# At the Deep End of dental inequality

## TL;DR

The paper discusses how dental practices in disadvantaged areas can form 'Deep End' networks to improve care and advocacy, similar to initiatives in general medical practice.

## Contribution

The paper adapts the Deep End concept from general medical practice to dentistry, offering practical guidance for establishing such networks in disadvantaged communities.

## Key findings

- Deep End networks in general medical practice have successfully improved care and reduced burnout in disadvantaged areas.
- The Deep End of dentistry is defined as the 10% of contracts serving the most deprived patients based on NHS England's CORE20PLUS5 framework.
- The paper provides actionable advice for dental teams to establish their own Deep End networks.

## Abstract

Due to the inverse care law, the crisis faced by NHS dentistry in England is felt most keenly by socioeconomically disadvantaged communities and the dental practices providing their care. Many challenges faced by these dental practices are shared by practitioners across the healthcare system. General medical practitioners (GMPs) in socioeconomically disadvantaged communities have set up local ‘Deep End' networks which advocate for patients and staff, share learning and best practice, and develop interventions for improving care and reducing practitioner burnout. Beginning in Glasgow, the Deep End movement is now global, spreading beyond GMPs to other areas of the healthcare system. The establishment of Deep End networks for general dental practitioners could serve as a powerful movement for identity, advocacy and action for socioeconomically disadvantaged communities and their dental practice teams. By adapting the GMP definition of the Deep End, the Deep End of dentistry in England is defined as the 10% of contracts treating the greatest proportion of deprived patients based on NHS England's inequalities framework, CORE20PLUS5. Administrative data from the NHS Business Services Authority is used to identify the Deep End. Advice for dental teams looking to set up a local Deep End dental network is given.

Groups of general medical practitioners in areas of widespread socioeconomic disadvantage have set up local ‘Deep End' networks to counter health inequality.Dental teams should consider establishing their own Deep End networks which could be a powerful movement for identity, advocacy and action for socioeconomically disadvantaged communities and the dental practice teams that serve them.This article provides interested dental team members with practical advice on how to set up a local Deep End network, including the publicly available data and methods required to identify potential members, important collaborators in policy and academia, and an approach to setting network objectives.

Groups of general medical practitioners in areas of widespread socioeconomic disadvantage have set up local ‘Deep End' networks to counter health inequality.

Dental teams should consider establishing their own Deep End networks which could be a powerful movement for identity, advocacy and action for socioeconomically disadvantaged communities and the dental practice teams that serve them.

This article provides interested dental team members with practical advice on how to set up a local Deep End network, including the publicly available data and methods required to identify potential members, important collaborators in policy and academia, and an approach to setting network objectives.