Local Insights Drive Change: Cornwall’s New Approach to NHS Dentistry

NHS Cornwall and Isles of Scilly Integrated Care Board (ICB) is poised to implement a new Dental Strategy, drawing from findings in a detailed report by Healthwatch Cornwall. The report, which engaged 1,097 members of the public and 96 dental practices, sheds light on the ongoing struggles faced by residents in accessing NHS dental services.

Healthwatch Cornwall’s Report Findings

Healthwatch Cornwall’s [report](add link) revealed critical challenges that have been placing immense pressure on dental care in the region:

• Access Issues: At the time of research, all NHS dental practices in Cornwall were closed to new adult patients.
• Systemic Problems: Underfunding and inherent issues within the NHS system contribute significantly to the crisis.
• Recruitment and Retention: Many dental professionals are reducing NHS commitments or switching to private practice due to various challenges.
• Geographic Barriers: Rural and remote parts of Cornwall face additional hurdles related to transport and access.
• Healthcare Impact: Other healthcare services such as GP surgeries and A&E departments are overwhelmed by dental-related cases.
• Lack of Public Knowledge: A gap in understanding how to access dental care persists among the public.
• Vulnerable Populations: Individuals on low incomes, those with disabilities, and residents in rural areas face severe difficulties. Many are forced to turn to private care, often incurring debt or missing treatment altogether.

Steps Being Taken

In response to the findings, Chris Reid, Chief Medical Officer for NHS Cornwall and Isles of Scilly ICB, outlined the measures underway to address these challenges:

“We are implementing a range of measures locally to address national pressures on NHS dentistry. This includes commissioning additional urgent care and stabilisation services, operating an emergency dental service to deliver 20,000 appointments a year, an extensive schools’ dental education programme and free dental treatment for local fishing communities, provided by Fishermen’s Mission and the Seafarers Hospital Society.

We also have a pilot which is helping to retain NHS treatment for children and other vulnerable patients and is treating some of those who have been waiting the longest.

We are recruiting a new dental clinical lead to work with us and have a dental engagement event for those providing care in Cornwall later in November. We will be working hard to develop a strategy that addresses the recommendations in the Healthwatch report – we are determined to serve our population better with access to NHS dentistry.”

Ongoing Projects and Solutions

• Emergency dental care appointments: Since September 2021 the NHS has commissioned additional urgent and emergency dental care appointments that people can access by calling NHS 111. The aim is to deliver 20,000 emergency dental appointments a year.
• Stabilisation: If patients seeking emergency dental care are identified with multiple urgent dental issues that need addressing, a treatment plan is put in place with additional appointments made as part of unscheduled dental care to make the patient dentally fit. This is known as stabilisation.
• Lostwithiel Pilot Programme: A collaboration between the NHS and a Lostwithiel dental surgery created a new pilot, enabling children and the most vulnerable patients to access an NHS dentist. This pilot aimed to address unmet dental health needs by targeting priority groups and reducing waiting list backlogs
• Seafit Smiles at Sea: This is an initiative delivered by the Fishermen’s Mission and the Seafarers Hospital Society. They use cross-agency, collaborative partnerships between the NHS, public health and Healthy Cornwall, dental providers, voluntary organisations, and the fishing industry, bringing preventative models of healthcare, treatment and advice to the quayside where the fishermen work. This consists of a range of services including NHS health checks, physiotherapy, dental treatment, mental health support, diet, smoking cessation, drug and alcohol reduction, prostate cancer, diabetes and liver checks. The Smiles at Sea initiative provides dental services to local fishing communities with a mobile dental unit to provide oral cancer screening and urgent and emergency dental care to fishermen and their dependent family members who can otherwise struggle to access a dentist due to the demands of their work and location.
• Big Brush Club: A supervised toothbrushing scheme funded by the NHS, being delivered to early years settings across the south west. It supports 3-to-5-year-olds attending reception, nursery or preschool in areas of deprivation. The aim of the programme is for every child to brush their teeth with fluoride toothpaste once a day and ideally twice a day at home too. Teaching good brushing routines from an early age helps reduce oral health inequalities among children. 180 (84%) schools take part in the scheme, which is approximately 7,919 children participating in the Big Brush Club in Cornwall.

Recruitment Efforts

To support recruitment, NHS England’s ‘golden hello‘ scheme offers incentives of £20,000 per dentist to encourage relocation to areas with historical staffing challenges. Cornwall ICB has invested £188,000 into 10 posts as of July 2024, underscoring its commitment to bolstering dental services.

Long-Term Goals

The ongoing efforts aim not only to increase access to NHS dental services but also to reduce oral health inequalities and prevent severe dental issues in children. By integrating these measures into Cornwall’s new Dental Strategy, the ICB seeks to foster sustainable, long-term improvements for the region’s residents.