Agenda and minutes

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No. Item


Apologies for Absence and Substitutions

The Committee is asked to note any apologies for absence and substitutions received from Members.


No Apologies were received for this meeting.


Declarations of Interest

Councillors are invited to declare any Disclosable Pecuniary Interests or Personal Interest, and the nature of it, in relation to any item on the agenda.



There were no declarations of interest by Councillors in relation to any item on the agenda for this meeting.


Questions on Notice pursuant to Council Procedure Rule 38

Subject to providing two working days’ notice, a Member of the Committee may ask the Chairman of the Committee a question on any matter in relation to which the Council has powers or duties which affect the Tendring District and which falls within the terms of reference of the Committee.



On this occasion no Councillor had submitted notice of a question.


Enquiry into NHS Dentistry Provision in the District of Tendring pdf icon PDF 216 KB

To assist the Committee with its enquiry a report of the Portfolio Holder for Partnerships is attached. The report provides the Committee with information on NHS dentistry provision in the District, and the wider Suffolk and North East Essex Integrated Care Board geography.



The Committee had before it a report that provided the Committee information on NHS dentistry provision in the District, and the wider Suffolk and North East Essex Integrated Care Board geography.


The Committee was joined by:


·         Lizzie Mapplebeck, Associate Director of Strategic Change, Suffolk and North East Essex Integrated Care Board


·         Greg Brown, Senior Performnace Improvement Manager, Suffolk and North East Essex Integrated Care Board


·         Professor Nick Barker, Oracle Dental Group



The Members heard how there were longstanding issues with NHS dental access that included NHS routine dental care and urgent dental care. This problem had been amplified by the current COVID-19 pandemic. Treating oral diseases costs the NHS £3.4 billion per year. The pain experienced with dental problems such as toothache or abscess could be considerable, intractable and distressing, and might lead sufferers to extreme measures to address pain if urgent dental care was not available. Examples included DIY dentistry and overdoses of paracetamol, which in turn increases pressure on urgent and emergency care. There were also wider societal impacts and costs that arose when people could not access urgent care, such as increased demands and pressures placed on the wider health care system such as accident and emergency and primary care services, as well as costs to employers and reduced productivity due to time off work.

Commissioning, Legislation and Dental Fees

Commissioning and Legislation

It was reported to the Committee that NHS England directly commissioned all NHS dental services at primary, community, secondary and tertiary settings depending on the care and treatment required. Across England Integrated Care Boards (ICBs) receive delegated authority from NHS England on 1st April 2023 to commission and manage dental services locally.

Currently, all dentists in northeast Essex (and Suffolk), were paid by commissioners for the Courses of Treatment (CoT) they provided, each CoT was allocated a Unit of Dental Activity (UDA). A UDA was the technical term used in the NHS dental contract system regulations to describe weighted CoTs.

The Committee heard how UDAs were developed as part of the 2006 NHS dental contract. Under the old NHS contract dentists were paid for every item of treatment they provided: examination, filling, crown or denture. Under the 2006 system they were paid per course of treatment, irrespective of how many items were provided within it. Thus, a course of treatment involving one filling (3 UDAs) attracts the same fee as one containing five fillings, a root treatment and an extraction (also 3 UDAs). This factor was behind much of the resentment against this system.

In March 2021, NHS England were asked by the government to lead on the next stages of NHS dental system reform. At the outset six aims were agreed when considering what a reformed dental system should bring. They were:

·         “Be designed with the support of the profession

·         Improve oral health outcomes

·         Increase incentives to undertake preventative dentistry, prioritise evidence-based care for patients with the most needs and reduce incentives to deliver care that is of low clinical value

·         Improve  ...  view the full minutes text for item 21.