Dental workforce challenges in rural England: Survey into recruitment and retention in Devon and Cornwall

Abstract

Abstract Introduction Devon and Cornwall have been identified as a “dental desert” with limited NHS dental access, high levels of oral health inequality and challenges in recruitment and retention of the dental workforce. Recruitment and retention of all members of the dental team has been identified as an important factor in the availability of dental services particularly within rural and coastal areas. During the last five years there has been an 8% decrease in the number of dentists working within the NHS in Devon, and although this may be due to a variety of factors, recruitment and retention appears to be key Aims The aim of this research was to explore the experiences of dental practices within Devon and Cornwall in relation to recruitment and retention of the dental workforce. Method A self-administered, online questionnaire was used to explore various aspects of recruitment and retention of the dental workforce in Devon and Cornwall. The questionnaire included categorical rating scale and free text question formats providing both quantitative and qualitative data. Rating scales were analysed using frequency analysis, and the free-text answers analysed using thematic analysis. Results 106 dental practices responded to the survey, providing a response rate of 36%. The vast majority of respondents (94%) considered recruitment and retention to be a major barrier to delivering NHS services. 77% of practices had a current staff vacancy; 57% had a dentist vacancy; and 48% had a vacancy for dental nurses. Thematic analysis led to identification of four main themes which were considered to influence recruitment and retention: NHS system; Economic Challenges; Logistics; Support Networks. The current NHS dental contract was identified as the main barrier in recruiting and retaining workforce within the NHS in the region. Other factors such as income generation, workload, economic challenges, geographic isolation, lack of support, training opportunities and career development were identified as important issues which affected both NHS and private practices in rural and coastal areas. Conclusion Recruitment and retention of the dental workforce is a major barrier to delivering oral healthcare services in the Southwest Peninsula. A large number of dental practices are failing to operate at capacity due to workforce shortages which is affecting both NHS and private practices. The situation is most acute in recruitment and retention of dentists and dental nurses, with NHS practices affected more than the private sector. Urgent action is needed at a local, regional and national level to avoid further deterioration.