Summary
The Oral Health Foundation has publicly responded to the 2025 announcement of a new partnership between the United Kingdom’s Department of Health and Social Care (DHSC) and the NHS England executive team, marking a significant step toward unifying leadership and operational functions within the national health system. This joint executive team aims to streamline policy and service delivery by combining resources and leadership structures, with a focus on reducing duplication and enhancing efficiency across healthcare sectors, including oral health services. The integration is part of broader health system reforms motivated by challenges identified during the COVID-19 pandemic and ongoing efforts to improve patient outcomes and workforce sustainability.
Oral health in England faces persistent challenges, especially among vulnerable populations such as hospital patients, children, and underserved groups, where poor oral hygiene can exacerbate health complications. The partnership supports existing and new initiatives that emphasize integrated care models, workforce development, and community engagement to address these disparities. Programs like Mouth Care Matters and its pediatric adaptation Mini Mouth Care Matters exemplify targeted approaches to improving oral health in both hospital and community settings. Furthermore, reforms aim to improve access to NHS dental services by promoting direct access to dental care professionals and incentivizing increased NHS work among dentists.
The Oral Health Foundation has expressed support for the partnership’s emphasis on multi-agency collaboration, transparency, and accountability, highlighting the importance of coordinated efforts among government bodies, health services, and community organizations to maximize impact on oral health outcomes. The Foundation also acknowledges the potential for the partnership to strengthen dental service delivery through improved dispute resolution mechanisms and enhanced strategic planning. However, ongoing challenges remain in shifting dental contracts toward outcome-based measures rather than activity-focused performance metrics, a key point of discussion among dental professionals and policy makers.
Overall, the DHSC and NHS England executive team partnership represents a notable structural reform with the potential to advance oral health policy and practice in England through integrated leadership and resource alignment. Its success will depend on effective implementation, continued stakeholder engagement, and robust monitoring to ensure equitable improvements in oral health access and outcomes across diverse populations.
Background
The partnership between the Department of Health and Social Care (DHSC) and NHS England executive team forms part of a broader strategy to enhance oral health outcomes across the United Kingdom. This collaboration is situated within a complex health system where multiple organizations and agencies work together to deliver integrated care and public health initiatives. DHSC holds overall stewardship of the health system and is responsible for holding NHS England accountable for commissioning and operational delivery, including expert clinical and public health leadership on immunisation and other public health programmes.
The need for improved oral health services is underscored by challenges such as the deterioration of oral health among vulnerable groups, including hospitalised patients where inadequate mouth care can contribute to complications like poor nutrition and pneumonia. Recognizing this, NHS England and its partners have developed targeted programmes, including paediatric adaptations such as Mini Mouth Care Matters, created in collaboration with Great Ormond Street Hospital for Children (GOSH). Furthermore, oral health initiatives emphasize the importance of collaborative partnerships across federal, state, and local agencies as well as public and private organizations to maximize effectiveness and resource synergy.
Foundation dentists working within general medical practices have benefited from experience in collaborative care and managing vulnerable populations, simultaneously helping to reduce avoidable presentations to accident and emergency services. Alongside clinical development, dentists have undertaken further certifications in areas such as fluoride varnish application, impression taking, oral health education, and radiography, enabling them to perform extended duties under dental supervision.
Community engagement and public awareness campaigns are integral to the partnership’s objectives. For example, collaborations with organizations like Neighbourhood Watch have facilitated dissemination of NHS 111 messaging through widely visible materials, encouraging appropriate use of NHS services. Such multi-agency efforts align with NHS England’s role in supporting the delivery of the NHS Long Term Plan, emphasizing shared goals, cross-agency collaboration, and mitigation of risks within available resources.
The Oral Health Foundation, an independent UK oral health charity, supports these initiatives by providing expertise and advocacy, contributing to the development of training programmes and resource sharing to strengthen oral health outcomes nationally. This integrated approach reflects the ongoing commitment of DHSC, NHS England, and their partners to address oral health disparities and improve population health through coordinated policy and practice.
The New Partnership Between DHSC and NHS England Executive Team
In a significant structural reform announced in 2025, the Department of Health and Social Care (DHSC) and NHS England are set to establish a single joint executive team as part of a broader transition to unify the two organisations. This move aims to provide unified leadership by bringing together policy and delivery functions under one leadership structure, thereby reducing duplication and enhancing efficiency in the health system. The joint executive team will begin managing directors from related work areas starting 3 November 2025 and will focus on combining resources to better support health service delivery.
This partnership is a response to concerns that having two separate organisations with overlapping responsibilities has hindered effective delivery for patients. The Prime Minister highlighted the need to end this duplication and streamline leadership within the NHS, with the integration intended to unlock workforce potential and improve operational outcomes. The collaboration will also see the joint team oversee strategic programme decisions with accountability mechanisms involving senior officials from both DHSC and NHS England, including the DHSC director general responsible for finance and the NHS England Chief Financial Officer.
