A verbal update will be made at the meeting.
7.1 Ms Jacob presented a verbal report. She said that from April 2023, dentistry, pharmacy and optometry was delegated to the integrated care service. When PCTs merged, they went to NHS England to be managed. From this point, there was a distance between dental provision and local health care commissioners. These services were still in the process of being transitioned, They will stay within NHS England in terms of oversight for the first half of this year and then North East London ICB would be doing the contracting element of the dentistry. This did not mean that they would plan how to meet dentistry needs, it would go to the integrated care service, and it would need to feature as part of the local care partnership board work as well as across South East London ICB.
7.2 Ms Jacob said that there was not sufficient dentistry access for residents in Lewisham. The budget that came down from NHS England was the same as before; there had not been an increase and this had presented a challenge. Work needed to be done with Children and Young People’s Directorate because children’s dentistry was important. She said that they did not have the right access, and there would be implication in terms of cost. Ms Jacob said that the Public Health team were working on obesity and diet because this linked to dental health. She expected to work closely with Lewisham and schools on preventative work.
7.2 Ms Jacob said she had started to engage with the local dentistry Committee; they had been engaging with the local care partnership and would be attending the next seminar where it was hoped that public health issues would also be discussed. They had a significant role to play, potentially, in the delivery of public health initiatives. A report on the breakdown of access levels rates of dental care as well as the action plan would be submitted to the next meeting of this board.
· Healthwatch cover dentistry in their quarterly reports. The comments received suggested that people were more satisfied with dentistry provision than they were with General Practice. In the last quarter, approximately 90% (130) of the comments were positive. Key negative comments were regarding communication, particularly charging, These figures needed further probing.
· Remuneration for dentistry was better in the private sector. Some of the reduction in access to dental treatment was due to dentists choosing to hand back part or all of their contract. In dentistry in secondary care, there were shortages of anaesthetists which impacted on the number of patients who could be seen
· The budget for dentistry would not increase and there would be financial pressure. Consideration should be given to using health Inequalities funding for preventative dentistry work in schools. South East London ICS would work with Public Health and Local Care Partnership to consider the priorities and where the greatest impact could be made. The findings would be reported to this board.
· More data was requested around dentistry provision for children and young people in the borough. This data existed for looked after children but this included children living outside of the borough. There was opportunity for more local co-ordination to be more efficient, effective and targeted.
· Information was requested on the provision of dentistry in the borough for the next Board meeting. This should include whether the level of provision was fairly even throughout the borough or whether there was inequality of provision in poorer areas.
· There were a number of dentists, however, the contract dealt with the incident not whole life of a person’s teeth which required a different contract. The core contract could not be changed but lewisham could produce a local incentive scheme with dentists with an NHS contract. The Local Dental Committee were keen to work with Lewisham and would be a good conduit between this authority and local dentists. This would need funding but the payback would be significant over time.
RESOLVED that that the following points be included in the report on dentistry to be submitted to the next meeting of this Board:
· Health inequalities and the financial pressures of providing this service within schools be submitted to this Board
· Data on what was happening particularly in Lewisham as well as across the ICS
· More information and data on dentistry provision and the impact on children and Young People be provided.
· Elders in a residential care setting. Provision of dental care was inconsistent. Some residents paid for dental treatment others did not.
· Pre-payment for dental services for NHS and private treatment. Information was required on how many dentists enforced pre-payment, particularly those insisting on payment months in advance. This was not something that the Board wanted for residents when there was a cost of living crisis.