HSC dental report

1. Health and Social Care Committee
NHS Dentistry
Ninth report of Session 2022-23

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Health and Social Care Committee – NHS Dentistry
● On 11 July 2023 the Health and Social Care Committee’s report on NHS
Dentistry was published. The opening paragraph reads
“NHS dentistry is facing a crisis of access, resulting in a decline in oral health.
The Government needs to undertake urgent and fundamental reform if people
are to receive the dental and oral healthcare they need.”
● The report looks at the areas of Access, the Dental Contract, Workforce and
Integrated Care Systems and makes 16 recommendations to the
Government, NHS England and Integrated Care Boards (ICBs)

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Access
Issues Recommendations
Not everyone can access a
dentist, or a dentist close to them
The ambition that every patient should be able to see an NHS
dentist, must ensure that the access is within a reasonable
timeframe and distance
The ambition should be the central tenet of the government’s
forthcoming dental recovery plan
Patients are not aware of how
dentistry works or what they are
entitled to
Patient information campaign to improve awareness of how NHS
dentistry works and what they are entitled to, such as registration,
recall intervals and exemptions from patient charge revenue
Patients being seen more often
than necessary
Practices should abide by NICE guidelines on patient recall
intervals.
Where a patient has not been seen for a period, not to be
automatically removed from a practice list without good reason

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The dental contract
Issues Recommendations
Dental funding Dental funding, including any underspend should be permanently
ring fenced in the ICB budget so it cannot be diverted away from
dental services, with checks in place to ensure compliance
Fundamental reform of the
contract is essential and must be
urgently implemented
Urgently implement a contract with a move away from the current
UDA system to a system with a weighted capitation element, which
emphasises prevention and person-centred care
Lessons should be learnt from the dental contract reform and a new
contract designed in full consultation with the dental profession
Patients are not registered with a
dentist
Registration for dental patients should be reinstated

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Workforce (1)
Issues Recommendations
Lack of understanding the
number and whole-time
equivalency of dentists and
dental care professionals
undertaking NHS work
Commission a whole dental workforce survey, including full and part-
time equivalents, NHS and private activity alongside demographic
data
Lack of data for use in workforce
planning and gap analysis
The collection of routine data and data on demand must be
improved. The data collections should be part of the Government’s
dental recovery plan.
Use of skill mix Reformed contract must ensure the full use of the skills of the whole
dental team

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Workforce (2)
Issues Recommendations
Dentists and dental care
professionals are leaving the NHS
and the profession or not joining
the NHS at all
Incentives put in place to attract and retain workforce, such as
payments for NHS commitment, audit and peer reviews and late
career retention payments.
Consideration to developing a careers framework, including
ongoing education, supervision and support.
These areas to form part of a communications drive for
professionals to return to NHS dentistry
Difficulties in overseas dentists
registering with the General
Dental Council (GDC)
Government must work with the GDC, so the backlog of
applications is cleared in a timely manner
To speed up the changes to the processes for new applications
(work that is currently underway)

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Integrated Care Systems (ICS’s) (1)
Issues Recommendations
Representation of dental
profession within the Integrated
Care Boards (ICBs)
The dental profession should be represented within ICB
membership so that they have the expertise to inform decision
making on dental contracting and flexible commissioning
opportunities and should include engagement with the profession
locally
Understanding of current the
memberships of ICBs
Accept the recommendation in the ‘Integrated Care Systems:
autonomy and accountability’ report so that the specific role and
areas of expertise of ICB members is collected centrally and is
known at a national level.
The information collected to be used to decide if the current policy of
keeping mandated representation to a minimum is correct and
whether areas are under-represented

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Integrated Care Systems (ICS’s) (2)
Issues Recommendations
Using the opportunities of
flexible commissioning
NHS England should provide to ICBs, information and evidence of the
effectiveness of existing flexibly commissioned services to allow for
informed local decision making
What are the opportunities of
flexible commissioning
NHS England to provide ICBs with clarity on what flexibilities they
have in commissioning NHS dental services, for use in targeting
resources to the needs of their population
Understanding the needs of the
local population
By end of July 2024, all ICBs to have undertaken an Oral Health
Needs Assessment (OHNA). This work to be supported by NHS
England such as by sharing examples of best practice and learnings.
NHS England to ensure each OHNA is sufficient to meets it’s
intended purpose

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Contact us
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any impact it may have on planning for the future, please contact us at
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