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NHS bosses discuss ‘grim’ state of access to NHS dental services in Nottinghamshire

Health leaders have described the state of access to NHS dental services in Nottinghamshire as ‘grim’ following an assessment by public health experts.

The report by NHS England in the Midlands says the pandemic had a “considerable impact” on dental services and the long-term effect on oral health is “a cause for concern”.

The Nottinghamshire County Health Overview and Scrutiny Committee discussed the issue at its meeting on March 28.

The report by NHS England shows Nottinghamshire currently has 109 general dental practices.

NHS England representatives also attended the meeting, where leaders discussed recovery plans for dental services post-pandemic.

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Councillors unanimously agreed at the end of the meeting to send a joint letter to Nottinghamshire MPs requesting support in reforming the current NHS dental contract.

Chair of the committee Cllr Sue Saddington (Con) said: “We wanted you to come to explain why people out there cant get dental appointments.

“We all meet people who pull their own teeth out and stick Blu Tack in – horrendous things.”

Caroline Goulding, Head of Primary Care Commissioning for the East Midlands, said: “Being completely transparent, dentistry was challenged before the pandemic in respect of access.

“The pandemic has significantly worsened that. Access to dentistry not just in Nottinghamshire but across the East Midlands is not where we want it to be.

“The team are doing everything we possibly can, there is a huge amount of work nationally to try to address bigger contractual issues.

“In Nottinghamshire, we are working at around 87 per cent restored pandemic activity.

“We feel that by the end of the financial year of 2024, we will have restored all activity from pre-pandemic.

“We are aware that there are huge swathes of the population that we need to access.

“It’s grim, I’ve got to be honest, with all the MP letters and patient complaint letters. We are doing everything we can within our scope to improve it for patients.

“My team investigate every single complaint with clinical advisers.”

Cllr Saddington said: “You’re saying the waiting lists will take two or three years to come down, people will have rotten teeth by that time.

“It isn’t acceptable that people are in pain and can’t get an appointment.”

Claire Hames, Commissioning Manager, East Midlands, said the team has commissioned weekend sessions for over 300 patients.

It has also secured funding for dedicated Urgent Care slots during surgery opening hours.

Two practices in Hucknall and Mansfield are also offering an additional 25 urgent care slots per week.

Measures are in place to deal with increasing backlogs – in Nottinghamshire two NHS practices have been contracted to provide 140 additional appointments at a cost of £70,000.

Nottingham city and Nottinghamshire councils have also been awarded £150,000 towards oral health improvement activities.

Another scheme called the ‘Golden Hello’ scheme intended to improve recruitment and retention among dentists will see payments of up to £15,000 for each new eligible full-time dentist within East Bassetlaw.

NHS England said it has received one application for the scheme.

Cllr Steve Carr (Lib Dem) said: “I’ve come across several people that I represent who have actually pulled out their own teeth which must be dreadful.

“This will have a long-term detrimental impact on residents.

“With NHS appointments scarce at best, people are being forced to spend hundreds if not thousands on private care.

“Fault lies solely with national government who have done next to nothing to tackle this crisis.”

Adam Morby, Regional Chief Dentist, replied: “As a practising dentist, I couldn’t agree with you more. Everything you’ve just said is 100 per cent correct.

“There are enough dentists in this country to deliver a service, unfortunately, the contract is stopping them from going into that.

“Currently we’ve got graduates leaving university, who have had public money to become a dentist, and they are going straight into private practice. That needs to change.

“We are limited with the workforce. We are fighting a losing battle at the moment, unfortunately.”

Cllr David Martin (Ind) said NHS dentistry is in a “systemic failure because of the contract”.

He added: “Our poorest residents have been let down by a lack of support from the government.

“I suggest this committee writes to all Nottinghamshire MPs to ask for action.”

The report also said the districts with the highest proportion of five-year-olds with tooth decay are Bassetlaw and Gedling, at 23.5 per cent of children.

Rushcliffe has the lowest proportion with 12.7 per cent

Cllr Michelle Welsh added: “I am concerned that people can’t get their children into an NHS dentist, I am very worried about that.”

All routine services were required to stop operating when the UK entered lockdown in 2020 – and a network of Urgent Dental Care centres (UDCs) was set up across the Midlands to allow those requiring urgent dental treatment to be seen.

Services reopened in June 2020 but social distancing was required.

“For a large part of 2020, many practices were only able to provide about 20 per cent of the usual number of face-to-face appointments and relied instead on providing remote triage of assessment, advice, and antibiotics (where indicated)”, the report stated.

Only in early 2021 did the situation start to improve, the report said.

Nottingham and Nottinghamshire Integrated Care Board has responsibility for dental services in the city and county.

The NHS England report stated: “Reduced access to NHS dental care over the course of the pandemic will have resulted in compromised outcomes for some patients.

“Due to the duration of the lockdown and the length of time during which routine face to face activity ceased, a number of patients who ordinarily would have had a clinical intervention may have struggled to gain access to NHS dental care.

“Some who were part way through dental treatment will undoubtedly have
suffered and may have lost teeth they would not have otherwise – temporary
fillings placed pre-lockdown, for example, and only intended as temporary
measures, may have come out causing deterioration in outcome.”

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