Source · Select Committees · Public Accounts Committee
Recommendation 9
9
Accepted
The threadbare provision of NHS funded dental care is a further example of a failure...
Conclusion
The threadbare provision of NHS funded dental care is a further example of a failure to provide preventative or protective routine care leading to more acute health problems.24 NHS England, rather than ICSs, remains responsible for most of NHS dentistry provision in England.25 In some parts of the country it is impossible to register with a dentist offering NHS treatment and there is huge concern about lack of access. We raised concerns about children’s dental health seriously deteriorating to the extent that they required hospital treatment.26 NHS England told us it has begun implementing the first steps in a wider programme of dental reform that it announced in July 2022; that these represented the first major change to the profession in fifteen years; and that the changes had been widely welcomed. These reforms included changing the national dental contract to recognise and provide greater payment for more complex work; allowing dental therapists to accept NHS patients for treatment to free up dentists to do more urgent or complex work; and increasing the amount of activity high-performing practices could undertake by 10%.27 NHS England is also, as part of its work with Health Education England on the NHS workforce plan, looking at ways to improve the pipeline into NHS dentistry, to make it a more attractive place for new dentists to come to do work and to stay.28
Government Response Summary
The government agrees with the committee's concerns and states that securing recovery of dental access is a key NHS priority, outlining existing measures such as funding allocations and reforms to the national dental contract.
Government Response
Accepted
HM Government
Accepted
6.1 The government agrees with the committee’s recommendation Recommendation implemented 6.2. Securing recovery of dental access is a key NHS priority. The pandemic had a significant impact on the delivery of dental services and NHS England is taking steps to recover dental activity and improve access to dental care. 6.3 NHS England provides its regional commission teams and Integrated Care Boards with a combined allocation for dental services, community pharmacy and primary care ophthalmology. In 2022-23 this is £5,440 million and it will rise to £5,597 million in 2023-24. 6.4 One measure of dental access is the proportion of people accessing NHS funded care. The number of unique adult patients seen in the 24 months to the end of 2021-22 was 34%, compared to 50% in the 24 months to the end of 2018-19. The portion of children seen in the NHS has fallen to 45% in the 12 months to the end of 2021-22, from 59% in the 12 months to March 2019. The Covid-19 pandemic caused significant disruption to services over a two-year period and the NHS is now recovering from this disruption. 6.5 As part of its work to recover services, NHS England published and put into effect the first round of dental contract reforms since 2006 after being asked to lead the NHS Dental System Reform in April 2021. The primary goal of this initial set of reforms was to improve accessibility. NHS England is aware that these efforts are just the beginning and is considering what further action is required to address the root issues affecting delivery. 6.6 NHS dental services are commissioned to provide urgent and routine treatment. People can attend any dentist accepting NHS patients and may therefore access care in a location convenient for them. Where a person is experiencing an urgent dental issue, and they are known to a dental practice, they should contact that practice to attempt to make an appointment. Where the person is unable to secure an appointment, or they are unknown to a dental practice then they should contact NHS 111 for assistance to find an emergency or urgent appointment. 6.7 Further information has been set out in a letter to the Committee, issued alongside the publication of this Treasury Minute on 30 March 2023.