(a)

there was a recognition for the need for an Oral Health Needs Assessment (OHNA) to evidence the issues within Plymouth;

(b)

Public Health and Peninsula Dental Social Enterprise (PDSE) worked collaboratively to produce and deliver the OHNA;

(c)

the OHNA has been used to support the bid submitted to NHS England for a new City Centre dental practice and to inform conversation between dental leads in Plymouth the Chief Dental Officer;

(d)

oral health was an integral part of health and wellbeing and oral diseases were largely preventable;

(e)

oral diseases impact negatively on quality of life and imposes a significant social and economic burden on the city;

(f)

over 14,000 people in Plymouth on the waiting list for routine NHS dental and 3,000 children in Plymouth on the waiting list;

(g)

in conclusion:

·       a partnership approach was required to address the wider determinants of health, to prioritise particular groups at higher risk of disease and to develop oral health programmes  and services which reduce health inequalities;

·       Plymouth would benefit from additional health improvement activity and from increased access to urgent and routine NHS dental care.

(h)

they would welcome working with social housing providers such as Plymouth Community Homes to help spread the word within the communities and reaching the more vulnerable groups within the city;

(i)

NHS England reported that the Oral Health Needs Assessment was in place and would inform the commissioning plans and procurement.  They were also looking at providing more urgent care to help more patients to receive treatment and improve access whilst trying to provide a more sustainable approach;

(j)

with regard to the 623 children having teeth extracted under general anaesthetic, it was reported that Plymouth was 4 times higher than the rest of the peninsula.  This was a challenge, however, the key was giving young people the best start in life, first dental steps and were in the process of  training midwives, health visitors, school nurses to give the key oral messages to parents and better access to dental care would help address this serious issue;

(k)

that with regard to community water fluoridation in Plymouth, it was reported that this was not a straight forward solution.  The main water pipe which supplies Plymouth also supplies neighbouring areas which meant that negotiating water fluoridation was made more difficult;

(l)

the number of students that have remained in the city following graduation had changed over the years, many factors such as students having to undertake a foundation year in another part of the country as well as students coming to the city to undertake their studies move back to their hometown when qualified had impacted on the number of dentists retained in the city;

(m)

also qualified dentists were not choosing to work in NHS Dental services because of the current NHS contracts leading to a shortage of dentist in this field.  Currently in Plymouth there were 17 vacancies.  The national contract needed to be revised to encourage more dentists to take the NHS route otherwise recruitment issues would persist;

(n)

NHS England reported that Plymouth remained a priority area and the current waiting list supports and evidences what was needed to commission and working with our partners to address the issues.  There were plans to be part of the primary care networks and would need to be looked at across the patch;

(o)

it was  highlighted to the Board that Plymouth has the smallest dental school in the country and there was no good reason for this inequity.  Plymouth could accommodate more students and we could accommodate more students we would be able to undertake more work within the community and help with retention in the city;

(p)

it was reported to the Board that the Child Poverty Action Plan since its inception five years ago included the issues within the city around poor dental health and access to dental care.  The Oral Health Needs Assessment helps with the visibility and member’s need to consider how to move this great work forward so that we are not sat here in a year’s time saying how shocking were children’s teeth;

(q)

this was such a fundamental issue but what we really need to focus on was poverty and that we're not addressing by picking off single issues and to have the serious conversations around this with communities, with charities, with social enterprises, with people out there trying to address this;

(r)

there were established care pathways for looked after children and Livewell SW was one of the service providers within the city, however it was clear that the demand exceeds capacity.  The Dental School were also happy to accept children in care but there was a need to have proper structure in place with sustainable services to address all of the needs and looked after children were an important part of the Oral Health Needs assessment;

(s)

the Dental School and (PDSE) provide a service to homeless people with an 84 percent re-attendance rate.  They started with a pilot to provide ½ day session per week which was increased to 2 days a week and were now at the limit on what they could provide.  They put forward a proposal to NHS England 12 months ago based on the oral health needs analysis and were hoping that there would be some progress on commissioning a proper service for this particular group otherwise these individuals would continue to suffer significant health inequality as a result of a lack of dental access;

(t)

that the Dental School and the University have two excellent clinical facilities located at the Cumberland Centre and Plymouth Science Park.  However these facilities do not provide students with real life experience of working in a general dental practice so they were keen to develop a dental practice for students to rotate through in their final years.  A proposal for a city centre practice for students have been made formally with a business case to NHS England seeking ongoing costs of treating the patients and that proposal was with NHS England for the last 12 months;

(u)

PCC working closely with PDSE to put the proposal together for the City centre dental practice and can only take the idea so far but need NHS England to take forward this contact, 14,000 on the waiting list which includes 3,000 children and this practice would reduce this number.