The creation of the joint executive team builds on existing collaborative frameworks between DHSC, NHS England, and other health bodies, such as the UK Health Security Agency (UKHSA) and Health Education England (HEE). These partnerships have been critical in delivering national health priorities, including public health commissioning, pandemic preparedness, workforce planning, and integrated service delivery models. For example, NHS England and HEE have been working together to align workforce, financial, and service planning with education, training, and COVID-19 recovery efforts, further strengthening the foundation for the new joint leadership model.
The partnership is expected to facilitate improved accountability and operational delivery within the NHS by fostering closer collaboration between policy makers and frontline service providers. It also seeks to support broader government health objectives by ensuring a more coherent strategic approach to managing NHS functions and reform agendas. This structural change is a key step toward “building back better” following lessons learned from the COVID-19 pandemic and ongoing public health reforms.
Oral Health Foundation’s Response to the Partnership
The Oral Health Foundation, an independent UK oral health charity, has expressed support for the new partnership between the Department of Health and Social Care (DHSC) and the NHS England executive team. Recognizing the importance of collaboration across multiple agencies, the Foundation emphasized that such partnerships are essential to optimize ongoing activities, enhance cross-agency cooperation, and explore new private-public opportunities to maximize synergy in oral health initiatives.
The Foundation highlighted that the U.S. Public Health Service Oral Health Coordinating Committee’s Framework underscores the need for collaborative partnerships spanning federal, state, and local agencies as well as public and private sectors, which aligns with the goals of the DHSC-NHS England partnership. This approach is seen as a critical step towards strengthening oral health outcomes through integrated efforts and shared priorities.
Furthermore, the Foundation acknowledged the strategic role of NHS England and DHSC in shaping dental services, particularly in the wake of recent reforms aimed at improving NHS dentistry access and recovery from pandemic-related pressures. It noted that timely engagement and dispute resolution mechanisms outlined in the partnership agreement demonstrate a commitment to transparency and accountability, which are vital for sustained progress.
In addition, the Foundation emphasized the importance of targeted initiatives to support vulnerable and underserved populations, citing successful community programs that have improved access to dental care for groups such as people experiencing homelessness and looked after children. The partnership’s potential to leverage multi-agency collaboration to extend such efforts was viewed positively.
Impact of the Partnership on Oral Health Services
The partnership between the Department of Health and Social Care (DHSC) and the NHS England Executive Team is poised to significantly influence oral health services across England by fostering integrated, collaborative approaches to care. Central to this impact is the alignment of workforce, financial, and service planning with education and training initiatives, which aims to address existing challenges in dental service delivery and enhance overall patient outcomes.
One of the key outcomes of this partnership is the promotion of integrated care systems (ICSs) as a vehicle for improving oral health through a ‘place-based’ approach. This model encourages the unification of previously siloed services, integrating oral health with general health management to promote a more holistic and preventative care framework. The collaboration is expected to facilitate joint working between dental and non-dental professionals, thereby enhancing education and awareness about the interrelationship between oral and general health, especially in the context of an aging population.
Efforts to improve access to NHS dental services are also a prominent focus. The partnership supports reforms designed to make urgent care appointments easier to obtain, incentivize dentists to increase NHS work, and implement direct access policies allowing dental care professionals (DCPs) to provide urgent care without prior dentist referral. These measures aim to address longstanding access difficulties and streamline service delivery.
Workforce development forms another critical component, with Health Education England (HEE) working alongside NHS England to maximize staff availability, restore services disrupted by the COVID-19 pandemic, and ensure medium- to long-term sustainability of the dental workforce. This includes upskilling nursing staff and allied health professionals through initiatives like Mouth Care Matters, which targets improved oral health for vulnerable populations such as hospital patients and older adults.
The partnership also enhances public health initiatives targeting underserved and vulnerable groups, including homeless individuals, looked after children, and migrants. By collaborating with local authorities, public health agencies, and community organizations, it aims to reduce oral health inequalities and improve service reach in regions such as Yorkshire and Humber.
Finally, the agreement sets out robust accountability and assurance mechanisms involving multiple organizations at national, regional, and local levels to monitor performance and implement action plans addressing inequalities and service challenges. This structured governance supports the delivery of the NHS Operational Planning Guidance and aligns with broader health priorities outlined by DHSC.
Monitoring and Evaluation of Oral Health Initiatives
The monitoring and evaluation of oral health initiatives within NHS England involve the use of key performance indicators (KPIs) and quality indicators to assess both activity and outcomes in dental care. The Dental Assurance Framework (DAF) report plays a central role by presenting KPIs based on data submitted by dental practices, including metrics such as Units of Dental Activity (UDA) totals, re-attendance rates, and specific clinical dataset items like inlays. These indicators are typically reported according to schedule months and provide insights into practice performance.
