Over the years, NHS reforms have influenced significant change within community dentistry in terms of commissioning and contracts, as well as the position of community dental services within trusts. The formation of the 2011 initiative to allow social enterprises to provide health and social care services was a huge turning point, as it has made way for companies to deliver NHS contracts whilst remaining independent of any NHS bodies.
For people with additional needs due to wider issues such as learning or physical difficulties, mental health, homelessness, socio-economic status or severe anxiety, this has made a world of difference. Indeed, all of the above examples face barriers in accessing high-street dental practices; but in community dental services where there are specialist facilities, equipment and skills, professionals can ensure that patients receive the necessary treatment safely and efficiently. For that reason alone, community dentistry and additional needs patients should be a priority for commissioning services moving forward, taking care to ensure that all individual needs – whatever the issues – are fulfilled across the board.
Of course, this will all depend on how the pending contract reform ends. We ourselves are currently piloting the community dental services aspect of the prototype programme across all of our Bedfordshire services (excluding general anaesthesia), working closely with NHS England and the Department of Health to determine the best approach. It is my hope that in time, there will be emphasis placed on prevention, so that community dental services can continue to meet the needs of patients with special or additional needs.
Certainly, contract reform is not community dentistry’s only problem. As with any service where health care delivery is dependent on NHS contracts, one of the biggest barriers is access to resources. With limitations in place, the pressure to make sure that resources are divided appropriately and thoughtfully can often be easier said than done for many community services. At CDS-CIC this is less of a problem because we can generate private income. However, we are continually looking at how we can allocate resources in a sensitive way that matches well with the culture and philosophy of our organisation, so that profits benefit the more disadvantaged members of our population.
A greater focus on informed commissioning and integrated care where each service works in harmony with one another could help to overcome resourcing limitations and improve access to important information and care.
Other barriers surrounding recruitment, education and training can also impact the delivery of patient care in community dentistry, which is why we work hard to ensure that professional development is available to the whole dental team. In turn, this guarantees a high standard of patient care.
Of course, alliances with external agencies and local authorities within the health and social care network can help to enhance the output of community services too. Oral health, after all, can have a much wider affect on general health and wellbeing, and it’s not just down to dental professionals to spread the oral health message, so it’s important that we work with more diverse groups and organisations.
At CDS-CIC we deliver clinical dental and oral health improvement services to those with additional needs, using a progressive and innovative approach. We have always pushed the boundaries in looking to improve the way in which patients receive care, and will carry on doing so to ensure that our company stays ahead of the curve. I am confident that other community dental services will endeavour to do the same.