NHS Shetland became aware on 8 November 2024 of Lerwick Dental Practice's decision to deregister some of its NHS patients.
As independent dental practices operate as private businesses, they have the freedom to make decisions about service delivery, including whether they treat patients under NHS regulations and on registering or de-registering NHS patients, which may not involve prior consultation. Unfortunately, NHS Boards are unable to control these decisions.
NHS Shetland Public Dental Service (PDS) is currently working at almost 50% less capacity than the pre-COVID workforce levels but has over 70% of the Shetland population registered with the service. Therefore, the PDS is only able to provide an emergency/non-routine service for the patients de-registered by Lerwick Dental Practice.
Across Scotland, the independent practice model provides up to 80% of primary dental care. However, we recognise that in Shetland, this model does not deliver the level of service required for the community.
In order to address the challenges faced in Shetland, we introduced the NHS Shetland 3-Phase Oral Health Strategy, which was approved in October 2023 by both NHS Shetland and the Shetland IJB. This strategy aims to re-focus NHS dental provision in a way that better serves the community. We are collaborating closely with the Scottish Government and are hopeful that this partnership will bring positive changes to Shetland’s dental services in the near future.
Although we are not yet at the required level of NHS service provision, progress is being made. There is ongoing recruitment of additional Dental Officers, and, in January 2025, we will also welcome Dr Heather Ballantyne as our senior clinician, who will bring valuable expertise to our team.
We have also made strides in other areas. Two orthodontic therapists embarked on a training programme earlier this year, strengthening our capacity to provide specialised care, and we recently held further mouth cancer screening clinics in Lerwick and Brae as part of Mouth Cancer Action Month.
Additionally, our Oral Health Improvement Team, who deliver the Childsmile programme, has achieved excellent results in the National Dental Inspection Programme (NDIP). Shetland has maintained a high level of decay-free children of Primary 1 age. The average figure of 80.4% decay-free has been consistent for a number of years and is evidence that the strong emphasis we put on oral disease prevention is working.
While challenges remain, please know that we are dedicated to improving NHS dental services in Shetland and will continue to prioritise your health and wellbeing as we move forward with these initiatives.