Ian Holmes and Hayden RisdaleToday, we want to share with you the work we have been doing to improve access to dentistry in West Yorkshire, one year on since we took on commissioning of these services. In May 2023 we set out our vision. Then in October 2023, we detailed the work we were progressing.

Ways of working

The way we commission services in the NHS has changed significantly. For all services we’ve moved to a more collaborative approach, recognising the importance of clinical leadership and effective partnership working to make things better. 

We’ve been investing time in building strong relationships with our dentists, practice owners and providers. We engage regularly with our Local Dental Committees who have shared our approach nationally as good practice, and even invited us to speak at a national British Dental Association conference. We’ve established a pragmatic way of working with our practices, based on forming a shared understanding and finding agreeable conditions to ensure service continuity.

We’ve also recognised that this approach requires the right capacity. In January we were delighted to welcome Andy Hobson, the new Deputy Director for Dental Commissioning, to the team. We’ve made a number of other appointments to expand the team. Alyson Corns is the Senior Dental Commissioning Manager; Hayley Smith is the Contracts Manager and Rob Pinder is our Business Support Officer.

Through this way of working we have improved engagement, and we believe we have improved the quality of decisions. We have made clinical leadership and collaboration a cornerstone of our approach.

Investment and improvement

In 2023/24 we prioritised using the full dental budget. Like all ICBs, we fell a little short of this due to workforce shortages and the scale of the challenges. However, we invested approximately an additional £8m through a £6.5m investment plan and a further £1.5m through enabling practices that were delivering their full contract to go 10% further, providing additional access to patients.

The £6.5m spans a range of initiatives, including urgent dental sessions, orthodontics, access for children living in our highest need areas, access for homeless groups, access for refugees and asylum seekers, access for domiciliary patients, and an innovative level 2 paediatric service.

These initiatives have undoubtedly made a difference. The urgent access scheme delivered 7,551 additional sessions throughout the year, meaning that up to 52,857 people received urgent dental care. The homeless scheme has provided access to 265 patients, and the refugee/asylum seeker scheme (which only began in January 2024) has provided 60 patients with treatment. This means we are meeting urgent dental needs, which we know are heightened given dental access issues, and the needs of those experiencing the highest inequalities.

Since becoming the commissioner in April 2023, we have also seen improvements in our core activity. The percentage of adults accessing NHS dentistry has increased by 5.5%, to 48.2%. Children accessing NHS dentistry has also grown by 9.9%, to 60.8%. This is above the national averages of 43% and 56% respectively.

A denist showing a toddler how to clean their teeth, with suppprt from dad.

Community Dental Services

Community Dental Services (CDS) are a priority area of dental transformation. These are dental services for people with additional needs such as learning difficulties and autism. You can find out more about CDS here. We’re building this through a strong partnership approach, working with the CDS providers, through the WY Community Health Services Provider Collaborative.

Our shared priority is to make West Yorkshire the best CDS collaborative in the country, focusing first on a consistent delivery model and recommissioning services over a longer time period. We have already made significant progress, developing a refreshed service specification and delivery model, as well as considering the longer-term improvement requirements and plans.

We are also making an immediate impact. Our level 2 paediatric scheme manages long CDS waits by enabling general dental practitioners with enhanced training to treat patients in the community. We are trialling this in Wakefield, with a view to expanding it into other localities and services. Providers are equally playing an active role in identifying wider system investment opportunities to deliver maximum benefit to patients at all points of the system. There are also examples of working together on mutual aid, including between Bradford District Care Trust and Locala, for paediatric exodontia (tooth extraction) – addressing capacity issues in one area with availability in another.

Looking ahead

We have made significant inroads in delivering our plan but we are in the early stages of a multi-year commitment where action is required at several levels.

We’ve already developed a 2024/25 investment plan to maximise our resources this year, rolling over the successful schemes to date and going further. We want to see further improvements in our access rates, improved performance, and to extend the approach we have taken on CDS to other priority areas.

The progress we have made to date is a good start but we have more to do. As we explained in our last blog, there are significant national barriers to progress which need to be addressed. If you have any thoughts as to how we can do more, we’d welcome hearing those. Please do reach out.

Thank you for reading,
Ian and Hayden