Presentation by the Senior Primary Care Manager (Primary Care Dental Commissioning Lead – North East and North Cumbria), NHS England – North East and Yorkshire – To Follow
Minutes:
The Senior Primary Care Manager (Primary Care Dental Commissioning Lead – North East and North Cumbria), NHS England – North East and Yorkshire, Chair of Durham and Darlington and Tees Local Dental Network and Consultant in Dental Public Health, NHS England – North East and Yorkshire gave a presentation (previously circulated) updating Members on NHS Dentistry in the Tees Valley.
In providing a summary overview of NHS dentistry, Members were advised that as part of the NHS Dentistry offer there was no formal registration of patients with dental practices and as such a patient could contact any NHS dental practice to access care; dental contracts and provision 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 as a result of the prolonged COVID-19 pandemic period and the requirement for NHS dental practices to follow strict infection prevention and control guidance, a backlog demand for dental care remained high with the urgency and increased complexity of patient clinical presentation.
Reference was made to the commissioned capacity for general dental services and Primary Care Orthodontic Services across the Tees Valley; Members were advised of the additional services commissioned by NHS England; Members were informed that Burgess and Hyder Group Partnership practice operating from Firthmoor Community Centre in Darlington had handed back their contract as of 31 March 2023; and that work was underway to try to replace the capacity as quickly as possible; a procurement was underway to increase capacity for Primary Care Orthodontic Services in Redcar and Cleveland. Details were also provided for the other services commissioned by NHS England.
The continuing pressures and challenges were outlined, these included Covid-19 impacts, dental workforce recruitment and retention and NHS dental contract and system reform, with details were provided of the national package of initial reforms to the NHS dental contract, which were published by NHS England in July 2022.
Details were provided of the local actions taken to date, including incentives for all NHS dental practices to prioritise patients that were struggling to access an NHS practice and that presented with an urgent dental care need; encouraging practices to maintain short notice cancellation lists; investment into the provision of additional dental clinical triage capacity; and additional funding made available to practices who were able to offer additional clinical capacity above their contracted levels. Members noted that this scheme was extended into 2022/23 and that 13 practices across the Tees Valley had signed up, an increase from 7 practices in 2021/22.
Members also noted that engagement had been undertaken with dental providers where contracts had been handed back and that interest had been generated following an improved offer; Darlington had been identified as a priority area for the recently launched workforce recruitment and retention initiatives; a funded advert had been placed in the British Dental Journal to attract overseas dentists into the area; and work was ongoing with Dental Clinical and Professional Leaders and Health Education North East Partners to further explore opportunities to improve dental workforce recruitment and retention.
Details were provided of the dental decay prevalence trend across the Tees Valley; Members noted the improvements from 2007/08 to 2016/17 and that the areas with lowest dental decay were those with fluoridated water supplies; reference was also made to the uptake of supervised toothbrushing programmes across the Tees Valley; and that a pilot safeguarding dental access referral pathway for children had been launched.
The next steps were outlined and included a review of the impact of the initial national reforms which were introduced from November 2022; the impact of the local initiatives; and continued work with local dental professional leads and wider partners to continue to explore local opportunities in order to improve NHS Dentistry access for patients. Reference was also made to the advice for patients and key messages.
Discussion ensued regarding the recruitment of overseas dentists; Did Not Attend’s; and Members raised concern regarding the number of Looked After Children (LAC) not receiving dental care. Members were informed that specific work was being undertaken with foster parents and LAC in relation to the barriers to access dental care and that the links with Virtual Heads would be explored.
Discussion also ensued regarding fluoridation, Members noted that this was one of the most effective ways to reduce dental decay in the population and that the Secretary of State for Health was progressing the agenda; and Members requested details of the schools that had signed up to the supervision toothbrushing programme.
RESOLVED – That the Senior Primary Care Manager (Primary Care Dental Commissioning Lead – North East and North Cumbria), NHS England – North East and Yorkshire, Chair of Durham and Darlington and Tees Local Dental Network and Consultant in Dental Public Health, NHS England – North East and Yorkshire be thanked for their informative update.