Recommendations & Conclusions
26 items
1
Conclusion
Ninth Report - NHS dentistry
Accepted
We believe there is a crisis of access in NHS dentistry. Many people are unable to access an NHS dentist or are travelling significant distances to get to one. Access varies across the country and is being experienced unequally by different groups. We believe everyone should be able to access …
Government response. The government accepts the recommendation and outlined several reforms announced in July 2022, including allowing high-performing practices to take more patients, fairer payment for complex care, and requiring NHS dentists to update their availability online. It also states a forthcoming …
Department of Health and Social Care
2
Recommendation
Ninth Report - NHS dentistry
Accepted
We welcome the Government’s ambition for everyone who needs an NHS dentist to be able to access one. This ambition must ensure access within a reasonable timeframe and a reasonable distance. The Government must set out how they intend to realise this ambition and what the timeline will be for …
Government response. The government accepts the recommendation and highlights existing measures, such as NHS England's Patient and Public Voice group to improve patient understanding and the contractual requirement for dental practices to quarterly update their NHS website profiles. It also notes additional …
Department of Health and Social Care
3
Conclusion
Ninth Report - NHS dentistry
Accepted
A lack of public awareness about NHS dental services and how practices operate is contributing to access issues. The Government and NHS England should roll-out a patient information campaign with the aim of improving awareness of how NHS dentistry will work and ensure the public are better informed about what …
Government response. The government accepts the recommendation, clarifying that there is no formal patient registration system. It supports adherence to NICE recall guidelines and details existing measures from 2022 reforms for practices to provide urgent dental care and use risk-based recalls, with …
Department of Health and Social Care
4
Conclusion
Ninth Report - NHS dentistry
Deferred
Practices should abide by NICE recall guidelines of up to two years for most adult patients, recognising the need for more regular recall for some, but people should not automatically be removed from dentists’ registers of NHS patients without good reason. This should be monitored by NHS England to ensure …
Government response. The government accepts the recommendation but responds by detailing measures unrelated to NICE recall guidelines or patient registration. The response outlines NHS England's guidance on ringfencing dental allocations for ICBs in 2023/24 and measures to address underperforming contractors by rebasing …
Department of Health and Social Care
5
Recommendation
Ninth Report - NHS dentistry
Acknowledged
We welcome the fact that to try and address the underspend, NHS England is applying a ringfence for 2023/24, to ensure that no ICB can divert funding away from NHS dentistry. We recommend that this ringfence applies permanently, and NHS England puts in place transparent scrutiny to ensure compliance.
Government response. The government partially accepts the recommendation, stating they need to build on existing contractual changes but do not commit to making the dental funding ringfence permanent. They are working on further reforms to the 2006 contract in discussion with the …
Department of Health and Social Care
6
Conclusion
Ninth Report - NHS dentistry
Rejected
We also welcome measures by NHS England to intervene on providers who are under-delivering on contracted NHS activity. We look forward to an update on how this work is progressing. We welcome this funding being used flexibly, however there cannot be further delays in doing so.
Government response. The government explicitly rejects a recommendation to introduce patient registration, which was not made in this conclusion. The response then outlines existing information on patient choice and practice availability, and commits to commissioning a dental workforce survey by early 2024 …
Department of Health and Social Care
7
Recommendation
Ninth Report - NHS dentistry
Accepted in Part
Fundamental reform of the dental contract is essential and must be urgently implemented, not only to address the crisis of access in the short-term, but to ensure a more sustainable, equitable and prevention-focussed system for the future. We are concerned that any further delay will lead to more dentists leaving …
Government response. The government partially accepts the recommendation for fundamental reform, committing to build on existing contractual changes and work on further reforms to the 2006 contract, though they rejected a previously piloted capitation model due to its identified shortcomings.
Department of Health and Social Care
8
Recommendation
Ninth Report - NHS dentistry
Accepted in Part
We welcome the Government’s recognition of the need for dental contract reform. The Department and NHS England must urgently implement a fundamentally reformed dental contract, characterised by a move away from the current UDA system, in favour of a system with a weighted capitation element, which emphasises prevention and person-centred …
Government response. The government partially accepts the recommendation for urgent reform, stating they will build on existing contractual changes and work on further reforms to the 2006 contract, but reject moving to a weighted capitation model based on previous pilot evaluations.
Department of Health and Social Care
9
Conclusion
Ninth Report - NHS dentistry
Accepted
We believe patient registration under a reformed capitation-based contract will better enable those patients who currently can’t access a dentist to be able to do so.
