Agenda item

The Board received a presentation by Debbie Stovin, Dr Sarah Robertson and Agatha Agema which gave an overview of how South Yorkshire ICB and City of Doncaster Council were working to improve oral health and reduce oral health inequalities in Doncaster.  The presentation covered:

• Population oral health data;
• A summary of the recent oral health needs assessment (OHNA);
• An overview of the dental commissioning challenges, including dental contract limitations;
• Access to dental care and the areas of opportunity to improve dental services through system working;
• The oral health position in Doncaster; and
• An overview of local community oral health improvement programmes.

The presentation concluded with a summary of what needs to happen in relation to further actions and next steps.

The Board noted that a South Yorkshire Dental Stakeholder event was to be held in Rotherham on the morning of 30 November.  This event was open to a wide range of partners and agencies, including HWB and Overview and Scrutiny members, ICB members, representatives from dental practices, Healthwatch and other agencies.  Further details and invites for this event were currently being sent out.

The officers then answered a wide range of questions on the presentation and the Board discussed various issues raised, including the following points:-

• The officers described what they felt would constitute success in 12 months’ time.  This included improving accessibility to dental services, better engagement with patients and reducing complaints.  Anthony Fitzgerald stressed that if the ICB chose to make dental services a priority, then resources could be reallocated to assist with this, but obviously the ICB could only work with the resources that were available to it and in the light of the contractual limitations that had been referred to in the presentation.

• The Board recognised the importance of targeting support for those who struggled with accessing dental services the most, e.g. homeless and other vulnerable people and families living in deprived areas.  Measures being taken included the establishment of a dental service for homeless people which it was hoped would commence in the next few weeks.  The Board was also informed that a flexible commissioning scheme was operating, which took referrals from health visitors and looked after children teams for any children who did not have access to an NHS dentist and who were at high risk of poor oral health.  Under this scheme, children were referred to one of the flexible commissioning dental practices for treatment.

• Rachael Leslie explained that the number one measure that would improve dental health and oral health was fluoridisation of water supplies across South Yorkshire, including Doncaster.  She explained that plans and a survey for an operable scheme to introduce this across the region had been drawn up by engineers and submitted to the Secretary of State for a decision.

• The Board noted the importance of supervised tooth brushing schemes for children so that they learned the basics of oral/dental self-care, while recognising the need to get the message across to parents/carers that tooth brushing at home should still be carried out by children twice a day.

• Councillor Nigel Ball expressed the view that dental services warranted additional resourcing and prioritisation in Doncaster, given that it had the highest incidences of tooth decay amongst the South Yorkshire local authority areas.  He also drew attention to the fact that although there were currently 24 dental practices across South Yorkshire which provided urgent access sessions, there was only one practice in Doncaster that supported the urgent care patient pathway, and he felt that this was clearly insufficient.  Cllr Ball also highlighted the apparent lack of up-to-date data in the report, citing as an example the figures relating to adult oral health impacts in Yorkshire and the Humber 2018 by local authority.  In response, Anthony Fitzgerald stated that the ICB would fully consider its options and the scope for prioritising dental services in Doncaster when it reviewed its resource allocations over the next 12 months.  He explained that there was a balance to be struck when allocating resources in terms of how much was put towards the provision of additional access sessions at dental practices in the short term, and how much was invested in the prevention and education elements, which would help in the longer term to improve the oral health of the population.  With regard to data, Anthony acknowledged that this was particularly poor in relation to dental health and access.  He explained that data in this field was notoriously difficult to calculate and measure but accepted that there was a need to improve data and transparency around dental services.

• In response to a question as to whether deprived communities in Doncaster were being engaged with, Debbie Stovin explained that the South Yorkshire Healthwatch organisations were represented on the local dental network and would be involved in the Stakeholder event on 30 November.  She added that work was being done with the ICB in looking at ways of improving communications with communities across South Yorkshire.  On this point, Fran Joel stated that she had some concerns that because Healthwatch organisations were being asked by the ICB to work together at a South Yorkshire level, the focus on Doncaster as a place and on the local data she was collecting at Healthwatch Doncaster might be overlooked and ‘lost’ when the information was received and discussed at the Stakeholder event later this month.

• Councillor Sarah Smith stressed the importance of having access to local data down to Ward level, which would help with understanding the health inequalities in specific areas, particularly those which had deprived communities living in them.

The Chair then summarised the recommendations/actions that would need to be taken forward and it was

RESOLVED:

1.   To commit to and provide the necessary resources for further engagement with stakeholders to ensure continued oversight of the local position for dental services.  It was essential that a clear picture of the local situation as regards access to dental services was available, such as the number of children who did not have access to a dentist.  The Chair stated that there was a wealth of anecdotal evidence that had been collected by Well Doncaster from engaging with local communities and it was important that this information was collated and made available for the Stakeholder event on 30 November;

2.   To provide a commitment for continued development of community oral health improvement programmes year on year to ensure continuity of programmes.  The Chair stated that she felt embarrassed as HWB Chair to hear the shocking statistics in relation to the number of children with tooth decay – this was a fundamental basic that needed addressing.  She added that it was also important to factor in the barriers that families faced, such as the cost of living, in trying to adopt healthier lifestyles, and provide additional support to families where needed;

3.   That a telephone number should be provided in addition to the digital platform to enable people to find dental practices that were accepting new patients, as it was important to recognise that some people were digitally excluded and did not have access to the internet;

4.   To ensure that oral health improvement is part of the Health and Wellbeing Strategy for Doncaster, and that there is continued support for water fluoridation;

5.   That the SY ICB looks at options for re-allocating resources in order to bolster oral health services as a priority.  Similarly, the City of Doncaster Council looks at resourcing in relation to prevention activities with regard to oral health;

6.   To carry out a refresh exercise of the Doncaster Oral Health Needs Assessment; and

7.   That the Board receives an update on this item at its meeting in March 2024.