Agenda item


To receive an update on dental services.


Kelly Nizzer, Andrew Biggadike and Rakhee Patel from NHS England reported on NHS dental services in north central London. 


Ms Nizzer reported that dental practices had been asked to close at the start of the Covid pandemic due to safety concerns for patients and staff.  They had remained closed for 12 weeks, which had caused a large backlog.  During this period, only patients in urgent need had been seen.  Urgent care hubs had been established and these had been treating between 1500 and 1750 patients per day.  These were still operating, although the numbers of them had been reduced.  Primary care dental services were being gradually re-established, with full capacity being reached in the current quarter.  The backlog in each borough varied and was dependent on the size of the NHS contract. 


£50 million of short term funding had been allocated by the government to address backlog.  The funding was only for eight weeks and could not be carried over.  It did not provide for the full range of treatments and was only intended to stabilise patients.  There was a London wide access issue for dental care and this had been the case before the pandemic.  Services were doing that they could to deal with it.  There were still 35 urgent care hubs and these were operational from 8:00 a.m. till 1:00 a.m. and were treating 600 patients per day.  This was not happening anywhere else in the country.  However, they could only see people who were in pain.  The eight weeks of additional funding was welcome but would not fully address the backlog. 


Mr Biggadike reported on waiting times for secondary and acute care.    There were no patients waiting for more than 104 weeks at the Royal Free but there a small number waiting for between 52 and 89 weeks.  At UCL, there was only one patient that had been waiting over 104 weeks and the majority were under 52 weeks.  The backlog was affected by clinical priority as those waiting for dental procedures were often not considered high enough.  Some additional funding had been obtained to provide additional general anaesthetic procedure rooms at Barts though.  North east London and Barts had the longest waiting list.   Community Dental Services were recovering well but still under pressure.  In respect of looked after children, there was a pilot project in place for high street dentists to treat them.  Oral health promotion was reliant on being commissioned by local authorities and some were better than others in doing this.


Ms Patel reported that there was variation in the levels of dental health amongst children in north central London.  27% of five year olds had been found to be suffering from some sort of decay.  Levels in Haringey and Enfield were well above the average.  Mr Biggadike stated that London wide fluoridation would address this but it was very unlikely to happen.  Some schools had supervised brushing as part of oral health promotion.  Some oral health promotion work was also done with special schools.   It would be beneficial for more work to be done but there was a lack of funding.  It was dependent on local authorities for funding and being made a priority.   It was noted that provision varied between boroughs.  Some provision was universal and some was targeted, with targeted services being the direction of travel. Four of the boroughs commissioned services from Whittington Health whilst Barnet had commissioned a private company and only provided for children and not care home or for people with a learning disability.   Levels of dental decay were highest amongst deprived communities.  


In respect of the oral needs assessment, Ms Patel stated that there was a need to do this across London.  All relevant data needed to be looked at, needs assessed and gaps identified.  It was important to ensure that practices were located in the right places when re-procurement took place.


Councillor Cornelius requested further information regarding oral health promotion in Barnet.  Mr Biggadike stated that Barnet had not procured its services from a community provider but was instead using an external provider.  Historically, it had only provided such services to children and young people.  He agreed to provide further details of the current situation to Councillor Cornelius.


In answer to a question regarding access funding, Ms Nizzer reported that funding could not be accrued and would not be sufficient to clear the backlog.  She was not anticipating any underspend though.  Continued funding had been provided for the urgent care hubs in London though.  It was noted that there would be ongoing challenges in Community Dental Services and secondary care as well. 


The Committee expressed concern at the size of the backlog and at the long waiting times for secondary care.  It expressed its support for efforts to secure additional funding  and improve access.  It was agreed that information would be sought from each Director of Public Health in north central London regarding funding for Oral Health Promotion and how this was allocated.




That information be sought from the Director of Public Health in each borough regarding funding for Oral Health Promotion and how this was allocated.


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