{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T23:29:20Z","timestamp":1775863760584,"version":"3.50.1"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T00:00:00Z","timestamp":1746835200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T00:00:00Z","timestamp":1746835200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Health Serv Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>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 \u2013 an under-served region of the UK.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>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 \u2013 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.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>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.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>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.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12913-025-12803-9","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T23:01:03Z","timestamp":1746831663000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Valuing and retaining the dental workforce: a mixed-methods exploration of workforce sustainability in the North East of England"],"prefix":"10.1186","volume":"25","author":[{"given":"Heidi","family":"Stelling","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan","family":"Brown","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bryan","family":"Burford","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Blaylock","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gillian","family":"Vance","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,5,10]]},"reference":[{"key":"12803_CR1","unstructured":"Bissett G. Dentistry Census\u2013 dentistry risks losing one third of UK\u2019s dental nurses in the next two years. Dentistry;\u00a02022. Available at: https:\/\/dentistry.co.uk\/2022\/02\/03\/dentistry-census-launches-taking-a-deeper-looking-at-dentistry-in-the-uk\/. Accessed 17 Oct 2022."},{"issue":"3","key":"12803_CR2","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1080\/14780887.2020.1769238","volume":"18","author":"V Braun","year":"2021","unstructured":"Braun V, Clarke V. One size fits all? What counts as quality practice in (reflexive) thematic analysis? Qual Res Psychol. 2021;18(3):328\u201352.","journal-title":"Qual Res Psychol"},{"key":"12803_CR3","unstructured":"British Dental Association. Nearly half of dentists severing ties with NHS as government fails to move forward on reform.\u00a02022. Available at: https:\/\/bda.org\/news-centre\/press-releases\/Pages\/nearly-half-of-dentists-severing-ties-with-nhs.aspx. Accessed 31 Oct 2022."},{"key":"12803_CR4","unstructured":"British Educational Research Association. Ethical guidelines for educational research. 4th edn. 2018. Available at: https:\/\/www.bera.ac.uk\/researchers-resources\/publications\/ethical-guidelines-for-educational-research-2018."},{"key":"12803_CR5","unstructured":"Burford B, Vance G, Abisola A, Rijula K. The Dental Workforce in Cumbria. Results of a survey and workshop: Health Education England - North East [PDF].\u00a02022. Available at: https:\/\/madeinheene.hee.nhs.uk\/Portals\/13\/Dental%20Workforce%20Survey%20Report%202022%20report%20Cumbria.pdf. Accessed 24 June 2024."},{"key":"12803_CR6","doi-asserted-by":"publisher","unstructured":"Davda LS, Radford DR, Scambler S, Gallagher JE. Accreditation and professional integration experiences of internationally qualified dentists working in the United Kingdom. Hum Resour Health. 2022;20(7):1-12. https:\/\/doi.org\/10.1186\/s12960-021-00703-y.","DOI":"10.1186\/s12960-021-00703-y"},{"issue":"6","key":"12803_CR7","doi-asserted-by":"publisher","first-page":"E17","DOI":"10.1038\/sj.bdj.2013.275","volume":"214","author":"TA Dyer","year":"2013","unstructured":"Dyer TA, Owens J, Robinson PG. What matters to patients when their care is delegated to dental therapists? Br Dent J. 2013;214(6):E17.","journal-title":"Br Dent J"},{"issue":"8","key":"12803_CR8","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1038\/s41415-023-5737-5","volume":"234","author":"D Evans","year":"2023","unstructured":"Evans D, Mills I, Burns L, Bryce M, Hanks S. The dental workforce recruitment and retention crisis in the UK. Br Dent J. 2023;234(8):573\u20137.","journal-title":"Br Dent J"},{"issue":"2","key":"12803_CR9","first-page":"1","volume":"231","author":"JE Gallagher","year":"2021","unstructured":"Gallagher JE, Colonio-Salazar FB, White S. Supporting dentists\u2019 health and wellbeing-workforce assets under stress: a qualitative study in England. Br Dental J. 2021;231(2):1\u201312.","journal-title":"Br Dental J."