Dear All,

Some of you might be already aware that our paper on NHS dentistry has generated
a very good national press coverage
today (see the Telegraph, the Guardian, the Daily Mail, and the Evening Standard
issues of today 10 May 04, among
others). I have been even contacted by Sky News TV for an interview. The paper
has been published today and is
available from:
Boulos MNK, Phillipps GP. Is NHS dentistry in crisis? 'Traffic light' maps of
dentists' distribution in England and
Wales. International Journal of Health Geographics 2004 May, 3:10
http://www.ij-healthgeographics.com/content/3/1/10
http://www.ij-healthgeographics.com/content/pdf/1476-072X-3-10.pdf

The paper has caused quite a stir in the press (and elsewhere :-); following are
some of the reports you can read
online:
http://www.dailymail.co.uk/pages/live/articles/health/thehealthnews.html?in_arti\
cle_id=301251&in_page_id=1797
http://politics.guardian.co.uk/publicservices/story/0,11032,1213260,00.html
http://www.dailymail.co.uk/pages/live/articles/health/thehealthnews.html?in_arti\
cle_id=301297&in_page_id=1797
http://icwales.icnetwork.co.uk/0100news/0200wales/tm_objectid=14226458&method=fu\
ll&siteid=50082&headline=map-reveals-
how-desperately-short-of-nhs-dentists-wales-is-name_page.html (long URL; may
wrap)
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2004/05/10/ndent10.xml&sShe\
et=/news/2004/05/10/ixhome.html
http://iccheshireonline.icnetwork.co.uk/0100news/0100regionalnews/tm_objectid=14\
227006&method=full&siteid=50020&headline
=town-with-fewest-dentists-name_page.html (long URL; may wrap)
http://www.thisislondon.co.uk/news/articles/10664552?source=Evening%20Standard
http://news.google.com/news?hl=en&edition=us&ie=ascii&q=nhs+dentists

An important point to note (also mentioned in our paper) is that a dentist
holding a GDS (General Dental Service)
contract to provide NHS services has no commitment at the present time to
provide specific levels of service, and may,
in fact, provide extremely limited access to NHS care and only have a small
number of NHS patients. The main problem
this paper is trying to highlight is that NHS work is not attractive enough to
dentists who are increasingly preferring
more lucrative private work. It is also hoped that our small GIS exercise in
this paper will act as another "proof of
concept and benefits application", which is much needed today to convince more
people about the value of GIS in health
and healthcare in order to gain and sustain proper support, and secure further
funding for wider and much better
coordinated GIS programmes within the NHS.

The original press release is pasted below.

With kind regards,
--Maged N Kamel Boulos

Press Release
NHS dentistry in crisis as UK lags behind Europe and US
Less than 4 NHS dentists per 10,000 people in England and Wales

The shortage of NHS dentists in the UK was dramatically illustrated this
week by an article published in International Journal of Health Geographics.
The 'traffic light' maps show shockingly low numbers of NHS dentists across
England and Wales, with only 26 of the 304 English primary care trusts and
none of the Welsh local health boards comparing favourably with other
European countries and the US.

On average there are 3.7 NHS dentists per 10,000 people in England and 3.6
NHS dentists per 10,000 people in Wales. This compares with over 5 dentists
per 10,000 people in Austria, Italy and Poland, 6 per 10,000 in the USA and
9 per 10,000 in Finland.

The maps colour primary care trusts red, amber or green according to the
number of NHS dentists per 1000 people employed. They show that the
availability of NHS dentists varies between regions, with the highest
density occurring in Westminster (8.8 dentists per 10,000 people) and the
lowest in Ellesmere Port and Neston (1.6 dentists per 10,000 people)*.

"Dentists tend to be concentrated in major cities and urban centres and away
from some of the deprived or less populated urban and rural communities,"
write the researchers.

The authors of the study, Maged N K Boulos and Guy Picton Phillipps, created
the maps using population data from the 2001 Census, and numbers of
practicing NHS dentists in England and Wales provided by the Dental Practice
Board. The data from England was collected on 31 December 2002, but since
then the number of dentists with NHS contracts in the country has only
increased by around 0.9%.

