A contributed City Dental Care analysis · Featured in Dentistry.co.uk
Registered isn’t the same as seen
This month we counted our NHS list, not by the number registered with us but by the number we had actually seen.
City Dental Care is a mixed NHS and private practice in central Edinburgh, treating patients at this address since 1998, as City Health Clinic until a rebrand refocused it on dentistry.
One Edinburgh NHS list, September 2026
Share of our active NHS list, by when each patient was last seen.
Our two-year participation rate is 46%. The last group asked to join our NHS list and were taken on, but never sat in the chair. On our books they are NHS patients; in NHS Scotland’s terms their registration was never completed, because it is the first appointment that completes a registration, not the sign-up.
The national picture
Public Health Scotland’s report for the quarter ending 31 March 2026 asks the same question nationally.
Registered with an NHS dentist, against seen in two years
Scotland, quarter ending 31 March 2026. The track is everyone registered with an NHS dentist.
5,273,339 people are registered, an estimated 95.1% of the population. Of those, 3,273,405, or 62.1%, participated within the previous two years.
The gap is not spread evenly
Two-year participation, most deprived areas against least deprived.
Movement nationally is slow: 61.7% at 30 September 2025, 62.1% at 31 March 2026.
What participation measures
Registration measures reach. Participation measures use. A patient can be taken onto a practice’s NHS list and never sit in the chair, so the registration is never completed by a visit. Participation also measures NHS dental use rather than access alone: a registered patient who has not participated may have attended privately, moved away, died or chosen not to attend. The two million is a ceiling on the access problem rather than a measure of it.
That second condition is the one worth sitting with. A transfer is not completed by signing up somewhere else; it is completed by an appointment. Someone who registers elsewhere and never attends is still on our list, and still on the national one. A register cannot shrink through inactivity, which is part of why registration sits at 95.1% while participation sits at 62.1%. It is also why we could tell a patient last seen a decade ago, truthfully, that they still had a place.
What appears to be working
In September we wrote to our NHS-registered patients not seen for two years or more. It was a service recall rather than an offer: one plain line saying it had been a while and they were still registered with us, a welcome back with no comment on the gap, and a link to online booking.
Ten days of data from one list is an observation worth testing, not a result. Three things already in place look to be working to some extent.
What the people who came back actually did
Ten days of one recall. An observation, not a result.
| Behaviour | Share | What it suggests |
|---|---|---|
| Clicks falling between 3pm and 9pm | 55% | People deal with this after work |
| Went to the booking page rather than the phone | ~5 in 6 | Given the choice, they avoid ringing |
| Of those who booked, booked online themselves | ~2 in 3 | Reception time is not the constraint |
We are open until 8pm Monday to Thursday (until 5pm on Friday), and online booking runs around the clock. A book that closes at five gives an evening thought nowhere to go.
The third is automated recall. Alongside a one-off exercise like this, we run automated recalls out of the practice management system. We have no clean figure for them, and would not trust one drawn from a few days, but they produce bookings steadily for very little staff effort, in weeks when nobody is running anything.
Three changes worth making
Treat participation, not registration, as the access metric
A register says who a practice is responsible for. The appointment book says who it is actually looking after. Counting the second is a morning’s work.
Make the return effortless
Booking that does not depend on someone answering the phone, appointments after work, and no telling-off. Our recall said one plain thing, that the patient is still registered, and welcomed them back without a word about the gap.
The absence of reproach is part of the design rather than an afterthought. Someone who has stayed away for years is braced for a lecture, and the surest way to avoid one is not to come.
Say plainly whether your NHS list is open
Rather than leaving patients to guess: a guess usually resolves as no. Our own NHS list is open.
None of this closes a two-million gap. But on one Edinburgh list, four in ten patients had sat in our chairs and not returned within two years, and around one in eight had never come in. Registered isn’t the same as seen.
National figures are from Public Health Scotland’s NHS dental data monitoring report for the quarter ending 31 March 2026, published 26 May 2026; PHS lists its next release for November 2026. Written by Dr Hamza Al Haddad, Director, City Dental Care, Edinburgh. A contributed City Dental Care analysis, featured in Dentistry.co.uk.
City Dental Care’s NHS list is open to new patients in central Edinburgh.