This week's leadership message comes from Hayden Risdale, Sayma Mirza and Peter Day. We also have a blog from Phil Wood

Hello, my name is Hayden Ridsdale and I’m a Senior Strategy and Transformation Programme Manager for the ICB.

I’m Sayma Mirza, Associate Director for Children, Young People and Families for the ICB,

And I’m Peter Day, a Consultant in Paediatric Dentistry working for the Bradford Community Dental Service and Leeds Dental Institute, and a Professor of Children’s Oral Health at the University of Leeds.

Today, we want to talk to you about children’s oral health.

Since taking on responsibility for commissioning dental services in April 2023, the ICB has made a concerted effort to improve access to dentistry for the general population and those most in need. We’ve adopted a whole pathway and life course approach, recognising that oral health, access to dentistry, and wider health and wellbeing are bound together.

Latest data shows that 42% of children and young people in West Yorkshire live in the most deprived quintile, compared to 24% nationally. There is a direct correlation between where children live, low household incomes and the impact on health and wellbeing in our region. This data and national policy, including the CORE20Plus5 framework, have influenced the strategic priorities set for children and young people across the West Yorkshire ICB. There is a particular focus on family resilience and early help, children’s healthcare in the community, complex and special educational needs and disabilities in addition to long term conditions and healthy weight and best start.

Good oral health starts in childhood, and it is under the objective to provide children the best start in life that the work to promote good oral health is delivered. However, there are worrying trends highlighted in the data:

• Nationally, over a third (35%) of 12-year-olds report being embarrassed to smile or laugh due to the condition of their teeth.
• Tooth decay most common reason for hospital admissions for children aged 5-9 years olds, with an estimated 60,000 days lost from school for children on this pathway.
• In Yorkshire and Humber, the rates of tooth extractions in hospital are five times than the area with the lowest rates, the East Midlands.
• Waiting times for children to be admitted to hospital can be up to 80 weeks affecting the most vulnerable children in society.
• The rates of tooth decay vary across our region, but show consistently high levels in comparison to the national average. For example around 1 in 4 children have tooth decay by the age of five, with this figure rising to over 40% in areas with the greatest deprivation, with each affected child having an average of 3-4 decay teeth.
• For children in year 6 the English average was 16% of children having one or more decay adult teeth, with this figure rising to 23% in Yorkshire and Humber.

Critically, tooth decay is preventable, with strong evidence to show the benefits for limiting sugary foods and drinks and brushing twice a day with fluoride toothpaste.

On 13 September 2023, a Child of the North report on oral health was published. You can find the report here. Peter and colleagues in academia lead engagement and the development of the report, working with the N8+ university partnership. Sayma and Hayden were delighted to represent the ICB in this process. The report focuses on the oral health of children living in the north of England and provides evidence-based solutions. It is particularly timely with the new government’s priorities around shifting from “treatment to prevention”. Key recommendations included:

• Implementation of a National Child Oral Health Strategy: A comprehensive approach to improve dental health across the country.
• Expansion of the Soft Drink Industry Levy: Extending the levy to cover all sugar-sweetened beverages to reduce sugar consumption.
• Introduction of a National Supervised Toothbrushing Programme: Targeting nurseries and primary schools in the most deprived areas, aimed at children aged 3-6 years.
• Improving Access to NHS Dentistry: Ensuring that children, especially those in underserved areas, have better access to dental care services.

The latest Child of the North Report, the evidence set out, and the dual strategic priorities of improving access to dentistry and providing children with the best start in life held by our ICB are exactly why we are taking action now.

In this blog post from June 2024, Hayden and Ian Holmes (Director of Strategy and Partnerships and Deputy CEO) set out how were dealing with dental access issues. This includes using our dental clawback, both last year and this year, to invest in additional access for children living in our highest need areas, as well as an innovative level 2 paediatric scheme which supports children with additional needs to be seen faster and outside of the Community Dental Service setting.

Through our partnership wide oral health group we have mapped existing prevention activity to understand gaps in provision across West Yorkshire, and are progressing with work to address the current gap in provision of the epidemiology survey. Delivering the survey is key to having a strong evidence base to target our interventions and monitor our impact.

We are also incredibly pleased to be supporting a range of the initiatives set out in the report, including HABIT (supporting health visiting teams to have effective oral health conversations with parents of young children), toothPASTE (supporting parents with autism child to take proactive steps towards optimal oral health conversations), BRUSH (increasing the number of supervised toothbrushing programmes for young children aged 3-6 years old attending nursery or primary school) and Raised in Yorkshire (a peer to peer oral health support programme for children attending secondary schools).

There is much to do to improve access to dentistry and the oral health of children, and people, living in West Yorkshire. We have taken significant strides toward this already, and are committed to continuing this journey. The findings of the report provide further evidence and guidance to inform the action that we can take, and that which is required nationally.

If you have thoughts and ideas, please reach out. Thanks for reading.