Agenda item

NHS Dental Services - Wokingham Borough

To receive an update on NHS dental services in Wokingham Borough. (30 mins)

Minutes:

Members were updated on NHS dental services in Wokingham Borough by Hugh O’Keefe, Contract Manager – Dental, NHS England South (South Central).

 

During the discussion of this item, the following points were made:

 

·         NHS England commissioned all primary care services.  In the case of dentistry, NHS England commissioned primary, community and secondary care services.

·         The commissioning of GP services was carried out by the Clinical Commissioning Groups. 

·         NHS England was divided into 13 local offices.  NHS South Central was further divided into South Central Thames Valley and South Central Bath, Gloucestershire, Somerset and Wiltshire.

·         NHS England Thames Valley expenditure on dentistry was £90m per annum; £63m primary care; £9m Community Dental Services and £18m on hospital based treatment.

·         Patient charges also applied.  Treatment was banded into three bands.  Children were exempt from charges for treatment as were some categories of adult.

·         Young children in Wokingham, on average, had amongst the best oral health in Thames Valley with approximately 14% of 5 year olds with decay experience.  The oral health in Wokingham was considerably better than that of the England mean with about 25% of children experiencing decay by the age of 5.  Slough had higher levels at 40%.

·         Poor oral health in children was linked to deprivation so it was likely that the more deprived wards would on average contain children with the worst oral health.

·         People were not registered with dentists in the same way as they were with a GP and could choose to attend any practice.  Approximately half the Thames Valley population regularly attended a dentist.  If people had an urgent need for dental care and did not have a regular dentist, they could contact NHS 111 who could direct these patients to practices that would see them on the day.  There were approximately 40 practices in Thames Valley that would see patients on the day.  These tended to be larger practices.  Members asked how many of these were in Wokingham Borough.  Hugh O’Keeffe agreed to feed back to the Committee.

·         Patients could also be signposted to NHS Choices which provided information on the dental services and practices available.

·         Access to dental services was discussed in detail.  Improving access to NHS dental services had become a national priority after the implementation of the new dental contract in 2006.  2009 – 2012 ‘ringfenced’ monies were identified to improve dental access.

·         It was noted that there were 14 NHS dental practices within the Borough with 10 delivering services to all groups of patients and 4 to children only.

·         Approximately 45.5% of the Wokingham population had attended an NHS dental practice in the 2 years prior to May 2017, an increase of about 3,500 patients when compared to May 2015.  This was slightly lower than the national average; however, it was likely that the use of private dental practices was higher in the Borough.

·         Members considered information regarding access to NHS dentistry by ward.  The majority of wards had good levels of access.  In response to a Member question, Hugh O’Keeffe explained that with regards to ‘rank deprivation’ the lower the score, the greater the level of deprivation.  He also clarified that UDA referred to unit of dental activity. 

·         Challenges for ensuring sufficient access included:

Ø  NHS resources were constrained;

Ø  The ‘ringfence’ for dental funding had been removed;

Ø  Improved primary care access had led to a greater number of referrals;

Ø  Competition for resources;

Ø  Across the Thames Valley there were a number of local authorities, including the Council, which planned to substantially increase their populations via housing developments.

·         NHS England also commissioned community dental services.  Berkshire Healthcare NHS Foundation Trust provided this service for Berkshire from a number of community based clinics.  They also provided General Anaesthetic services at the Royal Berkshire and Wexham Park Hospitals for special care patients and children.

·         If patients had more complex clinical needs, they could be referred to hospital for services including Maxillofacial Surgery, orthodontics, restorative work and complex extractions.

·         Councillor Soane asked whether data was available for tooth decay levels for children up to the age of 18.  Hugh O’Keeffe explained that local authorities ran surveys at different age cohorts: 3, 5 and 12 years old.  Councillor Soane asked whether education on the importance of oral health was provided in schools and was informed that other more targeted initiatives were often more effective.

·         Councillor Richards asked whether the number of NHS dental practices in an area could be limited and was informed that they could.

·         Councillor Jones questioned whether a patient’s records moved with them if they changed dental practices and was informed that generally they did not as the records were owned by the dentists.

 

RESOLVED:  That Hugh O’Keeffe be thanked for his presentation and that the update on NHS dental services in Wokingham Borough be noted.

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