We developed the PHE ROI tool to set out a costed proposal for primary care NHS dental providers in England to engage in case finding for people aged 40 years and older with previously undetected risk factors for CVD. In 2020 The Office of the Chief Dental Officer England commissioned an independent health economic review, supported by the NHS England and NHS Improvement CVD Team. There was a clear opportunity for primary care NHS dental providers in England to case-find people with risk factors for CVD on an opportunistic basis, in line with MECC. There was an average of 25.36 million unique presentations at English NHS dental surgeries per year between 2015//20 (NHSBSA data) for all ages and 12.06 million for the same period for people aged 40 years and older. Oral health settings offered an opportunity to support this programme.

The NHS Long Term Plan encourages collaborative working across NHS platforms to support early detection of high-risk conditions such as Hypertension, Atrial Fibrillation and raised cholesterol 1. Through collaborative leadership and MECC working, we are stronger in reducing health inequality. I believe that by having a workforce that is more representative of the community it serves, we will encourage better engagement by that very cohort of patients we are trying to reach in programmes such as Core20PLUS5. In my passion for reducing health inequalities, I am leading a programme with the Postgraduate Dental Dean at HEE Thames Valley and Wessex in collaboration with Reading University Healthreach team, to pilot a programme to develop the local oral health workforce to better mirror the community it serves. It is important we embrace the momentum in reducing health inequality in this moment as a ‘call to arms’. We have seen that a crisis situation can create opportunities for reinvention and that urgency can evolve sustainable change. COVID has evolved innovative processes that embody collaboration and the principles of MECC. The Pandemic has focused minds on the challenge of reducing health inequality and reminded us that prevention is more effective and cheaper than medical management of disease. We must seek any ‘silver linings’ for the NHS from the dark clouds of COVID. Oral Health and CVD Prevention – The Power of Making Every Contact Count (MECC)

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