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Petition Independent review of the NHS dental contract

The current dental care arrangements were launched in 2006 and by 2008 the House of Commons described the system as “failing by any criteria". These arrangements are failing patients and dental teams leading to access problems around the country.

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We need a dental service that has prevention at its heart with a priority of delivering access to care and reducing dental health inequalities.

We need a system that enables the whole of the dental team to contribute to improving health, empowering dentists, therapists, hygienists, technicians and nurses to work together to provide the best possible care for patients.

We are calling for an independent review of the existing contract and a radical rethink of the way in which dental services are delivered.

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Government responded

This response was given on 23 February 2021

The Government is committed to reducing oral health inequalities and ensuring that patients can access high quality NHS dental care.

There are currently no plans for an independent review of dentistry.

NHS England and Improvement (NHSE&I) has a duty to commission NHS dental services to meet local need. We acknowledge there are regional hotspots where access is an issue and NHSE&I have been active in many of these areas, prior to the pandemic, ensuring that services better meet patient needs.

We recognise, however, the limitations of the current NHS dental contract, which is why NHSE&I has also introduced initiatives such as ‘flexible commissioning' which allow local NHS teams to commission a wider range of preventative services from NHS dental practices, which also make use of the full skill mix of all disciplines within the dental team, with the aim of providing an increase service for patients and a multidisciplinary approach to delivery of NHS dental care.

Health Education England is also continuing to explore opportunities for flexible dental training pathways through their Advancing Dental Care programme, the aim of which is to improve dental workforce retention.

The Department has also been working closely with NHSE&I to test a new way of providing NHS dentistry which includes a remuneration model which incentivises an increased focus on prevention. It is yet not clear whether the approach has been able to offer sustainability for practices or value for money for the NHS. We have been working closely with prototype practices to understand this further and this information will feed into the evaluation report due to be published later this year.

Current NHS dental provision is particularly affected by the risk of COVID-19 transmission. The requirement for enhanced levels of PPE and increased PHE infection prevention and control procedures has significantly reduced the numbers of patients that NHS dental practices are safely able to see. Our immediate focus for dentistry must be tackling the impact that the COVID-19 pandemic is having on the provision of dental services and working with the profession to restore vital patient access to services, as safely and quickly as possible.

To facilitate these aims, the Department is working closely with NHS England and Improvement and the Office of the Chief Dental Officer on contractual arrangements for 2021/22 onwards. An announcement will be made shortly regarding these arrangements. Whilst the current focus remains on improving access to dental services in light of the pandemic, prevention focussed work is also ongoing to improve oral health.

Public Health England’s Child Oral Health Improvement Programme Board and the Adult Oral Health Oversight Group have continued to meet and provide strategic oversight for oral health improvement during the COVID-19 outbreak. This sits alongside the sugar reduction programme aiming to encourage food and drink companies to reduce the amount of sugar in popular products.

Water fluoridation is clinically proven to improve oral health and reduce oral health inequalities. The upcoming Health and Care Bill will give the Secretary of State for Health and Social Care the power to directly introduce, vary or terminate water fluoridation schemes. This will remove the burden from local authorities and allow for processes to be streamlined.

Department of Health and Social Care

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