Agenda item

Aileen Holyland, NHS Leicester City, will provide an update on progress with the commissioning of dental services in the City.  The Committee is recommended to receive the update and comment as appropriate.

Aileen Holyland, NHS Leicester City, gave a verbal update on progress with the commissioning of dental services in the City, explaining that:-

·            There currently were 215 dentists working in 58 NHS dental practices in the City.  Of these, 46 were general practices and 12 were specialist, (mainly orthodontic).  These practices also were able to offer private treatment;

·            31 practices across the City currently were accepting patients.  A plan showing their location in the City was tabled and is attached at the end of these minutes for information;

·            One large orthodontic practice in the City had a waiting list of approximately 12 – 18 months;

·            Contracts for dental services were activity based and were monitored through annual reviews;

·            A patient pathway had been commissioned with City practices for minor oral surgery;

·            The current budget for dentistry was £14.5 million.  Of this, approximately £12 million was ring-fenced for general dentistry;

·            Additional investment had been received during 2010/11 to set up new practices.  As a result, 2 new sites had been created in the City and five new contracts established with existing practices, enabling an additional 22,000 patients to be treated;

·            There was a target to treat 202,000 patients by 2013.  As at January 2011, just over 188,300 patients were being treated.  Information on the numbers of patients treated was tabled and is attached at the end of these minutes for information;

·            Monthly checks were made with each practice, by telephone, to determine if they were treating new patients.  This also was monitored through each practice’s annual review;

·            NHS Leicester City had the highest number of children in the East Midlands with decayed, decaying, or missing teeth.  This situation was being addressed, for example through the issue of tooth brushes and specific training for hygienists;

·            Some practices called patients every 6 months, even though National Institute for Health and Clinical Excellence guidelines stated that recalls could be every two years.  Leaving longer gaps between recalls would help release capacity for other patients to be seen;

·            Work was ongoing to try to make contact with hard to reach groups in the City;

·            Practices were being encouraged to market themselves;

·            There was a national proposal to introduce contracts with providers of dentistry services based on capitation, registration and quality.  Some local practices had applied to be included in the 60 pilot studies that would be carried out nationally;

·            Procurement was underway for a salaried dental centre and domiciliary provision was being reviewed;

The following points were then made during discussion on this item:-

·            The oral health team visited schools to educate children and young people in oral care and hygiene;

·            It was recognised that some people were scared of visiting the dentist and that work needed to be done to encourage them to attend;

·            Communication was important, particularly in settings such as care homes.  Further training could be useful, for example in how to communicate with people with dementia;

·            Dentists were required to give three months’ notice of leaving a practice, so that the PCT could make alternative arrangements.  However, it was noted that there had been a case where a dentist’s practice had closed, but there had been no clear signposting for patients from that practice to alternative provision;

·            Quality control was done through work with the Care Quality Commission and targets for practices.  If practices did not conform, the PCT could evoke contract levers, such as issuing remedial notices;

·            The water supply in this are did not have fluoride added, although evidence nationally and internationally showed there to be benefits of doing this;

·            There was a walk-in emergency dental centre off London Road.  Part of its role was to sign-post patients to a high street dentist; and

·            All cases referred for orthodontic work were assessed.  Complex cases were passed to the University Hospitals Leicester and the rest were passed to primary care providers.  For the former, there was an average wait for treatment of approximately three months.  For the latter, the average wait for treatment was approximately six weeks.

RESOLVED:

1)         that the report be noted; and

2)         that the Director of Corporate Governance be requested to circulate a list showing the 58 NHS dental practices in the City to all members of the Committee.