Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, pursuant to the Answer of 7 February 2017 to Question 62250, what assessment he has made of the effect of recent trends in the cost of multiple child tooth extraction on the Government's policies on the level of investment in dental practices.

NHS England commissions services based on need.

The information held by NHS Digital for primary care and secondary care cannot currently be broken down to distinguish between single and multiple extractions.

Total numbers of extractions in children are reducing. Information held by NHS Digital shows that for the latest year available the total number of extractions for children has reduced when compared to the previous year in both primary and secondary care.

The total number of primary care courses of treatment and teeth extractions from 2010/11 to 2015/16 can be found in Table 1 below.

A count of finished admission episodes (FAEs) which includes for a main operative procedure of 'tooth extraction' for children can be found in Table 2 below.

Count of the total number of courses of treatment (CoT)¹ that contain extractions and teeth extracted, for adults aged 18+ and children aged 0-17, 2010-11 to 2015-16, England.

Notes:

1. A CoT is defined as:

- an examination of a patient, an assessment of their oral health, and the planning of any treatment to be provided to that patient as a result of that examination and assessment; and

- the provision of any planned treatment (including any treatment planned at a time other that the time of the initial examination) to that patient.

2. Processing of the clinical dataset changed in 2013-14. Historically the clinical data were grossed up to match the Courses of Treatment data. Due to a change in the data structure this is not the case for data from 2013-14 and subsequent years.

The difference between the two datasets is due to a change in the processing of FP17 forms by NHS Business Services Authority. From 2013-14 any FP17 forms received more than two months after the date of completion are processed but no Unit of Dental Activity allocated. Historical figures have not been adjusted and the change in processing may be accountable for some of the year on year changes.

Count of finished admission episodes (FAEs)¹ by main operative procedure of 'tooth extraction'² for 0-19 year olds from 2010-11 to 2015-16³

Activity in English NHS Hospitals and English NHS commissioned activity in the independent sector.

Notes:

1. Finished admission episodes

A FAE is the first period of inpatient care under one consultant within one healthcare provider. FAEs are counted against the year in which the admission episode finishes. Admissions do not represent the number of inpatients, as a person may have more than one admission within the year.

2. Main operative procedure

The first recorded procedure or intervention in each episode, usually the most resource intensive procedure or intervention performed during the episode. It is appropriate to use main procedure when looking at admission details, (eg time waited), but a more complete count of episodes with a particular procedure is obtained by looking at the main and the secondary procedures.

OCPS 4 Codes used:

F10.1 – Full dental clearance

F10.2 – Upper dental clearance

F10.3 – Lower dental clearance

F10.4 – Extraction of multiple teeth NEC

F10.8 – Other specified simple extraction of tooth

F10.9 – Unspecified simple extraction of tooth

F10.9 includes, but is not limited to extraction of single tooth

3. Assessing growth through time (Admitted patient care)

HES figures are available from 1989-90 onwards. Changes to the figures over time need to be interpreted in the context of improvements in data quality and coverage (particularly in earlier years), improvements in coverage of independent sector activity (particularly from 2006-07) and changes in NHS practice. For example, apparent reductions in activity may be due to a number of procedures which may now be undertaken in outpatient settings and so no longer include in admitted patient HES data. Conversely, apparent increases in activity may be due to improved recording of diagnosis or procedure information.

Note that Hospital Episode Statistics include activity ending in the year in question and run from April to March, e.g. 2012-13 includes activity ending between 1 April 2012 and 31 March 2013.