Delivering a new approach to NHS dentistry


Michael Watson believes a new strategy is needed on the delivery of NHS dentistry in England

Sara Hurley is determined to provide a new approach to dental care and oral health, Michael Watson believes.

Outside the Ministry of Defence in Whitehall there are statues of three generals of World War II.

Two of them – Montgomery and Slim – are well known as field commanders; the third less so, General Alan Brooke, described on his plinth as ‘Master of Strategy’.

Alanbrooke, as he became known when we was made a peer, was head of the army and responsible for the strategy that, in the end, led to the defeat of Nazi Germany.

No matter how brilliant the field commanders are, or how inspiring the politicians such as Churchill are, without a strategy the future will be in doubt.

Strategy for oral health

So I was interested, when attending the Pendlebury lecture at the Faculty of General Dental Practice to hear the chief dental officer for England, Sara Hurley, outline the key themes of her proposed integrated strategy for oral health and dental care.

Over the past 25 years I have heard many people, dentists, politicians and civil servants give talks about the state of NHS dentistry and have drafted one or two of the speeches myself.

They have dealt with policy, with current problems in the service, but never before, I believe, with strategy, where NHS dentistry is going.

In her speech the CDO sought to define strategy as a ‘term often used incorrectly to describe policy, but actually the necessary pre-requisite to any policy; a synthesis of all the ideas, interests and ideologies at our disposal; the “art of the possible” if you will.’

Strategy is about achieving outcomes, better oral health and reaching those people who are most in need of services, the young, the old and the vulnerable.

Critical reform

The CDO said that contract reform is ‘critical…if we are to make the transition from dental activity to oral health as the desired outcome of the NHS dental service’.

The contract should be a means by which better oral health is achieved, not an end in itself.

There is more to NHS dentistry than achieving a UDA target, although at this time of year, the contracted number of UDAs is probably uppermost in the minds of dentists and commissioners.

A new strategic approach is needed and, judging by her speech, Sara Hurley is determined to provide it.

One comment

  1. 1

    Hi Michael,

    I couldn’t agree more about needing an ‘all new’ Strategic Approach – however nhs dental contract reform whilst loooong overdue, is but one small part of the overall Strategic solution = a 3-point plan as follows:

    1. A national Media campaign to improve public knowledge and empowerment, rather than almost total ignorance as we’ve had for over a decade :(

    2. The food industry addressed assertively and punitively if necessary, to dramatically reduce it’s obcession with adding excess sugars in almost all foods and drinks, simply to earn excessive profits at the expense of the nation’s well being!

    3. A dental contract based upon Protected-Time and Prevention, not voluminous UDAs and no time to help those who will eventually come through the doors in the next 5 years.

    1+2+3 will synergise and have many ‘local’ spin-offs too, even a much smaller scheme like ChildSmile in Scotland cost £1.6million initially but now saves the nhs over £4million net EVERY year and has reduced childrens hospital admissions too !!!

    No.1 could start within the month, No.2 could be a 3-4months initiative and No.3 could be the end of the year.

    Yes ALL possible, the ‘art of the possible’ if you like, if public pressure can get the Politicians to authorise and synergise from the Top-down.

    Sadly all we have now is Spin and Prevention of prevention upon the Political alter of volume-Targets :(

    This isn’t Sara Hurley’s fault, she has inherited a growing mess from the last lot but can’t say that publicly of course.

    But what she CAN do is say, you know what, as annoying as it is, we can start by admitting the nhs dental system in England is limited, we are doing our best within those limitations, but THE way forward Strategically is 1+2+3 Prevention above and that’s something the Media, DH, NHS England and the dental profession can ALL support whole-heartedly!

    What are we waiting for – another 8000+ children have been admitted to hospital since 4th January Telegraph letter signed by 400+ dental professionals raising concerns – isn’t it time to act urgently now?

    Yours also Strategically,


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