NHS Dental Statistics: Data Quality

This publication allows commissioners and policy makers to monitor levels of service delivery to target groups, highlighting changes over time. It provides information to the Department of Health and Social Care and local NHS managers, allowing for monitoring of the provision of dental services and dental expenditure, and helping to inform planning.

The annual publications (previously quarterly and biannual) include information on activity and patients seen, orthodontic data, clinical treatment data, information on patient charges and dental workforce statistics.. The activity data monitors levels of activity across treatment bands, highlighting changes in practice over time. The key use of the patients seen data is to monitor the effectiveness of the current dental contract.

Provisional activity data was previously published in the mid-year publication and adjusted to provide the estimated final position for national data. Adjustment methodology and factors are published in the guide to dental publications that accompanies the report.

• final activity data are published in the annual report
• patients seen data are all final data and are published in the annual reports (previously quarterly/biannaul)
• final data on orthodontics, clinical treatment and patient charges are published in the annual report
• figures for patient charges may be slightly lower than expected as information is not collected from closed contracts, although the volume of these is limited.

This publication is classed as Official Statistics and the publication date was pre-announced. There was no gap between the planned and actual publication date.

• activity data are published four and a half months after the end of the relevant financial year.
• patients seen data are published one and a half months after the end of the relevant financial year.
• patient charges, orthodontics and clinical data are published four and a half months after the end of the financial year.

This publication combines data in table format, commentary and supporting information. The data are freely available via the NHS England website.

Additional information is provided in Excel format at sub-national level, including csv files which are suitable for further analysis.

The activity, patients seen and patient charges data covers the period of the current dental contract (introduced in 2006 and revised in 2012) and are not comparable with other previous contracts. The methodologies are consistent with those used by the Welsh Assembly Government. Information was first published in 2008-09 on orthodontic activity. Orthodontic patients are included in the patients seen measure.

The clinical data are a national time series which began in 2008-09. This data is not comparable with clinical data from the previous contract.

Prior to 2011-12, the dental statistics were published as ‘Experimental Statistics’.

In April 2019 there were changes to the regional arrangements of NHS bodies, including CCG mergers and the creation of new NHS commissioning regions. These changes limit the capability of mapping dental practices within time series.  Read more about changes to regions and CCGs. 

Data for 2014-15, 2015-16, 2016-17, 2017-18 and 2018-19 was under-reported due to known data quality issues resulting from a change in the FP10 form (advanced mandatory services). These issues are being rectified and data will be published in due course. Consequently, data for the five years highlighted are not comparable with other years.

The data are published as soon after year end as possible. Time is allowed for analysing and producing the report without impacting on the timeliness of the data.

During each publication cycle data quality is assessed by the collection team and the publications team and, where queries arise, data suppliers are contacted to validate and confirm data submissions. Comments can be received through various media modes:

email: [email protected]

telephone: 0300 303 5678

All NHS England publications encourage on line feedback via a ‘Live Chat’ link on the right of web page. This feedback is used to help assess users’ needs and whether this report meets them.

This data is collected by NHS Dental Services, part of the NHS Business Services Authority (BSA). The majority of the information is collected electronically and data are made available to us for publication as a by-product of these processes. The current contract is designed to simplify data collection requirements.

The data contained in this publication are Official Statistics. The code of practice is adhered to from collecting the data to publishing: 

All publications are subject to a standard NHS England risk assessment prior to issue. Disclosure control is implemented where judged necessary.

For more detailed descriptions of datasets used in the NHS England dental publications see the beginners guide to dental data, included in the publication.

Please see links below to the relevant NHS England policies.

Statistical Governance Policy

Freedom of Information

On the 25 March 2020, dental practices were instructed to close and defer routine, non-urgent dental care including orthodontics and establish remote urgent care services to limit the transmission of COVID-19. The restrictions included:

•        Cease all routine dental care (including orthodontics) (UK-wide)

•        Cease all aerosol generating procedures (UK-wide)

•        Offer patients with urgent needs appropriate advice and prescriptions over the phone (UK-wide)

•        Cease all face-to-face urgent care (England, Scotland)

Due to the COVID-19 restrictions the number of FP17 and FP17W claim forms and therefore, the totals regarding activity, patient numbers, finances and  treatments, will be much lower than traditionally expected for the final quarter of 2019-20 and the entire 2020-21 financial year. It is anticipated the number of children patients will be impacted the most. Dental practices could commence opening from 8th June 2020 for all face to face care, including non-urgent treatment and where practices assessed they had the necessary safety requirements in place. Information about instructions from NHS England can be found online.

Dental headcount (2020/21)

The annual 2020/21 publication covers the first year of the coronavirus pandemic that has had a large impact on the healthcare profession. In terms of NHS dentistry, most practices were closed between April and June 2020 and some dental practitioners were redeployed to help with the initial Covid-19 response whilst others faced a longer layoff due to shielding and/or sickness. Although practices started to reopen from June 2020, increased fallow time between treatments and reduced minimum thresholds for NHS dental activity, potentially mean that not all dental practitioners returned to primary care dentistry during 2020/21. This may have contributed to the decrease in the overall dental headcount figure.

Below is a list of known data quality issues and their impact on the published data.

The NHS Business Services Authority (BSA) identified an error in the reporting of the number of dental patients seen figures affecting the period December 2020 to March 2022. During the period affected by the Covid-19 pandemic many dental practices began triaging patients to determine the required care. Patients who were only triaged do not meet the criteria for a patient having been seen however they were incorrectly included within the counts of patients seen from December 2020 to June 2021 and as a result the published counts in the 20-21 biannual report, and 20-21 annual report are approximately 0.4% higher than they should be at a national level. 