Government response. The government partially accepts, detailing existing and planned measures like a 5.13% uplift to NHS dental contracts and guidance for Integrated Care Boards on 'Flexible Commissioning' for local initiatives. They are also exploring tie-ins for new dentists and developing a …
Department of Health and Social Care
10
Conclusion
Ninth Report - NHS dentistry
Deferred
We uphold the recommendation from our predecessors’ 2008 report into Dental Services, that the Department should reinstate the requirement for patients to be registered with an NHS dentist. (Paragraph 55) Workforce
Government response. The government reinterprets the recommendation to be about making best use of the wider dental team's skills, citing July 2022 guidance to enable dental therapists and hygienists to open treatment courses and a completed consultation on allowing them to supply/administer …
Department of Health and Social Care
11
Conclusion
Ninth Report - NHS dentistry
Accepted
The Government states that the number of NHS dentists has increased over the past year. However, while the headcount has gone up over the past year, it has gone down over the past three years, and moreover headcount alone does not reflect how much NHS work these dentists are undertaking. …
Government response. The government accepts the importance of efficient processing for overseas dentists, confirming they are working with the GDC to clear the registration backlog. They highlight specific GDC actions to triple ORE Part 1 capacity and increase Part 2 sittings to …
Department of Health and Social Care
12
Recommendation
Ninth Report - NHS dentistry
Accepted
The Government and NHS England should commission a dental workforce survey to understand how many full-time and part-time-equivalent dentists, dental nurses, therapists and hygienists are working in the NHS, and how much NHS and private activity they are undertaking, alongside demographic data such as age and location.
Government response. The government accepts the recommendation, stating that NHS England introduced a new biannual dental workforce survey in October 2023, which will collect comprehensive data on the dental team and NHS activity, with initial data expected by early 2024.
Department of Health and Social Care
13
Recommendation
Ninth Report - NHS dentistry
Accepted
The Government and NHS England must improve the routine data that is collected on the number of NHS dentists and the wider dental team, and the levels of NHS activity they undertake, as well as data on demand, to assist with workforce planning and identifying gaps in provision. This must …
Government response. The government accepts the recommendation, stating that NHS England introduced a new biannual dental workforce survey in October 2023 to improve data collection on the dental team and NHS activity, with initial data expected by early 2024. They also highlight …
Department of Health and Social Care
14
Recommendation
Ninth Report - NHS dentistry
Accepted in Part
Any contract reform now will almost certainly be too late for those dentists who have already left the NHS or are considering doing so in the near future. The Government must urgently introduce incentives to attract and retain dentists to undertake NHS work. These should include, but not be limited …
Government response. The government partially accepts the recommendation, rejecting some specific incentives listed but committing to explore other measures, such as a tie-in for new graduates. It also agrees with the importance of a sustainable careers framework and is working with NHSE …
Department of Health and Social Care
15
Recommendation
Ninth Report - NHS dentistry
Accepted
The Government, NHS England and ICBs must ensure that the reformed contract ensures that full use is made of the skills of the whole dental team. (Paragraph 73) NHS dentistry 35
Government response. The government accepts the recommendation, having already published guidance in July 2022 to facilitate dental therapists and hygienists opening treatment courses, and completed a consultation on changes to human medicines regulations to expand their scope of practice, with a response …
Department of Health and Social Care
16
Conclusion
Ninth Report - NHS dentistry
Accepted
We support the implementation of the work of the Advancing Dental Care Review. Centres for Dental Development could have the potential to change how we approach training dentists in the UK to meet the needs of the populations who most require care. However, these are in their early stages and …
Government response. The government partially accepts, stating that Integrated Care Boards are responsible for undertaking oral health needs assessments to support commissioning priorities and are working towards having these assessments in place by July 2024.
Department of Health and Social Care
17
Conclusion
Ninth Report - NHS dentistry
Accepted
The backlog of applications for the Overseas Registration Exam is unacceptable and resolving this represents an opportunity in the short term to increase the number of dentists working in the NHS, and therefore create more appointments to enable patients to access much-needed services.
Government response. The government accepts the recommendation, detailing that it is working with the GDC to clear the backlog by tripling ORE Part 1 exam capacity and increasing Part 2 sittings for 2024. Additionally, it has streamlined processes for overseas-qualified dentists, including …
Department of Health and Social Care
18
Recommendation
Ninth Report - NHS dentistry
Accepted
The Government must work with the General Dental Council to ensure the backlog of applications for the Overseas Registration Exam is cleared in a timely manner, and to speed up changes to the process of international registration for new applicants seeking to work in the NHS.
