Source · Select Committees · Public Accounts Committee
Recommendation 24
24
Accepted in Part
National mobile dental van initiative proved ineffective; no Integrated Care Boards invested
Conclusion
The idea of identifying ICBs to commission mobile dental vans seems a particular example of an ineffective interaction between a national policy and an appropriate measure on the ground. NHSE and DHSC identified twelve ICBs to deliver the initiative,69 but none of these ICBs have since chosen to invest in a dental van.70 DHSC acknowledged that ICBs know their own “patches” the best, and that allowing them to use that knowledge to decide on the best way to provide dental service would be preferable to trying to direct that from Whitehall.71 NHSE also acknowledged the importance of working with local commissioners, especially given that dentistry is a delegated service, to share best practice and to have accountability for implementing reforms locally.72 We note that this will be tested in the proposed method for actioning the new government’s commitment to delivering an additional 700,000 urgent appointments.73 In written evidence after the evidence session, NHSE and DHSC told us that dental commissioning teams within ICBs will be working to make these appointments available as soon as possible from April 2025.74 67 Q 55 68 C&AG’s Report, para 2.11 69 NHSE, Dental recovery plan update, Annex B, published 10 May 2024 70 Q 49 71 Q 51 72 Q 48 73 Q 101 74 Letter from the Interim Permanent Secretary of the Department of Health and Social Care and the Chief Executive Officer at NHS England relating to a follow up on the oral evidence session held on 13 February 2025 on Fixing NHS Dentistry, 18 March 2025 16 2 Future reform of NHS dentistry Establishing the true cost of NHS dentistry
Government Response Summary
The government acknowledges the need to strengthen relationships with ICBs and reaffirms the importance of local decision-making. NHSE has taken active steps to engage ICBs on policy implementation and upcoming reforms, including future engagement and a wider consultation for 2026 Payment and Quality reforms.
Government Response
Accepted in Part
HM Government
Accepted in Part
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.