Reforming dentistry through primary care collaboration

The urgent need for reform in NHS dentistry is nearly universally acknowledged. Year after year complaints from the public continue to rise, highlighting trends in the commissioning and provision of NHS dental services and the growing number of patients seeking emergency care. These statistics reveal a troubling reality: too many individuals are experiencing avoidable harm due to lack of access to NHS dental care.

Labour has highlighted a dental recovery plan as a key initiative, with Wes Streeting prioritising meetings with dental professionals on his first day in office. This political momentum reflects a widespread recognition of the need for change. However, while there is broad consensus on the necessity of reform, significant debate remains about what the future of NHS dentistry should entail.

However, what is clear is that dentistry as a profession is eager to take on a more significant role as a system partner, and interdependence between partners in the system and dentistry is essential for success.

Innovative commissioning and system leadership

It has been widely recognised that historical activity metrics have led dental practices to prioritise and be incentivised by the delivery of clinical interventions. This approach inadvertently discourages participation in broader system objectives, particularly in prevention and addressing health inequalities.

We must explore innovative ways to commission NHS dental care that focuses on improving the oral health of the population, particularly through educational initiatives aimed at prevention and stabilisation, while addressing oral health inequalities. In our contract with NHS Suffolk and North East Essex (SNEE) ICB, the University of Suffolk Dental CIC, where I serve as CEO, is innovatively commissioned and provides oral healthcare and education focused on outcomes.

“Collaboration with regional clinical system leaders across each ICB footprint is essential to address oral health inequalities and improve access to NHS dental care”

We understand that the University of Suffolk Dental CIC is one part of the solution for SNEE. Collaboration with regional clinical system leaders across each ICB footprint is essential to address oral health inequalities and improve access to NHS dental care. One notable example of this collaboration is the Dental Prioritisation of Access and Stabilisation Scheme (DPASS), led by SNEE ICB and the Local Dental Network East of England. This initiative established a pilot service, currently offered by 15 dental practices across SNEE, where these practices work in partnership to create a bespoke NHS dental care model tailored to the community's most vulnerable populations.

A workforce fit for the future

While it is encouraging to see changes in how we plan and commission services, these efforts will only succeed with support for training, recruitment and retention of dental care professionals. This is a national challenge, particularly evident in rural and coastal communities such as SNEE, which is designated an ‘underserved’ ICB.

The dental care profession, along with our wider primary care colleagues, plays a vital role in enhancing the oral health of our communities. However, we must better utilise the diverse skills within the dental care profession, including dental hygienists/therapists and dental nurses. The University of Suffolk Dental CIC model emphasises the valuable contributions of the broader dental workforce and offers practical solutions for implementing this approach.

Primary care integration

Engaging with professionals across wider primary care highlights that the quality of data sharing remains a significant barrier to their role as system partners. For instance, pharmacists cannot update patient care records and opticians face challenges in communicating directly with hospital ophthalmology services. Similarly, dentistry is hindered by limited access to summary care records. Improving these access points would greatly enhance collaboration across primary care and beyond.

“It is essential to foster collaboration between dental care providers, GPs, pharmacies and optometrists to create an integrated approach to patient care”

However, true integration extends beyond digital interoperability. It is essential to foster collaboration between dental care providers, GPs, pharmacies and optometrists to create an integrated approach to patient care. This involves investment in primary care estates, sharing patient information, collaborating on clinical pathways and delivering comprehensive healthcare services under one unified system. Through the NHS Confederation's work with ICBs and system partners, we have a timely opportunity to reimagine primary care by integrating dentistry, GP services, pharmacy and optometry in a way that works for local communities. This collaborative framework can yield significant returns on investment and social value.

A united primary care sector

As we engage with the new government, it is vital for us to present a united primary care sector, demonstrating our collective commitment to advancing the health and wellbeing of our communities. We must advocate for policies that improve primary care and facilitate better integration among all primary care providers. Our commitment must focus on renewed energy and emphasis on primary care that sees collaboration and innovation as essential in driving forward the changes necessary for a healthier population.

Lorraine Mattis is CEO of University of Suffolk Dental CIC, non-executive member at Bedfordshire, Luton and Milton Keynes ICB, and a member of the Primary Care Network’s advisory group.  You can follow Lorraine on LinkedIn.