Agenda item

(To receive a report from NHS England and NHS Improvement (Midlands) which invites the Committee to consider a report on NHS Dental Services in Lincolnshire.  Representatives from NHS England and NHS Improvement: Rose Lynch, Senior Commissioning Manager, Jane Green, Commissioning Manager, Adam Morby, Regional Chief Dentist for the Midlands, Kenny Hume, Lincolnshire Local Dental Network Chair and Jasmine Murphy, Consultant in Dental Public Health will be in attendance for this item)

Consideration was given to a report from NHS England and NHS Improvement, which invited the Committee to consider and comment on NHS Dental Services in Lincolnshire.

The Chairman invited the following representatives from NHS England and NHS Improvement: Rose Lynch, Senior Commissioning Manager, Jane Green, Commissioning Manager, Adam Morby, Regional Chief Dentist for the Midlands, Kenny Hume, Lincolnshire Local Dental Network Chair, Jasmine Murphy, Consultant in Dental Public Health; and from NHS Lincolnshire Clinical Commissioning Group, Sandra Williamson, Chief Operating Officer to remotely, present the item to the Committee.

Lucy Gavens, Consultant Public Health, was also in attendance for this item.

The presentation referred to:

·       The national and local challenges dentistry was facing;

·       The locations of services in Lincolnshire;

·       The location of local dental surgeries in the county, accessible by car in rush hour and by public transport (not all services were accessible by public transport);

·       Details of the 2019 oral health survey of 5 year old children, which showed a wide variation in both the prevalence and severity of dental decay among young children across Lincolnshire.  Areas highlighted as being significantly worse that the England average were Boston and the East Midlands; and

·       Water Fluoridation.  It was highlighted that fluoridation was an effective and safe public health measure to reduce the frequency and severity of dental decay, and narrow oral health inequalities.  It was noted that water fluoridation was lacking on the East Coast.  It was noted further that in the next year or so Anglian Water was planning changes to the infrastructure of its water supply, which would lead to the removal of fluoride from the water supply for those parts of the county which currently received fluoridated water.

In conclusion, the Committee were advised of future opportunities and solutions for Lincolnshire which included: the rapid oral health needs assessment being undertaken for the County Council to better understand some of the impacts of the pandemic; the introduction of Integrated Care Systems from 1 July 2022; the ‘Golden Hello Scheme’ a scheme to encourage practitioners to work within NHS dentistry; the NHS Communications Team to share intelligence on local concerns; the role of Local Dental Network Chairs; and the Secondary Care - Getting it right first time oral surgery hospital dentistry review.

During consideration of this item, the Committee made some of the following comments:

·       Concern was expressed to the lack of NHS dentistry provision in Lincolnshire and the impact of this for the east of the county.  The Committee was advised that there had been a contract issue with the government, which would be addressed, concerning NHS/private distribution, which was a major problem as each provider was independent.  As with other areas of the NHS it was highlighted there was a shortage of practitioners across the county.  It was also highlighted that the ongoing impact of the Covid-19 pandemic had considerably impacted dental services and the availability of NHS dental care.  The Committee noted that NHS England/Improvement were looking into ways to encourage practitioners to work within dentistry;

·       Concern was also expressed to the length of time people were waiting to see a dentist;

(Note Councillor S R Parkin left the meeting at 1.00pm).

·       Some concern was expressed regarding the removal of fluoridation.  It was felt that fluoridation needed to be retained and supported;

·       The impact poor oral health had on a person’s wellbeing;

·       A question was asked whether children were dependent on their parents arranging for them to see a dentist.  Confirmation was given that it was the responsibility of parents/carers to take children and young people to the dentist.  It was highlighted that there were several programmes for children to encourage good habits in early years settings; and that toothbrushes and toothpaste were being provided to families living in Boston when their child reached 6-8 weeks of age.  Additionally, the Lincolnshire Smiles Programme was delivering a supervised toothbrushing programme in early years and primary education settings to prevent decay and establish good life-long oral health behaviours.  Further details of the activities across Lincolnshire led by the Public Health Team were detailed in Appendix 5 on page 385 of the report pack ;

·       Whether the oral health needs assessment had access to dental records.  It was confirmed that there had been access to some dental records;

·       One question asked was how many people were not receiving the care they needed.  The Committee was advised that this data was not collated or reported on;

·       Dentistry provision for pregnant women, one member enquired whether pregnant women were receiving the care they needed.  Reassurance was given that where there was a clinical need, patients were prioritised and that pregnant women fell into that category.  One member’s personal experience highlighted that this had not been the case.  The Committee was advised that there was a specific programme for Boston and that practitioners should be conveying the said health messages;

·       The cost of private dentistry;

·       The responsibility of all to look after their oral health;

·       The Department of Work and Pensions changes to benefits, which included access to dentistry and its effect on dental services.  Presenters were not aware of the changes and thanks were extended for drawing their attention to the matter;

·       One member enquired what the main reason had been for the lack of interest in securing a new provider for dental services in Mablethorpe and what was being done to make it a more attractive option.  The Committee noted that following a procurement exercise in 2019, NHSE/I had been unable to secure a new provider of NHS Dental Services in the Mablethorpe areas.  As a result, NHSE/I had commissioned Urgent NHS Dental care sessions until March 2023, whilst longer term commissioning intentions were finalised.  The Committee was advised that it was planned that general dental service would be in place for 2022/23 within Mablethorpe;

·       Further information was sought as to the areas that had seen NHS contracts handed back and the impact this had seen or will have on patients.  The Committee was advised that if a practice was to terminate its contract, the areas of need would be looked at and activity would be dispersed, if there was no expression of interest.

The Chairman on behalf of the Committee extended thanks to the presenters.

RESOLVED

1.      That the information presented by NHS England and NHS Improvement (Midlands) on NHS Dental Services in Lincolnshire be noted.

2.      That a further update on NHS dental services in Lincolnshire be received in six months’ time.