DENTAL leaders have urged ministers to fix Scotland’s “broken payment system” as figures reveal that NHS activity was more than 60 per cent lower in some areas last year than it was before Covid.

Statistics for January to November last year, provided by health boards under freedom of information, show that dentists submitted around 3.2 million claims for NHS work compared to 5.6m in 2019 - a decline of 43 per cent.

The steepest reductions in the number of claims were seen in the NHS Dumfries and Galloway region - down 55% to around 62,000 - and in NHS Orkney where there were 64% fewer NHS dental claims compared to 2019.

NHS Shetland also saw a 53% drop.

Previous analyses found that four in five dental practices in Scotland were not accepting new NHS patients.

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Covid measures which had limited the numbers of patients who could be seen during the pandemic were rolled back in Scotland last April, with dentists initially reimbursed by the Government on a ‘multiplier’ rate of £1.70 for every £1 of NHS work completed.

Although this was associated with a spike in activity, critics said it was “easily exploitable” because it encouraged dentists to prioritise simple procedures - such as one-off appointments which they could be reimbursed for immediately - rather than more complex courses of treatment which might take months to complete.

The multiplier was subsequently cut to 1.3 in July, then 1.2 in October, which practitioners said would not be enough to even cover the cost of carrying out denture repairs on the NHS given spiralling inflation. As of January, the multiplier fell again to a 1.1 rate.

READ MORE: 'Exploitable' payment system criticised by dental leaders 

HeraldScotland: Dental claims (lodged by dentists on completion of treatment) rose sharply in April but have remained at a similar level since then. The next set of official statistics are due to be published by PHS on Tuesday Dental claims (lodged by dentists on completion of treatment) rose sharply in April but have remained at a similar level since then. The next set of official statistics are due to be published by PHS on Tuesday (Image: PHS)

After the spike in activity in April, dental claims on NHS Scotland have plateaued at around 300,000 per month compared to 500,000 pre-pandemic.

From April 2023, the multiplier is due to be removed altogether.

The British Dental Association warns that without reform away from the fee-per-item model to an alternative that covers the costs of treatment and practice running costs, Scotland faces an “inevitable exodus of dentists from the NHS”.

Robert Donald, chair of the British Dental Association’s Scottish Council said: “Dentistry in Scotland is still lightyears away from business as usual.

"Ministers pledged free NHS dentistry for all, but to keep that promise they need to fix a broken system.

“Dentists are struggling, facing demand that can’t be met, with some NHS treatments already being delivered at a loss.

"They need to know that come April they will see real change, not just see the last safety net pulled away.”

READ MORE: Statistics mask reality of a shrinking NHS dental service 

Alex Cole-Hamilton, leader of the Scottish LibDems - who obtained the FOI data - said: “Today’s revelations are a painstaking indictment of this government’s failure to support NHS dentistry.

"Many will worry that dental work is only available to those who can afford to pay privately.

“Scottish Liberal Democrats previously discovered that some people have been so desperate they are choosing to turn to DIY dentistry. That is nothing short of appalling.”

A spokeswoman for the Scottish Government said it had provided dentists with funding “to address the cost of living crisis” and is “working with the sector on payment reform on top of the £150 million to protect services during the pandemic”.

She added: “Official statistics show considerable progress in getting back to levels comparable with before the pandemic and that our support maintained dentist numbers.

“ We want to be as inclusive as possible with a recent consultation looking specifically at cutting the complexity of NHS dentistry fee claims.”