Thank you for contacting me about dentistry.
NHS Dental Services
NHS England has a legal duty to commission NHS dental services to meet the needs of the local population. In the 24-month period ending 30 September 2020, 19.7 million adults were seen by an NHS dentist and in the 12-month period ending 30 September 2020, 3.6 million children were seen. While I know that this number has decreased by almost 50 per cent as a result of the pandemic, and necessary practice closures, I believe that the expansion of the vaccination programme will enable a return to normality and will ensure that people are able to access routine dental care.
I am encouraged that the recently published general practitioner survey, covering January to March 2020, showed that of 58 per cent of adults questioned who had tried to get an NHS dental appointment in the past two years, 92 per cent were successful.
The Government is continuing to test a new way of providing NHS dental services which aims to further improve oral health and increase access where needed. I am pleased that NHS England’s Starting Well programme is specifically aiming to improve access for those young children who are most at risk of tooth decay and who are not currently under the care of a dentist. As part of the NHS Long Term Plan, the Department of Health and Social Care reaffirmed its commitment to support 24,000 dentists to see more children from a young age to form good oral health habits. This £30 million fund is one of the ways in which the NHS is seeking to reduce health inequalities, by ensuring that funding is available for all children, regardless of where they live.
I too have seen reports on waiting list times for NHS Dental services and understand your concern about this. I have received assurances from colleagues that the Department for Health and Social Care is working closely with NHS England and NHS Improvement and the Chief Dental Officer for England to increase levels of service, as fast as is safely possible. NHS dentists have been asked to maximise safe care, focussing on urgent care and vulnerable groups followed by overdue appointments. This has been underpinned by the setting of activity thresholds for full payment of NHS contractual value. Nearly 700 urgent dental care centres also remain open across England to ensure that patients are able to access urgent dental treatment. I am told that the Government continues to explore what more can be done to increase capacity including piloting pre-appointment testing.
Dentists provide a vital service and I fully support steps to recruit dentists and dental care professionals. The NHS People Plan published in 2020 acknowledged that there is a shortage of dentists, which the NHS is committed to addressing; first of all, the Health Education England-led programme Advancing Dental Care is exploring the opportunities for more flexible dental training pathways. This programme sits alongside reforms to dental contracts as part of the NHS and Government’s commitment to improve retention and the working lives of dentists and dental care professionals. I know that in July 2020 my colleague the Secretary of State for Health and Social Care also announced welcome pay rises for thousands working across medicine, including Dentists.
Children's Oral Health
NHS England is also planning to test new ways to improve children’s oral health in high need areas by innovative commissioning, focused on encouraging the take up of services that are available. For instance, the Government is taking action to tackle tooth decay, an entirely preventable disease which affects roughly one in four children in England. I am already encouraged that tooth decay amongst 5-year olds is down to less than 25 per cent, a significant drop from 31 per cent in 2008. However, there is still much to be done.
In 2017, the Government launched Starting Well, a precisely targeted public health campaign, designed to improve children’s oral health and reduce tooth decay in the parts of England with the worst oral health. This followed recognition that tooth decay is a regional phenomenon, and one which significantly affects poorer areas. I appreciate that Scotland and Wales have introduced national schemes to improve children’s oral health in recent years; however, in the context of improving oral health in English children overall, and the clear links between tooth decay and deprivation, I think the Government’s locally targeted approach is best. I am encouraged that Public Health England have an extensive ‘toolkit’ of preventative measures which can assist dentists and healthcare practitioners to promote good oral health, and ensure families are well-informed and able to effectively look after their children’s dental condition.
If you are unhappy with the NHS dental care you have received, I would encourage you to speak or write to your dental practice first. If you are not satisfied with the way the dentist has dealt with your complaint then you can take your complaint to the independent Parliamentary and Health Service Ombudsman details can be found at www.ombudsman.org.uk.
As I understand it, continuous registration with dental practices is no longer required and patients are only registered with a dental practice during the course of their treatment. This differs from registration with a GP surgery as dental practices are not bound to a catchment area. If a patient is unable to access an urgent dental appointment through a practice, I would urge them to contact 111 for assistance.
I believe it is important that the NHS and the Government determine a safe and reasonable contractual arrangement with dentists, which recognises the constraints on practices and the need to maximise access for patients to see their dentist. I know that colleagues in the Department of Health and Social Care also want to ensure that NHS dentists are supported, but, at the same time, want to enable them to do as much as they can to look after their patients and help them get the treatments they need.
Units of Dental Activity (UDA) were established in 2006 as a mechanism for understanding how much work is undertaken, and allocating funding. I know that my colleague the Minister for Prevention, Public Health and Primary Care has acknowledged that this metric is not as effective as it could be, but I agree that while trying to provide care to as many people and as many of the most vulnerable as possible, now would not be an appropriate time to reform that system.
Between 1 April and 31 December, dental contracts were paid in full, minus the agreed deduction for running costs in the initial lockdown period, which is being taken from NHS schedules from April 2021. The focus is now on increasing dental provision as safely as possible. Safety of patients, dentists and dental teams has been central in establishing these targets, and mechanisms are in place for dentists to record patients who did not attend and other factors that might impact their ability to meet targets. I am also reassured that dentists and dental teams are patient-facing frontline health workers, who were invited to be vaccinated as part of the first swathe.
I understand that the coronavirus pandemic has been tough for us all. Dentistry is an integral part of the clinical services provided by the NHS and I would like to thank all those dentists, dental nurses and others in the industry that have gone above and beyond to ensure treatment has been able to continue safely and efficiently. I believe that the pandemic has highlighted challenges in dentistry, particularly relating to inequalities and children's oral health, and I will work with the Government to transform dentistry going forward.
Thank you again for contacting me.
Craig Whittaker MP