Peter Collins (Chief Medical Officer, NHS Devon ICB) introduced the Dental Services Update and discussed:

a)     Both primary and secondary dental services were not at the level required to serve the population, which was recognised as a national issue rather than solely local;

b)    The Board was assured that all possible options were being explored to provide care and improve access, including new and innovative approaches.

Melissa Redmayne (Senior Primary Care Commissioning Manager, NHS Devon ICB) presented the national position and local response and discussed:

c)     The dental contract was a national contract and widely recognised as unfit for purpose. The Government had reiterated its commitment to fundamental reform, but the latest consultation focused on interim measures rather than full reform. The consultation closed in August 2025, with changes anticipated in April 2026;

d)    The current model would remain based on Units of Dental Activity (UDA), but changes aimed to improve attractiveness, prioritise urgent needs, significant dental issues, children, and prevention, and allow better use of skill mix;

e)     A national urgent dental care incentive scheme had been announced, but Devon had already introduced a local scheme considered more attractive in terms of finance and operational support;

f)      The local dental recovery plan prioritised urgent dental care, commissioning additional stabilisation services to prevent repeat urgent cases, and commissioning access for vulnerable groups to reduce inequalities. Oral health initiatives continued with local authority partners, expanding from children to care homes;

g)     Key progress included increasing the minimum UDA rate to £34.66, above the national minimum of £28 and closer to the British Dental Association’s recommended £35, following strong feedback from stakeholders;

h)    A local urgent care incentive scheme launched in Q1 increased the urgent care rate to £105 (previously £40), representing a £5 million investment in Devon. Six providers were operating in Plymouth;

i)      Contract management changes released £2.6 million from under-delivered contracts in Plymouth, enabling commissioning of new services. Additional orthodontic activity was commissioned, including 1,235 units in Plymouth;

j)      A new procurement was launched for urgent care, stabilisation, and mandatory services for vulnerable populations. Plymouth had the largest lot, seeking 54,000 units per annum, with a contract value of £18 million over its life and £2.2 million per annum. Contracts were expected to be awarded in January 2026 and mobilised by May 2026;

k)     Services for vulnerable groups included provision for people experiencing homelessness and children looked after in Plymouth, with plans to expand to cancer pathways and patients on bone-strengthening medication;

l)      Workforce initiatives included a £327,000 Golden Hello scheme, offering £20,000 incentives for dentists committing to NHS activity for three years. Four appointments had been made in Devon, with one pending in Plymouth. A workforce group had agreed six priority areas;

m)   Devon held 150 NHS dental contracts and 13 orthodontic contracts. Q1 delivery was 211,000 appointments (87% of target), and Q2 delivery was 91% of target, with data still being finalised. Activity had not bounced back post-COVID, particularly in rural and coastal areas, and reversing this trend would take time;

n)    Urgent dental care remained the top priority, with a target of 81,750 appointments (Devon’s share of 700,000 nationally) by 2025/26, representing a 42% increase from baseline. Urgent care activity had declined by 24% since 2024/25, but recent performance showed improvement, moving Devon’s national ranking from 41st to 31^st.

Matthew Jerreat (Regional Chief Dental Officer, South West) added:

o)    Fluoride varnish application would only occur after dental assessment and would not mask decay. Preventative measures such as supervised toothbrushing were evidence-based and effective;

p)    Workforce challenges were significant, with students often returning to home regions or larger cities. Plans included marketing campaigns, videos promoting Devon, and developing apprenticeships for dental nurses and the wider team. Engagement with MPs and regional leadership was ongoing.

In response to questions, the Board discussed:

q)    Recognition of progress and the need for assurance that underspent funds would be reinvested locally. It was confirmed that no value-for-money schemes were being blocked due to lack of resource;

r)     Members raised concerns about patient expectations regarding registration with dentists. It was confirmed that reforms in April would address NICE guidance and improve continuity of access;

s)     The impact of UDA uplift on urgent care decline and raised technical concerns about fluoride varnish masking decay. It was assured that varnish would only follow assessment and prevention measures were evidence-based;

t)     Members emphasised the importance of public messaging to communicate improvements and manage expectations;

u)    Questions were raised about increasing hospital slots for children requiring extractions under general anaesthetic. It was confirmed that an internal business case was being developed to increase capacity and meet national standards;

v)     The Board discussed recruitment and retention challenges, noting plans for apprenticeships, marketing, and collaboration with the new Postgraduate Dental Dean. Members suggested using Plymouth’s branding assets to support recruitment campaigns.

The Board agreed:

1. To review, comment on, and debate the contents of the report, its implications, and next steps for Board partners;

2. To receive updates on procurement outcomes, workforce initiatives, and paediatric dental capacity at future meetings.