Report of Director of Primary Care & Strategic Commissioning, NHS Greater Manchester         

This report provides an overview on the provision and access to NHS Dental Services across Manchester.

The Committee considered the report of the Director of Primary Care & Strategic Commissioning, NHS Greater Manchester that provided an overview on the provision and access to NHS Dental Services across Manchester.

This report provided the context of current provision and services which were in place that were currently providing access to NHS dental services, as well as describing the challenges and pressures dental services were facing and initiatives to support patients in both improving their oral health and to access appropriate care through NHS dental services.

Key points and themes in the report included:

·         Providing an introduction and background;

·         Information on General Dental Care, Specialised Dental Services and Secondary Care Dental Services;

·         Discussion on the impact of Covid, noting that the risk of cross-infection was significantly increased for services operating in and around the mouth;

·         Information on the national contracting and performance arrangements;

·         Patient feedback information and analysis;

·         Information on the actions to improve access to NHS dental services, noting that all NHS General Dental Practices continued to prioritise patients in pain, children, patients who were deemed as high risk, such as those receiving treatment for cancer, and those who were mid-way through a course of treatment; 

·         Information on access to Urgent Dental Care services; noting that there were 13 Urgent Dental Care sites across Greater Manchester, with provision in the City of Manchester;

·         Information on Secondary Care Dental services;

·         Information on the initiatives to address health inequalities, including the Dental Home for Looked After Children;

·         An update on the Healthy Living Dentistry (HLD) project;

·         Child Friendly Dental Practice (CFDP) Scheme; and

·         Projects to improve oral health, noting that oral health was particularly poor in Manchester and across Greater Manchester.

Some of the key points that arose from the Committee’s discussions were: -

·         Recognising the challenge presented by the pandemic to the delivery of dental services;

·         Patients who had not accessed dentists during the pandemic should not be penalised and removed from a Practice’s patient list;

·         Noting and condemning the national contract arrangements that resulted in Practices only being funded to deliver NHS services for 55% of the adult population;

·         Residents experienced difficulties in registering with NHS Dentists;

·         Recognising the importance of oral health on wider health outcomes;

·         Further data was requested in relation to children’s oral health;

·         Support the call for water fluoridation in Manchester as a means of improving oral health, noting the positive outcomes this had delivered in Birmingham; and

·         What was being done to support access for vulnerable residents.

The Head of Primary Care (Greater Manchester), NHS Greater Manchester stated that the frustrations and challenges articulated by Members were not unique to Manchester and were a national issue. In response to requests for additional Manchester specific data following the meeting he advised that this would be provided. In response to a question regarding the numbers of children accessing NHS Dentistry, he advised that in Manchester this was 52.2% of children compared to the national average of 46.9%, commenting that children were a priority group in recognition of the importance of oral health and wider health outcomes. Reference was further made to ‘Baby Teeth DO Matter’ as one example of initiatives to improve children’s oral health.

The Chair, Manchester Local Dental Committee stated that an important Public Health intervention to improve oral health in Manchester and Greater Manchester would be the introduction of fluoridation and he called for the Council to lobby for this. Members endorsed this suggestion and recommended that the NHS Greater Manchester Integrated Care lobby for the introduction of water fluoridation in Manchester.

The Secretary, Manchester Local Dental Committee advised that COVID had significantly impacted on the service due to the nature of transmission. He advised that following the relaxation of rules activity had begun to increase by approximately 50% compared to the previous year, noting that they were still in a recovery phase. He commented that it had been noted that patients who were now presenting were requiring more treatment due to not seeing a dentist during the pandemic.

The Head of Primary Care (Greater Manchester), NHS Greater Manchester Integrated Care acknowledged the comment regarding support for vulnerable residents. He advised that it was recognised and that this need would increase due to the changes in the demography of the city. He commented that work was underway to address and plan for this through workforce recruitment and training to increase capacity and specialist provision. He further commented that Practices were encouraged to support patients if a patient felt that they had unfairly been removed from a Practice’s patient list.

The Executive Member for Healthy Manchester and Adult Social Care thanked Jim Rochford, Secretary, Manchester Local Dental Committee and Don McGrath, Chair, Manchester Local Dental Committee for agreeing to attend the meeting at short notice and contribute to the discussion and answer Members’ questions.

Decision

The Committee recommend that the NHS Greater Manchester Integrated Care lobby for the introduction of water fluoridation in Manchester.