Agenda item

This report provides Members with an update on the provision of NHS dental services in York.

Consideration was given to an update report on the provision of NHS dental services in York. The report was part of ongoing consultation between Members and the various Health Trusts.

Members were reminded that at their meeting on 3 December 2007 they had requested the inclusion of the following information in future updates:

·        Information from the Office of National Statistics on numbers of people who did not see a dentist at all.

·        How long patients waited to be allocated an NHS dentist and how much additional capacity was being created as opposed to additional capacity being made available when patients moved on.

·        A report back on progress with commissioning a Sunday morning emergency dental clinic.

Amanda Brown, Assistant Director of Commissioning and Service Development – PCT, attended the meeting and gave Members a short presentation on the provision of NHS Dental Services in York (copy attached to minutes).

The presentation related to the North Yorkshire and York commissioning plans. She reported that the Oral Health Commissioning Group had reviewed commissioning across North Yorkshire relative to population, density and deprivation. This information was then matched to numbers on the dental access database; the exercise had identified geographic areas where commissioned access was below average in England.

Points that she raised included:

·        The maps detailed the existing contracted levels in North Yorkshire and these showed that the York area was generally well served;

·        York had 4 units of dental activity per person commissioned;

·        Provision was not as good west of the city and in the rural areas;

·        People who worked in York but lived outside the city were taking up dental care in York;

·        The PCT were looking to commission services in other areas to create capacity in York;

·        Dental Access Database – over 2000 patients had been assigned to a dentist between September 2007 and May 2008, with a further 1200 being assigned since May;

·        65% of the population sought an NHS dentist with the remainder being split between private care and those using emergency services;

·        Confirmed that the PCT had no records of how many patients were visiting private dentists;

·        The out of hours dental service was not adequate in York, there was only a Saturday and Sunday morning service available but this was currently under review;

·        Confirmed that the PCT hoped that patients would sign up with a dentist for preventative care rather than only using emergency services;

·        A unit of dental activity was the contract currency with dentists (NHS treatment broken down into 3 bands 1 unit for examinations, x-rays, scale and polish, 2 units for fillings and 3 units for crowns and bridges);

·        2006/07 - 50% of contact work had not been completed. Some dentists had been asked to complete the work the following year and others had had the money clawed back;

·        Patient’s time on the waiting list had reduced; the original wait had been 6 months;

·        Confirmed morale of dentists was pretty poor generally across the country.

Members made the following comments:

·        There had been a downward trend in people accessing the NHS Information Centre since March 2007;

·        Dentists income guarantee was to be lost in 2009 how would this be managed;

·        Requested details of the Local Clinics network and the recommendation from the Select Committee that Consultation Committees should be established;

·        Patient Charge Revenue questioned York’s figures;

·        Controls in place to prevent dental patients walking in off the street to register rather than adding their name to the waiting list. Felt that the figures of those patients added to the list and those assigned were not realistic;

·        Concern at how the service could be expanded when there were no controls over dentists or incentives to retain them;

·        There were insufficient dentists wanting to perform NHS work (75% of dentists under 25 years did not want to take on NHS work);

·        Disappointment that the dental update information had been requested from the PCT some 7 months ago;

·        Felt that dentists did not like the UDA system or the quality of work they had to perform;

RESOLVED:     (i) That the update and presentation from the PCT be noted;

(ii)       That a further update on dental services in the York area be added to the work plan (date to be confirmed by the Chair);

(iii)     That written updates be provided by the PCT in advance of future meetings.

REASON:                  In order to carry out their duty to promote the health needs of the people they represent.