Agenda item

The Committee considered a report of NHS England and NHS Improvement – Midlands which provided an overview of NHS dental services commissioned in Leicester, Leicestershire and Rutland, and updated on the challenges and commissioning intentions to improve NHS dental services and oral health of the local population. A copy of the report, marked ‘Agenda Item 8’, is filed with these minutes.

The Committee welcomed Jane Green, Contract Manager – Dentistry and Optometry, and Tom Bailey, Senior Primary Care Contracts Manager both from NHS England and NHS Improvement – Midlands to the meeting for this item.

Arising from discussions the following points were noted:

(i)          Nationally, 50% of the population accessed NHS dentistry services, though the percentage varied for individual localities. Prevention work was a priority for NHS England and work was taking place to engage with those people that did not visit the dentist unless they had a specific problem. The Starting Well pilot had taken place in Leicester City due to its poor record on oral health but the pilot had not covered the rest of Leicestershire whereas the Healthy Teeth, Happy Smiles programme covered the county as well and had been supported by the Council’s Public Health Department, as had work on providing fluoride varnish for children.

(ii)         There were areas of Leicestershire which did not have good access to dentist services, and it was not uncommon that NHS practices would close in some localities and be replaced with private dentist practices leaving no NHS provision. The levels of access to dental services across Leicestershire could change throughout the year depending on capacity. Conversations were taking place with Healthwatch and the Leicestershire County Council Public Health Department to ascertain what measures could be taken to tackle the problem but ultimately it was down to contractors and providers where services were located. NHS England agreed that after the meeting members would be provided with details of the distribution of NHS dental contracts across the County.

(iii)       Concerns were raised that many patients were not aware that since April 2006 they were no longer registered to a dental practice and were only attached to a dental practice when they were in an active course of treatment. Patients might not be aware that if they could not get an appointment at their nearest practice they could go to other practices to receive services. This issue was explained on the NHS website but it was acknowledged by NHS England that more needed to be done to publicise the situation.

(iv)       There were orthodontic providers available in Leicestershire and pathways to those providers were accessible from primary care. However, there was a national recruitment problem and there could be very long waits for patients to access these services. Work was taking place with University Hospitals of Leicester NHS Trust (UHL) to address the issue and UHL was due to produce a business case for reopening the waiting list for orthodontic treatment. 

(v)        Concern was raised that it was not always clear to patients what they were being charged for when they received treatment at a dental practice. Reassurance was given that patients could apply under the low income scheme and get treatment at a reduced rate.

(vi)       NHS England were holding conversations regarding where dental services fitted into Integrated Care Systems with the hope that they could become a more integral part of the system.

(vii)     Ensuring that military personnel had access to dental treatment was part of NHS England’s national remit.

RESOLVED:

(a)        That the overview of the NHS dental services commissioned in Leicester, Leicestershire and Rutland, and the update on the challenges and commissioning intentions to improve NHS dental services be noted;

(b)        That NHS England and NHS Improvement – Midlands be requested to give consideration to how they can better inform the public that patients are no longer registered to a dental practice and are only attached to a dental practice when they are in an active course of treatment.