A&E Departments Are Bursting With Dental Emergencies

A&E Departments Are Bursting With Dental Emergencies

The distress of patients in pain trying to access NHS dentistry are a factor of daily life for most who work in the profession, with even fully private practices fielding calls from patients desperate to find a dentist in a hurry.

Some, unable to find an NHS dental appointment and unable (or unwilling) to pay for private treatment, will resort to Dickensian methods of DIY dentistry, pulling their own teeth with pliers designed for carpentry.  But many, many more, end up at A&E.

Writing in the esteemed Health Service Journal, Matthew Taylor, Chief Executive of the NHS Confederation* said ’Accident and emergency departments are overflowing with people in severe dental distress, with tooth decay being the most common reason for hospital admission among children aged five to nine in recent years.

One senior dentist recently told us that 11 per cent of NHS 111 calls in his integrated care system were dentistry related.

Longstanding issues relating to the dental contract not offering high enough rates for dentists to provide NHS care …..have contributed to a decline in the availability of NHS dentistry. This has led to thousands of people across the country going private or, very concerningly, turning to self-care.

Where we do spend money, we do so on an inverse care gradient that means we spend less per head of population in the areas with the highest levels of deprivation’ wrote Mr Taylor.

Enter the ICSs

The HSJ feature confirmed that ICSs will take on the commissioning of NHS dentistry from NHSE in April and ‘while no one should under-estimate the scale of the challenge involved in improving dentistry services, this an opportunity to do things.’

Mr Taylor’s stressed that ‘NHS England must encourage those with dental expertise to join local systems, including by assisting ICSs with recruitment, so that institutional commissioning knowledge and experience are not lost when commissioning responsibilities are transferred.’ 

‘ICS leaders have told us they are keen to apply a system lens to the problems in dentistry. A focus on prevention, for instance, could help to stem the tide of the most severe dental cases in future and it is hoped ICSs’ commitment to health equity will improve access for the most urgent cases.

For the first time, dentistry will be commissioned alongside wider primary and secondary care services, incentivising financial efficiency, signposting and better integrated pathways.

Tackling the crisis faced by members of the public seeking urgent care is a recognised priority with a need ‘to set up an urgent dental care system that connects individuals from NHS 111 to a clinical triage and designated urgent care provider.’

Community and domiciliary services have also been identified as key areas for expansion based on local demographics.

Mr Taylor cited some positive steps being taken.  “We are already seeing encouraging innovation in pockets of the country. In Suffolk, an innovative partnership between the University of Suffolk and the Suffolk & North Essex Integrated Care Board is seeking to create capacity through the set-up of a community interest company specifically to provide NHS dentistry.

In the Midlands, leaders are looking to place a new urgent dental care service alongside an accident and emergency department.”

It’s widely accepted, however, that there are no quick fixes and that without a workforce no amount of additional funding will make much impact.

As Parliament’s Health & Social Committee prepares to put dentistry under its spotlight, Mr Taylor writes “We also believe that national funding made available for dentistry should stay within dentistry.

Often when NHSE has provided funding it has been made available until the end of the financial year and any underspend has not been carried forward, instead being “clawed back” to plug gaps in other areas of spending.

We must address this and invest now in dentistry infrastructure ahead of April. We will be setting out our views in more detail through the committee’s inquiry.”


** The NHS Confederation, formerly the National Association of Health Authorities and Trusts, is a membership body for organisations that commission and provide National Health Service services founded in 1990. The predecessor organisation was called the National Association of Health Authorities in England and Wales according to Wikipedia.

0
0
0
s2sdefault

You need to be logged in to leave comments.

Please do not re-register if you have forgotten your details,
follow the links above to recover your password &/or username.
If you cannot access your email account, please contact us.

Mastodon Mastodon