Agenda item

Michelle Ford, Assistant Director of Commissioning and Jayne MacDonald, Head of Primary Care and Community Commissioning (NHS dentistry), Eastern & Coastal Kent Primary Care Trust and Bob Deans, Deputy Chief Executive, West Kent Primary Care Trust will be in attendance for this item to respond to questions about the commissioning and provision of NHS Dentistry.

(Michelle Ford, Assistant Director of Commissioning, Jayne MacDonald, Head of Primary Care and Community Commissioning (NHS Dentistry), Eastern & Coastal Kent Primary Care Trust, and Bob Deans, Deputy Chief Executive, West Kent Primary Care Trust, were in attendance for this item)

(1)              The Committee had last looked at the issue of dentistry on 9 March 2007.

(2)              The Primary Care Trusts had been invited, in advance of the meeting, to submit to the Committee written evidence in response to questions which covered the following issues:-

(a)               whether the commissioners had a clear and reliable picture of the extent and distribution of  unmet need for NHS dentistry, and what data sources they were using for this purpose;

(b)               what steps the PCTs were taking to ensure services were provided to address that unmet need;

(c)               whether the current General Dental Services contract was sufficiently attractive to dentists to allow commissioning of adequate levels of provision in all areas – or whether dentists still felt they are having to work “on a treadmill” because of the target-driven nature of the contract (based on Units of Dental Activity);

(d)               whether salaried provision had been considered as a possible means of commissioning NHS dental services for underserved communities;

(e)               to what extent the PCTs were experiencing shortfalls in expected patient charge revenue and whether this was affecting their ability to provide adequate dental services;

(f)                 whether, if PCTs had experienced shortfalls in patient charge revenue, the investment of additional funds (£30 million nationally) by the Department of Health as a one off measure to offset shortfalls in 2007–8 was going to resolve the problem;

(g)               whether they had sought, as some PCTs reportedly had, to link capital funding for dentists with a commitment to see more patients who were eligible to pay NHS charges, in order to reduce the risk of a shortfall in patient charge revenue;

(h)               whether the PCTs had clawed back contractual payments to dentists failing to achieve the 96% threshold of contracted Units of Dental Activity and, if so, how many dentists this had affected;

(i)                 whether the PCTs could guarantee that dental budgets would not be raided after ring-fencing of those budgets ended in 2009;

(j)                  What steps the PCTs were taking to ensure that dentists provided more complex treatment where clinically appropriate; spent more time with patients, allowing a more preventative approach to oral health; and provided proper continuity of care for patients;

(k)               whether the PCTs were putting into Dental Public Health the resources necessary to allow the identification of unmet need for dentistry and inequalities in oral health, so that dental services could be properly planned to address those issues.

(3)              The Committee also had before it correspondence relating to issues of concern raised by the Eastern & Coastal Kent Patient and Public Involvement Forum Swale Locality Group.  Having heard and received responses to its questions, the Committee reached the following conclusions:

a)             The Committee welcomed the reported interest shown by dentists in taking up NHS contracts.  The PCTs were asked to give further consideration to the way that they communicated with the public and patients, particularly around charges for dental services. It was felt by the Committee that there was a perception that the public did not know what they are expected to pay and this might be exacerbating health inequalities by discouraging the less well-off from seeking treatment.

b)             The Committee would recommend that there was an independent audit undertaken of dentistry provision across the county.  The Committee would also welcome quarterly reports being made available to it regarding NHS dentistry provision.

c)             Details of unmet need for dentistry across the county should be made available in the Primary Care Trusts’ Local Delivery Plans. The Committee would welcome details of how many NHS dentists there were in total and where they were situated across the county.

RESOLVED:-

            (a)       That the conclusions of the Committee be drawn to the attention of health colleagues; and

            (b)       that a progress report on how the Committee’s views were being taken forward should be made available to the Committee in four months’ time.