Agenda item

The Committee received a presentation on the NHS Primary Care Dental Services and Dental Access Recovery (for copy of slides, see file of minutes).

Sarah Burns, Joint Head of Integrated Strategic Commissioning, County Durham Care Partnership, Durham County Council and North East and North Cumbria Integrated Care Board was in attendance to deliver the presentation that provided a summary overview of NHS Dentistry; out of hours urgent care services; challenges; NHS contracts; actions; dental access; further actions and next steps; advice for patients; oral health promotion strategy 2023-2028; water fluoridation and supporting background information.

Councillor Jopling indicated that this was down to contracts and asked the Officer if they were in a position to issue contracts or if these had to come from the government.

The Head of Integrated Strategic Commissioning responded that locally they could issue contracts, but it had to be within the context of the national contract. She commented that some of the measures announced earlier this week were designed to address some of those issues.

Councillor Stubbs referred to his knowledge of dentists and his own experience and indicated that he felt that dentists had already decided the future and any plans were a lost cause. He agreed with a number of things such as the promotion of oral hygiene that should be done through the NHS but indicated that the dentistry model had been decided. He commented that his own dental practice was now no longer an NHS dentist and you had to pay £23 a month. He asked for some reassurance that there was a future for dentists as he felt it was going to be a model like opticians where it was accepted that you pay for your appointments and glasses.

The Head of Integrated Strategic Commissioning responded that work was ongoing and had been for a number of years on the national reform of the dental contract that was needed. Locally they could not supersede that, but they could look at some of the measures detailed in the presentation such as commissioning the capacity to ensure it meets the needs, particularly in the underserved areas or people who depend on NHS dental care. They would look to see how they could attract dentists to work in the region and implement all of the sensible measures that they can that will help current NHS dentists remain. She stated as an Integrated Care Board (ICB) their role was to ensure that they had provision to meet the need and the NHS provides dental treatment for the population. She hoped that dentistry was not a lost cause and stated that they would work hard to ensure they do everything they can, and they understand where the gaps and the challenges are and targeting their resources where there were the greater inequalities, and they were looking to maintain services across the county.

In response to a further question from Councillor Stubbs, the Head of Integrated Strategic Commissioning stated that dentists were still committed to work in the NHS and some of the national announcements were moving us into the right direction.

Councillor Crute stated that he shared Councillor Stubbs concerns regarding dental services and that it was part of a wider issue within the NHS. He commented that the dental service needed to be reformed and he feared for the future of dentist and the lack of appointments. He referred to the government intervention and asked if there were any timescales for this and if there was any protection for existing patients.

The Head of Integrated Strategic Commissioning responded that they did not have timescales yet. She advised Members that Pauline Fletcher would be providing an update and summary to scrutiny committees across the region. She stated that there were ways to safeguard against patients being removed from a list.

Councillor Hovvels referred to fluoridisation in water that they did a lot of work on that was picked up by the Secretary of State that would have a massive impact in terms of health and asked about the timescales around this.

The Head of Integrated Strategic Commissioning indicated that they did not have timescales but as soon as they do, this would be shared with Members. She stated that the Northeast was priority for fluoridisation.

Councillor Crute referred to the pressure group who were against fluoridisation in water that had proven health benefits and asked if the pressure group were still active.

The Head of Integrated Strategic Commissioning advised Members that this moved from local responsibility to the Secretary of State and any representations would now go to the Secretary of State.

The Principal Overview and Scrutiny Officer confirmed that the Council had set up a joint Overview and Scrutiny Committee in 2019 on fluoridisation and several organisations attended the session and they did commit to further sessions once the position was clearer around fluoridisation. However the promotion of these schemes had now moved from the Local Authority to the Secretary of State. He anticipated that there would be an update on the oral health strategy at the March meeting that may include an update on fluoridisation.

Councillor Savoury stated that the dental practice in Weardale was full, and transport was an issue and families were disadvantage as they could not access dentists in other areas due to finances and stated that oral health particularly in children deteriorates quickly. She continued that when they do eventually receive treatment a lot of treatment is required and asked where the nearest urgent care centre would be for the Weardale area.

The Head of Integrated Strategic Commissioning advised that the urgent care centre would be Durham or Darlington.

Councillor Savoury asked if they could look at the dental services within the rural communities of Weardale.

The Head of Integrated Strategic Commissioning responded that this was one of the national announcements about improving access in rural communities. She advised Members that they had being looking at the transport offers in Durham and that they had a local volunteer driver service and were looking to see if this could be extended for dental treatment.

Ms McGee asked if the additional capacity would be focusing on urgent treatment and stated without the routine treatment this would increase the urgent requirement. She then referred to the early detection of mouth cancer that was detected by routine dental treatment. She then referred to other approaches to dental commissioning in other parts of the country such as Ipswich where the ICB have commissioned NHS practices with dentists who are salaried, taken away all the concerns about contracts and asked if they would use this approach.

The Head of Integrated Strategic Commissioning responded that she was not sure if this would work locally but a regional group were looking at how they could secure NHS services. They have salary dental services such as the community dental service, she was not sure if this would work for general dentistry. In terms of the oral cancer risk there has been a campaign locally to highlight the risks and signs of cancer to increase people’s awareness.

Resolved: That the contents of the presentation be noted.