What NHS Wants from NHS Dentists
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- Published: Tuesday, 06 August 2024 08:10
- Written by Peter Ingle
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NHS contractors have a more complex relationship with their patients than private providers. While their patients may in theory pick and choose who they see, there is hardly an oversupply of NHS dental services. Whether a practice keeps its contract, and use of the familiar blue and white logo, is not in the gift of patients. Irrespective of patient charges or National Insurance payments their ‘buyers‘ are ICB commissioners.
If keeping these commissioners happy has become a basic survival skill for NHS practices, at least one ICB Chief Executive has helpfully set out what his team will be shopping for.
In a blog on the NHS England website Ed Garratt OBE, Chief Executive of NHS Suffolk and North East Essex Integrated Care Board (SNEE ICB), explained how trying to rectify health inequalities will be ‘front and centre’ of his dental commissioning strategy. Dentists in the area who see their future with an NHS element will need to know what innovative new partnerships and contracts he will be looking for.
The ICB has been responsible for dental commissioning since April 2023. From the start it had a vision ‘to make routine and urgent NHS dental care available to everyone in its population who either wants it or needs it’. At that time 31% of the local population had tried but been unable to make an appointment over the preceding two years. This figure reached nearly 50% for children in care.
In an area recognised as underserved, according to NHS statistics, workforce is an issue. The NHS recovery plan packages will play a part and Ed refers to the University of Suffolk scheme closely associated with former CDO Sara Hurley: “In February, the University of Suffolk welcomed the first students on its bachelor of science dental hygiene and dental therapy course. Graduates will be able to carry out many of the routine tasks performed by dentists, freeing up the latter to concentrate on more complex treatments.”
He also refers to the associated University of Suffolk Dental CIC which obtained its contract in a one horse race, and will see NHS patients in its purpose-built surgery units on Ipswich waterfront. Patients referred to NHS 111 from health and social care organisations will be seen, “soon.” Given the scheme’s original claim that it would see its first patients in the winter of 2023 it appears to be running substantially behind schedule, though this is not mentioned in the blog. It is made clear that the CIC will prioritise certain patients including those requiring emergency care, the homeless and transient, and children in care. With 18,000 hours of appointments a year it remains to be seen if there will be any access for the comparatively stable patients who were seeing high street dentists under the NHS until the access crisis hit, and contracts were returned or removed.
The ICB are also setting up a mobile clinic to target high needs areas. It will take patients on a referral basis and the contract will be with the CDS.
£700,000 has been allocated to set up another mobile unit that will target deprived coastal and rural areas. 15 additional services have been commissioned allowing more NHS appointments to be made in the evenings, weekends and bank holidays. The providers in these schemes are contracted to prioritise the same disadvantaged groups as the University of Suffolk Dental CIC.
The ICB have reviewed all their dental contracts which fell below the ICB’s payments average and set a minimum payment rate to try and ensure that those services providing NHS care can continue to do so. Subsequently the ICB looked at areas of high deprivation in Suffolk and north east Essex and they will be trialling a localised payment rate in Clacton-on-Sea, where there are significant health inequalities.
Dr Garratt concludes: “Our vision is one we are determined to realise, but we recognise that this will take time, effort and imagination. What is extremely encouraging is the enthusiasm and drive we have generated with our partners and providers to embed equity in NHS dental access and I feel both excited and humbled to be a part of it.”
Dr Garratt is also a Visiting Professor of Integrated Care at the University of Suffolk and an Honorary Professor at the University of Essex in the Institute of Public Health and Wellbeing. He has worked in the NHS for 20 years, largely in senior roles including as Deputy Director of Commissioning and Head of Communications and Engagement at NHS East of England.
He has also worked on major national policy by supporting the development of the NHS Constitution (2009) and the Government’s NHS White Paper (2021). Dr Garratt has a published doctorate in English Literature from the University of Cambridge and a first-class degree in History from the University of Sussex.
Any GDPs under the impression that the mixed practice model will remain sustainable with a core of comparatively healthy and prosperous patients happy to purchase composites, hygiene sessions, implants and aligners, as add-ons, may want to review their business plans
Health warning: This feature is based upon a blog by one ICB’s CE, published in late July 2024. It may or may not be representative of other ICB’s thinking.
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