Summary of the Dental Results from the GP Patient Survey; July to September 2014

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1 Introduction Summary of the Dental Results from the GP Patient Survey; July to September Dental questions were originally added to the GP Patient Survey in January to March 2010, as the Department of Health wanted information on NHS dental access and demand for services based on people s reported experience. 2. The GP Patient Survey was chosen to capture this information as a portal to access the proportion of the population who do not use NHS dental services (or have not recently), to give a fuller picture of people s dental behaviour and experience. 3. This paper summarises the key findings of the July to September 2014 survey dental results and makes comparisons to the survey results from the same time the previous two years (July to September 2013 and July to September 2012). 4. Due to revisions to the questionnaire and methodology in 2011/12 comparisons cannot be made to previous years. The July to September 2014 GP Patient Survey is the sixth publication since these changes were made. General Survey Information 5. For the July to September 2014 GP patient survey 1.3 million adult GP patients were contacted and 425,000 replies were received. This represents a 32% response rate; a decrease of 2.0 percentage points compared to July to September 2013 results. 6. Further information on the GP Patient Survey and technical details regarding its collection and the weighting of the data, can be found on the GP Patient Survey Website at: 7. The reminder of this publication relates to the additional analysis carried out on the dental section of this survey. Figures are given to the whole percentage; however percentage change is express at the decimal point, for accuracy. 8. Survey region breakdowns are based on the address of the respondent and not the address of the dentist. 1

2 Key Findings Overall picture of respondents dentistry usage 9. The following graph (Figure 1) shows the overall survey population breakdown of dental behaviour in England. 100% 90% 80% 70% 60% 50% 40% 30% 20% Figure 1: Dental Attendance: Percentage of patients who have seen an NHS dentist in England in the last two years, and if not, the reason why; 10.4% 10.5% 10.7% 7.3% 6.9% 6.5% 7.6% 7.9% 8.4% 5.4% 5.0% 5.0% 8.9% 8.8% 8.7% 3.3% 3.1% 3.0% 57.1% 57.7% 57.7% Didn't try to get an NHS dental appointment in the last two years: Reason "I haven't needed to visit a dentist", "I don't like going to the dentist" Stayed with their dentist when they moved from NHS to private Prefer private dentistry Didn t think they could get an NHS appointment ¹ Other reason Did try to get an NHS dental appointment in the last two years Tried to get an NHS appointment in last two years but were unsuccessful Did have an NHS dental appointment in the last two years 10% 0% Jul-Sep 2012 Jul-Sep 2013 Jul-Sep Other reason includes: I no longer have any natural teeth, I haven t had time to visit a dentist, I m on a waiting list for an NHS dentist, NHS dental care is too expensive, Another reason. 10. Overall, just under three fifths (58%) of respondents from all English Regions stated that they had visited an NHS dentist in the last two years. Of the remaining, 11% didn t try to see an NHS dentist because they didn t need to go or do not like going and 8% didn t try because they prefer private dentistry. 11. The access to NHS dental care from the same period in 2012 to 2014 has been broadly stable with the number of respondents stating that they Did have an NHS dental appointment in the last two years increasing slightly to 58% in 2014 from 57% in The proportion of respondents who did have an appointment for 2013 and 2014 has remained the same. 12. The proportion of respondents who Prefer private dentistry has been on the increase and this could be explained by the benefits of improving economic fortunes which have resulted in households having more disposable income. 13. Respondents who Didn t think could get an NHS dental appointment have decreased to 5.0% of the respondents in the last two years from 5.4% reported in

