LDC Chair's Report 2025

Welcome to the AGM of Lincolnshire LDC. We welcome new and familiar faces on

the night, and I hope you find tonight’s meeting informative.

In many ways, last year was as busy a year as I can remember. The July election

heralded a new Government with a Labour MP elected in Lincoln and a Reform MP

in the Boston and Skegness constituency. On the first Monday in office, the Minister

of Health met with representatives of the BDA. Contract Reform was a priority on the

agenda. Lack of access to NHS dental care is nationwide and particularly in rural

and coastal areas like Lincolnshire. Compared to other areas in the Midlands we

continue to perform at the lower end with respect to access. Lincolnshire is often

referred to as a Dental Desert, and whilst I can see why this expression is quoted,

this widely used term does nothing to help with recruitment and retention in our area.

You may remember in February of 2024, the long-awaited Dental Recovery Plan was

published. The key points were a minimum UDA rate of £28. A patient premium to

examine new patients who had not been seen for 2 years. Golden Hellos to

encourage new dentists to the area and Dental Vans to try to improve accessibility in

areas where transport links were difficult. There was to be a focus on tooth brushing

and prevention for school age children in targeted areas, and on prevention themes,

a consultation at national level on fluoridation of water supplies. All these intentions

were steps in the right direction …. Except …. The patient premium ended in March

of this year. We have had one application to the Golden Hello Scheme, even though

11 practices expressed an interest. I personally contacted every practice who

applied, for feedback as to why they thought no one seemed interested in applying.

The answer consistently coming back was that Lincolnshire’s UDA was too low

compared to neighbouring areas. These days a dentist can choose more or less

anywhere, where they want to work, and to attract and retain a workforce we must

be competitive. Dental vans were always likely to be a non-starter (no pun intended),

but both preventative measures have proved to be more positive. The toothbrushing

scheme/ Lincolnshire Smiles goes from strength to strength, helped by an additional

input of money from Lincolnshire County Council and consultation regarding

Fluoridation, is ongoing with the North-East as the test case.

In February and March our attention was distracted by the resignation of senior staff

at NHSE and the subsequent abolition of NHSE itself, as it integrates back into the

Dept of Health and Social Care. Jim Mackey, the current transition chief executive of

NHS England, will oversee this integration with the goal of reducing duplication and

streamlining functions.

Hard on the heels of this announcement, came the news that all ICBs were told to

reduce running costs by a further 50%. These cuts must be made by the third

quarter of 2025/26 ie end of December. The short-term aim is to stabilise NHS

finances and try and reduce the NHS deficit. These cuts, however, are likely to

involve major changes and may make the task of delivering long term transformation

harder. Uncertain times lie ahead, with recruitment paused, and jobs & services at

risks. Specialties go unsupported without an MCN itself or an MCN Chair.

Since these announcements were made, there has been further developments. To

deliver on the required reduction in ICB running costs and maintain viable teams

delivering the functions and duties placed on ICBs, it is clear that NHS Lincolnshire

ICB will no longer be financially viable in its current form. Our current planning

assumption is that NHS Lincolnshire ICB, working closely with ICB colleagues in

Nottingham and Nottinghamshire, and Derby and Derbyshire ICBs, will cluster

together to develop shared teams and operating models. How this plays out,

however, remains to be seen.

These proposed changes coincided with the planned retirements of Lincolnshire ICB

Chief Executive John Turner in June and Chair Gerry McSorley in September. Both

have been very supportive of Dentistry and welcomed me into committees where

there has previously been no dental input. Our level of integration and understanding

with the Medical Directorate and the other pillars of primary care is very strong, and

you can be assured that the Dental Voice is listened to.

I commented in last year’s report about the development of the Lincolnshire Dental

Strategy and highlighted the need to translate discussion into meaningful ways that

will help our patients and as well as our dental teams. I am pleased to report there

have been developments and notable successes. Two of the themes of the strategy

are Integration and Prevention. Two pilots …. One to measure blood pressure and

another to check bloods for diabetes, are now up and running. The blood pressure

pilot is more advanced, and the 5 participating practices are in areas of deprivation.

Selected Optometry practices are also involved. To date, circa 40% of those tested

had clinically high blood pressure, with 4.5% of this number having blood pressure

so high, that an immediate A & E referral was recommended. Not only has recording

their blood pressure potentially saved lives, or prevented disabling conditions, but

significant financial savings have also been made to the NHS Budget. Personal

stories have been reported and the public engagement overall, has been excellent.

The BP Pilot finishes in August when results will be collated. Depending on these

outcomes, there may be a case for extending the pilot both in terms of time scales

and participating practices.

