NHS Dentistry: From National Health Service to Whack-a-Mole
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- Published: Thursday, 18 April 2024 09:19
- Written by Peter Ingle
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Reading any recent press release or announcement from the Government or NHS about healthcare, one can expect to see the reduction of inequalities being given as a key objective.
Two recent stories underline the disconnection between that frequently stated ambition, and actual outcomes in dentistry. In the same week that Secretary of State Victoria Atkins, claimed that dental access was now much better, residents of Newcastle and Darlington saw the reality of this supposedly improved NHS dental provision.
In Newcastle, Dentaid, the charity originally set up to bring basic dental care to the developing world, said that high demand there meant that it would be making a five day visit, the longest time it had spent at a single UK site. Appointments for their mobile unit were been filled within two hours.
Mobile units have been offered as a solution to providing access in hard to reach, typically rural areas, as recently reported by GDPUK (Paul S’s pub feb 28th) reporting on a mobile unit serving isolated coastal communities. In contrast the City of Newcastle has an urban population of nearly 300.000.
An example of the treatment carried out by volunteer staff and students was a five year old who had been unable to sleep due to pain from a dental abscess. While the extractions provided represented an improvement for children in this situation, it demonstrates a lack of routine care and prevention. University researchers monitoring the patients had found that the average child had three teeth that were decayed, missing or filled.
The mobile unit, attached to an established foodbank, could only offer a brief respite mopping up some of the emergencies that in its absence often end up at A and E. BBC News quoted Dr Emma Lim, a paediatrician from the Great North Children’s Hospital, who was involved in bringing the dental bus to Newcastle. “We have wards and wards of children who are having surgery for something that you could avoid, that is shocking," she said. “That is for the price of a toothbrush, toothpaste and a bit of knowledge.”
Thirty five miles down the A1 in Darlington the local ICB has taken, what some will see as a pragmatic approach, to the access crisis. In June 2024 a short term urgent dental access centre is set to open at a community centre. Patients will be able to access it via NHS111.
A spokesperson for the ICB welcomed the news but admitted that there was a “long way to go to recover to pre-pandemic levels.” Longer term there is an ambition to set up a new general and routine dental service in the Eastbourne ward of the town from January 2025, but this will be subject to a successful procurement process.
The Labour candidate for this ‘red wall’ constituency, had her own view on the plans, saying: “This sticking plaster approach to public services is simply not good enough for the people of our town or indeed the country.”
A feature on the plans, in the Northern Echo, included a helpful explainer section. This made clear that the centre was not “a traditional dental practice” but a temporary urgent access centre. It would have controlled referrals and not be open for “general or day to day routine appointments.”
Badly needed as it is, the emergency centre may be delayed by a familiar obstacle. The opening in June is subject to registration with the CQC, however they have a significant backlog of registrations to process.
Both of these stories demonstrate that dental provision will increasingly vary depending upon location, as each ICB come ups with their own plans. They also show that the ambition to provide comprehensive care including prevention, is being increasingly abandoned in favour of isolated projects designed to mop up emergencies.
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