Written evidence submitted by Sarah Olney MP (DTY0090)

Introduction:

As the Member of Parliament for Richmond Park, I am regularly contacted by constituents who are unable to access NHS dentistry services.

I am submitting evidence to this inquiry on behalf of my constituents and local healthcare providers. This evidence is informed by constituent correspondence and by conversations that I have had with dentists, patients, healthcare providers and Healthwatch Richmond.

What steps should the Government and NHS England take to improve access to NHS dental services?

The Government must focus on improving access to NHS dentistry.

Many constituents of Richmond Park are unable to register with an NHS dentist. Healthwatch Richmond regularly refers patients to dental services outside of London so that they can receive care through the NHS. Healthwatch also reports that only 2% of dentists nationwide are taking on NHS patients.

Funding

Richmond upon Thames has the lowest funding for NHS dentistry in London, apart from the City of London. Despite the Government announcement of an additional £50 million funding for dentistry across England, the picture in Richmond remains challenging and I understand that no dentists had notified NHSE that they were taking on new patients in Richmond as of October 2021. Healthwatch Richmond also found that private patients were 16 times more likely to be able to access treatment.

The allocation of funding for NHS dentistry must be assessed to ensure that it corresponds to local need. Richmond is an affluent borough, but there remain pockets of high deprivation and a large demand for dental services from those who cannot seek treatment in the private sector.

NHS website improvements

I would also like to draw the Committee’s attention to the submission from Healthwatch Richmond, which highlights the importance of improving the functionality of the NHS website to enable people to search for NHS dentists offering appointments that match their needs. Constituents often contact my office, and Healthwatch Richmond, after failing to locate a dentist service through the NHS website.

The search function on the NHS website only returns the nearest 50 dental practises, regardless of their capacity to take on NHS patients. Due to a shortage of dentists taking on new NHS patients, this means that the search function often fails to return a viable result.

Above all, the plan to address the current crisis must have a long-term focus and be subject to Parliamentary scrutiny.

What role should ICSs play in improving dental services in their local area?

Local oversight

There needs to be more local oversight of dentistry services. Local healthcare leaders in my constituency inform me that they would welcome dentistry and optometry services being brought into the remit of Southwest London ICS. However, this should only happen if the necessary funding from central Government is provided.

Increased capacity

ICSs could play a pivotal role in increasing capacity of NHS Dentistry, by being able to use other healthcare facilities and resources within their provision to offer dentistry services. This could reduce distances that patients must travel to access care, as well as wait times.

However, the involvement of ICSs should not mean that they simply inherit the crisis in NHS Density and subsequently take on responsibility for resolving it. There must be a thorough assessment conducted of the extent to which ICSs are able to improve services, which may differ between regions.

How should inequalities in accessing NHS dental services be addressed?

Children in low-income families

Tooth decay is consistently the number one reason for hospital admissions among young children and children from the most deprived areas are already three times more likely to have hospital extractions than their peers.

In order to improve access to dental services for children, especially those in low-income families:

1. There should be an emergency scheme to launched to ensure children, pregnant women and young mothers have access to their free check-ups on time.
2. Supervised tooth brushing training for children in early years settings, such as nurseries.
3. The removal of VAT on children’s toothbrushes and children’s toothpaste.

Does the NHS dental contract need further reform?

Yes. According to the British Dental Association “reform of the dysfunctional NHS dental contract is now a matter of urgency”. The current quota-based system penalises dentists for taking on patients with high needs, and they are often not properly reimbursed for the work they do for NHS patients. This encourages many to return their NHS contracts and focus solely on private patients.

The NHS dental services contract needs to be reformed, and supplemented by increased funding, to ensure patient demand is met and dentists are incentivised to take on NHS patients.

The British Dental Association have done extensive research and set forward detailed proposals on possible reforms to the NHS dental contract.

What incentives should be offered by the NHS to recruit and retain dental professionals, and what is the role of training in this context?

A few proposals related to the above:

1. An increase to the number of dentist training places in the UK and continued recognition of EU trained dentists’ qualifications.
2. Proper workforce planning for health and social care to be written into law, including projections for dentists and dental staff.
3. Contracts should incentivise dentists to take on NHS patients and ensure they are properly reimbursed for the work completed through NHS contracts
4. Levels of stress and burnout are also high among dentists. The Government should look at increasing funding for mental health support services to help dental workers cope with the pressures of their work.                                                                                                                Jan 2023