Dentistry : evidence to the House of Commons Health and Social Care Select Committee inquiry
All Integrated Care Boards (ICBs) will have taken on responsibility for the commissioning of NHS dentistry from NHS England by 1 April 2023, making this inquiry a timely opportunity for the committee to undertake this inquiry. This upcoming change in commissioning arrangements offers the ability to do things differently.
ICS leaders are enthusiastic to apply a system-lens to the problems in NHS dentistry and see a focus on prevention and upstream work – keeping patients out of hospital – as a key way for health services to stem the tide of the most severe dental cases which are becoming all too common in the current context.
That said, ICS leaders are anxious about what they are inheriting and they know that it is unlikely that we are going to see drastic improvements to patient outcomes nationwide in year one of the new commissioning arrangements without further national support.
Both commissioners and providers of dental services have concerns about the existing dental contract, which often disincentivises dentists from taking on more NHS patients.
ICS leaders want to be empowered with greater flexibility in the contract so they can develop new models of care and ensure the NHS can provide care for those patients who need it.
In order to make the most of this opportunity, there are a number of things ICS leaders want to see from government and NHS England, in common with wider NHS Confederation members.
- A clear strategy for commissioning support and the transfer of expertise from NHSE (or elsewhere) into systems.
- Dental underspend remain with ICBs rather than being ‘clawed back’ by NHSE. This will allow systems to reinvest dental funding back into transformative dental services, from new UEC centres to preventative programmes, rather than being used to plug gaps elsewhere in the national budget.
- Workforce shortages in dentistry to be included in the government’s long-term NHS workforce plan, which must be fully funded by Treasury.