In November 2025 NCL ICB won the HSJ Award for the category of Reducing Inequalities and Improving Outcomes for Children and Young People Award.
Oral health inequalities remain a significant and under-recognised public health concern, with poor dental health disproportionately affecting children in deprived areas. North Central London’s Dental Transformation Programme shows what’s possible when dental care is prioritised and shaped locally. By committing recurrent funds and reinvesting NHS dental underspend into both primary and community dental settings, the ICB has been able to co-develop a range of targeted workstreams that are transforming dental outcomes for children and young people. Working closely with Whittington Community Dental Service (CDS), local authorities, public health teams, schools, and charitable organisations, the programme is preventing problems early and reaching those most at risk. It demonstrates how collaborative, community-focussed action can create healthier futures for children and young people.
NCL ICB aimed to reduce the number of children requiring extractions in secondary care, promote preventative behaviours (toothbrushing and sugar reduction), and build trust with communities historically underserved by dental services.
In NCL, we believe our work exemplifies the NHS’s commitment to prevention of ill health and tackling inequities. Ultimately, our goal is to highlight how the NHS England’s Core20PLUS5 approach, targeting dental services, can deliver tangible improvements for inclusion health groups, demonstrating the impact of effective partnership working across a range of organisations and with local communities in tackling health inequalities.
Following a deep-dive exercise into dental health inequalities in NCL, data identified a clear link between deprivation and adverse oral health outcomes in children, including hospital admissions for tooth decay. Children from the most deprived wards not only experience more severe tooth decay but also face associated anxiety, school absence, and long-term health risks, reinforcing the cycle of inequality.
With the delegation of dental commissioning responsibilities in 2023, NCL saw a unique opportunity to drive change. Faced with dental underactivity, the ICB made a strategic decision to reinvest underspend into dentistry to improve access and outcomes. The ambition was to reduce health inequalities through a two-fold strategy:
- Expand access to NHS primary dental care by commissioning additional Units of Dental Activity (UDAs), enabling practices to see more patients, particularly in underserved areas.
- Invest in upstream, community-led prevention, focused on children and inclusion health groups, aligning closely with NHSE’s Core20PLUS5 framework.
Key initiatives:
- Supervised Toothbrushing Programme (STB): Co-designed with the CDS and local authorities, this targets 3-4-year-olds in early years (EY) settings in the most deprived wards. EY staff are trained to deliver daily toothbrushing sessions and promote good oral health. STB is reinforced by educational materials for parents and policies promoting healthier food/drink choices. ICB funding supplements local and national funding.
- Giving Up Loving Pop (GULP): Delivered by Tottenham Hotspur Foundation to Key Stage 2 children (aged 7-11) in 20 schools in high-deprivation areas, focusing on sugar reduction, hydration, oral hygiene, and physical activity.
- Dental General Anaesthetic (GA) suites and weekend clinics: Designed to expand CDS’ capacity to treat children, reducing reliance on secondary care.
Impact:
- STB has reached 1,000+ children and trained 280 staff.
- GULP reported increased preference for water (in school: 51.1% to 79.2%; sports: 21.3% to 49.7%). 75% of participating classes were in the 20% most deprived areas, ensuring the intervention targeted those most at risk.
- Daily toothbrushing improved from 47.1% to 61.8% and children demonstrated better recognition of high-sugar drinks such as smoothies and milkshakes.
- Additional clinics reduced acute referrals by 85%, increased GA appointment capacity by 65%, and cut waiting times from 21 to 17 weeks.
These results demonstrate that targeted, data-informed investment, designed and delivered in partnership with local communities, can reverse entrenched oral health inequalities.
At its heart are strong partnerships bringing together Local Dental Committees, Community Dental Services, local authorities, public health teams, and charitable organisations. These trusted relationships, coordinated by the ICB through Transformation Partners in Health and Care, allowed co-design solutions to be delivered at pace.
The NCL Dental Transformation Programme provides a strong foundation for improving lifelong health among children and young people (CYP). Embedding preventative oral health behaviours early is supporting a stronger start in life and mitigating long-term health inequalities.
