The queue meandered into the distance, past offices, flats and houses; there were hundreds waiting, shoulder to shoulder, old and young.
But this patient crowd were not tennis fans outside Wimbledon or mourning the loss of a monarch or hoping to purchase a bottle of Prime – they were trying to register for an NHS dentist in England in 2024.
The scenes outside St Pauls Dental Practice in inner-city Bristol – where 1,500 patients were registered for NHS treatment in two days – became one of the defining images of the week.
They have been branded “a visual representation of the depth and scale of the crisis in NHS dentistry”.
The practice was previously a Bupa dental branch, which closed down in June last year. After a passionate campaign led by residents, it reopened under new ownership on Monday, with queues building as early as 5am and lasting well into Wednesday. At the same time, Rishi Sunak unveiled a £200m plan to restore NHS dentistry, which has been derided by professionals.
Second through the door was Carol Sherman, 59, who lives opposite the practice. In the cold and dark she took her place at 5am on Monday, her car parked close by as a safety measure.
“I was desperate and I thought I wanted to stand a chance to get it,” she said. “I thought the only thing to do is to get there.”
Just when the branch closed last June, she started experiencing “excruciating pain” in her teeth and was left with no choice but to go private, spending upwards of £500 on two fillings. She did not want to have to spend that again.
Sisi Hussein, 39, was several places behind Sherman in the queue. She arrived at 8am to find about 40 people ahead of her, and waited in line for five hours before getting registered at 1pm.
A St Pauls resident, she was an NHS patient under the previous Bupa ownership but since its closure she has moved between private practices seeking help. Hussein has spent about £600 on care for herself and her 16-year-old son.
Previously working as a cleaner at a bowling alley, she is on universal credit after tripping on a pavement and injuring her foot. She is also on a waiting list for physiotherapy so she can return to work.
Faced with persistent pain in her tooth, she was at a loss. “I just couldn’t afford it, I’d already spent all my money at the dentist,” she said.
During her registration check-up under the new ownership, she discovered her tooth would have to be removed, despite the money spent on private treatment.
“All the money I had spent on private treatment, it was a waste,” she said. “It was just really hard to find an NHS dentist. They were all full, not taking patients on. It was so hard.”
Later on Monday, Rose Robinson, 47, from St Werburghs, a neighbouring suburb, arrived at 11am and spent three hours in the queue before being told by police to go home after a fight broke out further up the line.
Determined to get a place, the healthcare assistant returned on Tuesday, when a ticketing system had been introduced, and spent 30 minutes in the queue before being registered.
She had been a patient under the previous ownership since she was a child but lost her place on their books during the pandemic after not booking an appointment for more than a year.
“I literally can’t afford private prices,” she said. “The same as many other people. So I was just praying that nothing would go wrong with my teeth.”
Something did. One of her back teeth is cracked, causing pain when she bites down. “I’m just avoiding chewing on that side completely,” she said, adding she now hopes to get it fixed.
Jen Witts, 43, joined the back of the queue around the same time Robinson went through the door and waited in the drizzle and cold for about two hours. She too was an NHS patient under the previous ownership and was able to get an appointment on the last day before it closed. The dentist identified a loose tooth, which they were unable to fix on the day, and it has remained loose.
“I literally thought, I’m never going to have an NHS dentist again in my life,” the charity mental health facilitator said. “It’s been a real cause of stress and worry because I can’t afford private and when I came out I just started crying. I was so overwhelmed.”
In the time the practice was closed, Witts moved to Saltford, a village east of Bristol, about 8 miles away. Even though St Pauls was the nearest practice accepting new adult NHS patients, Witts still felt some guilt. “Should I be trying? I did ask the dentist if it was OK my applying when I’m not local, even though I was a patient before. I work for a mental health charity in Bristol, so I kind of felt like I do my bit for the community.”
According to the British Dental Association, 23,577 dentists carried out NHS work in the 2022-23 financial year, the lowest number since 2012. The BDA says the £3bn dental budget has remained static for a decade, falling in real terms by more than £1bn since 2010. Four in five dentists in England are not taking on new NHS patients, according to analysis by the Labour party.
Of those the Guardian spoke to in the queue, all praised the Save St Pauls Dentists campaign for being instrumental in the return of the practice to the neighbourhood.
Before the branch closed its doors under the previous management, protests began outside on a weekly basis, the group held meetings with NHS officials and the housing sssociation, hundreds of pounds were raised, and its petition garnered more than 1,500 signatures.
Barbara Cook, a community artist and one of the campaign leads, said: “Campaigning works, it can work. Don’t just be beaten down and think you can’t do anything because now’s the time for us to stand up.”
Cook said campaigners were horrified by the closure. “We thought, if we let this go, it will be GPs next. Because we know to get an appointment with a GP is horrendous.”
She said the success of the group in working with public bodies showed what could be achieved if campaigners were not treated as “pesky protesters”.
The community mobilisation, combined with the power of social media and the huge demand for NHS dentistry created the perfect storm for this week’s scenes, according to the dentists and managers at the practice.
“The system is at breaking point, almost already broken,” said Gauri Pradhan, the principal dentist at the practice. “We need to fix it. I’m sure if there was better remuneration offered to the dentists people would look into getting back NHS contracts.”
Pradhan said it had been challenging to run an NHS contract – “We are all passionate about NHS dentistry, there is a sense of pride” – but reveals previous experiences have seen them running at a loss to cover the contracts, and pointedly refers to the work as “charity”.
Campaigners such as Cook are setting their sights on the wider issue.
“For me, it’s far from over,” she said. “The battle for dentistry, this is just like it’s only just begun.”
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