Dentists' Working Patterns, Motivation and Morale - 2022/23

The primary source of data for this report is the Dental Working Patterns (DWP) Survey.

The DWP Survey was sent to all primary care UK dentists who conducted some NHS/Health Service work in 2022/23 (please see Annex A for a copy of the survey). Dentists answer questions about their working patterns, motivation, and morale.

Participation in the survey is voluntary. For the 2022/23 survey, on behalf of NHS England, the General Dental Council (GDC) sent invitational emails to dentists in England, Wales, Northern Ireland, and Scotland.

Dental Workforce data provided by each country, which contains dentists’ working activity and demographic information, was used to compile the population and weighting variables, as described in the Methodology section. A Glossary and an explanation of the dental and contract type classifications applicable in each country are available in the Glossary of Terms section.

The survey was conducted online and monitored by NHS England. Inbuilt validation rules ensured that all respondents provided a valid response to every applicable survey question. Some questions, such as those relating to business arrangements were not relevant to certain dentists and thus did not require a response from all.

Only those dentists who indicated they worked for the entirety of the financial year, excluding any annual leave, are included in the analysis; part-year dentists are excluded from the sample. The full-year populations used in this report were estimated from the survey response and will, therefore, differ from the dental populations presented in other NHS England publications. Up-to-date workforce numbers in England can be found at https://digital.nhs.uk/data-and-information/publications/statistical/nhs-dental-statistics. The sample and 'full-year’ population sizes are shown in Annex B .

• All results are estimates based on samples. These results are then weighted up to the dental population in each country and are, therefore, subject to sampling error which can occur because a sample population may not respond or behave in the same fashion as the entire population.
• Small dental populations for some subgroups mean that extreme values can have noticeable effects on the averages, and where results are based on small samples a footnote has been included. In such cases results may be subject to more uncertainty and differences may not be statistically significant.
• All averages are means.
• The majority of  values within tables are rounded and totals and differences may appear not to sum. This includes full-year population counts where given, as these are weighted estimates calculated from the entire population and from the proportion of dentists who responded to the survey and had worked for the full year discounting any annual leave taken.

When comparing these results to earlier years, it is important to note that for a variety of reasons, including changes in the survey administration, the response rate has decreased for most dental cohorts. However, the sample population has remained closely aligned to the overall population as detailed in Annex C  that discusses the representativeness of the survey. The Methodology section also lists changes to each iteration of the survey since it was first run in 2008. Whilst results for each country are shown in this report, it should be acknowledged that there are differences in dental contractual arrangements, which may affect the country specific results and mean that care should be taken when making comparisons between countries.

The results by country are presented in tables within the UK Timeseries Excel file as well as in the csvs and Interactive Power BI dashboard.

Weekly hours devoted to dentistry refers to the hours spent on primary care NHS/Health Service or private dentistry, and relates to both clinical and non-clinical work, including administrative and management duties. All survey respondents have undertaken some NHS/Health Service work during 2022/23 (for more detail in the report population, please refer to the Annex B.

The tables relating to NHS/private share consider dentists’ working patterns (as measured in the survey) comparing those who spend more of their time on NHS/Health Service work with those who spend more time on private undertakings. Due to differing contractual arrangements, results should not be compared across the four UK countries.

The motivation and morale questions were first added to the 2014 DWP Survey. Please see Annex D for further information on the development and analysis of the questions. The motivation and morale questions are listed below in Table 1 (please see Annex A for a copy of the entire survey). In built validation rules mean that dentists must answer every question to complete the survey, so the motivation data is not distorted by missing data.

^{1. Spoken recognition or acknowledgement (i.e. not financial) from colleagues.} 

^{2. Pre-tax income (after all expenses removed) for primary care dentistry)}

The analysis considers the responses to the questions in two main ways:

A. Individual Motivation Question Analysis

Results show the percentage of dentists who responded in each Likert category (‘strongly agree’, ‘agree’, ‘neutral’, ‘disagree’ and ‘Strongly disagree’) to each question. To help interpretation, responses to the two positive categories (‘strongly agree’ and ‘agree’) are then combined and an 'overall average' figure is also presented which is the average of the 'strongly agree' and 'agree' percentage scores for each question.  

Due to the low response rate to the 2022/23 Dental Working Patterns Survey, the multivariate analysis, that has been provided for all countries in previous years, has only been possible  for England this year. Please see the accompanying multivariate analysis csv that can be found on the Overview page of the report and Annex E for details of this analysis. For other countries, please see previous reports for this more detailed analysis.

A ‘motivation index’ is calculated for each dentist by taking the average score of their responses to the six motivation questions. Responses are scored from 0% for ‘strongly disagree’ in increments of 25 to 100% for ‘strongly agree’. The highest possible ‘motivation index’ for dentists is 100% and the lowest is 0%.

This is a different methodology to that used in the ‘Individual Motivation Question’ (and ‘Strongly Agree/Agree’) analyses. The average ‘motivation index’ considers the proportion of dentists choosing each Likert category (‘strongly agree’, ‘agree’ to ‘strongly disagree’) for every motivation question to represent all responses as accurately as possible.

The ‘motivation index’ allows the relationship between motivation and different working patterns such as weekly hours of work or NHS share to be explored using multivariate analysis. Details about the assumptions made to support this calculation are discussed in Annex D.

C. Morale

Unlike motivation, which is usually defined as an individual’s internal drive for behaving in a particular way, morale generally relates to feelings of satisfaction and confidence in life. Motivation and morale are often linked, but while higher motivation often leads to higher morale in individuals, high morale does not guarantee that individuals work more effectively even though they may have a positive attitude towards their work.

Because of the differences between motivation and morale, responses to the morale question are analysed separately.

Please note, all dentists who responded to the survey answered every motivation and morale question as well as the question on leaving general dentistry.