Agenda item

This paper provides the Committee with an update on work being undertaken on oral health in the city, including work in schools, and oral health promotion programmes. Since April 2023 dental commissioning and policy is the responsibility of the NHS via the Integrated Care Board; the paper from the ICB at Annex C outlines the dental commissioning and contracting arrangements locally.

The Committee considered a report which provided an update on work being undertaken on oral health in the city, including work in schools and oral health promotion programmes. The Committee were joined for this item by Debbie Leadbetter, Primary Care Programme Lead (Dental and Optometry) for the NHS Humber and North Yorkshire Integrated Care Board (ICB), Jason Atkinson, Chair of the Humber and North Yorkshire Local Dental Network, and Mark Green, General Dental Practitioner.

Officers introduced the report, noting the council’s statutory oral health promotion responsibilities and outlining the work being done by the Oral Health Promotion Service in schools, workforce development, and collaborative work with the ICB and local and regional partners. They noted that dental access in York was below the regional average for adults at 39.7%, and above the regional average for children at 61.3%. Urgent care rates were higher in more deprived wards of the city with rates of routine care higher in less deprived wards. The proportion of the population on waiting lists for dental procedures was above the regional average, and while York had an above average number of dentists per head of population this included a mix of NHS and private provision.

Debbie Leadbetter outlined the Humber and North Yorkshire ICB Commissioning Overview (Annex C to the report), providing a summary of progress since the ICB had assumed responsibility for commissioning dental services from NHS England in April 2023. She noted the ongoing challenges to dental access, including a lack of flexibility in the existing NHS dental contract, and highlighted the importance of flexible commissioning in improving access to urgent care and for vulnerable groups. Jason Atkinson and Mark Green emphasised the impact of these developments from their experience as dental practitioners.

The committee discussed children’s oral health, including supervised toothbrushing schemes. These had been run by the Oral Health Promotion Service over the last year in six settings and feedback from schools and parents had been positive. Officers confirmed that a suitable provider had not been secured to undertake the National Dental Epidemiology Survey for five-year-olds locally, but a working group was looking at how this might be addressed on a regional basis for 2026. It was confirmed that there was good uptake across the city for Health Visitor reviews at 9-12 months, with accompanying oral health promotion. The ICB was also looking to commission child-only contracts to address gaps in access for children.

Members enquired about dental access for vulnerable groups. It was confirmed that until the ICB assumed commissioning responsibilities, dental services for care home residents had not been commissioned since 2006. Efforts were being made to encourage dentists to specialise in gerontological care, and the Oral Health Promotion Service was developing an offer aimed at older people, as well as expanding existing pathways for looked-after children. Technology was being used to improve translation services for patients who needed them.

The committee discussed the opportunities presented by the integrated care system reforms to transform healthcare in smaller communities around York. The visitors declared a willingness to participate in the creation of new primary care centres that might incorporate dental services, pharmacies, and GP surgeries on single sites as a way of better managing resources and ensuring residents had access to health services without having to rely on cars or limited public transport.

Officers and visitors responded to questions from the committee on urgent care provision and dental health inequalities. It was confirmed that there was not currently a dedicated emergency provider in York, but that flexible commissioning was being used by the ICB to bolster emergency care and to commission services located in areas of high need and higher deprivation. It was noted that better data was needed for a fuller picture of the extent of urgent need, as well as for tracking provision for shifting populations including students in the city. 

The Executive Member for Health, Wellbeing and Adult Social Care was in attendance and welcomed the progress that had been reported. She raised concerns around the impact of inequalities on emergency pathways with patients being sent out of York for support, the oral health of secondary school children, and access to dental provision for pregnant women.

[Cllr Healey left the meeting at 18:20, and Cllr Runciman left the meeting at 18:59. Cllr Coles was in attendance 18:08 – 19:12].

Resolved:

i.                To note the report.

ii.               To welcome the work of the ICB and partners to increase access to dental services.

Reason:     To support work to prevent dental decay and improve the oral health of our population.

[The meeting adjourned for a comfort break from 19:12 – 19:18].