Agenda item

33.1     The Committee considered a report from NHS Sussex providing a progress update on work underway to enhance routine and urgent dental care access for people across the county.

33.2     The Committee welcomed that the report included a number of positive developments, although noted its ongoing concern regarding the future provision of NHS dentistry in the county. The Committee commented that reform, in particular to the dental contract, by national Government was necessary to address the challenges in dentistry.

33.3     The Committee commented that its preference was for NHS Sussex to use East Sussex specific data wherever possible, rather than Sussex-wide information, and requested that NHS organisations bear this in mind when writing future reports.

33.4     The Committee asked how many of the 26,500 additional appointments for Sussex would be for East Sussex.

33.5     Carole Crathern, NHS Sussex Head of Primary Care Commissioning Dental & Optometry explained that the target for NHS Sussex of 26,500 additional appointments had only come a couple of weeks prior, and that it was still planning how these would be used. NHS Sussex was seeking to expand its urgent dental care and stabilisation programme based on demand.

33.6     The Committee asked why East Sussex only had 4 out of 17 ‘golden hello’ posts in Sussex.

33.7     Carole Crathern explained that Lewes and Hastings were the two areas in East Sussex that had been identified as priority areas for ‘golden hello’ posts, and that NHS Sussex had approved every application that it received from providers for those posts. Nish Suchak, East Sussex Local Dental Committee (LDC) Chair added that East Sussex had done comparatively well nationally in accessing golden hello posts. He added that one of the reasons few dentists had taken up golden hello posts was because it tied dentists in for 3 years, which was a high level of risk of practices to take on. He added that a lot of new dentists found it difficult to work for the NHS and reform to the national contract was needed.

33.8     The Committee asked how patients in Rother would be able to access services, including the Urgent Dental Care & Stabilisation Programme (UDCS), noting the lower level of contract performance as well as the size of the district and travel concerns.

33.9     Carole Crathern explained that NHS Sussex had not yet been able to identify providers willing to offer the UDCS in Rother, despite interest in other areas of the county. NHS Sussex was working to address this and set up sites delivering the programme in Rother, as well as to support providers in the district to increase their contract performance and delivery of Units of Dental Activity (UDA).

33.10   The Committee asked for clarity on how many patients were being treated privately in East Sussex.

33.11   Carole Crathern explained that NHS Sussex did not hold data on private patients.

33.12   The Committee asked which practices in Hastings were delivering the Additional Hours Scheme.

33.13   Carole Crathern said that the three practices in Hastings offering the Additional Hours Scheme were: Springfield Road, Priory Road and Flint House surgeries. The Additional Hours Scheme would be stopping at the end of March as the appointments would be transferring to the expanded UDCS programme, although in effect it would be the same service under a new name.

33.14   The Committee asked how many more dentists needed to work for the NHS for there to be a comprehensive service in East Sussex.

33.15   Magaret Case, East Sussex Local Dental Committee member, noted that in Lewes there was an average of 1.43 Units of Dental Activity (UDAs) per head of population, which equated to approximately one and a half check-ups a year per person. Her view was that a minimum of 4 UDAs per head of population was needed to ensure everyone received the level of dental care they needed, such as having fillings or crowns put in.

33.16   The Committee asked how the contact number for the UDCS was being publicised.

33.17   Carole Crathern explained that NHS Sussex had been trying to promote the helpline through all available avenues. NHS Sussex was hoping that dental practices not signed up to deliver the UDCS would be signposting patients to it where appropriate, and was going to explore how this could be done in conversation with the Local Dental Committee.

33.18   The Committee asked about for more detail on how NHS Sussex was working with local authorities to promote oral health in schools.

33.19   Carole Crathern explained that NHS Sussex had run a task and finish group working with Local Dental Committee members and local authorities to explore a flexible commissioning scheme which would offer child friendly dental practices for parents to take children younger than 1-years-old and taken them on as regular patients. This work also explored whether some practice staff could act as ‘champions’ and provide outreach. The Government had also committed to a supervised school toothbrushing campaign which was expected to come in at some point in autumn 2025, and NHS Sussex would work with local authorities to roll that out.

33.20   The Committee asked if there would be funding to support the supervised toothbrushing programme in schools.

33.21   Carole Crathern said that details had not been provided on the supervised toothbrushing campaign, but that NHS Sussex would work closely with local authorities to deliver it.

33.22   The Committee asked what if NHS Sussex had information or data on the consequences of lack of access to dental care, for example in missed or late diagnosis of mouth cancer.

33.23   Carole Crathern said that there was data available for extractions, but was unsure on data for mouth cancer. Cllr Osborne commented that having data on the consequences of lack of access would be helpful in lobbying Government in order to support a more preventative approach to healthcare. Nish Suchak added that dentists were not paid for preventative work and reform of the dentistry contract was needed to support practices to do more preventative work such as blood pressure checks or smoking cessation.

33.24   The Committee asked that data on the domiciliary dental care pilot for elderly care home residents be shared when available.

33.25   Carole Crathern agreed to provide data on the pilot, which had gone live in Crawley in November, when it was available.

33.26   The Committee asked what support was available for patients who could not afford to pay the NHS rate for dental treatments.

33.27   Carole Crathern explained that there were some exemptions for patient charges, but that these were set nationally so NHS Sussex could not change this.

33.28   The Committee asked if tooth extractions had increased.

33.29   Carole Crathern agreed to look into the data on extractions and provide the information to the Committee.

33.30   The Committee RESOLVED to:

1) note the report; and

2) receive an update report at an appropriate date, subject to the timing of the publication of the Public Accounts Committee report on Fixing NHS Dentistry.