Agenda item

The Scrutiny Panel will be asked to approve the content of the draft final report and agree recommendations, for submission to the Executive.

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.