Source · Select Committees · Public Accounts Committee
Recommendation 23
23
Accepted
Centrally planned dental initiatives failed to increase activity or influence local behaviour
Conclusion
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
Government Response Summary
The government acknowledges the need to strengthen relationships with ICBs and regions, stating that NHS England has already taken active steps to engage them. This is evidenced by their work with ICBs in preparing for the delivery of 700,000 additional urgent dental appointments from April 2025 and planned 2026 reforms.
Government Response
Accepted
HM Government
Accepted
4.1 The government agrees with the Committee’s recommendation. Recommendation implemented: April 2025 4.2 Whilst NHSE sought to engage ICBs and regional colleagues in the development of the Dental Recovery Plan (DRP) NHSE acknowledge that there is more to do to strengthen relationships, and this is an ongoing activity. Local areas know the needs of their population best and are best placed to make decisions about how care is delivered and the priorities for investment. Since the DRP was published NHSE has taken active steps to engage with ICB and regional colleagues on key areas of government policy, evidenced by our work with ICBs in preparing for the delivery of the government’s commitment on 700,000 additional urgent dental appointments from April 2025. 4.3 The aim of this engagement has been to understand ICB concerns and to ensure a shared understanding of the policy and how it is to be implemented. 4.4 NHSE has also undertaken engagement with ICB and regional colleagues on the detail of the Payment and Quality reforms planned for 2026. This will be further enhanced by ICBs, and other stakeholders, having the opportunity to engage in a wider consultation. 4.5 The government continues to engage with key stakeholders and representatives of the dental sector to deliver the shared ambition to reform the dental contract in order to improve access to treatments for NHS dental patients. ICBs are crucial to achieving this ambition.