Agenda item

Presentation by Senior Primary Care Manager (Dental Commissioning Lead – North East and North Cumbria), NHS England and NHS Improvement – North East and Yorkshire and Chair of our Durham and Darlington and Tees Local Dental Network

The Senior Primary Care Manager (Dental Commissioning Lead – North East and North Cumbria), NHS England and NHS Improvement – North East and Yorkshire and Chair of Durham and Darlington and Tees Local Dental Network gave a presentation (previously circulated) updating Members on NHS Dentistry in Darlington.

In providing background on NHS dentistry, Members were advised that a patient could contact any NHS dental practice to access care; dental contracts were activity and demand led; contract regulations set out contract currency which was measured in units of dental activity (UDA) and these were attributable to a banded course of treatments; NHS dentistry regulations did not prohibit the provision of private dentistry by NHS dental practices; and in 2019-20 only 90.5 per cent of the total commissioned capacity in Darlington was being utilised.

Reference was made to the commissioned capacity as of August 2022 for general dental services; Members were advised of the additional services commissioned by NHS England; and Members were informed that Middleton St George Dental Practice handed back their contract in 2020. 

The pressures and challenges were outlined, these included Covid-19 impacts, workforce recruitment and retention and NHS dental contract; and details were provided of the package of initial reforms to the NHS dental contract, which were published by NHS England in July 2022. It was reported that engagement to inform the next stages of the reform programme had commenced.

Details were provided of the local measures and actions taken to date, including incentives for all NHS dental practices to prioritise patients that had not been seen in the practice within the previous 24 months (adults) and 12 months (children) who require urgent dental care; increased investment into the new Dental Out of Hours Service contract; and additional funding made available to practices who were able to offer additional clinical capacity above their contracted levels, of which take up in Darlington was limited to only one practice that delivered additional 15 sessions during February and March 2022.

The next steps to improve access to dental services were outlined and included a review of plans for the recommissioning of the activity lost from the Middleton St George NHS contract handback; seeking expressions of interest from NHS practices that may have the capacity and capability to deliver additional access as an interim measure to assist with the current demand for NHS dental care; and work with current practices to explore how NHS England can support them to maximise their clinical treatment capacity and make contracts sustainable in the long-term.

Scrutiny were assured that all NHS dental practices were able to safely provide a full range of treatments however demand for care remained extremely high with dental practices having to balance addressing the backlog of care with managing new patient demand; Practices had been asked to prioritise patients with the greatest clinical need; and opportunities were being explored to increase the clinical capacity available and improve access for patients.

Discussion ensued on the overall picture of dental practices in Darlington and which were NSH practices and the reasons why residents were having problems accessing dentists; and Members also requested some information on patients attending Accident and Emergency at the hospital to access care. 

It was generally felt that the more information and simple messages could be provided to residents to explain the reasons why access to dental practices was a problem; outlining the clinical definition for urgent care and also explaining that residents are able to contact any dental practice and that they are not specifically assigned to one would be helpful.  Members also expressed their concerns that the NHS Choices website was not kept up to date so that residents can have relevant information.

Further discussion ensued with the representatives from NHS England on how they were planning to encourage new NHS practices; what planning was being undertaken to allow for the infrastructure required within the Local Plan and further housing development; and what changes can the authority expect to see within the next six months.

Members were advised that NHS England priority was to ensure increased capacity for urgent care; source improved clinical capacity and progress procurement; support existing practices to deliver the current level of commissioned capacity; prioritise areas where greatest improvement needs to be addressed; and incentivise new providers.

RESOLVED – That the Senior Primary Care Manager (Dental Commissioning Lead – North East and North Cumbria), NHS England and NHS Improvement – North East and Yorkshire and Chair of Durham and Darlington and Tees Local Dental Network be thanked for their informative presentation.