Local views on dental services will shape Cornwall and Isles of Scilly new dental strategy

NHS Cornwall and Isles of Scilly Integrated Care Board are using findings and recommendations made in Healthwatch Cornwall’s dental services report, to shape a new dental strategy for the area.

The report comes after Healthwatch Cornwall undertook engagement with 1,097 members of the public and 96 dental practices to understand the experiences and challenges of local people accessing dental services in Cornwall.

The Healthwatch Cornwall report  findings will be used to shape the new Dental Strategy due for discussion at the Integrated Care Board in November 2024.

In April 2023, NHS Cornwall and Isles of Scilly ICB took over responsibility for dental services in Cornwall from NHS England.

Working to improve the provision in the county, Chris Reid, Chief Medical Officer for NHS Cornwall and Isles of Scilly ICB said:

“We are implementing a range of measures locally to address national pressures on NHS dentistry. This includes commissioning additional urgent care and stabilisation services, operating an emergency dental service to deliver 20,000 appointments a year, an extensive schools’ dental education programme and free dental treatment for local fishing communities, provided by Fishermen’s Mission and the Seafarers Hospital Society.

We also have a pilot which is helping to retain NHS treatment for children and other vulnerable patients and is treating some of those who have been waiting the longest.

We are recruiting a new dental clinical lead to work with us and have a dental engagement event for those providing care in Cornwall later in November. We will be working hard to develop a strategy that addresses the recommendations in the Healthwatch report – we are determined to serve our population better with access to NHS dentistry.”

Work to improve dental access underway

• Emergency dental care appointments. Since September 2021 the NHS has commissioned additional urgent and emergency dental care appointments that people can access by calling NHS 111. The aim is to deliver 20,000 emergency dental appointments a year.
• Stabilisation. If patients seeking emergency dental care are identified with multiple urgent dental issues that need addressing, a treatment plan is put in place with additional appointments made as part of unscheduled dental care to make the patient dentally fit. This is known as stabilisation.
• Lostwithiel Pilot Programme. A collaboration between the NHS and a Lostwithiel dental surgery created a new pilot, enabling children and the most vulnerable patients to access an NHS dentist. This pilot aimed to address unmet dental health needs by targeting priority groups and reducing waiting list backlogs
• Seafit Smiles at Sea. This is an initiative delivered by the Fishermen’s Mission and the Seafarers Hospital Society. They use cross-agency, collaborative partnerships between the NHS, public health and Healthy Cornwall, dental providers, voluntary organisations, and the fishing industry, bringing preventative models of healthcare, treatment and advice to the quayside where the fishermen work. This consists of a range of services including NHS health checks, physiotherapy, dental treatment, mental health support, diet, smoking cessation, drug and alcohol reduction, prostate cancer, diabetes and liver checks. The Smiles at Sea initiative provides dental services to local fishing communities with a mobile dental unit to provide oral cancer screening and urgent and emergency dental care to fishermen and their dependent family members who can otherwise struggle to access a dentist due to the demands of their work and location.
• Big Brush Club. A supervised toothbrushing scheme funded by the NHS, being delivered to early years settings across the south west. It supports 3-to-5-year-olds attending reception, nursery or preschool in areas of deprivation. The aim of the programme is for every child to brush their teeth with fluoride toothpaste once a day and ideally twice a day at home too. Teaching good brushing routines from an early age helps reduce oral health inequalities among children. 180 (84%) schools take part in the scheme, which is approximately 7,919 children participating in the Big Brush Club in Cornwall.
• Smarter Smiles. is delivered by Smile Together Dental CIC in partnership with Peninsula Dental Social Enterprise and Cornwall Council. Together we’re making a sustainable difference to the oral health of children and adults with additional needs across Cornwall and the Isles of Scilly. Creating engaging environments that encourage individuals to make positive and sustainable behaviour changes to improve their oral health and well-being.

Recruitment incentives for dentists

NHS England published guidance earlier this year for dentists who are interested in securing ‘golden hello’ funding to support their recruitment efforts.

The scheme is designed to encourage relocation to areas that have historically struggled to recruit, attract new workforce to the NHS, and retain those who might have otherwise moved into private practice. A ‘golden hello’ of £20,000 is offered per dentist for up to 240 dentists, with payments phased over three years.

Since the last update in July 2024, Cornwall ICB has invested £188,000 in 10 posts across Cornwall.

First dental steps programme

Cornwall ICB is supporting an oral health improvement initiative called First Dental Steps, where health visitors and midwives are trained to give oral health care advice to families with children under two and have oral health care packs (toothbrushes and toothpaste) to give to families in need. This work is being undertaken in partnership with local authorities. A continuation of the programme in 2024/25 has been agreed and is being extended to other areas in the South West.

The First Dental Steps programme is an oral health improvement intervention, embedded in the Healthy Child Programme. It incorporates public health and NICE recommendations into a multi-stranded oral health initiative and builds on the learning from a recent pilot delivered across six South West sites.  

In the short-term it is anticipated that the intervention has the potential to support the promotion of preventive dental care for children aged 0 to 2 years. The universal element of the programme has the potential to impact upon 163,000 children (aged 0 to 2 years old) across the South West, with a targeted offer to approximately 4,000 vulnerable children. 

In the longer term it is expected that implementation will support the realisation of the following benefits:

• An increase in dental access and attendance for children aged 0-2 years;
• A reduction in the prevalence and severity of dental caries, alongside a reduction in oral health inequalities in young children;
• A reduction in hospital-based tooth extractions for children due to dental decay.

Health visitors and community nurses have received training in oral health promotion, so they can support families with young children in providing evidence-based advice, alongside toothbrush and fluoride toothpaste packs. Children at high risk of decay are identified and referred directly to community dental teams for further help where needed.