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Healthwatch and Croydon LDC working to highlight local patient needs

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Dr Sushil John, Chair of Croydon Local Dental Committee (LDC), discusses how Croydon’s LDC has engaged with Healthwatch with the…


By Integrated Care Journal

Healthwatch and Croydon LDC working to highlight local patient needs

Dr Sushil John, Chair of Croydon Local Dental Committee (LDC), discusses how Croydon’s LDC has engaged with Healthwatch with the aim of ensuring NHS dentistry will be both sustained and valued at a local level.


During the 2020 Covid-19 pandemic, England’s Chief Dental Officer closed all NHS dental practices to face to face patient contact for three months. A direct consequence of this was the creation of a backlog of patients requiring NHS treatment which was only exacerbated by Croydon’s pre-pandemic service rates.

Prior to the pandemic, access to NHS dental services was limited to around 50 per cent of the population. Healthwatch Croydon rightly identified this access issue for patients, leading to an open dialogue with Croydon’s LDC. This permitted a clear understanding of how the NHS approach to primary care dentistry created this issue, both before and during the pandemic.

"It is only by demonstrating our value to these local stakeholders that they will be in a position to advocate effectively for an appropriate NHS dental service in their local area." Dr Sushil John, Chair of Croydon Local Dental Committee (LDC)

Meetings were initially focussed on the process of how NHS dentistry is carried out with stakeholders assuming that dentistry is commissioned in a similar manner to our GP colleagues. This, however, is not the case; unlike GP practices, dentistry is commissioned on treatment delivery rather than registration of a specific population. It was important for Healthwatch Croydon to understand the private element in the delivery of dentistry which runs alongside and often subsidises the NHS aspect.

These meetings made Healthwatch Croydon more interested in learning about the care NHS dentists provided to their patients. This required a greater understanding of the NHS contract and its limitations, which result in barriers to access and a delay in patients seeking care. The access issue stems from the fact that activity varies between dental practices and is capped; if this cap is not met, dental practices face financial penalties.

The activity measures included in the dental contract ignore the realities of patient need in a local area. This is partly because of the lack of registration and partly because the system is underfunded to the extent that only half of the population could access care. These terms demonstrate the blatant inequalities that exist in healthcare in addition to the inverse effect of a target-based system. This is further augmented by the inherent variations between NHS contracts; those solely for children under the age of 18, another for patients receiving certain state benefits and others where all patients have access to NHS care.

The engagement resulted in two projects run by Healthwatch Croydon. The first used a survey to establish the issues faced by patients during the pandemic and the second assessed dental websites. These projects revealed a lack of patient awareness around the delivery of NHS dentistry as a result of insufficient communication, as well as a clear interest in and desire to access NHS dental services by the local population. The data was shared with the LDC through virtual meetings and their results will be published shortly, referencing the collaboration of local dentists in this work.

As we continue to work with Healthwatch Croydon, we hope that patients, their advocates and other local stakeholders will increasingly see the value of NHS dentistry and its importance to overall wellbeing. The LDC strives to engage with all local stakeholders such as Healthwatch. It is only by demonstrating our value to these local stakeholders that they will be in a position to advocate effectively for an appropriate NHS dental service in their local area. This, in turn, will ensure that NHS dentistry will be both sustained and valued at a local level as the transition into integrated care systems takes place.


#ACJInsight #ACJPrimary #ACJ

Dr Sushil John, Chair of Croydon Local Dental Committee (LDC), discusses how Croydon’s LDC has engaged with Healthwatch with the aim of ensuring NHS dentistry will be both sustained and valued at a local level.


During the 2020 Covid-19 pandemic, England’s Chief Dental Officer closed all NHS dental practices to face to face patient contact for three months. A direct consequence of this was the creation of a backlog of patients requiring NHS treatment which was only exacerbated by Croydon’s pre-pandemic service rates.

Prior to the pandemic, access to NHS dental services was limited to around 50 per cent of the population. Healthwatch Croydon rightly identified this access issue for patients, leading to an open dialogue with Croydon’s LDC. This permitted a clear understanding of how the NHS approach to primary care dentistry created this issue, both before and during the pandemic.

"It is only by demonstrating our value to these local stakeholders that they will be in a position to advocate effectively for an appropriate NHS dental service in their local area." Dr Sushil John, Chair of Croydon Local Dental Committee (LDC)

Meetings were initially focussed on the process of how NHS dentistry is carried out with stakeholders assuming that dentistry is commissioned in a similar manner to our GP colleagues. This, however, is not the case; unlike GP practices, dentistry is commissioned on treatment delivery rather than registration of a specific population. It was important for Healthwatch Croydon to understand the private element in the delivery of dentistry which runs alongside and often subsidises the NHS aspect.

These meetings made Healthwatch Croydon more interested in learning about the care NHS dentists provided to their patients. This required a greater understanding of the NHS contract and its limitations, which result in barriers to access and a delay in patients seeking care. The access issue stems from the fact that activity varies between dental practices and is capped; if this cap is not met, dental practices face financial penalties.

The activity measures included in the dental contract ignore the realities of patient need in a local area. This is partly because of the lack of registration and partly because the system is underfunded to the extent that only half of the population could access care. These terms demonstrate the blatant inequalities that exist in healthcare in addition to the inverse effect of a target-based system. This is further augmented by the inherent variations between NHS contracts; those solely for children under the age of 18, another for patients receiving certain state benefits and others where all patients have access to NHS care.

The engagement resulted in two projects run by Healthwatch Croydon. The first used a survey to establish the issues faced by patients during the pandemic and the second assessed dental websites. These projects revealed a lack of patient awareness around the delivery of NHS dentistry as a result of insufficient communication, as well as a clear interest in and desire to access NHS dental services by the local population. The data was shared with the LDC through virtual meetings and their results will be published shortly, referencing the collaboration of local dentists in this work.

As we continue to work with Healthwatch Croydon, we hope that patients, their advocates and other local stakeholders will increasingly see the value of NHS dentistry and its importance to overall wellbeing. The LDC strives to engage with all local stakeholders such as Healthwatch. It is only by demonstrating our value to these local stakeholders that they will be in a position to advocate effectively for an appropriate NHS dental service in their local area. This, in turn, will ensure that NHS dentistry will be both sustained and valued at a local level as the transition into integrated care systems takes place.


#ACJInsight #ACJPrimary #ACJ