Health and Wellbeing Board Face the Public 2021

Thank you for your question.  Please see below for your response which has been provided by the NHS Dental Commissioning Lead: North East and North Cumbria.

We are sorry to hear that you are experiencing difficulties accessing NHS dental care.  The NHS dental sector has faced significant challenges during the COVID-19 Pandemic due to the close proximity of working between a dental professional and a patients’ airway and the relatively high proportion of aerosol general procedures (AGPs) undertaken that increase the likelihood of COVID-19 infection spread. This is likely to be a factor in the difficulties you are experiencing at this time. 

The reason being that in response to these patient safety challenges there continues to be a need for all NHS dental practices to comply with nationally mandated COVID-19 standard operating procedures, the impact of which has and continues to result in NHS dentistry operating at significantly lower levels of capacity during 2020 and 2021 than would normally be available.  These national COVID-19 standard operating procedures for dentistry mandate that the reduced capacity available during the on-going COVID-19 Pandemic period be prioritised towards:

• Patients seeking urgent or emergency dental care.
• Patients with greatest clinical need, attending to incomplete care plans and reaching out to high needs dental patients and vulnerable groups most at risk of avoidable dental disease.

Due to this new way of working and reduced number of appointments, access to routine dentistry is therefore limited at this time.  NHS England are however, working with NHS dental providers to explore opportunities to improve access and to maximise the reduced treatment capacity they have available, within the constraints of the nationally mandated Covid-19 infection prevention control measures that they have to operate within to ensure that treatment can be provided safely for both patients and staff.

By way of clarification, unlike general medical services, the NHS Dental regulations do not require patients to be ‘registered’ with a practice; they operate on a demand led basis with a patient being the direct responsibility of the NHS dental provider only whilst they are in an ‘open’ course of treatment.  There is therefore no contractual obligation on them to provide on-going regular care, and where teeth and gums are healthy a check-up may not be needed for up to 24 months for adults.  

Should patients have an urgent dental problem, NHS England have advised that they telephone a local NHS dental practice.  Dental issues will be triaged over the telephone and an appointment offered where appropriate – this will either be at the practice or at one of our local urgent dental centres. If after telephone triage the dentist decides the issue is not deemed urgent, advice may be given on how to self-manage the dental problem until a more routine appointment is available. For urgent dental care out of hours or at weekends that cannot wait patients are advised to ring NHS 111. 

We hope you find this information/clarification helpful.

Thank you for your question. 

Hartlepool Borough Council developed an integrated community based model for stop smoking support to address the changing smoking habits of our people and, therefore provides opportunities for support on a wider basis than previously offered.

The need for a new approach is highlighted by statistics showing there has been an average decline of 40% in the number of people accessing local specialist clinic since 2014/15 even though there are still more than 14,000 smokers in Hartlepool. 

The aim in Hartlepool is to ensure smokers receive support tailored to their particular needs and circumstances, with this support being based on the most up-to-date research which includes combining brief intervention support and supporting the use of products that smokers choose to use, for example, GP prescribed medication, NRT products or vaping (e-cigarettes) .

As a starting point for the service, people of Hartlepool can access support from: 

• Support Hub navigators in the community hubs in Hartlepool. These staff offer a programme of stop smoking support to complement the smokers’ choice of smoking intervention (for example e-cigarettes, bought Nicotine Replacement Therapy  (NRT) or GP prescribed medication. This would include agreeing a quit date, developing an action plan and an offer of 4 face to face / virtual  appointments to support the quit attempts.
• Liaison with trained Health Visitors, School Nurses and Family Support workers who offer support to families with stopping smoking and quit attempts as part of their visits.
• Specialist services continue to offer their current stop smoking support, for example specialist mental health services, antenatal services for pregnant women and their partners and support when in hospital as an in- patient.
• There is also support available using digital options of support such as quit lines, support websites and stop smoking apps.
• Pharmacies in Hartlepool continue to offer stop smoking support with quit attempts using brief advice support and learning how to deal with cravings.
• In some circumstances GP surgeries prescribe medication with support from hub navigators whilst using the medication.

We are in the process of updating Hartlepool Now website with details of the support available in Hartlepool. The link below takes you to the developing support to stop smoking pages: 

https://www.hartlepoolnow.co.uk/organisations/31317-stop-smoking-support-services

Support from hub navigators for stop smoking services for Hartlepool can also be found on the link. Hartlepool Vape shop premises information is not included, however, due to changes in the details of Vape premises offering support due to the impact of COVID. It would therefore be careless to advertise inaccurate information. 

The national help page is due to be updated on October 25^th 2021 so new updated information for all local authorities will be added to the Hartlepool Now page in due course. 

Hi Tom,

Thank you for your question. Please see the answer below which has been provided by the NHS Tees Valley Clinical Commissioning Group.

Practices have been initiating and receiving phone contacts with patients in many practices for a long time. Talking to patients to gather detailed information about their symptoms, referred to as taking a patient history, remains the cornerstone of medical practice and studies show that the diagnosis can be reached on history taking alone in 60-80% of consultations. Physical examination and the use of tests / investigations will not always be required to reach a diagnosis.

Where a health care practitioner knows that they cannot reach a diagnosis without examination or tests are needed, they would arrange to have face-to-face contact with the patient, or to perform tests before prescribing if this is clinically necessary, or use the results to be able to refine what treatment is needed.

The added convenience of telephone consultation is particularly important for patients who cannot easily attend face-to-face appointments during normal surgery hours, such as carers, the housebound, people in work and those who work away from home.

Where practices have significant numbers of patients needing interpreting services, phone consulting may also provide safety benefits as there can be a wait to book a face-to-face interpreter, with telephone-based interpreting services generally being able to provide an interpreter within a few minutes, making it straightforward to incorporate these in telephone consultations.