Agenda item - Dental Services in the Covid Emergency

1.1         This item was presented by Mark Ridgeway, NHS England Dental Commissioner.

1.2         Mr Ridgeway explained that NHSE commissions NHS primary and acute dental services. Where dental practices are commissioned to undertake NHS dentistry, they do so via a contract for a specified level of activity. This is negotiated with each individual practice.

1.3         The Covid crisis impacted access to dental services, with practices closed between March and June 2020. Practices were still able to offer general and analgesic advice and to prescribe ant-biotics in this period. Urgent dental care hubs were established, as were services for the most clinically vulnerable.

1.4         Practices re-opened in June 2020, but with significantly reduced capacity due to additional hygiene requirements (particularly with regard to aerosol procedures) and the difficulty of sourcing some specialist PPE. In consequence, practices focused on urgent needs.

1.5         NHSE has offered additional funding for Sussex dental practices to undertake additional NHS hours, but take-up of this offer has been relatively low, with practices citing safety and staffing issues.

1.6         Not all practices who undertake NHS dentistry have met their activity requirements in the past year due to the impact of closures and reduced capacity. However, practices have been paid the full amount they were entitled to under their NHS contracts in order to help them remain financially sustainable. Practices are required to meet at least 60% of their contracted NHS activity this year.

1.7         In response to a question from Cllr Deane on in-reach into care homes, Mr Ridgway responded that there had been some in-reach for urgent needs, although only limited services could be delivered in this way.

1.8         In answer to a question from the Chair on community dental services, Mr Ridgeway confirmed that Sussex Community NHS Foundation Trust holds the contract for Brighton & Hove.

1.9         In response to a question from Fran McCabe on when services could be expected to return to normal, Mr Ridgeway responded that this was dependent on national guidance. Currently, the local requirement is that practices deliver at least 60% of their contracted NHS capacity this year.

1.10      In answer to a question from Fran McCabe on how people can get help with urgent dental problems if they cannot contact their dental practice, Mr Ridgeway stated that all dental practices should be contactable and able to offer advice. NHSE will follow-up if they become aware that any practice is not meeting its contractual responsibilities to NHS patients.

1.11      In response to a question from Cllr McNair on recruitment in Brighton & Hove, Mr Ridgeway told members that there should not be any particular recruitment problems associated with the city.

1.12      In answer to a question from the Chair on whether the local dentist/patient ratio was improving, Mr Ridgeway responded that it was, in part due to the launch of a new dental service in Moulescoomb. Mr Ridgeway also agreed to follow-up on a query from the Chair as to whether the new service currently has any dentists operating.

1.13      The Chair noted that there was a perception that practices are prioritising their private work over NHS dentistry. Mr Ridgeway responded that NHSE has no means of auditing private dental work as this is not within its jurisdiction, but that it is working with practices to ensure that they meet their current targets for NHS activity.

1.14      Fran McCabe noted that Healthwatch are getting a number of reports of people being told that there are no NHS appointments available for them, but that private appointments would be available. Mr Ridgeway responded that this is something that NHSE are looking into. There are financial penalties if practices fail to meet their NHS activity targets (i.e. currently 60% of their contracted NHS activity).

1.15      The Chair suggested that the HOSC should schedule an update report within the next 12 months and should look specifically at community and children’s dentistry in the next 6 months.