How £20,000 'golden hello's, mobile dentistry vans and more emergency appointments might fix Somerset's dentistry crisis

By Daniel Mumby - Local Democracy Reporter 3rd Jun 2024

The number of Somerset adults who regularly see an NHS dentist has dropped dramatically over the last six years (image by Pixabay)
The number of Somerset adults who regularly see an NHS dentist has dropped dramatically over the last six years (image by Pixabay)

'Golden hellos' worth £20,000, mobile dentistry vans and more emergency appointments will all be used to try and turn around Somerset's dentistry crisis.

The number of Somerset adults who regularly see an NHS dentist has dropped dramatically over the last six years, with declining trends being accelerated as a result of the coronavirus pandemic.

The Department for Health and Social Care (DHSC) published its long-awaited dental recovery plan in February, putting in place numerous initiatives to ensure more people could access NHS dentistry.

NHS Somerset has now laid out how these national initiatives will be complemented by more local measures, focussed around the county's growing urban areas.

Rather than working directly for the NHS, dentists are private contractors, who enter into agreements with NHS England to provide a certain amount of treatments (known as units of dental activity) per year.

Each dental practice has an agreed amount of units of dental activity which it must perform – and if it doesn't meet them, the NHS allows other practices to bid for the remaining units on a short-term basis to meet demand (known as 'clawback').

In 2023/24, just over one in six adults in Somerset (18.22 per cent) saw a dentist once within a two-year period – a drop from just over half of adults (56.81 per cent) in 2017/18.

In the same period, the proportion of Somerset children who saw a dentist at least once every two years fell from three in five (60.64 per cent) to less than one in three (32 per cent).

 Somerset has a lower access rate to NHS dentistry than the average across the south west, and has a lower proportion of dentists taking on NHS contracts.

Matthew Mills, NHS Somerset's head of pharmaceutical, optical and dental services, published details of the county's dental recovery plan ahead of a meeting of the NHS Somerset integrated care board in Frome on May 23.

He said in his written report: "The south west experienced challenges prior to the covid-19 pandemic, with difficulties in recruiting to dentist and dental nurse vacancies.

"This impacted on the ability of providers to provide the full range of appointments they are contracted to deliver.

"High street dental practices which are not fulfilling their contract typically do not take on new patients, due to existing patient demand, and this can exacerbate access issues.

"High street dental practices are paid at different rates following historical arrangements. This leads to competition and challenges recruiting and retaining staff."

To address these underlying issues, NHS Somerset is targeting its resources at improving access to NHS dentists in urban areas which are experiencing significant housing growth, focussing on Bridgwater, Burnham-on-Sea, Chard, Highbridge, Taunton, Wellington and Yeovil.

A number of national programmes have already been introduced by the DHSC to recruit dentists and encourage them to take on NHS patients.

These include a new patient payment of up to £50 per patient, in addition to existing practice funding, and a £20,000 'golden hello' for dentists willing to practice in areas of high demand.

The DHSC is also rolling out a new "dental van service" for rural areas, spending £720,000 on mobile services for patients who struggle to access existing practices.

At a more local level, NHS Somerset will be implementing various measures to produce more NHS dental appointments in key areas, including the following:

  • Procuring additional services from dental practices in Chard, Crewkerne and Wellington, using strategies trialled in the St. Paul's area of Bristol (£1,836,600)
  • Contracting additional urgent care appointments to handle more dental emergencies (£396,000)
  • Expanding a "stabilisation pilot" beyond the former West Somerset area to ensure patients don't need to rely on urgent care appointments (£330,000)
  • Improving the NHS 111 services to ensure people with dental emergencies are directed to the most appropriate facilities (£300,000)
  • Speeding up the commissioning process to ensure dental contracts are up-to-date and meet local need (at a projected cost of £200,000)

Mr Mills said: "We aim to address the challenges faced in the provision of NHS dental services across Somerset in a systematic and organised manner.

"Our aim is to ensure that people in Somerset have timely access to necessary NHS dental services, regardless of geographical location, socio-economic status or disability."

     

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