The
Scrutiny Panel will be asked to approve the content of the draft final report
and agree recommendations, for submission to the Executive.
Minutes:
The Democratic Services Officer presented a
brief overview of the draft final report on the topic of Dental Health and the
Impact of Covid-19. The following information was provided:
·
The
aim of the scrutiny review was to examine the oral health of Middlesbrough’s
population and the accessibility of local NHS dentistry services.
·
The
Terms of Reference, for the review, were detailed at paragraph 2 of the report.
·
Background
information, included at paragraphs 3 to 14 of the report, provided a
definition of oral health, NHS dentistry and details on access to NHS dental
services.
·
Evidence
in respect of Term of Reference A was included at paragraphs 15 to 24 of the
report and covered the Local Authority’s responsibilities in respect of oral
health and NHS England’s responsibilities in respect of dentistry.
·
Evidence
in respect of Term of Reference B was included at paragraphs 25 to 35 and
covered oral health data in respect of Middlesbrough’s children and adults,
information on oral health promotion and the future work of the Local Authority
to improve oral health.
·
Evidence
in respect of Term of Reference C was included at paragraphs 36 to 61 and
covered information on Covid-19, dental workforce recruitment and retention,
NHS dental contract and dental system reform and work being undertaken to
improve access to dental care.
·
Evidence
in respect of Term of Reference D was included at paragraphs 62 to 79 and
covered information reported by Healthwatch, detailing the views and
experiences of the local population during the period March 2020 to October
2023. It also included information on the future work of Healthwatch and the North East and North Cumbria Integrated Care Board (ICB).
·
Evidence
in respect of Term of Reference E was included at paragraphs 80 to 110 and
covered programmes to reduce oral health inequalities, such as targeted
supervised tooth brushing in childhood settings, the provision of toothbrushes
and paste by post, targeted community fluoride varnish programmes, water
fluoridation programmes, the development of an oral health strategy and
improving access to Teesside University’s Student Dental Facility.
·
Additional
Information was included at paragraphs 111 to 119 and covered advice for
patients with an urgent dental treatment need and safeguarding. Whilst those
areas were not directly covered by the terms of reference, they were relevant
to the work of the scrutiny panel.
·
The
conclusions were detailed at paragraph 120 of the report
and they summarised the main findings of the review and identified key areas
for further consideration, in terms of Middlesbrough’s oral health and access
to dental care services.
Following the publication of the agenda, two
comments had been received from the North East and
North Cumbria Integrated Care Board (ICB) and NHS England.
·
In
terms of paragraph 49 - The ICB had requested that the sentence, which
referenced ‘For example, a dentist is
paid the same fee, regardless of whether they perform one filling on a patient
or 10.’ was replaced with ‘Recent national dental contract reforms introduced
in November 2022 have gone some way to start to address this with the
introduction of enhanced UDAs, to support higher needs patients who require
treatment on three or more teeth or more complex molar endodontic care to
permanent teeth, recognising that this care can be more time consuming.’
·
In
terms of Conclusion g) - NHS England had requested the removal of the final
sentence ‘Furthermore, the prospect of the SDF delivering a targeted
community fluoride varnish programme, for Middlesbrough’s population, should
also be explored.’ It had been explained by NHS England that the fluoride
varnish programme was best delivered by NHS dental practices that were
previously commissioned, as they already had a relationship with the school and they had provided urgent care for children that
did not have a dental practice and who were picked up as part of the fluoride
varnish application. It was also thought that any community fluoride varnish
programme, without a direct prescription, would have needed to have been under
the oversight of a consultant in dental public health.
The scrutiny panel was in
agreement that the draft final report should be updated to reflect the
proposed amendments submitted by the ICB and NHS England.
Following consideration, the following
recommendations were agreed for inclusion in the final report:
a) That a further census survey of 5-year-old children is undertaken to
enable analysis of data at a ward-level to identify health inequalities and
enable the delivery of more targeted support.
b) That a locally tailored oral health strategy is developed, which is
based on an oral health needs assessment.
c) That the Local Authority works with the relevant local authorities in
the North East, the Office for Health Improvement and
Disparities (OHID), NHS partners and the relevant water companies to support
and delegate responsibility to respond to the OHID national water fluoridation
public consultation (due in early 2024) to the Director of Public Health.
d) That the Health Scrutiny Panel receives regular updates on progress made
with implementing a water fluoridation scheme for the region, including the
outcome of the public consultation.
e) That targeted work is undertaken to increase uptake of the supervised
tooth brushing programme and ensure engagement of the early years settings and
primary schools located in town’s most deprived areas.
f)
That, for those families who choose not to engage with the health
visiting service, free toothbrushes and toothpaste are sent via postal delivery
to encourage parents to adopt good oral health practices.
g)
That a targeted community fluoride varnish programme
is commissioned to reduce health inequalities across Middlesbrough’s
population.
h)
That, to influence the national reform of NHS dentistry, the Chair of the Health Scrutiny Panel writes to the Secretary of State
and the NHS
England regional team undertake work, to make access to NHS dental services
equal and affordable for everyone in the region.
i)
That an update is submitted to the Health Scrutiny Panel in 6 months’
time in respect of:
·
the North East and North Cumbria Integrated
Care Board’s (ICB) recovery plan to improve access to NHS dental services; and
·
how feedback from the local population has been utilised
to formulate solutions and determine future plans.
j)
That
Teesside University, the Local Authority and the North East
and North Cumbria ICB work collectively to overcome and address current
referral restrictions associated with the Student Dental Facility, with an aim to improving
accessibility for those experiencing problems with accessing NHS dental care.
AGREED
That the final report on
Dental Health and the Impact of Covid-19 be approved and submitted to the
Overview and Scrutiny Board for consideration, subject to the report being
updated to reflect the proposed amendments from the ICB and NHS England and the
inclusion of the agreed recommendations.
Supporting documents: