How will compulsory COVID vaccinations affect the current recruitment crisis in UK dentistry?

The year 2020 has been a tragic insignia of suffering, loss, and despair. We had a brutal usurper amidst us, wresting freedom and peace in the communities worldwide. For a good chunk of 2020, the public rhetoric surrounding this pandemic was combative. Politicians, health officials, and our country’s very best voiced their hopes on “crushing” the novel virus and the soaring mortality curves that came with it. 

In only a few petrifying months, the virus had taken hostage millions of people, killed thousands of others, tanked the global economy, undid years of progress on extreme poverty, and upended millions of people’s lives. Suffice to say, this was much more than just a health crisis – it was a social, economic, and human crisis.

Unsurprisingly, we are at year two of the COVID-19 debauchery and with the year’s end approaching at full speed, we might even be headed to the third consecutive year of a COVID-19 ridden society. This year, however, we have much to pin our hopes on. We’re better prepared this year, with effective vaccines soon circling every corner of the world. And even though we are now equipped with powerful antivirals to defang our newest collective nemesis, the cases are once again on the rise and has prompted fears of another big surge in the near future.

While the country has been bogged down by the pandemic, the dental industry has also endured a catatonic insult. A chronic workforce shortage, an impending recruitment complication, and the damaging timing of Brexit have all but weakened the foundations of dentistry. This has called for drastic measures, but it doesn’t seem like the bigger population are on board for it.

The UK government has issued a mandate to make the COVID-19 vaccinations compulsory for the NHS frontliners, including the dental staff. This was done in a desperate bid to boost uptake and reduce the impact of the new Omicron variant, currently spreading across a large number of countries. The latest figures show that around 90% of the NHS staff have received two doses of the vaccine but in other articles, the data is as low as 78%. 

The Vaccine mandate

The UK is ramping up its COVID vaccine booster campaign in an attempt to stymie the progress of the virus and its successive variants in the country. On 9 November 2021, the Health and Social Care Secretary, Sajid Javid, announced that all frontline NHS staff will be required by law to be fully vaccinated against COVID-19 by Spring 2022. The regulations, subject to parliamentary approval will come into force on 1 April 2022. 

The government claims that they have decided to implement this measure “in order to protect the most vulnerable patients, including those with disabilities, people with underlying health conditions and the older population, as they are at higher risk from COVID-19 and are more likely to use health and care services.”

Speaking in the House of Commons, Sajid Javid said that after considering thousands of responses to a consultation launched in the summer, they decided that the vaccine will be made mandatory for all caregivers. He added: “We must avoid preventable harm and protect patients in the NHS, protect colleagues in the NHS and of course protect the NHS itself .”

All staff who have face-to-face contact with patients will be required to be vaccinated unless exempt due to medical reasons. This new law will apply to all dental practices in England, undertaking CQC regulated activities. These measures of control will protect workers as well as patients by preventing unexpected absences that have already added enormous pressure on the hospitals, GP practices, and the NHS trusts.

Who will have to be double-jabbed?

Anyone in patient-facing roles, excluding those who are medically exempt, will have to be double-jabbed. This will include doctors, nurses, dentists, domiciliary care workers who provide in-person care to patients in their homes.

This mandate will also apply to anyone who may have social contact with patients, even if they are not directly involved in their care. This will include staff such as porters, receptionists, and caretakers.

Vaccine mandate for dentistry

Mandatory vaccinations, as we mentioned before, will apply to anyone who is performing a CQC regulated activity. It means that dental practices whether NHS, private, or mixed, will be in need of double vaccinations. COVID booster jabs are not part of the mandatory vaccinations.

Currently, 110,000 NHS workers are completely unvaccinated. This is almost seven per cent of the workforce. Around 30,000 of these will be exempt from receiving the vaccine, according to the Government’s figures. Roughly 22,000 are expected to take up the jab before the intrusion of the new law with compliance with the grace period between the vaccinations

This leaves an estimated 73,000 unvaccinated by April when the mandate takes effect. They will most definitely be facing the sack or redeployed to new roles that do not favour direct interaction with patients.

How will the jab mandate affect dentistry?

The government requests concerted compliance from the NHS staff to get their vaccinations as it remains the single strongest protection we currently have against COVID-19. While we can vouch for this attempt to obviate a re-collapse of the industry like the one we witnessed the past year, some are growing concerned about the impact these measures could have on staffing.

Tens of thousands of unvaccinated workers could lose their jobs with countless healthcare organizations facing a critical workforce shortage. The effect this could have can be damaging to the physical and mental wellbeing of the mass. Many dentists are losing goodwill for their jobs as this compulsory vaccination comes to fruition. Most importantly, people with disabilities will be hit the worst due to this dictation. 

In support of this, Dr Chaand Nagpaul, BMA council chair, said that although the Association is “pleased” the Government has decided to delay the policy until next year, they are concerned about the effect it could have on the dental service.

He had this to say about this pressing issue: “Even if a small number of staff were forced out of work because they are not vaccinated, this would have a big impact on a health service that’s now under constant pressure and already has more than 93,000 unfilled vacancies.

“There may be potential for some healthcare workers to move to non-patient facing roles, and we would urge employers to explore all possible options rather than lose staff completely.”

With the dental sector already facing staffing shortages and insurmountable recruitment issues, any reduction in the workforce will heavily impact the stability of this sector causing it to finally reach its tipping point.  

How bad is the UK dentist shortage?

The UK struggled to recruit qualified dentists in the past. According to the BDA, 68% of the dental practices in England alone struggled to fill and retain vacant posts for dentists in 2018. This pandemic has magnified this problem that was already very severe. According to the NHS, in some areas like West Suffolk, numbers have faced a crunch from 71 dentists per 100,000 people in 2020 to only 56!

Also according to the BDA, a staggering 35 million NHS dental appointments have been ‘lost’ in England alone since the beginning of lockdown in March last year. Most dental professionals are in tacit agreement with the claim that the pandemic virtually shut down dentistry last year. This is further supported by the fact that in May last year, 83,000 NHS dental treatments took place compared with the usual average of 3.3 million, according to Healthwatch England.

It has left a huge backlog of work, with some patients now being informed that they must wait up to three years for a routine appointment or six weeks for emergency care. Additionally, vacancies have been opening up rapidly with a mortifyingly low rate of applicants. In fact, one recruitment website reported a 46% rise in vacancies and a 72% increase in salaries for dental nurses this year as compared to 2020.

Even though the vacancies and salaries have been at a record high this year, fewer candidates are coming through the pipeline to meet practice needs. This recruitment disaster coupled with the damages of short staffing has no doubt crippled the dentistry sector. This might be the worst crisis has faced in its history.

Takeaway

Given the current staffing crisis in the NHS and the possible implications of introducing such new policies in the midst of winter pressures, we may be looking forward to a significant milestone in UK dentistry history. This could very well commensurate loss of capacity for dentists but the future effects are vague.

The vaccine has already had a significant impact on reducing the number of hospitalisations and deaths. Public Health England estimated that over 112,000 lives have been saved so far. This is why COVID-19’s trajectory hinges on the steps we take today so that we can adapt to living with the pandemic and in ways that make the coexistence much less taxing. 

References:

  1. British Dental Association (BDA), “England: Mandatory COVID vaccine for healthcare workers” –

https://bda.org/news-centre/latest-news-articles/Pages/England-Mandatory-COVID-vaccine-for-healthcare-workers.aspx

  1. General Dental Council (GDC), “COVID-19 vaccination guidance” –

https://www.gdc-uk.org/information-standards-guidance/covid-19/covid-19-guidance-from-the-gdc/covid-19-vaccination-guidance