Agenda item

This report provides a summary on the oral health of the borough’s population and access to NHS dental services. It uses data to profile the oral health of Hammersmith and Fulham residents, describes the provision and use of NHS services, in addition to how the services are commissioned.

Helen Byrne (Head of Commissioning, Public Health) and Hilary Tovey (ICP Health Equity team) presented the report which gave a summary of the borough’s plan for oral health and access to NHS dental services.

Helen Byrne said the plan aimed to reduce tooth decay and increase access to dentistry. She noted that within Hammersmith & Fulham, only 40% of children and 44% of adults had access to dentistry. The Chair asked what lack of access meant in this context. Helen Byrne said there were 30 dentists in the borough, but officers didn’t have data on how many NHS places were available. She said services were not promoting oral health early enough to young families and dentistry was not embedded into the early life health checks. She said officers wanted to work across the system to build a consistent oral health offer. Hilary Tovey said there needed to be a whole system response including better access to dentists and improved oral health promotion. Helen Byrne added that oral health was also an issue for adults, particularly in vulnerable populations like refugees, asylum seekers, and the homeless.

Councillor Natalia Perez asked if the solutions to these problems would involve the voluntary sector as she felt they were well placed to reach the groups we needed to engage. Helen Byrne said charities and the voluntary sector would be consulted on how best to communicate with different communities.

Shad Haibatan (SOBUS) felt there was a need for more granular data because different communities had different levels of poverty, distrust, and exclusion. He noted that SOBUS worked closely with diverse communities and health was a key area of focus for them.

Hilary Tovey said one of the challenges was that dentists could choose to offer either NHS or private places. The Chair said the dentists’ contract was the key factor because currently it paid less to offer NHS places.

The Chair asked if the ICB could directly commission more dentists.Hilary Tovey said the ICB could not grant licenses for new dentists, but it had looked at using delegated commissioning to provide incentives for existing dentists. In 2024 the ICB had allocated £2.7m for enhanced Unique Dental Activities (UDAs) for new patients to get people back to regularly seeing a dentist. She noted that since starting the programme there had been an increase in the number of new patients.

Nadia Taylor said it was a complex problem with many factors contributing to the current crisis. She noted that in her role as a School Governor she had seen the impact of the reduction in funding and services, and the cost-of-living crisis also had a big impact. She added that Healthwatch had produced a detailed report on the impact of the cost-of-living crisis and dental treatment was shown to be one of the most difficult services to access.

Carleen Duffy said residents regularly called Healthwatch to ask which dentists took NHS patients. There was an online list, but dentists were responsible for updating it and it was often out of date.

The Chair asked which public body was responsible for dentists in the local area. Helen Tovey said NHS London was responsible for dentists and the ICB was responsible for prevention and promotion of oral health services. The Chair asked if we could keep the information about NHS places updated ourselves. Hilary Tovey said we could make the information available in school settings.

Carleen Duffy reported that the Healthwatch survey showed 120 people out of 240 had or anticipated not being able to use dentist in the next 12 months. And many people didn’t know about low band payments or what services were available. She suggested that a represented from the dental health team attend Healthwatch’s family day.

The Chair noted that one of the ICBs stated intentions was to improve access to dentistry in areas of higher need and asked what they were doing to address that. Hilary Tovey said she could provide an update after the meeting.

ACTION: Hilary Tovey

The Chair asked how much difference the Government’s plan would make in practice. Helen Tovey said there needed to be a consistent message, with local agreement around NHS places and dentists needed to keep their information up to date. She added that it was important there was a complete pathway, with both community dentistry and general practice services available where necessary.

Linda Jackson addressed the Board and noted that the paper set out the problem and the current gaps. The challenge for teams now was to come up with a more detailed plan, including measurements for success. She said the plan should also highlight areas that were outside of local control and needed to be raised at a national level. The Chair agreed and requested a further report with clear measures and success outcomes.

ACTION: Linda Jackson / ICB

Councillor Perez asked that Healthwatch share their findings so they could be considered and incorporated into any future plans.

ACTION: Carleen Duffy

Councillor Perez asked if schools could have an updated list of dentists accepting NHS patients. The Chair also asked how officers and the ICB were planning to work with local schools to encourage pupils to keep their teeth healthy. Helen Tovey said the ICB were working with CLCH to go into schools, and she could provide feedback once the work had started. The Chair requested a plan for improving oral health in schools.

ACTION: Helen Tovey

The Chair asked for more detail on what the changes to the Healthy Schools programme were and their impact on children’s oral health. Helen Tovey said historically there was a Health Schools coordinator who helped schools, then they were removed, and schools were left to organise the programme themselves. Schools felt the transition was poorly handled and there was a lack of coordination.

The Chair thanked everyone for their contributions. He said he was disappointed at the current situation but was glad it was on the agenda and was a priority for the ICB. He said there were good opportunities with schools and Family Hubs, and he looked forward to seeing a more detailed action plan.

RESOLVED

1. Support the development of a Hammersmith and Fulham specific oral health plan aligned with the North West London Integrated Care System approach to improving child oral health.

2. Support the approach to address poor levels of oral health in the local population, drive improvements to NHS dental services and reduce inequalities for the Hammersmith and Fulham population.

3. Request that the Director of Public Health reports back to the Board on progress and the priority actions agreed.