Update from ICS on dental services in Yorkshire and Humber – July 2022

Some patients are continuing to experience difficulties in accessing dental services in parts of the region.
dentist examining patient

This is an update from the Humber and North Yorkshire Integrated Care System (ICS)

The Yorkshire and Humber regional dental commissioning team is working closely with local dental networks as well as providers to increase capacity and improve access to local dental services. They remain committed to ensuring patients with urgent needs and delayed treatments are seen first, with routine and non-urgent dental care provided on a prioritised basis. Key areas of progress within the last three months are set out below:

  • National funding released earlier this year has now been made available for practices, with the capacity, to offer appointments to patients with urgent needs.
  • Financial incentives have been offered to all NHS dental practices to ensure they prioritise patients who have not been seen in the practice within the last 12/24 months and who require urgent dental care.
  • An Oral Health Needs Assessment has been carried out to help ensure funding and resources are allocated directly to local communities that are identified as areas of greatest need.

Work is also underway to identify solutions to the recruitment and retention pressures in NHS dental services and to understand and address the constraints of the current national NHS dental contract mechanisms.

A recap on why dental services are experiencing pressures:

The COVID-19 pandemic and the requirement to follow strict infection prevention control guidance to ensure that patients could be treated safely, significantly impacted dental services. Demand for NHS care is therefore significantly higher than pre-pandemic levels at all practices.

While the number of available appointments for regular and routine treatment is increasing, dental practices continue to balance the challenge of clearing any backlog with managing new patient demand, all at the same time facing significant workforce challenges.

What is being done about the difficulties in accessing a regular dentist?

New reforms to the dental contract - the first in 16 years - mean NHS dentists will be paid more for treating more complex cases, such as people who need three fillings or more.

Dental therapists will also be able to accept patients for NHS treatments, providing fillings, sealants, and preventative care for adults and children, which will free up dentists’ time for urgent and complex cases.

To make services more accessible for people, dentists must update the NHS website and directory of services so patients can easily find the availability of dentists in their local area.

High-performing dental practices will have the opportunity to increase their activity by a further 10% and to see as many patients as possible.

The new reforms will ensure that dentists, who are operating at full capacity for the first time in two years, will be able to recover dental services following the impact of the pandemic.

Frequently Asked Questions

1. How do I find an NHS dentist for routine care?

  • We are aware that some practices are operating waiting lists to manage those patients requesting routine NHS dental care.
  • Patients can contact any NHS dental practice to access care, irrespective of where they live.
  • As independent contractors, dental practices are responsible for managing their appointment books and are best placed to advise on the capacity they have available to take on new patients.
  • Practices providing NHS treatment are listed on www.nhs.uk. It is their responsibility to maintain accurate information on the website. While it is not a contractual requirement for dentists to keep www.nhs.uk up to date, we strongly encourage practices to do this as a matter of priority at this time so it is as accurate as possible.
  • It may be helpful for you to be aware that NHS England does not hold information on practices currently accepting new patients so is not in a position to advise on arranging appointments, or access for patients.

2. I have joined a local NHS dentist waiting list, how long will I wait and how will I be contacted?

  • Individual dental practices will provide information to you on how they manage their waiting lists and how they routinely contact patients when space becomes available.
  • While we appreciate this can be frustrating, we would ask that wherever possible, individuals do not assign themselves or their family members onto waiting lists at multiple dental practices.

3. I have an NHS dentist but have been told it is a few months wait for my NHS treatment. I’ve been given the option of having the treatment privately and this will be quicker – why is this?

  • NHS England’s expectation is that all NHS-funded capacity is used to deliver the maximum possible volume of safe care for patients and we are supporting providers with this approach.
  • Many practices offer both NHS and private treatment.
  • Mixed practices will have separate appointment books for both NHS and private treatment, with staff teams employed for these different arrangements.
  • NHS provision is delivered across contracted opening hours i.e. XXXX, However, demand for NHS treatment means the practice could have used up their available NHS appointments and therefore offer the private option to patients.

4. What will be the cost and difference between private and NHS dental treatment?

  • Before any treatment is started there will be a personal dental plan to sign which will explain the NHS treatment the dentist will provide and how much it will cost. If any private treatment has been discussed this, and the cost, will also be listed separately.
  • Please be aware that the NHS will provide all treatment that the NHS dentist feels is clinically necessary to keep teeth, gums, and mouth healthy. Here are the details on who is entitled to free NHS treatment and also what types of treatments are available on the NHS and the cost.

5. I don’t have a regular dentist, but I have now developed an urgent dental issue – what should I do?

  • If you develop an urgent dental issue, you can telephone any NHS practice during normal working hours and explain the nature of the dental problem so that the urgency of the treatment need can be determined.
  • If the practice is unable to offer an appointment because their appointment slots have already been taken up, they will advise you to ring another NHS dental practice or alternatively visit www.111.nhs or call 111.
  • The NHS111 health advisor will undertake a clinical triage and where the dental need is deemed to be clinically urgent, an appointment will be made at the nearest in-hours urgent dental care hub, or alternatively depending on the time of the call, into the dental out of hours treatment services. If the issue is not deemed urgent, patients will be signposted to another NHS dental practice and/or given self-care advice until an appointment can be offered.

6. My regular dentist has closed or has gone fully private and I have been advised that I will have to sign up for a private dental plan to access dental care with them, which I can't afford, what do I do?

  • We appreciate that the loss of any NHS dental practice will be a concern for patients and local communities.
  • Where this occurs, NHS England local dental commissioners are committed to exploring all opportunities to address any gaps in provision as quickly as possible.
  • It is important to note that patients are not registered with a dentist in the same way they are with a General Practitioner (Doctor) – patients can contact any NHS practices to access care. Here are the details on who is entitled to free NHS treatment and also what types of treatments are available on the NHS and the cost.

7. What other general advice can help patients in looking after and protecting their teeth?

  • If your teeth and gums are healthy – a check-up, or scale and polish may not be needed every six months.
  • Stopping smoking and limiting alcohol intake along with reducing the amount of sugary drinks and food can all be beneficial in keeping your teeth and gums healthy.
  • Every dental practice is working extremely hard to provide care to as many patients as possible, if a routine appointment is not yet available, please be understanding and respectful at all times.
  • All dental practices are being encouraged to prioritise patients for treatment based on urgency and priority groups, such as those more at risk of dental disease or children.
  • Appointments for some routine treatments, such as dental check-ups, may still be delayed.
  • If you develop an urgent dental issue telephone your regular dental practice (or any NHS practice if you don’t have a regular dentist) for advice on what to do next or visit www.111.nhs.
  • If the dentist decides the issue is not urgent, you may be given advice on how to self-manage the dental problem until an appointment becomes available. You will be advised to make contact again if your situation changes/worsens.

8. What about out-of-hours care for dental matters?

  • A toothache should initially be managed with over-the-counter pain relief until an appointment can be made with your general dental practice. A pharmacist can advise you what is the best pain control to meet your needs.
  • Lost fillings, crowns or bridges, broken teeth, or braces are not usually deemed to be clinically urgent and patients are advised to contact their local dental practice when they re-open.
  • Only ring NHS 111 out of hours when your dental needs cannot be met by self-care and cannot wait until your regular practice – if you have one - is open to contact them for advice

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