Decision details

To approve the acceptance of a recurring annual amount of £64,092 from NHS BSW ICB to fund oral health improvement work in Wiltshire.

Since 2013 the responsibility for public health, including oral health improvement, has been with local authorities, as set out in the Health and Social Care Act (2012). Local authorities have an important statutory role in assessing local oral health needs and commissioning evidence based oral health programmes appropriate to those needs.

For children specifically, we know that poor oral health may be indicative of poor diet, impaired nutrition and growth, dental neglect and wider safeguarding issues. Dental disease can impact on children’s ability to sleep, eat, speak, play and socialise with other children.

Oral health is referenced in the ‘Best start in life and beyond: Improving public health outcomes for children, young people and families’ which provides guidance to support the commissioning of the Healthy Child Programme. It provides opportunities to integrate oral health improvement into service specifications and an effective programme of delivery for zero to 19-year-olds.

For adults, poor oral health can lead to pain and discomfort, sleepless nights, loss of function and self-esteem, and in turn disrupt family life. It can also lead to time off work. Experiencing tooth decay or having missing teeth or ill-fitting dentures can lead to an individual becoming socially isolated.

Research has shown that such oral complaints can negatively affect a person’s confidence and their employment chances, including being promoted at work. The maintenance of oral health is a life skill that will have long term effects, not only on tooth decay but to a life free from disability.

In addition, local authorities are required to commission or provide oral health surveys to inform oral health need, planning and evaluation of oral health promotion programmes, planning and evaluation of dental service provision as well as the power to make proposals regarding water fluoridation schemes.

A historic arrangement made the oral health promotion funding across Wiltshire and Swindon part of the NHS England block contract with Community Dental Services (CDS), of which was allocated to Great Western Hospitals (GWH). This funding arrangement impeded Wiltshire and Swindon Public Health teams from undertaking or commissioning oral health promotion programmes as they held no specific funding for this. Discussions took place during 2022, between Wiltshire and Swindon Public Health Teams, NHS England and the Community Dental Service to extract the oral health promotion money from the CDS contract at GWH and allocate to the Public Health teams. An agreed amount of £97,000 was allocated to be used across Swindon and Wiltshire.

The ICB received funding from Great Western Hospitals Foundation Trust via NHS England to support oral health improvement in Swindon and Wiltshire. The ICB has agreed to work with Wiltshire Council and Swindon Borough Council to facilitate this to best utilise the oral health improvement monies to achieve maximum impact and best value.

Consequently, the ICB has determined to allocate £97,000 to Swindon and Wiltshire (split proportionately between the two organisations based on £32,908 to Swindon and £64,092 to Wiltshire) to fund oral health improvement to deliver the programme as outlined below.

The proposal is to utilise the oral health promotion money to:
• Fund oral health promotion training amongst dental workforce and wider health and social care workforces.
• Fund the provision of oral hygiene packs to be used as part of MECC conversations in outreach work.
• Pilot new and innovative approaches to oral health promotion in meeting local population need.
• Where necessary, it may be used to fund engagement work with seldom heard groups to gain a better understanding or dental and oral health needs.

The scope of proposed work is not limited to the above list and will be in discussion with ICB Commissioner for Dental Care across BSW.

Funding will be on a recurring annual basis, commencing from financial year 2024/2025 with the agreement that local authorities can accrue any underspend each year.

I confirm that in making this decision I have considered the following in line with Wiltshire Council’s Constitution: (Please insert ‘Yes’/ ‘No’ / ‘Not Applicable’ and any other comments necessary to evidence the issue identified has been addressed)

Key decision requirements: Yes

Views of relevant cabinet member(s), committee chairman, area board(s): Yes

Consultation with cabinet member(s), the Leader and Scrutiny (for Executive decisions taken under Emergency Powers): Yes

Consultation in accordance with requirements and expectations of consultation with the public: NA

Implication of any council policy, initiative, strategy or procedure: Yes

Staffing, financial and legal implications: Yes

The assessment of any associated risks in accordance with the Council’s risk management strategy: Yes

Involvement of statutory officers and/or directors: Yes

Regional or national guidance from other bodies: Yes

The council’s constitution: Yes

Not applicable.