Agenda item

Implication of new NHS contracts and service implications

Presentation of David Gallagher, Executive Area Director (Tees Valley & Central) and Primary Care SRO

The Committee received a presentation from David Gallagher, Executive Area Director (Tees Valley & Central) and Primary Care SRO.  The presentation covered the challenges currently facing dentistry provision, progress made so far in recovering access to services, workforce resilience, improving oral health and information relating to a current consultation on fluoridation of tap water.

A number of challenges were highlighted in relation to the provision of dentistry services, including a national dental contract that has not been revised since 2006, the impact of covid on causing delays to treatment and routine appointments, a number of practitioners handing back contracts and a loss of time and resources through around 2.5k missed appointments.  It was noted that issues with dentistry access is a national problem and that, unlike being registered with a GP surgery, individuals do not have the same right of access to a NHS dentist list.

The Committee was advised that work was ongoing to tackle the challenges in dentistry in three phases: immediate action to stabilise services; a more strategic approach to workforce strategy and delivery; and developing an oral health strategy to improve oral health and reduce pressure on dentistry.  It was noted that there was no quick fix to improving access to dentistry.  A significant amount of time had been spent on stabilising services, but this was challenging with contracts being handed back.

The progress made so far in relation to recovering access to services included around £3.8m non-recurrent investment being available for 2023-24 and £7.5m recurrent funding earmarked for new dental contracts.  In relation to appointments, 15k additional appointment slots had been commissioned and 48.2k secured from existing practice capacity for patients in greatest clinical need.  Over 800 additional sessions had also been commissioned from dental out of hours providers until the end of March 2024.  Additional treatment capacity had also been commissioned, with 39,080 additional units of dental activity in 2023-24 and 53,537 additional units for 2024-25.

In relation to building practice and workforce resilience, there was a flexible commissioning scheme in place to provide a training grant to support employment of overseas dentists.  It was noted that this scheme represented a small part of addressing the overall staffing and retention of dentists.  Work was ongoing with local dental networks and committees to improve workforce recruitment and retention overall.

The Committee was informed that each local authority and its health and well-being board is responsible for their oral health strategy.  Key elements to improving oral health include supervised tooth brushing within schools and pre-schools, oral health training to health and social care staff and fluoride varnishing.  It was noted that there was a regional consultation currently being undertaken by government on expanding water fluoridation across the North East to reach an additional 1.6 million people.  It was noted that some areas in the North East are already covered by water fluoridation and the proposed scheme would cover Northumberland, County Durham, Sunderland, South Tyneside and Teesside, including Redcar and Cleveland, Stockton-on-Tees, Middlesborough and Darlington.  It was explained that water fluoridation is an effective and safe public health measure and can reduce the likelihood of dental decay and minimise its severity.  The consultation was on track to commence in early 2024 and would last for a minimum of 12 weeks.

Following the presentation Members were invited to ask questions or make comments on the information provided.  The following issues were raised and clarified:

-       It is currently challenging to find a dentist that is taking on NHS patients.  Information online in relation to practices with availability is not always up-to-date.  The recruitment of oversees dentists will help with accessibility but that is a small part of the overall recruitment and retention drive.  Identifying incentives to keep people working for the NHS is a priority, along with training a higher number of dentists to help the current shortfall.

-       In relation to the water fluoridation consultation, it was noted that the scheme would be funded nationally and not by local authorities.  It was discussed whether there were any harmful effects of water fluoridation and if a cost/benefit exercise had been undertaken.  It was noted that there is a cost/benefit element to everything but that there would be no impact on water quality and that the amount of fluoride that would be put into the water is under the maximum amount recommended by the World Health Organisation.

-       It was highlighted that dentists/dental nurses used to attend schools to demonstrate to children effective brushing of teeth.  It was noted that current workforce retention meant this was difficult to achieve but that knowing how to brush teeth properly was important.  It was also commented that the pandemic, and the backlog created as a result, had impacted on young children being routinely taken to the dentist.

-       It will be important to ensure that the needs of vulnerable groups in particular (including many elderly people) are addressed in securing access to routine dental treatment and that appropriate support is provided to such groups to do so.

The Chair thanked David for the information presented.

RESOLVED

i.              The presentation be noted

ii.             The Committee receive a further update on dentistry during the 2024/25 municipal year.