NHS Dentistry Services: Carshalton and Wallington

(Limited Text - Ministerial Extracts only)

Wednesday 7th September 2022 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (James Morris)]

It is a pleasure to serve under your chairmanship, Mr Twigg.

I congratulate my hon. Friend the Member for Carshalton and Wallington (Elliot Colburn) on securing this important debate on dentistry. I recognise the scale of the challenge that he described and we are committed to addressing the challenges of NHS dentistry. Those challenges continue to be real across the country, but, as he remarked, we have taken steps to address these issues. We are committed to improving dental access and making NHS dentistry a more attractive place for dentists and their teams to work.

I appreciate that access to NHS dentistry varies across the country, as my hon. Friend described, and that access was a big issue before the covid-19 pandemic. However, the pandemic further exacerbated those challenges, as we had to reduce the amount of care delivered, in line with the infection prevention and control measures that were introduced at that time. The activity thresholds for NHS dentistry were carefully set at that time by NHS England, and balanced access for patients against necessary infection prevention and control measures. At that time, dental practices were asked to prioritise urgent care and care for vulnerable groups, supported by over 700 urgent dental care centres, of which I think there are a number in his constituency.

Services have gradually been returning to normal levels, and I am pleased to say that in July 2022 NHS England asked dental and orthodontic practices to return to full delivery—that is, 100% of their contracted activity. The sector has worked hard to deliver as much NHS activity as it can, with many contractors already delivering 100% or more of their contracted activity for some time. As my hon. Friend mentioned, at the start of this year an additional £50 million was secured and made available for NHS dental services, to support the dental access challenges further and to provide patients with more dental appointments. That additional funding supported NHS dental teams in increasing capacity and giving more people access to vital dental care across England.

Those most in need of urgent dental treatment, including vulnerable groups and children, were prioritised for the additional available appointments that were made possible through that funding, with a third of activities being provided at the weekend and outside core hours. That funding meant that those with higher level of need were seen, with over two thirds of treatments being for the provision of urgent care. More than 64,000 additional patients were seen. I would like to pay tribute, as did my hon. Friend, to all the staff at dental practices and community dental services who went above and beyond to provide this extra care for patients.

We are beginning to see some improvements in NHS dentistry as we recover from the pandemic. The most recent NHS dental statistics report, published a few weeks ago, showed delivery of more than double the number of courses of treatment, compared with the previous year, an additional 539 dentists returning to NHS dentistry and an increase in preventative care provided to children.

As my hon. Friend said, it is clear we need to go further. We are pressing ahead with the package of measures that he alluded to, which we announced on 19 July. To go ahead with the dental reform package was one of the first decisions that I took as a Minister. We worked closely with NHS England, which negotiated with the British Dental Association, and engaged with many other stakeholders on these improvements. The changes include improving the criticised 2006 NHS dental contract to ensure that practices are more fairly remunerated for the care they provide to patients, and enabling practices to make better use of the range of dental care professionals in a practice.

We want to see all members of the team, including therapists, nurses and hygienists working their full scope in a practice, which will make it easier for more people to access care. Practices will be supported to adhere more closely to the National Institute for Health and Care Excellence guidelines on recall intervals, which indicate that a healthy adult with good oral health need see a dentist only every two years, and a child every one year. That will free up capacity to deliver additional care required by higher need patients.

The changes that were also alluded to will also enable NHS commissioners to have greater flexibility in commissioning additional services to meet local need and will enable improved and more responsive management of those contracts. The highest performing practices will be able to deliver beyond their contract and treat more patients.

We will also improve information for patients who are looking for care, which is why we will make it a requirement for dentists to update their information on the NHS website. In addition to those changes, which will increase dental access and recruitment and retention of the dental workforce, Health Education England is working to implement recommendations from its recent 2021 “Advancing Dental Care Review” as part of its four-year dental education and reform programme.

The aim of that work is to develop a skilled, multi-professional oral health workforce, more able to support patient and population needs within the NHS, by reforming dental education and training. The programme will help address inequalities in dental care access across the country, better targeting areas that are currently less well served.

We know that international dentists are a vital part of the UK’s dentistry workforce. To improve the recruitment of overseas dentists and to ensure that international dentists remain a vital part of our workforce, we are currently working with the General Dental Council on legislative proposals that will allow the regulator greater flexibility to expand the registration options open to international dentists. The changes will support alternative routes to the overseas registration exam where appropriate, as well as expand access to the exams.

We aim to introduce the legislative changes this year, subject to the outcome of the recent consultation on the parliamentary approval process. In the meantime, current arrangements ensure that UK regulators continue automatically to recognise relevant qualifications of dentists from the European economic area, and we want to continue to facilitate their vital contribution to the dentistry workforce.

I want to emphasise that the reforms that we introduced on 19 July are one step. I and the Government recognise that they are a first step in a reform programme. In the longer term, we are looking at committing to improve access to urgent care and at the necessity of further workforce and payment reform. We will continue to work with NHS England and the dental sector to consider what further long-term changes may be necessary.

Question put and agreed to.