3 Overall survey population breakdown of dental behaviour by region 14. The demand for NHS dental services shows regional variation in responses for those who tried to visit an NHS dentist in the last two years. London has the highest proportion of those who have not tried to get an NHS dental appointment in the last 2 years who stated that they didn t need to go or don t like going (15% of all respondents). 100% 90% 80% 70% 60% 50% Figure 2. Dental attendance: Percentage of patients who have seen an NHS dentist in the last two years, and, if not, the reason why by Region 15.3% 3.2% 9.9% 11.4% 7.7% 6.2% 9.9% 3.8% 8.6% 10.8% 10.8% 9.0% 6.6% 6.6% 8.1% 2.7% 7.5% 3.9% 8.5% 2.7% 5.8% 3.7% 8.1% 3.2% Didn't try to get an NHS dental appointment in the last two years: Reason "I haven't needed to visit a dentist", "I don't like going to the dentist" Stayed with their dentist when they moved from NHS to private Prefer private dentistry 40% Didn t think they could get an NHS appointment 30% 20% 10% 50.0% 54.1% 60.0% 62.6% ¹ Other reason Did try to get an NHS dental appointment in the last two years: Tried to get an NHS appointment in last two years but were unsuccessful 0% London South of England Midlands and East of England North of England Did have an NHS dental appointment in the last two years 1 Other reason includes: I no longer have any natural teeth, I haven t had time to visit a dentist, I m on a waiting list for an NHS dentist, NHS dental care is too expensive, Another reason. 15. South of England has the largest proportion of patients who sought private dental care at 20% with 9% of these respondents stating that they stayed with their dentists when they moved from NHS to private and 11% stating that they prefer private dentistry. 16. Demand for NHS dental services is highest in the North of England with 63% of all respondents stating that they had managed to get an appointment to receive NHS dental care followed by Midlands and East of England at 60%. Demand for NHS dental care remains lowest in London with only 50% of the respondents stating that they had managed to get an NHS dental appointment in the last 2 years. The low demand levels for NHS dental care in London could possibly be explained by the fact that most residents of London work in the South East of England and are likely to seek dental care in this region given the convenience of doing so. 3

4 Tried to get an NHS dental appointment % of all respondents tried to get an NHS appointment in the last two years, the maximum recall period recommended by NICE guidelines. This was a 0.2 percentage point decrease compared to July to September Of those that tried in the last two years, 53% had tried in the last year; 40% within the last six months and 24% in the last three months. 18. There are regional variations in demand for NHS dentistry services with demand being highest in the North of England at 66%. In contrast, demand levels to NHS dental services remain lowest in London at 54% followed by South of England at 57%. Successful in getting an NHS dental appointment 19. Of those that tried to get an appointment in the last two years, 93% were successful. The success rate (when excluding those who stated that they can t remember whether they were successful) was 95%, an increase of 0.2 percentage point when compared to July to September 2013 survey responses and an increase of 0.5 percentage points when compared to the July to September 2012 survey. 20. Those respondents who had not been to the practice before were less successful, at 76%, compared with 97% who were successful when trying to make an appointment at a practice they had visited before. 21. Lower levels of success were also reported by younger adults (as shown in figure 3) and ethnic minorities (figure 4). Figure 3. Percentage of those who tried to get an NHS dental appointment in the last two years who succeeded, by Age-band (including can't remember) 97% 96% 95% 94.8% 95.0% 96.2% 96.5% 95.1% 95.3% 94% 93% 92% 91% 93.1% 93.0% 90.6% 90.9% 90.4% 90.2% 92.0% 92.3% 93.2% 93.6% 90% 89% 88% 87% 86% Jul-Sep 2013 Jul-Sep 2014 Overall Jul-Sep 2013 Overall Jul-Sep The odds of failing to get a GP dental appointment are almost twice as likely for both ethnic minorities compared to the white majority and young adults compared to older agegroups (45-75+)². ²A logistic regression model was used to explore associations between success in getting a GP dental appointment and age or ethnicity. The results showed a statistically significant relationship at α=1% level. 4

