The NHS Confederation is keen to ensure that primary care trusts (PCTs) are equipped with the necessary skills to commission and deliver dental health services.

PCTs took over responsibility for commissioning primary care dental services in April 2006 after a Public Accounts Committee report highlighted disturbing variations in the numbers of NHS dentists and the standards of oral health in England. We believe that by taking responsibility for commissioning NHS dental services, PCTs will be able to respond to local needs and, by exerting influence over where dental practices are located, they can help reduce the number of people currently unable to register with an NHS dentist.

NHS Employers and the British Dental Association (BDA) have announced a successful outcome to the BDA ballot on proposals to modernise the salaried dentists' contract. Work is now underway to support the implementation. For more details visit the NHS Employers website.

Health Select Committee inquiry on NHS dental and orthodontic services

The health select committee's report (published on 3 July 2008) recommended that where PCT commissioning of dentistry services is poor they should seek advice from dental public health specialists. It also claimed that PCT allocation must be based on needs assessment.

The NHS Confederation submitted evidence to the Health Select Committee on NHS dental and orthodontic services in December 2007. The key points were:

• PCTs have lacked the capacity to realise the potential of the contract - both in management resource and access to dental public health expertise.
• There is an opportunity to consider the future direction of dental services within the Primary and Community Services Strategy, which is being produced as part of Professor Lord Darzi's NHS Next Stage Review.
• PCTs need to consider dental services alongside all their other local priorities. We estimate that it would cost £2.3bn to introduce full coverage of NHS dentistry across the country.
• Clinical engagement is crucial; where good relations are developed, good performance management arrangements are usually in place.
• Incentives for prevention and health promotion should be strengthened.
• Funding needs to be reviewed due to the shortfall created as a result of less income from patient charges than expected and due to the consequences of allocations based on historical activity. This is particularly significant in the run up to 2009 when PCT allocations for dentistry cease to be ring-fenced.

Review of dental public health

The Department of Health is reviewing capacity and capability in dental public health with the aim of contributing to health improvement and significantly improving oral health, reducing oral health inequalities, ensuring patient safety and improving quality in dentistry.

The review aims to increase focus across England on:

• Effective health promotion and prevention of oral disease
• Provision of evidence-based oral and dental care
• Effective dental clinical governance.

These aims will be achieved through a health, social care and education system in which there is appropriate dental public health capacity, capability, leadership and skill mix. The goals of the review are to ensure:

• Dental public health informs the development of healthcare policy at all levels of policy making
• The NHS commissions to improve the oral health and well-being of the population, to reduce oral health inequalities and to make oral health services available for all, tailored to individual need
• The wider dental team works with other healthcare workers and other agencies to promote health and prevent disease, including through a common risk factors approach
• There are robust systems to ensure pateint safety and promote high standards of effective clinical performance in dentistry
• The education and training of dental and healthcare professionals and others contributes to oral health improvement
• High quality research supports oral health improvement and the delivery and organisation of high quality evidence-based dental care.

NHS Employers and the NHS Confederation are representing organisations' views on the review. For more information email graham.saunders@nhsemployers.org

How we involve members

To find out more about how to get involved contact the Network or visit the PCT Network pages.

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