To receive an annual review on improvements in dental access and planned oral health improvement initiatives.

(Note:  Lincoln Sargeant – Director of Public Health, Mark Richards – Public Health Specialist, Councillor Hayley Tranter – Cabinet Member for Adult and Community Services, Public Health and Inequalities, Paul Green, Director or Primary Care and Melissa Redmayne Senior Commissioning Manager (Pharmacy, Optometry and Dental) NHS Devon Integrated Care Board (ICB) have been invited for this item.)

The Director of Public Health together with the representatives from the NHS Devon Integrated Care Board (ICB) and Head of Service for Safeguarding, Early Help and Business Intelligence gave a presentation, as circulated prior to the meeting, on the Annual Review of Dentistry Provision in Torbay. 

Members asked questions in relation to the number of Family Hubs in Torbay and the capacity available at the Hubs to support families with oral health; what age did fluoride varnishing start; was there any evidence on vaping being linked to Oral Cancer, similarly to smoking and alcohol; was there possibility of a triage type system that could be introduced into dental surgeries; could dentists visit schools to carry out checks on children and young people; detail on the way the waiting list system operates; the likelihood of NHS patients being able to access a dentist; the age brackets of people who were no longer on NHS waiting lists; how families access dental services; if education was being carried out with young children attending nurseries; when teenagers become of age and they were no longer entitled to free dental treatment, were they being added to the NHS waiting lists; how a resident experiencing dental pain could access emergency treatment; if dental contracts were annually reviewed; and what outreach work was carried out with residents of Torbay experiencing homelessness. 

In response to questions, Members were advised that there is a Family Hub in Torquay, Paignton and Brixham.  In 2023, the footfall to all of the Family Hubs was 17,000 visits.  There were a lot of activities that were carried out within the Family Hubs including Health Visitors holding sessions.  There was also a website and a virtual Family Hub that could be accessed by residents Home - Family Hub.

Members were advised that the fluoride varnishing service starts from  2 years old children and the resources were provided at school for children to take home twice a year. 

In regard to the question on vaping and any evidence linked to oral cancer, Members were advised that there was currently no evidence regarding this but this could change over time.  There was still evidence linking smoking and alcohol use to oral cancer. 

Members were advised that the introduction of a triage type system into dental surgeries would be a difficult system to introduce due to the limitations on treatment that could be provided by staff other than professionally qualified dentists. 

Members noted that Public Health colleagues do visit local schools to provide services to work with teachers and parents on oral health education. 

Members were advised that NHS Devon were commissioning additional urgent dental care appointments and ‘stabilisation’ sessions across Torbay.  Work was being carried out to increase access to Dentistry by implementing measures to support dental services including an increase unit of dental activity (UDA) rates, increasing the recruitment and retention of the South West dental workforce and to rebase UDA activity for the dental workforce to achieve levels to support financial sustainability. 

Members noted that there was a multi-agency approach through the Family Hub services, which were universal at all hubs.  There was a lot of resources available online for residents to access.  Should any Members have contact with any vulnerable families, efforts should be made to encourage them to make contact with the Family Hubs and the practitioners could then provide more targeted support. 

Supervised toothbrushing education was provided in early years facilities and this would be further extended into 2025.  Regarding young adults accessing treatment when no longer entitled to free NHS treatment, Members were advised that there were gaps in activities experienced by young adults, however there was a lot of young adults being added to the NHS waiting list.  Work was required to investigate as to why South Devon was only one of two counties that operate a waiting list. 

Members were advised that should any residents require urgent treatment and cannot access a dentist, then contact should be made through the 111 service and the residents would be directed to available urgent care service facilities. 

The Dental Contract was a National Contract, and the process to remove dental funding from a practice underperforming was not an easy task and support needed to be provided to those practices where it was noted that there was an underperformance, to resolve the issues and improve performance for local residents. 

The Sub-Board was advised that was an ICB steering group with other local authorities where work being undertaken with homeless residents was discussed and it was advised that the work being undertaken in Plymouth was being reviewed as a possibility to be replicated in Torbay. 

Resolved (unanimously):

1.            that the Adult Social Care and Health Overview and Scrutiny Sub Board notes the contents of the submitted report;

2.            that the Senior Commissioning Manager (Pharmacy, Optometry and Dental) NHS Devon Integrated Care Board (ICB) be requested to provide an update to the Adult Social Care and Health Overview and Scrutiny Sub Board, on waiting list information and how many and for how long people are on waiting lists;

3.            that ICB colleagues be requested to provide regular updates to the Adult Social Care and Health Overview and Scrutiny Sub-Board on work force planning and new dentists coming to work in Torbay;

4.            that the Director Public Health be requested provide information on key areas that Members could allocate their Member Ward Funds to and information on key areas that Members can share with their constituents and for them to encourage vulnerable people to engage with the three Family hubs around oral health promotion; 

5.            that an annual update on Dentistry Access and Oral Health Promotion is added to the Adult Social Care and Health Overview and Scrutiny Sub-Board Work Programme; and

6.            The Children and Young People’s Overview and Scrutiny Sub-Board be requested to review the Children’s Neglect Strategy.