Recommendation 23

The dental recovery plan’s four main initiatives were centrally planned by NHSE and DHSC with instructions given to commissioners as to how to carry them out.65 The plan’s delivery, therefore, was heavily reliant on ICBs implementing these initiatives at a local level and delivery by dental practices. The NAO’s report notes that ICB’s had “mixed experiences” of engaging with NHSE and DHSC, and that while some met with the national team to discuss local initiatives and any overlap with the proposed national schemes, these were not always fully taken into account.66 Given the failure of the plan to deliver any increase in activity, it seems clear that these nationally–planned initiatives failed to influence behaviour at a local level, although NHSE told us that they have seen feedback that the initiatives were 60 Q 3; C&AG’s Report, para 2.9 and 2.12 61 Health and Social Care Committee evidence session on 19 March 2024, NHS dentistry, see Q186 62 C&AG’s Report, para 1.5 63 NHSE, Opportunities for flexible commissioning in primary care dentistry: A framework for commissioners, published October 2023 64 C&AG’s Report, para 2.11 65 DHSC, Faster, simpler and fairer: our plan to recover and reform NHS dentistry, published 7 February 2024 66 C&AG’s Report, paras 2.11, 2.15 15 welcomed.67 The NAO’s report notes that there was some flexibility at a local level, for example where the new patient premium potentially overlapped with existing local schemes, and that regions were taking different approaches to implementing the ‘golden hello’ incentive payments.68