On March 17 the government published the Neighbourhood health framework.
The Framework sets out the purpose and ambition of neighbourhood working in line with the NHS 10 Year Plan.
Dentistry is not included in this document, though the Framework states that:
“Over the next few years, we will look at how we can support other important services to effectively contribute to neighbourhoods, such as community pharmacy, dental services, optometry, learning disabilities and neurodiversity services and others. In the meantime, important reform agendas will continue to improve services in these areas.”
This reinforces the direction of travel set out in the NHS 10 Year Plan, where dentistry has a role in the future of integrated working. The statement also reiterates the government commitment to further reform of the NHS dental contract.
The big question, though, is whether or not the reforms to the dental contract will support integrated ways of working or whether they will continue to keep dentistry isolated. The current tranche of reforms, with their focus on unscheduled and urgent care, after all do not support integrated ways of working and in many cases could undermine the possibility for local initiatives as budgets are used up faster.
The LDC Confederation has been clear that a local understanding of what NHS dentistry is for is needed to both support integration and also to inform national guidance and reforms.
Supporting this, the Framework states:
“If they choose to, ICBs can – and will – go further and earlier in such services as part of their neighbourhood plans. Importantly, ICBs will work with local authorities to agree how to design and deliver those aspects of neighbourhood health that require joint working across the NHS, social care and other local services. They will also agree, through HWBs, how neighbourhood health will support wider local priorities for improving overall health outcomes and reducing health inequalities.”
The LDCs in the LDC Confederation will work closely with their ICB leads to develop an understanding of how dentistry could work as part of neighbourhoods to ensure that national conversations are led by local plans. While locally led changes are unlikely to be implemented any time soon it is imperative that conversations start as early as possible to make sure that further developments and guidance are in line with local plans.