Government response. The government accepts the recommendation, detailing GDC's increased ORE exam capacities from August 2023 and 2024, and listing specific measures already taken to streamline international registration processes for overseas-qualified dentists to work in the NHS.
Department of Health and Social Care
19
Conclusion
Ninth Report - NHS dentistry
Acknowledged
We are concerned that the absence of explicit mention of the dental contract in the Long Term Workforce Plan reflects the lack of priority given by the Government and NHS England to contract reform. We believe it indicates a lack of recognition of the urgent need for reform before any …
Government response. The government acknowledged the committee's concern that the absence of explicit mention of the dental contract in the Long Term Workforce Plan reflects the lack of priority given by the Government and NHS England to contract reform.
Department of Health and Social Care
20
Recommendation
Ninth Report - NHS dentistry
Accepted in Part
Given the varying views expressed regarding a tie-in for new graduates into NHS dentistry, we urge NHS England and the Government to ensure full consultation with professionals and representative bodies, as they seek to explore the potential merit of such a policy, although its success depends on fundamental contract reform, …
Government response. The government partially accepts, committing to explore incentives like a tie-in as part of the NHS Long Term Workforce Plan and agreeing on the importance of a careers framework. They are working with NHSE to develop a career pathway and …
Department of Health and Social Care
21
Recommendation
Ninth Report - NHS dentistry
Accepted in Part
The dental profession should be represented on Integrated Care Boards to ensure they have the necessary expertise to inform decision-making around contracting and flexible commissioning. This should include wider engagement with the profession locally, for example through Local Dental Committees and Local Dental Networks.
Government response. The government partially accepts, stating that while they have not changed their stance on mandatory representation, existing legislation allows ICBs the discretion to appoint additional members, including dental professionals, where locally deemed necessary. DHSC will continue to work with NHS …
Department of Health and Social Care
22
Recommendation
Ninth Report - NHS dentistry
Accepted in Part
We contest the Department’s rejection of the recommendation in our ‘Integrated Care Systems: autonomy and accountability’ report, and reiterate that they should centrally gather information relating to the membership of ICBs, including the specific role of members and their area of expertise. We also recommended the Department should review that …
Government response. The government partially accepts, stating that NHS England has published guidance on effective clinical leadership and ICBs are asked to ensure diverse professional integration. However, the government has not changed its stance on centrally gathering and reviewing ICB membership information …
Department of Health and Social Care
23
Recommendation
Ninth Report - NHS dentistry
Accepted
We welcome the initiatives outlined by the Chief Dental Officer to help ICBs commission dental services in a way that best meets the needs of their local populations. NHS 36 NHS dentistry England should provide evidence of the effectiveness of these initiatives, so that ICBs can see for themselves which …
Government response. The government accepts the recommendation, stating that NHS England published guidance in October 2023 with commissioning options for ICBs, and will release a further publication in 2024 providing practical examples of services and commissioning options to spread best practice.
Department of Health and Social Care
24
Recommendation
Ninth Report - NHS dentistry
Accepted
In light of the current national contracting arrangements, NHS England must provide clarity to ICBs about what flexibilities they have with regard to commissioning NHS dental services and targeting resources according to the needs of their populations.
Government response. The government accepts the recommendation, stating that NHS England published guidance in October 2023 to provide ICBs with clarity on commissioning flexibilities within the national dental contractual framework, and will issue further guidance with practical examples in 2024.
Department of Health and Social Care
25
Conclusion
Ninth Report - NHS dentistry
Acknowledged
ICBs have been delegated responsibility for commissioning dental services by NHS England. They offer an opportunity to improve access locally, better integrate services around patients and address inequalities.
Government response. The Government acknowledges that the transfer of responsibility for commissioning NHS dentistry services to ICBs provides a greater opportunity to tailor services around the needs of the local population.
Department of Health and Social Care
26
Recommendation
Ninth Report - NHS dentistry
Accepted in Part
By the end of July 2024, every ICB should have undertaken an oral health needs assessment, in consultation with service users, patient organisations and the profession. NHS England should provide support to ICBs to undertake this, including sharing examples of best practice and learnings from other ICBs. NHS England must …
Government response. The government partially accepts the recommendation, acknowledging that not all ICBs may complete oral health needs assessments by the July 2024 deadline due to varying maturity. However, it confirms that all ICBs are working towards having these assessments in place …
Department of Health and Social Care