Agenda item

(To receive a report from NHS Dental Services, which provides the Committee with an overview of Dental Services in Lincolnshire.  Carol Pitcher, Primary Care Senior Contract Manager, NHS England and Jason Wong, Local Dental Network Chair for NHS England Central Midlands, will be in attendance for this item)

The Chairman welcomed to the meeting Carole Pitcher, Primary Care Senior Contract Manger, NHS England – Midlands and East (Central Midlands) and Jason Wong, Local Dental Network Chair, NHS England, Central Midlands.

In guiding the Committee through the report, reference was made to the local context with regard to commissioning and dental care services.  It was reported that there were 71 contracts providing dental services in Lincolnshire, a breakdown of how these services were provided was shown on page 54 of the report.

It was highlighted that following the outcomes of the Oral Health Needs Assessment, agreement had been made for the commissioning of new contracts as part of the dental procurement programme to improve access to general dental services in priority areas.  These were highlighted as being Boston, Lincoln, Sleaford and Spalding.  Details of the Dental Procurement across Lincolnshire and Leicestershire were shown on page 60 of the report; and results of the procurement process were shown on page 61.  It was highlighted that preferred bidders had not been identified for Louth and the Skegness/Spilsby areas as the bids evaluated had not met the financial sustainability requirements.

It was also highlighted that the new services identified for Boston, Spalding and Johnson Community Hospital had not commenced in January 2019, as originally planned.  The Committee was advised that NHS England were disappointed not to have the new services in place for January 2019.  It highlighted that the preferred bidders had been unable to find the workforce required to operate these services safely.  The Committee was advised further that local providers in Spalding had confirmed that they were able to continue to provide urgent dental services as an interim measure; and two dental sessions a week were being provided from the Johnson Community Hospital Dental practice; and that this arrangement would run until January 2020.  The Committee was advised that care taking options were currently being reviewed for the provision of NHS dental services in the Mablethorpe area.

It was reported that the NHS England Local Office had offered Lincolnshire dental providers the opportunity to bid for additional non-recurrent activity to improve access to NHS dental services, whilst longer term commissioning plans were considered.  It was noted that the outcome had been the award of non-recurrent activity equating to an additional capacity for approximately 5,000 patients in Gainsborough, Skegness, Spilsby, Lincoln, Boston and Spalding.  The Committee was advised that following the results of previous procurement, the Local Office was planning to re-procure the NHS dental services for Spalding, Boston, Louth, Spilsby/Skegness and Mablethorpe in 2019.

The Committee was advised that Lincolnshire did not have the number of dentists it required; and as a result steps were being taken to up skill the existing workforce.  Details of dental foundation training were shown on page 57 of the report. 

The Committee was advised that all dentists' delivering services as part of an NHS contract were required to be registered with the General Dental Council, and needed to be included onto the national performer list to ensure they were suitably qualified and trained to deliver NHS dental services.

The Committee was advised further that dental recruitment and retention nationally was an increasing pressure; and that NHS England and Local Dental Network (LDN) were exploring a number of options to develop a workforce strategy to improve recruitment and retention of the dental workforce in Lincolnshire.  This work included flexible commissioning; peer mentoring schemes; increasing the number of foundation dentists, dental core trainees and leadership fellows in Lincolnshire; as well as considering whether a Dental School in Lincolnshire would assist in developing the local workforce.

During discussion, the Committee raised the following issues:-

·         The difficulties residents were having in finding a dentist;

·         The problems of the contracts from 2006; and the time constraints these imposed on dentists.  The Committee was advised that the Contract reform focussed on activity delivery, and was not focussed on maintaining care.  This had caused issues for the profession, but it was hoped that from 2020 once the core offer had been agreed, provision  for Lincolnshire would improve;

·         The problems of access to a dentist with Lincolnshire being such a rural County;

·         Clarification was sort regarding current provision.  Confirmation was given that Mablethorpe, Louth, and Boston had no routine dental provision, but there were practices in Boston accepting new patients, but there was no extra provision in Mablethorpe and Louth.  It was also noted that some practices in Skegness were accepting patients;

·         Contracts – Some concern was expressed to the fact that bidders were able to bid for a contract they were unable to provide; and that there was no period of notice.  Confirmation was given that this was the case with some of the contracts.  It was noted that some existing contracts from 2006 there was a requirement for three months' notice, which was not a long time to manage a termination.  It was highlighted that established practices in Mablethorpe had failed as they were unable to keep the workforce;

·         One member enquired where residents could obtain information relating to the availability of dental services.  The Committee was advised that information was contained on the NHS website;

·         The need to promote dentistry as a profession more;

·         The need to promote better with young children how important it was to look after their teeth;

·         A question was asked how likely it was to have a Dentistry School in Lincolnshire.  It was noted that in the East Midlands there was only one school in Birmingham.  The Committee was advised that Private Dentistry Schools had been approached, a suggestion was made for the University of Lincoln to be approached; and

·         The need for the Committee to highlight how ineffective the commissioning of Dental Services was across the country.

The Chairman on behalf of the Committee extended thanks to the two representatives and requested that an update should be received on the dental workforce strategy and plans for improving dental care in Spalding, Mablethorpe and County wide when available.

RESOLVED

1.    That the NHS Dental Services Overview for Lincolnshire be received.

2.    That the Committee receives an update when available on the dental workforce strategy; and plans for providing dental care in Spalding, Mablethorpe and County wide.