The NHS BSA have corrected this reporting error and NHS England have republished corrected data for December 2020 to June 2021 in the 21-22 biannual report, published in February 2022.

Further to this, this issue was also found to impact the data from July 2021 to March 2022 and NHS England have theerefore republished corrected data as part of the annual 22/23 report published in August 2023.

Due to the way data are collected, the 18-64 adult patients seen age band is a derived field i.e. 18-64 is derived using the following calculation:
18+ age band - (65-74 age band + 75-84 age band + 85+ age band)

Due to a reporting error, a number of contracts record values for the 18+ age band which are lower than the sum of the 65-74, 75-84 and 85+ age bands , resulting in negative values for the derived 18-64 age band. The impact of this on aggregate figures is very low.

From November 2022, NHS England introduced changes to UDAs awarded for some Band 2 claims. Any Band 2 claim with a Date of Acceptance on or after Friday 25 November 2022 will be split into three categories:

• Band 2a
• Band 2b 
• Band 2c

Any Band 2 course of treatment or UDA which started prior to 25 November 2022 will still be recorded as 'legacy' Band 2 activity. As courses of treatment can span many weeks/months/years it is possible for courses of treatments which concluded after 25 November 2022 to still be recorded under the 'legacy' band 2 treatment band, rather than the newly implemented Band 2a, 2b or 2c sub-bands. 

For further information please see: https://www.nhsbsa.nhs.uk/units-dental-activity-uda-changes-band-2-treatments-friday-25-november

Please note that 'legacy' band 2 activity is a derived field i.e. legacy band 2 is derived using the following calculation:
Legacy band 2 - (band 2a + band 2b + band 2c)

For a small proportion of dental contracts the UDA value will be negative. Negative UDA occurs when FP17 forms are revoked for example due to them being submitted against the incorrect contract number; in this example they would then be re-submitted on another FP17. This affects a very small proportion of contracts and has a minimal impact on aggregate figures.

Some contractor tags and practice codes have several names associated within the mapping file and therefore appear to have duplicate rows. This is due to name changes which occur mid year.

Band 2 activity undercounting - December 2019 - March 2022

The NHS Business Services Authority (BSA) have identified an error in the data provided which underpins the NHS Dental Statistics publication from December 2019 to March 2022. Some data for adult patients in receipt of income-related Employment and Support Allowance (ESA) who received Band 2 dental treatment were not included and therefore the published counts are lower than they should be. 

The NHS BSA have quantified the impact of this missing data and have ascertained that the missing data accounts for <3% of all band 2 activity, and <1% of activity across all treatment bands.

Please note that no other treatment bands are affected, nor are data pertaining to patients seen, or clinical activity.

Due to the scale of this issue we will not be publishing corrected versions of this data. This issue will be rectified for data in the 2022/23 Annual publication.

3 errors were identified with the NHS Dental Statistics published in August 2023 and NHS England have therefore republished corrected data on 27/10/2023. The details of the errors are listed below:

1. An error regarding the mapping from dental contract to local authority (LA)  meant that some counts of dental activity/patients seen were allocated to the wrong local authority (LA). This is due to the fact that mappings are done from practice postcode to Lower layer Super Output Area (LSOA ), and then from LSOA to Region, Integrated Care Board (ICB) and LA separately. The use of the latest LSOA population data from 2020 (which uses 2011 LSOAs) and the more recent 2021 LSOAs to do the mapping ultimately caused a mismatch in some of the allocations in the underarching mapping data.

This has now been rectified for the following files:

• • Activity: geo_dental_activity.csv (2018/19 – 2022/23)
  • Charges: geo_dental_charges.csv (2018/19 – 2022/23)
  • Clinical: geo_dental_clinical.csv (2018/19 – 2022/23)
  • Orthodontic: geo_dental_orthodontic.csv (2018/19 – 2022/23)
  • Patients seen: geo_dental_patients_seen.csv (2018/19 – 2023/24)
  • LA activity and patients seen data in excel: dental_geographical_breakdown_22_23.xlsx (tables 1c, 1f, 2c, 2f, 3c and 3f)

Please note that only the LA data has changed within these files; the ICB and Region data remains unaffected as these mappings were correct. The overall national counts are also unaffected, it is purely the allocation of the activity/patients seen to the correct local authority which was affected

2. Due to the mapping error described above, the population counts which are used to determine the proportion of the population who have been seen by an NHS dentist were incorrect whereby the population counts were lower than they should have been. This impacts the population data for all geographies (ICB/Region/LA and National) and also impacts the proportions of patients who were seen within the recommended time frames as these calculations use the population as the denominator.

This has now been rectified for the following files:

• • Population data: Dental_national_overview_22_23.xlsx (tables 4b and 4d)
  • Population data: Dental_geographical_breakdown_22_23.xlsx (tables 3d, 3e and 3f)
  • Patient seen population CSV: geo_dental_patients_seen.csv (2018/19 – 2023/24)

At National, Regional, ICB and LA level this causes changes in the proportion of the population seen by an NHS dentist in the recommended timeframe depending on the area. The smaller the geographical area, the larger the impact of this error. The file below details the scale of these changes at each geographical level for June 2023.

3. An 18-64 age band was identified as being incorrectly included in the contract level patients seen file for 2019/20 for the months April, May and June 2019; additional age band breakdowns other than 18+ were only introduced in July 2019. This age band has been removed for the affected months within the dental_patients_seen_2019_20.csv file.