Greater Manchester is home to a bold experiment. Since 1 April last year, a £6 billion Health and Social Care budget has been devolved to the region and all of us at senior level have responsibility for helping to achieve the fastest possible improvement in the health and well-being of the 2.8 million who live here.
Improving children’s oral health: we have our work cut out
The process has been nicknamed Devo Manc – but this catchy abbreviation conceals a difficult reality. In the field of children’s oral health, which as a consultant in paediatric dentistry is my main concern, we have our work cut out, to say the least.
We anticipate that Greater Manchester will be included in a new prevention initiative that was announced by Health Minister, Alistair Burt at the BDA 2016 Conference to improve those parts of England identified as having the poorest oral health of 0-5 year olds.
This work will continue with the Children’s Oral Health Improvement Programme Board – a multi- organisation team working collaboratively to improve children’s oral health across England. Then there is the annual spend of over £5 million on paediatric dental general anaesthesia (PDGA), the need for which must be dramatically reduced.
Manchester is proud of its industrious heritage. We continue to work hard, we see ourselves at the centre of the Northern Powerhouse and with devolution we really do have the opportunity to take charge.
Change hasn’t happened over night, but in our first year we have:
- Managed Clinical Networks (MCNs) running in all specialities, with agreed work plans for the forthcoming year;
- A population health plan for Greater Manchester which recognises the importance of children’s oral health and includes Dental Check by One #DCBy1 – encouraging a first check up by a child’s first birthday;
- A commitment to train additional paediatric specialists who will become our local leaders;
- Agreement of urgent criteria for PDGA which are now in place across Greater Manchester;
- A bid submitted to support a regional programme of prevention which would see evidence-based interventions commissioned in our areas of highest need;
- The start of collaborative working – for example with local authorities to stop the decommissioning of oral health improvement services;
- A reduction in waiting time for children requiring PDGA.
Giving children’s oral health the priority it deserves
That dental disease, which let’s remember is almost always preventable, remains the most common reason for a child aged 5-9 to be admitted to a hospital in England is beyond belief and don’t get me started on the persistent inequalities in oral health which are, quite frankly, immoral in this day and age.
Breaking down barriers between providers: prevention first
But, aside from the scale of the challenges, we also have ongoing work to break down barriers between provider organisations and as consultants we have to adapt to new roles. We are becoming local leaders, providing clinical expertise to strategic planning and that may not feel comfortable for our commissioning colleagues or for our lead employers who have yet to see the fruits of our labours. They might be wishing that we were running a theatre list or a new patient clinic instead of developing and training our MCN.
But despite this, it feels very exciting to be part of the transformational change in Greater Manchester. On a personal level I feel extremely fortunate to be working under the inspirational leadership of Chief Operating Officer, Jon Rouse, who, when addressing the Local Dental Federation earlier this year, made it clear that he not only understands the need to put #preventionfirst
but that he is also going to support those of us leading the rapid response that our population deserves.
I have also forged new relationships – with our commissioners, with our consultants in dental public health, with my general practitioner colleagues and with my colleagues working in the community dental services.
To be part of such a forward thinking team is an honour and believe me, together we will make a difference.
Consultant in Paediatric Dentistry, University Dental Hospital of Manchester