Agenda item

To report the findings and recommendations of a Rapid Scrutiny Exercise reviewing the provision of NHS Dental Services in Wiltshire. 

Introducing the next item, the Chairman reminded the Committee of their agreement in February to carry out a rapid scrutiny of NHS dental services before responsibility for commissioning was transferred from NHS England to the Integrated Care Board (ICB). He then referred the Committee to the report from the scrutiny carried out on 29 March, thanking the input of Jo Lawton of NHS England and Jo Cullen from the ICB. He summarised the main findings as being that Wiltshire residents need greater access to NHS dental services, the ICB would face significant challenges in improving services, ongoing scrutiny was needed and that more information was desired on the work being done to improve access to health services in disadvantaged communities.

The Chairman then called on the Cabinet Member for Public Health, Councillor Ian Blair-Pilling, to speak to the item.

Councillor Blair-Pilling summarised the rapid scrutiny session as sitting in the foothills of a mountain of a learning curve, explaining that dental care was remarkably different and distinct from other forms of healthcare. He emphasised that while it was important for scrutiny to make its own choices, this work could benefit from being conducted as a joint enterprise with the ICB, with updates coming from both.

The Director of Public Health, Kate Blackburn, suggested the recommendation that the Public Health team bring a report on inequality back to Committee covering public health and dental care was of such a scale so as to necessitate collaboration with the ICB as part of a system approach. The Director suggested that rather than a massive report, a focus on dental provision and access would be more suitable and achievable, as well as bringing in the work being done by the Wiltshire Health Inequalities Group’s work.

The Chairman noted The Director’s point and invited the Leader of the Council’s input.

Councillor Clewer noted the new structure of the Integrated Care System involving the ICB and the Integrated Care Partnership. He advised that it could prove unproductive for too many Councils to be trying to assess the issues processes of the Integrated Care System before it was on its own two feet. He suggested that the work would be better suited to the Integrated Care Partnership as one of their statutory requirements.

The Committee discussed the issue further, with Councillor David Vigar highlighting that unnecessary reports were to be avoided and that instead, regular updates were all that was required. Councillor Cape noted that one of her key takeaways from the report was that the root cause of issues with dental provision was the way in which the payment system for dentists operated. She suggested that until that systemic issue was properly addressed at a national level, the Committee were unlikely to make any significant progress in improving dental service provision. The Director of Public Health agreed that while there was work they could undertake to address issues surrounding inequality, the fundamental problems they faced were national ones. Councillor Clewer added that the area was essentially dysfunctional and that the ICB would need time to decipher and then address it. Councillor Blair-Pilling stated that the priority of Public Health was addressing inequality, and that was work in which they could make headway, establishing links of communication and ensuring people are better informed.

Resolved:

To amend the recommendations in the report to request performance updates on dentistry from Public Health and the ICB including areas of high deprivation.