FOI2026/2007

I am writing to make a request under the Freedom of Information Act 2000 regarding NHS-funded domiciliary dental services across Greater Manchester.

This request relates specifically to dental services for patients who are unable to access conventional dental practices because of frailty, disability, mobility restrictions, complex health needs, residence within a care/nursing home, or other clinical circumstances requiring treatment in their place of residence.

Please provide the following information for the most recent complete financial year and, where available, the current 2026/27 financial year.

1. Current domiciliary dental provision

Please provide details of all NHS-funded or NHS-commissioned domiciliary dental services currently available across Greater Manchester.

For each service, please provide:

• Provider name
• Contract/service type
• Areas/localities covered
• Whether care homes/nursing homes are included
• Patient eligibility criteria
• Referral criteria and referral pathway
• Treatments/services commissioned
• Current annual contract value
• Contract start date
• Contract expiry/review date
• Whether the contract contains a maximum activity/capacity level

2. Capacity and activity

For each commissioned domiciliary dental service, please provide:

• Number of patients treated during 2024/25
• Number of patients treated during 2025/26
• 2026/27 activity to date, if available
• Number of domiciliary visits delivered
• Number of care-home/nursing-home residents treated
• Number of individual care homes/nursing homes visited
• Current waiting time for domiciliary assessment/treatment, if recorded
• Current waiting list size, if recorded

Where this information is not held centrally, please state this.

3. Unmet demand

Please provide any information held regarding:

• Number of domiciliary dental referrals received
• Number accepted
• Number declined
• Number unable to be fulfilled because of capacity
• Patients waiting for domiciliary dental care
• Care homes reporting difficulty accessing NHS dental services
• Complaints or concerns received regarding access to domiciliary dentistry
• Patients requiring domiciliary care who have instead been directed to private dental treatment because NHS capacity was unavailable

If these figures are not recorded, please confirm that NHS Greater Manchester does not routinely collect this information.

4. Needs assessment

Please provide copies of, or links to, the most recent:

• Oral health needs assessment relating to older people
• Oral health needs assessment relating to care-home residents
• Needs assessment relating to domiciliary dentistry
• Equality/health inequalities assessment concerning access to dentistry by housebound or vulnerable adults
• Service review or capacity assessment of NHS domiciliary dental provision in Greater Manchester

Please also confirm:

When did NHS Greater Manchester last formally assess whether the current level of commissioned NHS domiciliary dental provision is sufficient to meet the needs of the Greater Manchester population?

If such an assessment has been undertaken, please provide a copy.

If no such assessment has been undertaken, please confirm this.

5. Care-home population

If held, please provide NHS Greater Manchester’s estimate of:

• Number of care/nursing homes within Greater Manchester
• Number of residents living within those settings
• Number estimated to require domiciliary dental care
• Number currently receiving NHS domiciliary dental services

6. Commissioning and expenditure

Please provide the total NHS Greater Manchester expenditure on domiciliary dental services for:

• 2023/24
• 2024/25
• 2025/26
• Budgeted expenditure for 2026/27

Please also provide details of any:

• Dental commissioning underspend
• Recovered/clawed-back dental contract funding
• Unallocated primary dental care funding

for 2024/25 and 2025/26.

Where dental funding has been recovered or remained unspent, please state whether NHS Greater Manchester considered using any of this funding to increase domiciliary dental capacity.

7. Additional domiciliary capacity

NHS England’s Opportunities for flexible commissioning in primary care dentistry: A framework for commissioners identifies additional capacity for domiciliary services as an area in which ICBs can invest to address areas of population need.

Please therefore provide copies of any documents, reports, meeting papers, business cases or recorded commissioning decisions from 1 April 2024 onwards relating to:

• Increasing NHS domiciliary dental capacity
• Reducing NHS domiciliary dental capacity
• Commissioning new domiciliary dental services
• Expanding existing domiciliary dental services
• Care-home dental access
• Identified gaps in domiciliary dental provision

8. Commissioning decisions

Please confirm whether NHS Greater Manchester currently considers existing commissioned domiciliary dental provision sufficient to meet the needs of eligible patients across Greater Manchester.

If yes, please provide the recorded evidence, needs assessment, report or other information upon which this conclusion is based.

If NHS Greater Manchester has identified insufficient provision, please provide details of any action plan or commissioning intentions designed to address the gap.

9. Future commissioning

Please confirm whether NHS Greater Manchester currently has any plans during 2026/27, 2027/28 or thereafter to:

• Procure additional domiciliary dental services
• Increase capacity within existing contracts
• Establish a pilot domiciliary dental programme
• Commission additional care-home dental provision
• Invite providers to deliver additional domiciliary dental activity

Where such plans exist, please provide the anticipated procurement/commissioning timetable and, where already published, the relevant procurement notice or commissioning documentation.

10. Responsibility and accountability

Finally, please provide the job title(s), team or department responsible within NHS Greater Manchester for:

• Assessing population need for domiciliary dentistry
• Planning domiciliary dental services
• Commissioning domiciliary dental services
• Monitoring domiciliary dental capacity and performance
• Addressing inequalities in access to dental care for care-home residents and housebound patients

An excel document was sent to the requester with this response.  If you require a copy of the full response, together with the attachments, please contact NHS GM’s FOI team – nhsgm.foi@nhs.net