Sir, I write as a retired Consultant in Dental Public Health, as well as a current member of the BDA and Chair of Healthwatch Leeds. In BDJ In Practice's August 2022 issue, Catherine McCanny writes about some of the unfortunate consequences of the way in which NHSE/I Yorkshire and the Humber have carried out the recent procurement process for orthodontic contracts.1

I would go even further in my criticism of the way in which this has been carried out which has completely ignored the effects on patients undergoing NHS orthodontic treatment. Most orthodontic patients need regular review appointments every month or so. None of the orthodontic practices in Leeds previously contracted to provide NHS treatment were awarded new contracts. I am not aware whether they tendered for new contracts or not, but I do know that none have accepted wind-down contracts to complete already commenced courses of treatment.

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The new contracts were due to commence in April but neither local dental practitioners nor existing patients were notified of the new orthodontic contract holders by this time and it seems that the new orthodontic practices were not ready to commence providing orthodontic treatment until well after the date at which their contract was due to start. In fact, a number of patients were still contacting Healthwatch Leeds for advice in September as they had still not been informed about where their treatment would be continued. Patients who needed urgent attention, for example because of fractured wires which were causing trauma to the soft tissues, were told to contact 111 - what were the staff at 111 supposed to do? The only advice they could give was to cut off the broken wires - not the best way to facilitate their treatment, especially as they were still waiting to be told where and when their treatment would be continued.

From where did NHSE/I obtain their orthodontic advice, from where did they get an input from patients' representatives to ensure that they were aware of the steps needed in a timely way to ensure smooth continuity of care for the patients and the mental trauma caused by not knowing where to turn for ensuring that their treatment continued in an orderly way? The whole process has been a disgrace and those at NHSE/I should be ashamed of such cavalier treatment of children receiving NHS care.