Improving Dental Services across Lincolnshire
Summary
Access to NHS dental care continues to be one of the main issues we hear about from the public. Difficulties getting support has led to many people living in pain.
As far back as 2015, the number of poor experiences shared with by residents about substandard dentistry has been continuous, and we have raised these concerns about the decline on behalf of our residents. During this time, Healthwatch have consistently worked closely to raise concerns with Lincolnshire MPs and Councillors, NHS Lincolnshire ICB, NHS England Midlands Dental Commissioning Team, Healthwatch England, as well as with local and regional dental networks. Healthwatch Lincolnshire also contributed to the National Parliamentary NHS Dentistry enquiry and provided evidence for the Health Select Committee.
We know that people from the most deprived communities struggle the most to access dental care because they cannot afford it. Although we welcome NHS England’s recent changes to the dental contract, we believe further reform is needed to fix the issues.
Healthwatch Lincolnshire’s ‘An NHS Dentist 4 all - Improving Dental Services across Lincolnshire’ campaign will run from 1 October 2022 until 31 March 2023. During this time, we will be raising our concerns both locally and nationally so we need all the help we can get to bring to the attention of as many people as possible, the need for more NHS Dentists in Lincolnshire.
So, what have you told us so far?
1. The lack of NHS dental care is having a negative impact on peoples' immediate and future health
2. Existing NHS patients are finding their NHS practice is now solely private
3. Other patients throughout the county have never had the opportunity to have an NHS dentist due to lack of services
4. Patients are being left with no alternative but to pay for private treatment (however, many cannot afford this)
5. Individuals are routinely travelling to other counties for NHS dental services
What Lincolnshire people are calling for...
1. More NHS dentists and practices throughout the county - This increase in provision should be throughout the county, not just in more urban areas.
2. Improve NHS dental provision for children - Whilst there should be more NHS dental services in the county for everyone, there should be a specific focus on children. Many were concerned about the lack of NHS practices taking on new child patients, with some children in the county having never seen a dentist, and the impact this would have on their current and future oral, physical and mental health.
3. NHS practices should not be able to become solely private - Repeatedly individuals shared their experience of once being an NHS patient at a practice, only to find out (often with no prior warning) that their practice had 'handed back their NHS contract' and were becoming a practice that only offers private treatment.
4. Better pay and contracts for NHS dentists - Many acknowledged the fact that the reason some dentists are no longer providing NHS care is due to their pay and contract for NHS treatment. Therefore, both should be improved.
5. A local dental teaching hospital - To improve NHS dental services in Lincolnshire a local dental teaching hospital was suggested. This would hopefully encourage more dentists to practice in the area.
6. Private patients at NHS practices should not be prioritised over NHS patients - Other individuals who are registered with dental practices which hold an NHS contract but also accepts private patients, felt that private patients were given priority over NHS patients.
7. More money should be spent on prevention - A common suggestion to improve NHS dental services in Lincolnshire was to spend more time, effort and money on preventative measures.
8. Greater transparency on the cost of NHS treatment and the introduction of payment instalments - There was also a call for treatment bands (what treatment is included in each band) and prices to be more clearly explained. Individuals also expressed concern over the cost of the higher bands of treatment and wished they were able to pay for their treatment in instalments.
9. Greater transparency on waiting and practice lists - Respondents called for greater transparency on what being on a practice or waiting list and not being able to join a waiting list means.
Read the report for greater detail.
What needs to happen?
We believe that action in four areas needs to be taken to address the issues that people have shared with Healthwatch Lincolnshire.
- A more rapid and radical reform of the way dentistry is commissioned and provided – recognising that the current arrangements do not meet the needs of many people who cannot access NHS dental care in a timely way and acknowledge issues faced by the dental profession.
- Address the twin crises of access and affordability - ensuring that people are not excluded from dental services because of lack of provision locally or difficultly in meeting charges. Currently, there are significant inequalities that must be removed. New arrangements should be based on maximising access to NHS dental services, with particular emphasis on reducing inequalities.
- Provide better information about NHS dentistry – improving information, including online, so that people have a clear picture of where and how they can access services, and the charges they will need to pay. Particularly, the reform must address dentistry ‘registration’ which causes significant confusion for both services and patients.
- Create dental hubs to provide more holistic health care – harnessing opportunities, such as the development of Primary Care Networks, to link oral health to other key issues such as weight management and smoking cessation.
What action we’ve taken
Healthwatch Lincolnshire continue to raise dental access concerns both locally and nationally. The findings from this campaign have been submitted as evidence to the Health and Social Care Select Committee as part of their inquiry into NHS dentistry. Whilst access to NHS dentistry is poor throughout the country, we hope our submission will continue to highlight the exceptionally poor situation in Lincolnshire.
The findings of this report will also be shared and directly influence the Lincolnshire Dental strategy 2023 - 2026 that is currently being put together. This strategy will set out what needs to be done over the next three years to improve NHS oral health services and drive improvements in oral health across the county.
In January 2022, NHS England announced £50 million additional funding for dentistry. We’re pleased to see the Government and NHS England take action. However, more needs to be done as this is a fraction of what is required and didn’t reach all the areas in need.
On 19 July 2022, NHS England announced some changes to the dental services contract including:
- Improved payment to encourage dentists to take on more complex cases
- Flexibility about which dental professionals will be able to provide treatment, freeing up dentists’ time
- Where dentists do not deliver as many units of dental activity (UDAs) as their contact allows, the funding for unused capacity may be transferred to other dental practices that can provide additional appointments.
We will continue to monitor the feedback we receive to find out whether these changes are making any real improvement for people - particularly children as well as adults who require urgent treatment. We will continue to work with NHS England to ensure that people’s views are able to influence the future of NHS dentistry.
We will also be focusing our attention on seldom-heard groups: those who are living in deprived and rurally isolated areas, cancer patients, wheelchair users, pregnant women, parents, those with sensory loss as well as the dental workforce themselves.
Downloads
Find out more about our findings
Download our findings in full. If you need this document in a different format, please email info@healthwatchlincolnshire.co.uk or call 01205 820 892