5 23. Young adults aged between years who had been unsuccessful were more likely to be attempting to get an appointment at a practice that they had not been to previously, 51% compared to 46% of patients from all the older agegroups. 24. The results suggest that patients who have been to a practice before are more likely to be successful at getting an appointment. They also suggest that older people are more successful compared to younger adults. However, this might be a reflection that people who have previously been to a practice before are also older rather than the two characteristics of previous visits and age driving the chance of success separately. This can be tested using statistical analysis³. The results of this analysis suggest that we cannot say that age and previous visits are independent predictors of successfully getting an appointment. This could mean that older people are more successful than younger age groups because they are more likely to have gone to the practice previously. Figure 4. Percentage of those who tried to get an NHS dental appointment in the last two years who succeeded, by Ethnicity (including can't remember) 95% 94% 93% 92% 91% 90% 89% 88% 87% 86% 85% 84% 83% 82% 81% 80% 79% 94.1% 94.1% 89.2% 89.0% 86.9% 86.9% 85.9% 85.9% 81.2% 93.1% 93.0% 80.3% White Mixed Asian or Asian British Black or Black British Other Ethnic Group Jul-Sep 2013 Jul-Sep 2014 Overall Jul-Sep 2013 Overall Jul-Sep 2014 ³ The chi-square test was used to check whether younger people who failed to get a dental appointment were trying to get an appointment at a practice they had not been to before. 5

6 Regional breakdown of success rates 25. Regionally, the success rate in getting an NHS dental appointment for the 24-month measure was highest in the Midlands and East of England (96%). London has the lowest success rate (93%) of all the regions; however London s demographic makeup contains a high proportion of younger adults and ethnic minorities which contributed to this figure. All English regions recorded increases in the proportion of patients who succeeded in getting a dental appointment for the first two years (July to September 2012 and July to September 2013) with the exception of London whose success rate has slightly decreased from levels reported in The success rates for London have however remained the same for the most recent two years. 97% Figure 5. Success rate in getting an NHS Dental Appointment in the last 2 years (excluding can't remember) from 2012 to % 95% 94% 95.0% 94.8% 94.4% 94.2% 95.2% 95.1% 94.8% 94.8% 94.4% 95.4% 95.6% 95.7% 93% 92.8% 92.7% 92.7% 92% 91% London South of England North of England Midlands and East of England Jul-Sep 2012 Jul-Sep 2013 Jul-Sep 2014 England 2012 England 2013 England

7 Figure 6. Percentage of respondents who tried to, and succeeded in getting, an NHS Dental appointment in the last two years, at Clinical Commissioning Group (CCG) level July to September 2014 (excluding can t remember). 26. At CCG level, success rates in getting an NHS dental appointment range from 87% for NHS Newham to 99% for NHS Newbury and district. Figure 6 shows geographically the range of success rates at CCG level. 7

8 27. The top three CCGs with the highest success rates over the two-year period were NHS Newbury and district, (99%), South Tyneside (99%) and NHS South Cheshire (98%). 28. The bottom three CCGs with the lowest success rates over the two-year period were NHS Newham CCG (87%),NHS Corby(88%) and NHS Bradford City CCG (88%). Overall Experience of NHS dental services 29. Of the respondents that tried to get an NHS dental care in the last 2 years, 84% of respondents rated their NHS dental experience as positive, an increase of 0.5 percentage points compared to July to September % stated they had a very good experience, 0.7% point higher than the responses from the same period last year. Of the remaining responses 36% stated a fairly good experience, 9% of respondents stated it was neither good nor poor, and fairly poor and very poor had a 4% and 3% share of the total respectively. 31. Satisfaction rates with the overall patient experience of NHS dental care remain high in the North of England and Midlands and East of England with 86% and 85% respectively of respondents rating their patient experience as positive while London had the lowest with 81%, a 0.2% improvement from the previous year. All regions recorded increases in respondents who rated their patient experience as positive as compared to the previous year (see figure 7 below). 32. Patient experience is influenced by whether patients were successful in getting an appointment. Nationally, those who were successful in getting an appointment rated their patient experience as positive (88%), compared to only 20% of those who were unsuccessful. This in part explains the regional differences seen. 86% 85% 84% 83% 82% Figure 7. Positive experience of NHS Dental Services from all those who tried to get an NHS dental appointment in the last two years 2012 to % 83.8% 83.3% 81.7% 82.7% 83.9% 84.9% 84.9% 85.5% 84.5% 85.1% 85.3% 81% 80% 79.6% 80.4% 80.6% 79% 78% 77% 76% London South of England North of England Midlands and East of England % Positivity Jul-Sep 2012 % Positivity Jul-Sep 2013 % Positivity Jul-Sep 2014 Overall Jul-Sep 2012 Overall Jul-Sep 2013 Overall Jul-Sep

