Written Statement: Gwên am Byth oral health programme - increased funding

The Gwên am Byth (A Lasting Smile) oral health programme for people living in care homes was launched in 2015. This statement is to provide members with an update on the programme and announces a doubling in funding by Welsh Government to £0.5 million a year to ensure the programme is rolled-out fully to all care homes in Wales during 2020/21.

The key aim of Gwên am Byth is to improve oral hygiene and mouth care for older people living in care homes through the development of a consistent all-Wales approach. Many residents have poor or inadequate oral health when they move to their care home, often as a result of deteriorating health and mobility during the preceding years including people living with dementia. Gwên am Byth aligns with our Oral Health and Dental Services Response to A Healthier Wales, with the programme principles being that care homes will ensure:

• an up-to-date mouth care policy is in place
• staff are trained in mouth care (including at induction) and the home keeps a register of training
• residents have a mouth care assessment at appropriate intervals
• the assessment leads to an individual care plan, designed to support good oral hygiene, and 
• residents are referred to the dental team if necessary.

Experience from the first four years of the programme has shown that delivering improved oral health to the care home population is complex and challenging. Although over half of care homes are now participating in Gwên am Byth, and 5,670 residents have a mouth care plan being delivered, the increase in funding will allow the programme to expand to include all care homes. Where capacity allows the principles of the programme will be developed to include the pre-care home cohort of older people.

There has been positive feedback from care home staff, residents, carers and Community Dental Service staff who deliver Gwên am Byth. In addition, care home staff are engaging with the programme which is leading to a better understanding of how good oral health can impact on their residents. 

Gwên am Byth is now an integral part of the Care Home Improvement Cymru programme which is also funded by Welsh Government with delivery led by Public Health Wales/1000 Lives Service improvement. This has allowed the Care Home Improvement Cymru programme to benefit from the learning and experience of Gwên am Byth, while further strengthening Gwên am Byth as an integral part of Wales’ national care home improvement work. Earlier this year the Care Quality Commission reported on the very poor state of oral care for residents in care homes for older people in England, and how few homes meet NICE guidelines. Organisations such as the British Association for the Study of Community Dentistry and the British Society for Gerontology welcomed the report and highlighted the good practice in Wales in the Gwên am Byth programme. 

Funding for Gwên am Byth is allocated to health boards and is ring-fenced for use on the programme only, mirroring the approach taken with resources for the Designed to Smile child oral health improvement programme.

This statement is being issued during recess in order to keep members informed. Should members wish me to make a further statement or to answer questions on this when the Assembly returns I would be happy to do so.