Agenda item

This report is for information, sharing a report from Healthwatch York about the availability of NHS Dentistry in our city.

The Board considered a report for information from Healthwatch York about the availability of NHS Dentistry in the city. The Manager, Healthwatch York was in attendance to present the report and respond to questions.

Key points raised during the presentation of the report included:

·        People seeking NHS Dentistry services are the most common calls Healthwatch York received.

·        Healthwatch York undertook a 2 month consultation with local dentists, from which they determined that it was not possible for people to find an NHS dentist in the city.

·        It was believed that the creation of integrated care systems provided an opportunity for creating a strong voice of healthcare professionals to lobby for change of dental contract commissioning at national level.

·        Oral health should be linked to other key issues through the integrated care systems, such as weight management, smoking cessation, cancer awareness/detection, mental wellbeing and self-confidence.

·        The four areas for action detailed in the report:

a.   Rapid and radical reform of the way dentistry is commissioned and provided.

b.   Tackling the twin crises of access and affordability, with particular emphasis on addressing health inequalities

c.   Improving the clarity of information about NHS dentistry

d.   Consideration of the role of dentistry to support people’s overall health, harnessing opportunities such as the integration of health and care through Integrated Care Systems arrangements, to link oral health to other key issues such as weight management, smoking cessation, cancer awareness and detection, and mental wellbeing.

Key points raised by Board members included:

·        That it was especially worrying that children were unable to access dentistry.

·        Dentistry has been a priority of City of York Council for a number of years, for example the creation of an Oral Health Improvement Group to work on an Oral Health Improvement Strategy which was led by Public Health and chaired by a local dentist. This work was put on hold as a result of the pandemic but was being relaunched.

·        City of York Council’s Health and Adult Social Care Policy and Scrutiny Committee had been examining dental care as an area of concern for some years, and had decided to look at the issue in more detail at the January 2022 meeting, with the dental commissioner for NHS England and Chair of the Oral Health Improvement Group were to be invited to these discussions.

·        Despite attempts to improve dentistry service in the city, it was acknowledged that the issue could not be resolved locally. Lobbying the Chief Dental Officer, Government and MPs was one way of raising awareness of the issue.

·        Between March and June 2020, the NHS dental service was only for urgent cases, with phased re-opening of the service thereafter; it was reported that the service was operating at 60% capacity in September 2021.

·        The ability for dentistry to meet local needs was hampered by the fact that it was commissioned by national contract.

·        Health inequalities, especially for those with mental health issues and learning disabilities were being exacerbated by the lack of NHS dental services.

·        A consequence of the absence of dentistry was that patients would present themselves to GPs or A&E with dental problems, who should not be treating dental issues, but have been forced to prescribe medication for them. This also added to the pressure to general health services. Exact figures of A&E attendance for dental issues were to be brought to a future meeting.

·        It was also noted that a large proportion of calls to 111 were related to dentistry issues.

·        Many dentists are unhappy with the way dentistry is commissioned, it was suggested that the Board should lobby for an oral health protection service delivered by dentists, instead of the current commissioning by units of dental activity.

·        There was a Healthwatch England convened meeting with representatives from Healthwatches around the country and NHS England. Many of the issues York faced were experienced throughout the country. It was reported there was an appetite for a national campaign to reform dentistry.

·        It was suggested that lobbying could be conducted through the Local Government Association, that a letter should be written to the Secretary of State for Health and Social Care and the Chief Dental Officer.

Resolved:

i.             That Healthwatch York’s report, NHS Dentistry: A Service in Decay be received and noted.

ii.            That the Director of Public Health write to the Chief Dental Officer and/or the Secretary of State to express the Health and Wellbeing Board’s concerns

iii.          That the Director of Public Health contact the Local Government Association to see if their HWBB support function could be used to lobby on behalf of HWBBs across the country in relation to access to dental services

Reason: To keep up to date with the work of Healthwatch York.