While KPIs have been widely adopted, their focus has traditionally been on performance and efficiency rather than patient-centered outcomes. The Department of Health’s vision, influenced by the Steele Report, emphasizes the need to develop dental contracts that prioritize outcome measures over mere activity levels. However, the existing Dental Access Contracts (such as Personal Dental Services Plus or Warburton contracts) tend to concentrate on operational performance and fiscal considerations rather than directly driving improvements in patient care.
Quality indicators, although derived from manufacturing industry concepts, have been introduced to enhance healthcare delivery in dentistry. Their effective use is intended to improve patient care quality rather than merely to judge service performance. Nonetheless, initial experiences within NHS dentistry have demonstrated challenges in defining and measuring quality, especially balancing assessments at population and individual levels.
Training and capacity building are also integral to the evaluation framework. For example, a training needs analysis conducted among non-dental, patient-facing staff within Birmingham Community NHS Foundation Trust identified requirements for enhancing oral health promotion and support within community settings, highlighting the importance of workforce preparedness in delivering oral health initiatives effectively.
Public and Professional Reactions
The partnership between the Department of Health and Social Care (DHSC) and NHS England Executive Team has elicited a range of responses from both the public and dental professionals. A key aspect of the collaboration focuses on addressing shortcomings in NHS dental care delivery, particularly through the development of outcome-based dental contracts rather than activity-based models. This approach reflects recommendations from the Steele Report and aims to incorporate quality indicators that measure patient outcomes, although current contracts such as the Personal Dental Services Plus have predominantly emphasized performance metrics over outcomes.
Dental care professionals have highlighted the significance of direct access and shared care within NHS services, emphasizing that these approaches can work together to enhance patient care. Direct access allows dental care professionals (DCPs) to provide urgent care to NHS patients without prior referral, supporting more timely interventions. Moreover, shared care practices, where treatment responsibilities are delegated within dental teams and explained clearly to patients, are seen as complementary strategies that improve service delivery within practices and across treatment courses.
From a community perspective, training and empowerment initiatives like the Oral Health Ambassador scheme have been recognized as important for strengthening oral health promotion and prevention efforts. These initiatives align with the broader goals of the partnership to improve oral health outcomes through community engagement and professional development.
Public perception and patient-reported outcomes also play a critical role in shaping the partnership’s focus. A consensus among primary care dentists and representative organizations has identified key clinical indicators—including pain, function, appearance, and oral disease markers—that reflect both professional assessments and patient experiences. These indicators serve as foundational data for monitoring oral health status and guiding improvements in primary dental care services.
Related Initiatives and Future Directions
The partnership between the Department of Health and Social Care (DHSC) and NHS England’s executive team aligns with several ongoing and planned initiatives aimed at improving oral health across England. Central to these efforts is the optimization of current activities and strengthening cross-agency collaboration to create synergies with federal and nonfederal oral health programs. This approach supports both the enhancement of existing services and the identification of new opportunities for private-public partnerships.
NHS England’s recovery and reform plan for dentistry includes a range of government-delivered public health initiatives, particularly focusing on improving children’s oral health and supporting workforce growth and development as outlined in the Long Term Workforce Plan. Key deliverables for 2022 to 2023 emphasize the need for coordinated action at national, regional, and local levels, with DHSC overseeing the system and holding NHS England accountable for commissioning and operational delivery. Furthermore, NHS England collaborates closely with UK Health Security Agency (UKHSA) through various boards and oversight groups to support screening and immunization programs that contribute to disease prevention throughout the life course.
Partnerships extend beyond central government bodies to include local councils, school health partnerships, other health professionals, and community organizations, aiming to provide joined-up care that addresses broader oral health needs. The move towards integrated care systems presents an opportunity to embed oral health more firmly within place-based health and care frameworks, breaking down silos between dental and general health services. This integration is especially important given the recognized links between oral health and overall health, and the challenges posed by an aging population.
Specific programs such as Mouth Care Matters, initially targeting older adults in hospital settings to prevent complications like pneumonia and malnutrition due to poor oral hygiene, are expanding to include pediatric versions like Mini Mouth Care Matters in collaboration with Great Ormond Street Hospital for Children (GOSH). These initiatives highlight the focus on vulnerable populations and the necessity of tailored approaches within the broader public health strategy.
Looking forward, the partnership underscores a commitment to making NHS dentistry more accessible and responsive to diverse oral health needs across England. The emphasis on integrated care, workforce development, and multi-agency collaboration is poised to drive significant improvements in oral health outcomes and disease prevention in the coming years.
The content is provided by Harper Eastwood, Lifelong Health Tips