},{"key":"12803_CR10","unstructured":"Health Education England. HEE\u2019s Advancing Dental Care Review: Final Report. 2021. Available at: https:\/\/healtheducationengland.sharepoint.com\/Comms\/Digital\/Shared%20Documents\/hee.nhs.uk%20documents\/Website%20files\/Dental\/ADC%20Final%20report%20launch%20Sept%2021\/Advancing%20Dental%20Care%20Report%20Sept%2021.pdf. Accessed 31 Oct 2022."},{"issue":"12","key":"12803_CR11","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1038\/s41404-022-1817-5","volume":"35","author":"S Hearnshaw","year":"2022","unstructured":"Hearnshaw S. Flexible Commissioning-a new approach. BDJ In Pract. 2022;35(12):18\u201321.","journal-title":"BDJ In Pract"},{"key":"12803_CR12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12913-020-4980-6","volume":"20","author":"RD Holmes","year":"2020","unstructured":"Holmes RD, Burford B, Vance G. Development and retention of the dental workforce: findings from a regional workforce survey and symposium in England. BMC Health Serv Res. 2020;20:1\u201311.","journal-title":"BMC Health Serv Res"},{"key":"12803_CR13","unstructured":"Ministry of Housing, Communities and Local Government. English indices of deprivation.\u00a02020. Available at: https:\/\/www.gov.uk\/government\/collections\/english-indices-of-deprivation. Accessed 2 Mar 2025."},{"key":"12803_CR14","unstructured":"NHS England. Opportunities for flexible commissioning in primary care dentistry: A framework for commissioners. NHS England;\u00a02023a. Available at: https:\/\/www.england.nhs.uk\/long-read\/opportunities-for-flexible-commissioning-in-primary-care-dentistry-a-framework-for-commissioners\/. Accessed 10 Dec 2024"},{"key":"12803_CR15","unstructured":"NHS England. Long term workforce plan. 2023b. Available at: https:\/\/www.england.nhs.uk\/publication\/nhs-long-term-workforce-plan\/. Accessed 3 Oct 2023."},{"key":"12803_CR16","unstructured":"NHS England. NHS IMPACT Driver Diagram. NHS England; 2024. Available at: https:\/\/www.england.nhs.uk\/long-read\/nhs-impact-driver-diagram\/. Accessed 25 May 2024."},{"key":"12803_CR17","unstructured":"Office for National Statistics. Mapping income deprivation at a local authority level. 2019. Available at: https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/personalandhouseholdfinances\/incomeandwealth\/datasets\/mappingincomedeprivationatalocalauthoritylevel. 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Br Dent J. 2022;232(2):109\u201314.","journal-title":"Br Dent J"},{"issue":"6","key":"12803_CR20","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","volume":"19","author":"A Tong","year":"2007","unstructured":"Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349\u201357.","journal-title":"Int J Qual Health Care"}],"container-title":["BMC Health Services Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-025-12803-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12913-025-12803-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-025-12803-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T23:01:08Z","timestamp":1746831668000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmchealthservres.biomedcentral.com\/articles\/10.1186\/s12913-025-12803-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,10]]},"references-count":20,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["12803"],"URL":"https:\/\/doi.org\/10.1186\/s12913-025-12803-9","relation":{},"ISSN":["1472-6963"],"issn-type":[{"value":"1472-6963","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,10]]},"assertion":[{"value":"20 December 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was carried out in accordance with the British Educational Research Association [BERA] [] Ethical Guidelines for Educational Research, fourth edition, London (). This study also adhered to the principles outlined in the Declaration of Helsinki for ethical research involving human participants. Ethical review and approval were given by the ethical committee of Faculty of Medical Sciences, Newcastle University, (reference 2313\u20133). Informed written consent was obtained from all the participants in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"672"}}