The two other elements of the Lincolnshire Dental Strategy are Workforce and

Access. Without the first, it is unsurprising there are issues with the second.

Over the past year, much work has been centred on the Lincolnshire Institute of

Dental and Oral Health, and I am pleased to report that we are moving at pace. You

may have seen that thanks to Mayoral Funding from Greater Lincolnshire, we have

received £1.5 million to fund capital costs for the new School of Dental Therapy and

Hygiene, based at Lincoln University. These are exciting times with the initial focus

on developing a curriculum and establishing Senior Clinical roles. However, there will

be another part to the Institute, and this will concentrate both on service delivery and

training. A site has been earmarked for development but there are several aspects to

consider before progress can be made. The stated aim of the University is to have a

Dental School in Lincolnshire, but this will not happen overnight. Baby steps are

being made but there is much work is to be done, and we must keep ahead of the

game, as other areas are also likely to be considering the option of a Dental School

within their locality.

An aim we all share is to grow our own workforce, and this is the whole dental team,

not necessarily just Dentists. The Institute will play an important role in career

development, as will the Lincolnshire Training Hub. However, what must not be

forgotten is the contribution the LDC make with our Aspiring Dentist Programme as

well as the careers in Health Care Day at Lincoln University

The plan is to have a soft launch for the Institute, possibly in September, and we will

keep you informed when a date is announced.

In terms of access to NHS Dental Care, we have the lowest delivery of care in the

Midlands which is a reflection of the workforce difficulties we face in trying to recruit

and retain dentists in our area. Interestingly, Lincolnshire, per head of population,

has very high amounts of treatments carried out by therapists. This may be a

reflection of the number of overseas dentists we have in Lincolnshire now working as

Therapists.

You may well be aware that the Provision of Urgent Care appointments has been

prioritised by Government. Nationally, the expectation is that 700k should be

provided with circa12k appointment assigned to Lincolnshire. The ICB attended our

LDC Meeting in March to discuss how these appointments can be delivered in the

County. The LDC gave collective views, but an East Midlands approach was

adopted. Ideally, the LDC would favour a more even distribution of these

appointments, rather than a concentration in a limited number of practices.

As well as access to, and delivery of, general dentistry being an issue, we also have

had to deal with a failed IMOS procurement. However, I believe a new procurement

has started, but with no change to the service specification. The procurement

method has changed to Provider Selection Regime; For those interested details are

below:

https://www.find-tender.service.gov.uk/Notice/032672-2025?

The situation in Orthodontics is however even more critical, as anyone trying to

make a referral has found out. In Lincolnshire, the service has been placed on the

ICB Risk Register, but solutions are not easy. This is a national issue, as well as a

local one, but Lincolnshire has one of the worst, if not the worst, service provision in

the Country with the inequality of service demonstrable. The LDC understand the

frustrations practitioners may have, both in accessing care in primary and secondary

settings. Please be assured that efforts are being made at the highest level to try and

improve the situation.

However, I wish to finish on a positive note.

In March, the ICB held the inaugural Lincolnshire Primary Care Valuing and

Recognition event at Lincolnshire Showground. There was over 250 people in

attendance. All 4 pillars of Primary Care, (Pharmacy, Optometry, Medicine and

Dentistry) were represented. Well-deserved awards were given to The Maltings

Dental Practice, The Design Studio and individual awards to Jimmey Palahey, Helen

Sloss, Catherine Jordan and Jane Bellamy.

In collaboration with the LDN and ICB, we are at last compiling a data base for

practices (Those with NHS Contracts and those fully Private). Thank you to everyone

who has contributed. An aim will be to improve communication to all.

The LDC Constitution has been changed and upgraded, essentially to keep us up to

date with changes relating to inclusion and diversity, data protection and social

media.

The LDN has recently appointed a Chair, Fiona Ellwood, for a DCP Network to be

established in Lincolnshire. Dentistry is a team effort, and the value of this team

cannot be underestimated. This will be an important network with a clear sense of

purpose with aim to listen to the voice of DCPs. I would strongly encourage practices

to support this network. It will benefit everyone.

Finally, the LDC understands the many concerns practices currently have. Contract

Reform cannot come quick enough, but NHS Dentistry has been underfunded for

years and how this will translate into Contract Reform remains to be seen. Be

assured that the LDC, the ICB, the LDN, Dental Public Health, and other key

stakeholders are working tirelessly on your behalf, and I would like to thank them all

for their support throughout the year.

Kenny Hume Lincolnshire LDC Chair