On 18 September the London Assembly Health Committee held their second evidence gathering session in their investigation into dental access in the capital.
The speakers on the panels were:
- Vicky Hobart, GLA Group Director of Public Health and Deputy Statutory Health Adviser
- Charlotte Klass, Consultant in Public Health/Dental Public Health, NHS England London Region
- Jazz Bhogal, Assistant Director, Health, Children & Young Londoners, GLA
- Kelly O’Neill, Director of Public Health, London Boroughs of Hounslow and Hillingdon
- Chris Groombridge, Chair and Founder of Teeth Team
- Mike Derry,Chief Officer, Healthwatch Richmond
The Committee heard that there is variable levels in decay in children’s permanent teeth across the different local authorities. This variation was echoed across wards as well showing great differences among communities. Looked after children in particular were reported to have greater levels of decay, and overall oral health need. Decay was most prevalent in the most deprived areas, with the rate being twice as high, with one in four children in deprived areas experiencing decay compared to one in ten in the least deprived.
In addition, the Committee heard that the main cause of hospital admission for children aged five to nine continued to be dental extraction, with the latest data from 2022/2023 showing over 5000 admissions with dental caries as the primary diagnosis. The impact of dental decay on children and families was also explained. The variation across London was attributed to deprivation, which was consistent across the country.
The oral health of older adults, particularly those in care homes is much worse than the general population. A trend the Committee was told would continue as the population continued to age with more general health conditions. The relationship of oral health to other conditions such as diabetes and community acquired pneumonia were also discussed.
The Committee heard about the benefits of water fluoridation; that oral health needs to be integrated with the health and social care sector; supervised toothbrushing and fluoride varnish programmes need to be supported; and that making every contact count needs to include oral health. Vitally, the Committee was reminded that oral health cannot be improved by looking at oral health alone, but through improvements in the wider determinants of health.
In the second session of the day, Healthwatch Richmond outlined the public experience of accessing dental care. It was explained that for the majority of residents in Richmond there simply isn’t any access to NHS dentistry. This was a regular problem in Richmond, with Healthwatch receiving contacts from the public frequently. The issue was reported to be the same across London Healthwatch. Often residents had to seek care far outside the borough. Even where practices were accepting patients, waiting times for an appointment could be very long. It was reported that urgent dental care pathway through NHS 111 was effective, but did not help patients enter regular care.
The Committee discussed the statement by Lord Darzi that there are enough dentists, just enough willing to work on the NHS. Healthwatch Richmond agreed that most commissioned activity is delivered, suggesting that there is not enough commissioned in the right way and that if it was then there are probably enough dentists if they were appropriately incentivised.
Healthwatch Richmond explained that the best opportunity for wins was through local commissioning and by clear and transparent data to ensure that commissioners could be held to account during the year.
The full recording of the evidence session is available on the GLA website.
