Catch up on our Open Meeting from 5 July 2023

SWL NHS Dental Services Update
Mark Creelman, Place Executive - Merton and Wandsworth, NHS South West London Integrated Care Board

Mark explained how it is important to the Integrated Care Board (ICB) to hear from people across south west London about their experiences and concerns about NHS dental services, particularly ongoing problems with access that people are facing. NHS complaints are now being dealt with at ICB level and will be grouped and themed into different areas and the new NHS dental services steering group will discuss how improvements can be made.

Mark spoke also about community pharmacies and how more needs to be done to educate professionals about providing appropriate advice to residents in order to take some of the pressure off emergency care and GP services.

He acknowledged some concerns exist with the national dental contract which cannot be changed at this time. NHS dentistry under the current contract can create challenges for dentists which makes it less appealing for them to take on NHS patients. 

Concerns were raised by Open Meeting attendees about health inequalities and people not accessing treatment for crucial dental work due to affordability, meaning they could end up in hospital. Mark assured the Open Meeting that the ICB is listening to this feedback and aware of the access issues but that ultimately the problem lies with the contract and this is what needs to change at a national level. 

Personalised Care Film – Attracta Asika, Head of Transformation, Kingston & Richmond, NHS South West London Integrated Care Board

Attracta shared plans that General Practice professionals will be up-skilled about how to support patients though Personalised Care. She explained that this will to look at all aspects of a patient's life that contribute to their health and wellbeing. There is currently a large communication campaign rolling out across the primary care networks in order to promote this more holistic way of working.

Conversations with GP's will be centred more around what matters to the individual, rather than just what could be wrong with them. This personalised care initiative aims to not only treat physical symptoms but to treat the social causes of ill-health. This requires a community response and leans on social prescribing methods to support people to feel better.

A short film was shared and feedback was provided by Open Meeting attendees on this. The communication campaign will run from November 2023 and will include posters and leaflets with information about what support is available. These will be given to patients in all GP surgeries. 

Kingston NHS Dental Provision Presentation and Q&A - Kunal Patel, General Dentist, Local Dental Committee (LDC) Director for Kingston

Kunal spoke about some of the challenges in dentistry specifically in Kingston. He explained that the main problem regarding access to dentistry services, is affordability for dentists offering NHS dental care. Under the current NHS contract there are different bands for different levels of treatment. However, the challenge for dentists is that it does not matter if a patient needs one filling or seven fillings (for example), the payment to dentists under the NHS contract is limited to only one item of care. This means dentists lose time and money when providing NHS treatments.

Access and cost problems mean that some people in need can't afford treatment (NHS or private) and so leave their teeth in poor state which can lead to bigger problems in the future. Sometimes, it is not cost effective for dentists to take on NHS patients and newly qualified dentists are even less likely to work for the NHS causing a staff retention and staff shortage problem.

As Mark outlined in his update about south west London level challenges, these issues are largely due to the current NHS dental contract which was rolled out in 2006. Under the current contract, what many patients do not realise is that they can register with any dentist across England but even if registered as an NHS patient at your dentist, this does not entitle you to NHS treatment. The current targeted system means dentists are not obligated to treat NHS patients, some only have targets for children. 

Dentists are aware that improvements need to be made in accessibility to NHS treatment, as well as increasing the workforce, the problems relating to health inequalities and people needing ongoing continual care at NHS prices. Commissioning lies with the North East London ICB (but the funding for Kingston NHS dental provision sits within South West London) and as Mark outlined above, not a lot can be changed under the current national contract. However, we continue to listen to patient feedback at every level, in the hope to apply pressure at national level, so that changes can happen. 

Community Voices Kingston covered the following areas:

• New Intensive Treatment Unit, Kingston Hospital - Angela Clarke, Associate Director, Kingston Hospital NHS Trust
• Emerging strategy for Kingston Hospital NHS Foundation Trust, and Hounslow and Richmond Community Healthcare NHS Trust – Jo Farrar, Chief Executive, Kingston Hospital Foundation Trust
• Engagement report back from Joint Forward Plan – Hannah Keates, Engagement Manager Kingston, NHS SWL ICB