17 JANUARY 2019

On Monday 7 January 2019, NHS England released its Long Term Plan. Its goal is to make sure the NHS is fit for the future and meets the health needs of a changing society.

We have looked at what the plan includes for oral health and what impact it may have.

1. HPV vaccinations for boys

Firstly, the NHS is taking proactive steps against the human papillomavirus (HPV) by introducing gender-neutral HPV vaccinations:

‘From September 2019, all boys aged 12 and 13 will be offered vaccination against HPV-related diseases, such as oral, throat and anal cancer. This will build on the success of the girls’ programme, which has already reduced the prevalence of human papilloma virus (HPV) 16 and 18, the main cancer-causing types, by over 80%. This will reduce cervical and other cancers in both men and women in the future.’

While we knew that this was going to be included, it is still great to know that from September 2019 up to 400,000 boys per year are going to be protected from HPV diseases¹. HPV is responsible for around 5% of all cancers as well as countless other diseases and infections. This move will have an extremely positive effect for future generations.

2. Improving health provisions for those with learning disabilities and autism

Also detailed in the plan was the NHS’ commitment to improving the understanding of the needs of people with learning disabilities and autism. They state that:

‘Across the NHS, we will do more to ensure that all people with a learning disability, autism, or both can live happier, healthier, longer lives…Over the next five years, we will invest to ensure that children with learning disabilities have their needs met by eyesight, hearing and dental services, are included in reviews as part of general screening services and are supported by easily accessible, ongoing care.’

’By 2023/24, a ‘digital flag’ in the patient record will ensure staff know a patient has a learning disability or autism. We will work with the Department for Education and local authorities to improve their awareness of, and support for, children and young people with learning disabilities, autism or both. And we will work with partners to bring hearing, sight and dental checks to children and young people with a learning disability, autism or both in special residential schools.’

Work to improve care for some of our most vulnerable members of society is long over-due. The latest figures estimate that there are roughly 1.5 million people with learning disabilities,² and 700,000 people on the autistic spectrum, in the UK.³ Earlier this month, the BBC uncovered how numerous vulnerable patients had been let down by the NHS when it came to their oral health.  It is important that those with learning disabilities and autism get the support they need to best look after their teeth, both in and out of the dentist.

3. Improve children’s oral health

The NHS has set out plans to better children’s oral health. Tooth extraction remains the most common reason for hospital admissions for 5 to 9 year-olds, so clearly work needs to be done. To combat this the NHS plans to:

‘support [children and young people’s] health development by providing holistic care across local authority and NHS services, including primary care, community services, speech and language therapy, school nursing, oral health, acute and specialised services.’

The NHS implemented the ‘Starting Well Core’ initiative late last year which supports 24,000 dentists across England in 13 ‘high-priority areas'. We hope that this statement of intent from NHS England, who will have learned a lot from the success of other programmes like Childsmile in Scotland and Designed to Smile in Wales, will lead to the introduction of further programmes.

4. Improving oral health in care homes

Finally, the NHS Long Term Plan explains how they plan on improving oral care for those in care homes. To do this they say:

‘We will upgrade NHS support to all care home residents who would benefit by 2023/24, with the Enhanced Health in Care Homes (EHCH) model rolled out across the whole country over the coming decade as staffing and funding grows. This will ensure stronger links between primary care networks and their local care homes, with all care homes supported by a consistent team of healthcare professionals…As part of this, we will ensure that individuals are supported to have good oral health, stay well hydrated and well-nourished and that they are supported by therapists and other professionals in rehabilitating when they have been unwell.’

Just as is the case with children and those with disabilities or autism, it’s important that the elderly get the help they need to look after their oral health. This is especially important considering that we currently have an ageing population which is set to rise. Recent figures predict that by 2045, over 65s will account for almost a quarter of the population (24.6%).⁴ It’s important that those in care homes are not forgotten about and that they get the appropriate help needed to take care of their oral health.

Conclusion

The Oral Health Foundation welcomes the NHS’ Long Term Plan and hopes it will go far in achieving what it sets out to regarding oral health. To achieve those goals, we will need to see more interprofessional collaboration within the healthcare sector and adequate funding from the government. The Oral Health Foundation will be monitoring the implementation of the plan closely and making sure it is being carried out effectively.

References

1. HPV Action, Gender Neutral Vaccination, Why Gender Neutral Vaccination? http://www.hpvaction.org/gender-neutral-vaccination.html (accessed 10 January 2019)
2. The Mental Health Foundation, Learning Disability Statistics https://www.mentalhealth.org.uk/learning-disabilities/help-information/learning-disability-statistics- (accessed 10 January 2019)
3. The NHS Information Centre, Community and Mental Health Team, Estimating the Prevalence of Autism Spectrum Conditions in Adults - Extending the 2007 Adult Psychiatric Morbidity Survey (2012)
4. Overview of the UK population: March 2017, Office for National Statistics (2017)