"Programmes are urgently needed to increase the numbers of dentists, and to
make NHS work more attractive to them" say the researchers. They suggest
that the Government should set targets to increase the provision of NHS
dentists to 5 dentists per 10,000 people at the very least (since NHS
dentists are not serving their target populations full time), and to provide
better payment schemes to dentists.

Increasing the overall figure of NHS dentists by just 1 dentist per 10,000
people would require around an extra 5250 dentists. "Such large figures
could be met in the short term by improving programmes to attract more
dentists to undertake NHS work and relying on suitably qualified foreign
dental graduates," suggests Boulos and Phillips.

Another short-term remedy would involve reallocating dentists from areas
with a surplus to neighbouring areas where a shortage has been identified.
The 'traffic light' maps will help pinpoint areas where this solution could
work. For example, dentists could be assigned from Cambridge City primary
care trust where there are 6.5 dentists per 10,000 people to also serve the
rural South Cambridgeshire primary care trust, which employs 1.6 dentists
per 10,000 people.

The authors believe that the situation could be even worse than their maps
indicate. "A dentist holding a General Dental Service contract to provide
NHS services has no commitment at the present time to provide specific
levels of service, and may in fact provide extremely limited access to NHS
care, with only a small number of NHS patients."

To get an accurate picture of the provision of NHS dentistry across England
and Wales further research is needed. An investigation to ascertain the
proportion of NHS to private work that dentists in each primary care trust
perform must be carried out.

# # #
* Lists showing the five best and worst regions in both England and Wales
with regard to numbers of NHS dentists are included in the study

Interactive versions of the maps are available online at
http://healthcybermap.org/PCT/dentists

# # #

This press release is based on the following article:

Is NHS dentistry in crisis? 'Traffic light' maps of dentists' distribution
in England and Wales
Maged N. Kamel Boulos and Guy Picton Phillipps
International Journal of Health Geographics 2004, 3:10
To be published 10 May 2004

Upon publication this article will be available free of charge according to
International Journal of Health Geographics' Open Access policy at:
http://www.ij-healthgeographics.com/content/3/1/10

Prior to publication, the full text of this article can be viewed by
journalists under embargo at
http://www.ij-healthgeographics.com/imedia/1331745172341850_article.pdf

# # #

For further information about this research, contact either Maged N Kamel
Boulous at M.N.K.Boulos@... or Guy Picton Phillipps at
Guy.picton-phillipps@...

Alternatively, or for more information about Open Access publishing, contact
Gemma Bradley by email at press@... or by phone on +44 207 323
0323

# # #

International Journal of Health Geographics
(http://www.ij-healthgeographics.com) is published by BioMed Central
(http://www.biomedcentral.com), an independent online publishing house
committed to providing Open Access to peer-reviewed biological and medical
research. This commitment is based on the view that immediate free access
to research and the ability to freely archive and reuse published
information is essential to the rapid and efficient communication of
science. BioMed Central currently publishes over 100 journals across
biology and medicine. In addition to open-access original research, BioMed
Central also publishes reviews, commentaries and other non-original-research
content. Depending on the policies of the individual journal, this content
may be open access or provided only to subscribers.


--Maged N Kamel Boulos
PhD, MSc (Med Informatics), MSc (Dermatol & Venereol), MBBCh
Lecturer in Healthcare Informatics
School for Health (http://www.bath.ac.uk/health/)
University of Bath
WH 6.10, Claverton Down, Bath BA2 7AY, UK
Telephone: +44 (0) 1225 384204
Fax: +44 (0) 1225 383225
E-mail Address: M.N.K.Boulos@...
Home Page: http://staff.bath.ac.uk/mpsmnkb/
Editor-in-Chief, Int J Health Geogr (peer-reviewed, indexed in PubMed)
http://www.ij-healthgeographics.com (with RE Hoskins, PhD)

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