9 Did not try to get an NHS dental appointment 33. Just under two fifths (39%) of adults who responded to the survey had not tried to get an appointment with an NHS dentist in the last two years (figure 8). Over one-fifth (22%) of all respondents had never tried to get an NHS dental appointment, while 18% of respondents last tried over two years ago. 34. Regionally, the largest proportions of respondents who have not tried to make an NHS dental appointment in the last two years were seen in London and the Southern CCGs. NHS Central London (Westminster) had the highest proportion, with 38% of all respondents who had never tried in the two year period. In comparison, NHS Great Yarmouth & Waveney, in the Midlands and East of England, had the lowest proportion, with only 12% of respondents not attempting to get an NHS appointment in the last two years. 35. For the respondents who have never tried to get an NHS dental appointment, London and South of England had the highest proportions, accounting for roughly a quarter of respondents for each Region (28% and 24% respectively). 50% Figure 8. Percentage of respondents who did not try to get an NHS dental appointment in the last two years (more than two years ago and never tried) by Region 45% 40% 35% 30% 25% 21.8% 18.5% 19.6% 24.2% 27.9% 20% 15% 10% 5% 17.5% 15.7% 17.7% 19.0% 18.1% 0% England North of England Midlands and East of England South of England London More than 2 years ago Never Tried 9

10 Reasons for not trying to get an appointment 36. The main reasons stated by respondents for why they have not tried to get an NHS dental appointment in the last two years is I don t like to go or I haven t needed to go with just over a quarter (27%) of the respondents stating this reason (see figure 9) % of the respondents who didn t try to get an NHS dental appointment gave their reason as I didn t think I could get an NHS dental appointment. The proportion of people who gave this response has decreased by 0.1 percentage points compared to the previous year s results % of respondents did not try to get an NHS dental appointment in the last two years because they preferred private dentistry, an increase of 1.1 percentage points compared to the same period last year. Those respondents who stayed with their dentist when they moved from NHS to private made up 16% of all the responses submitted. It should be noted that there was a 1.1% decrease in respondents who stayed with their dentist when they moved from NHS to private. 100% 90% Figure 9: Proportion of respondents who did not try to get an NHS dental appointment in the last two years, by reason for not trying from 2012 to % 18% 16% Stayed with their dentist when changed from NHS to private 80% 70% 60% 19% 20% 21% 15% 15% 15% Prefer to go to a private dentist ¹Other 50% 40% 30% 20% 10% 8% 8% 7% 14% 13% 13% 26% 27% 27% No longer have any natural teeth Didn't think they could get an NHS dentist "I Haven't needed to go"/" I Don't like to go" 0% Jul-Sep 2012 Jul-Sep 2013 Jul-Sep Other reason includes: I no longer have any natural teeth, I haven t had time to visit a dentist, I m on a waiting list for an NHS dentist, NHS dental care is too expensive, Another reason 10

11 39. These two private dentistry reasons accounted for over a third of all responses (38%) of those who have not tried to get an NHS dental appointment in the last two years. However there are regional differences apparent, varying from 29% in London to 47% in the South of England (as shown in figure 10). Figure 10. Percentage of respondents who have not tried to get an NHS dental appointment in last two years as they went private 48.0% 46.0% 44.0% 42.0% 40.0% 38.0% 36.0% 34.0% 32.0% 30.0% 28.0% 26.0% 24.0% 22.0% 20.0% 28.7% 37.9% 37.7% 37.8% 28.6% 28.5% 33.7% 34.0% 33.8% 38.2% 38.1% 37.9% 46.2% 46.8% London North of England Midlands and East of England South of England 47.3% Jul-Sep 2012 Jul-Sep 2013 Jul-Sep 2014 To access the full dental results for previous years, please click on the following link: Contact For further information regarding these statistics, or for any comments on this publication, please contact the following address: gpsurveydental@dh.gsi.gov.uk 11

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