Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.