previous 12 months to receive NHS dental treatment compared to 12 months to February 2020.

There may be a small over-estimate in these estimates due to longer term trends and fluctuations within the data though the scale of these changes are smaller than the changes presented above.