Last updated: 01 March 2024
What is this report?
This report:
• Explains why people experiencing homelessness might struggle to maintain good oral health and access dental services. This will include feedback from a focus group of Experts by Experience.
• Looks at the different types of NHS dental service and how people experiencing homelessness can be supported to receive treatment.
• Investigates alternative models of dental care, developed specifically with people experiencing homelessness in mind.
• Offers some recommendations as to how access to dental services can be improved.”
Who is it for?
This report is for anyone commissioning or designing dentistry services and want to make them more inclusive for people who are homeless.
Summary
The difficulties faced by people experiencing homelessness in accessing dental services are varied and can be significant.
They range from a lack of information about how dental services work, to being refused care from a dental practice. In common with other socially excluded groups, many people experiencing homelessness have endured trauma, which can also affect their ability to seek and receive treatment.
It’s getting even more difficult to find an NHS dentist and many lists are full. I’ve tried 4 different dentists in my local area, with no luck.
Seeking treatment
To explore these difficulties further and how they might be overcome, we held a focus group with Expert by Experience participants, all of whom have direct experience of homelessness.
Participants spoke about how they didn't feel that dental services were accessible to them, and what came across strongly were:
- a lack of clarity on entitlement to NHS dental treatment
- the belief they needed to provide ID or a current address to sign-up with a dental surgery
- digital exclusion, e.g., the requirement to sign up and/or complete forms online
- the attitude of some dental practice staff and the feeling they were being judged for experiencing homelessness
- the impact of the increased risk of things like anxiety and unresolved trauma on accessing dental care
- inadequate training for dentists and front facing staff in trauma and psychologically informed approaches and in understanding the complexities faced by people experiencing homelessness
Key recommendations for better provision:
- It is important to encourage collaboration between VCSE organisations, dentists and local commissioners.
- Alternative funding streams and flexible commissioning should be explored. Alternative models are summarised below
- Support through peer and/or link worker advocacy helps people experiencing homelessness to access and complete dental treatment
- Practical guidance and information are a must
There should be signposting by surgeries who cannot see you due to the waiting list, with advice on where you can be seen.”
