Stelling Heidi, Brown Megan, Burford Bryan, Blaylock Paul, Vance Gillian
School of Medicine, Newcastle University, Newcastle, UK.
School of Dental Sciences, Newcastle University, Newcastle, UK.
BMC Health Serv Res. 2025 May 10;25(1):672. doi: 10.1186/s12913-025-12803-9.
NHS dentistry is experiencing significant recruitment and retention challenges, particularly in rural, coastal, and deprived urban areas. Issues have been exacerbated by the Covid-19 pandemic, leading to unequal distribution of dental professionals across UK geographies. Despite workforce policy initiatives, issues persist. This study explores factors influencing workforce sustainability in the North East of England - an under-served region of the UK.
Forty-six participants, including 30 dentists, 3 dental care professionals, and 13 managers, contributed to this study. Four focus groups were held at two events in July 2023 - one in the north of the region, and one in the south to enable broad stakeholder engagement and reflect the different geographies within the region. These groups generated qualitative data to elaborate on the factors influencing workforce sustainability and ideas for change. Analysis involved a codebook approach to thematic analysis.
Thematic analysis identified four key factors influencing workforce sustainability: careers, collaboration, costs, and contentment. Career development in a supportive learning environment was essential for professional growth and retention, yet systemic barriers hindered progression. Collaboration, both within dental teams and across regulatory bodies, played a vital role in improving job satisfaction and service delivery, but fragmented communication remained a challenge. Financial pressures, particularly rigid NHS contracts and inadequate remuneration, emerged as significant concerns impacting recruitment and retention. Contentment was shaped by work-life balance, professional recognition, and the ability to provide high-quality care without excessive bureaucracy. These systemic challenges collectively contribute to workforce instability, particularly in the North East.
Findings highlight critical systemic barriers that threaten workforce sustainability in NHS dentistry. Addressing career progression pathways, improving collaboration, reforming contracts, and enhancing professional support systems are essential for sector stability. Without coordinated action from employers and policymakers, NHS dentistry will remain unsustainable, necessitating urgent interventions to support workforce retention and service provision.
英国国民医疗服务体系（NHS）的牙科服务正面临着严重的招聘和留用挑战，尤其是在农村、沿海和贫困城市地区。新冠疫情加剧了这些问题，导致牙科专业人员在英国各地的分布不均。尽管有劳动力政策举措，但问题依然存在。本研究探讨了影响英国东北部（一个医疗服务不足的地区）劳动力可持续性的因素。
46名参与者为本研究做出了贡献，其中包括30名牙医、3名牙科护理专业人员和13名管理人员。2023年7月在两个活动中举行了四个焦点小组会议——一个在该地区北部，一个在南部，以促进广泛的利益相关者参与，并反映该地区内不同的地理位置。这些小组产生了定性数据，以详细阐述影响劳动力可持续性的因素和变革想法。分析采用了主题分析的编码手册方法。
主题分析确定了影响劳动力可持续性的四个关键因素：职业发展、协作、成本和满意度。在支持性学习环境中的职业发展对于专业成长和留用至关重要，但系统性障碍阻碍了职业晋升。牙科团队内部以及监管机构之间的协作在提高工作满意度和服务提供方面发挥了至关重要的作用，但沟通碎片化仍然是一个挑战。财务压力，特别是僵化的NHS合同和薪酬不足，成为影响招聘和留用的重大问题。满意度受到工作与生活平衡、职业认可以及在不过度官僚的情况下提供高质量护理的能力的影响。这些系统性挑战共同导致了劳动力不稳定，尤其是在东北部地区。
研究结果突出了威胁NHS牙科服务劳动力可持续性的关键系统性障碍。解决职业晋升途径、改善协作、改革合同以及加强专业支持系统对于该部门的稳定至关重要。如果雇主和政策制定者不采取协调行动，NHS牙科服务将仍然不可持续，因此需要紧急干预以支持劳动力留用和服务提供。
