A free clinic for people experiencing homelessness in Plymouth has had a transformational effect, but those running it say scope for expanding the model to support other patient groups, and increasing service levels for existing patients is limited.
A recent evaluation of the clinic has concluded that the model is currently constrained by NHS funding, and suggested that services recognising the complex and diverse needs of vulnerable patients require higher prioritisation within dental commissioning.
In January 2018, Peninsula Dental Social Enterprise (PDSE), a not‐for‐profit organisation linked to the University of Plymouth’s Peninsula Dental School, established a community clinic to improve access to dental care for people experiencing homelessness. In the last year, the clinic has expanded its offer to include individuals using drug and alcohol services, as well as vulnerable women at risk of having multiple children removed from their care.
PDSE currently provides this service pro bono to the local community as part of its mission to ensure access to dental care for groups who may feel excluded from mainstream dentistry.
A recent evaluation of the clinic carried out by researchers from the University’s Faculty of Health found it was “a highly successful, acceptable and accessible dental care model for people experiencing homelessness that could be implemented in other locations”. However, the study also said that because many of the people it helps have high needs requiring extensive – and expensive – treatment, it would not be financially viable under a contract based on the current NHS dentistry payment method in England.
The research found the average cost per course of treatment in the clinic is £854.50, almost three times the sum available from the NHS, if the service were state funded only, of £300.
It concluded that for the life-changing approach to be rolled out more widely, new flexible models of care are needed that allow dental professionals to provide routine and continuing treatment for socially vulnerable adults with high needs.
Rob Witton, PDSE Chief Executive and Director of Social Engagement and Community-based Dentistry in Peninsula Dental School said:
“PDSE is absolutely committed to addressing oral health inequalities in local communities and helping those who need it most. I am grateful to all of our partners for making this initiative so successful. Our ambition is to receive NHS funding so we can expand our model across Devon and Cornwall to help more people.
"However, for this to happen, we would welcome NHS England considering a more flexible approach to commissioning dental care, and therefore ensuring everyone can enjoy good oral health – whatever their background or personal circumstance.”
Since the start of the Community Clinic and up to 18 February 2020, 89 vulnerable individuals have received a range of dental treatments. Outcomes from continuous evaluation of the Community Clinic model often describe dental care as a catalyst for change in many areas of a patient’s life: