Agenda item

To receive an update from NHS England (dental services commissoners) on dental services in the Borough.

The Committee received an update on access to NHS Dental Services in Wokingham Borough from Hugh O’Keeffe, Senior Commissioning Manager Dental, NHS England and NHS Improvement – South East.

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

·       Access remained a challenge and services had been operating at below full capacity because of the pandemic.  This related largely to the safety issues involved in the provision of dental services, which slowed down the rate at which patients could be treated.

·       Practices were continuing to prioritise patients within the existing available capacity.  The key criteria used was urgency (pain, swelling and breathing), incomplete care plans and those with more frequent recall requirements, such as children, high oral disease risk and wider health issues.  Practices were working within a national standard operating procedure

·       Worse oral health was starting to be seen with more people requiring longer treatment plans or admittance into hospital.

·       Net capacity was increasing, and it was hoped that it would increase further from October.

·       Members were reminded that people were not registered with a dental practice.  It was often those who did not have an established relationship with a practice who had found accessing dental services more difficult during the pandemic.

·       Hugh O’Keeffe outlined some of the schemes in place to support those who were having difficulties accessing services.  Additional access sessions were commissioned from several practices on a voluntary basis – 13 in BOB, 3 of which were in the Borough.  Further provision was always being sought.  There was also advice about accessing services, available via NHS 111 and the NHS.UK website.

·       A decision had been taken to invest significantly in referral services, particularly non hospital specialised dental services based in the community such as special care and paediatrics and out of hospital oral surgery.  This was to help reduce the waitlists for these services.

·       There had been a 3 month reduction in patients waiting more than 52 weeks for hospital services, although this area was likely to remain a challenge going forwards.

·       A pilot scheme was being run to support access for Looked After Children.

·       There was a backlog in the dental system, which was likely to remain for some time, but it was hoped that the aforementioned schemes would help to make significant inroads over the next 12-18 months.

·       A Member asked what percentage of Wokingham Borough residents regularly attended a dentist, and also how many practices there were in the Borough.  Hugh O’Keeffe agreed to circulate this information following the meeting.

·       In response to a Member question regarding decreasing waitlists at the Royal Berkshire Hospital, Hugh O’Keeffe commented that the focus had been on those waiting the longest for services, and additional sessions had been run.  In addition, the Royal Berkshire Hospital did not admit oral and maxillofacial surgery patients, so the service did not face the same pressure on hospital beds as those that did admit.

·       Dentists were paid on the activity delivered.  60% was the minimum threshold applied for the period 1^st April – 30^th September 2021, and if any less was delivered at the end of the period, then financial recovery would take place.   Dentists were currently reporting that the high demand for urgent care meant that a relatively low proportion of work was routine.  Urgent cases generally took longer to treat and achieving the target was challenging.  The rate at which patients could be treated was slower than pre pandemic because of the additional safety requirements.

·       In response to Member questions regarding patient ratios, contract allocations and how much was spent on NHS dentistry in the Borough, Hugh O’Keeffe commented that investment was focused on additional sessions to ensure greater capacity in the system.  Members were informed that there had been some investment within the Borough in the last decade, with newer practices in Earley and Finchampstead.

·       The Committee discussed the forthcoming Integrated Care System and the possible role of dentistry within this.

·       Nick Durman spoke of a resident who had had a broken filling and had tried 10 different practices for assistance, without success.  Hugh O’Keeffe stated that practices would undertake an urgency assessment.  Additional access providers might be able to assist in such instances but only if they had sufficient capacity.

·       A Member questioned how frequently information provided to NHS 111 was updated.  The Committee felt that communication around the availability of additional capacity in the system could be improved.

·       In response to a Member question regarding resilience, Hugh O’Keefe again referred to the additional access sessions.

·       Members were assured that no practice had had to close for some time due to staff isolating because of Covid.  A Member asked about staff vaccination levels and was informed that the individual practices would hold this information.

·       Members asked how it would be ensured that there was adequate dental provision given the increasing population within the Borough.

·       A Member questioned the frequency that residents should be seeking a dental check-up and was informed that the frequency related to the individual’s general oral health.  Typically, those who were older or with poorer oral health, had to visit more frequently.

·       Members questioned whether some private appointments could be converted to NHS appointments and was informed that consideration was being given as to how this could be achieved in the short term, in a way which was financially robust.

RESOLVED:  That

1)    the update on access to NHS Dental Services in Wokingham Borough be noted.

2)    Hugh O’Keeffe be thanked for his presentation.