Case studies
Grin and bear it? – Community Dental Services
Not having access to a dentist can be life threatening. The growth of one Bedfordshire-based organisation is a result of offering real care to the community. Here at Social Enterprise UK, growth, which the government has focused on since inception, means everyone rises together, that everyone’s life is improved. For that to happen, we need to ensure we look after the most vulnerable members of our society. Access to dental care is challenging for people. The government admitted as much in a 2024 policy paper. An aging population, more complex health needs and an increase in children with high levels of tooth decay are all creating a significant rise in demand for services. If you’re homeless, have learning disabilities, mental health issues or severe anxiety, finding a dentist can feel like a mountain to climb. The growth of Community Dental Services CIC (CDS), which specialises in caring for vulnerable patients and operates 58 clinics across much of the East of England and the Midlands, is therefore no surprise. Patients with complex needs who require specialist treatment are referred to CDS by a general high street dentist or health or social care professional. Dental health is a key indicator of overall health and wellbeing but is often overlooked. Poor oral health contributes to chronic conditions such as diabetes, cardiovascular disease, and respiratory infections. And then there’s mental health; poor oral health can erode confidence, limit social interaction and damage mental wellbeing. A business for the community CDS was formerly part of the NHS. After what one former Clinical Director described as “a never ending cycle of constant reorganisations and frequent cuts to our dental budgets to fund other parts of the health service,” senior leaders took up a ‘Right to Request’ option made possible by 2010 health service reforms, asking the Regional Health Authority to leave the NHS and set up independently. The founders wanted to control the destiny of the organisation and make changes to the service in the best interests of patients and employees. One of those founders is the current CEO Helen Paisley. It was the beginning of Community Dental Services Community Interest Company (CIC). CDS is a business which operates as a social enterprise. It is wholly owned by employees, who have representatives on the Board and can influence how it is run, especially concerning the care provided to patients. It is now commissioned by the NHS and local authorities to provide community dental services, oral health improvement, and epidemiology surveys in seven counties. CDS provide more than 63,000 patient appointments annually and 5,275 children have participated in supervised toothbrushing programmes. Those concerned about NHS privatisation by stealth should know that, as a community interest company, any surplus is reinvested straight back into patient care, oral health improvement or into community oral health projects. Beginning with a single contract in Bedfordshire in 2011, CDS now provides special care and paediatric dental services in seven counties. Turnover has grown to £34m and a lot of jobs have been created: the workforce has grown to 500. Growth through innovation As an independent business, CDS has been able to innovate free of the bureaucracy of the NHS. It has invested in a mobile dental fleet to reach underserved communities, including partnering with local charities to support homeless people, a group that is notoriously hard to reach and who face many barriers to accessing healthcare. Growth has also come from ‘flexible’ commissioning, where CDS has responded quickly in developing new micro services that address local commissioner priorities, enabling the business to test new service models that are potentially scalable. A good example is a recent ‘pop-up’ clinic in Luton where CDS provided examinations, oral health advice and preventative treatment to 100 local children in a sports centre. Commissioned by Luton Borough Council to address the high levels of child oral health improvements needed locally, it supported a ‘Covid generation’ of children who have never seen a dentist, received preventative advice or had simple interventions such as small fillings. Labour won the 2024 election promising growth, describing it as 'good jobs and productivity in every part of the country making everyone better off.' As a business, Community Dental Services are certainly productive and creating jobs. And if ‘health is wealth’ as the old saying goes, plenty of people are better off because of the work of this growing social enterprise. communitydentalservices.co.uk
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