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Dental Action Plan (Tamesode & Glossop) Nov 2009

NHS-Tameside and Glossop 

December 2009

Version control

Version Date October 2009

Edition: FINAL

Presented to Previous Board and Sub-committee Meetings:-

Oral health advisory group 15^th October 2009

CMME  27^th October 2009

Date   Meeting   Minute (annex no.)

Healthcare Commission Core and Developmental Standards

Core standards -

·     Second domain: clinical and cost effectiveness C5

·     Third domain: governance C11

·     Fourth domain: patient focus C16

·     Fifth domain: accessible and responsive care C17, 18, 19

·     Seventh domain: public health C22

·     

Developmental standards -

·     Second domain: clinical and cost effectiveness D2

·     Fourth domain: patient focus D9

·     Fifth domain: accessible and responsive care D11

·     Seventh domain: public health D13

 
 

Background

The Tameside and Glossop Dental Strategy and Action Plan was endorsed by PEC in February 2007 and by Board in October 07. The aims of the strategy are:

·     To promote good oral health in the context of good general health and well-being for the population of Tameside and Glossop, to reduce prevalence of dental caries and to reduce inequalities between different communities.

·     To ensure the provision of accessible, safe, evidence based and effective services to meet the defined routine and urgent care needs of the population. This will include integrated primary dental care and specialist services provided by both independent contractors and the salaried services

The objectives of the strategy are:

To improve oral health by reducing dental caries and other preventable oral conditions

·     To reduce the prevalence of tooth decay in children and young people

·     To close the gap in oral health between Tameside and Glossop and England

·     To improve dental health in those Tameside and Glossop Super Output Areas in the most deprived 10% of England relative to dental health in Tameside and Glossop as a whole

To improve access to preventively orientated dental services

·     To ensure that every Tameside and Glossop citizen will be able to have a full oral health assessment at least once every 2 years

·     To ensure that all citizens have access to emergency and routine dental care to meet their treatment needs

Achievements

Achievements since the endorsement of the 2007 strategy and action plan include the following:

Dental access

·     Unmet need for routine dental care was defined in a paper to PEC in July 2008 and formed the basis for the commissioning of the Dental Access Service which opened fully in January 2009.

·     ABC was established as a single point of contact triage system to direct patients to a choice of providers.

·     The in-hours access service was integrated in the triage system to provide a pathway including urgent as well as routine care.

·     Services have been commissioned to meet the needs of the Gamesley population within the Dental Access Service.

·     The Dental Access Service has been successful in targeting patients with high dental need and those from the areas of Tameside and Glossop with the poorest oral health.

·     The out of hours service emergency service has been re-commissioned in a consortium with Stockport and Trafford PCTs.

Oral health

·     The oral health of five year olds (07-08 figures just released) has improved significantly – both in terms of reductions in the prevalence and severity of decay, not only compared to the results of previous surveys but also relative to the NW average. This reflects the success of a systematic, evidence based, partnership approach to improving oral health.

·     Dental practices have been engaged in delivering preventive interventions and in giving brief advice on smoking cessation.

 
 

 

Tameside and Glossop as a centre of dental excellence

·     A high specification, eight surgery dental centre of excellence has opened in Ashton Primary Care Centre. This has allowed:

o      The development of an innovative programme of dental outreach training for students from the University of Manchester School of Dentistry covering both paediatric and general dentistry.

o     The co-location of the PCTDental Service (PCTDS) specialist services in one site, accessible from throughout Tameside and Glossop

o     The potential for provision of primary care based specialist services and development of Dentist with a Special Interest schemes including supporting the development of specialist skills by local practitioners.

Specialist services

·     The review of the PCT dental service (PCTDS) was implemented including the development of care pathways for children and other vulnerable groups who cannot be treated in general practice.

·     Care pathways are under development around orthodontics, oral surgery and restorative dentistry.

Contract monitoring

·     Development of a dashboard of key performance indicators for contract monitoring.

Clinical governance

·     Development of a clinical governance dental action plan to prioritise implementation of the PCT clinical governance strategy

·     Revised practice inspection programme based on Standards for Better Health.

·     Development of a dental audit assistant programme

Communication

·     Communication with practices has been strengthened by the establishment of regular professional development meetings for the whole dental team focussing on PCT priorities.

·     Development of a dental practice manager forum

·     Establishment of a Local Orthodontic Committee for Manchester East and North providing a partnership approach to orthodontic issues.

·     Comms team and dental health team have actively promoted the of uptake of dental services to reach the population as a whole and targeted at-risk groups.

National dental policy developments since 2007

Independent review of NHS dentistry in England. ¹

This review was commissioned by the Secretary of State and involved extensive engagement with patients, dental professionals and the NHS. It sets out a clear vision for NHS dental services that are easily accessible, provide a comprehensive range of treatments to meet clinical need and are provided to a high quality. The review makes recommendations :

·     Improving public information to help people find an NHS dentist.

·     Widening the contract currency to include capitation payments for patients in continuing care, and overt incentives for prevention and quality.

·     Developing a clearer patient pathway including access to specialist care

·     Improving the collection and use of information to monitor and develop the quality and effectiveness of the care patients receive

The accompanying letter from the Head of Primary Care highlights PCT’s existing local flexibility to build a selection of indicators into dental contracts in order to incentivise practices to meet defined needs.

The dental access programme

The dental access programme reflects public concern about the availability of NHS dental services and the DH has committed to any eligible person seeking dental services being able to see them within a reasonable time period. The Dental Access Programme consists of four workstreams:

·     Developing a new indicator for dental access

·     Supporting the additional procurement of dental services

·     Supporting possible gains through contract management

·     Communication and stakeholder engagement

HTM 01-05: Decontamination in primary care²

This health technical memorandum aims to ensure that patients and dental staff are receiving and providing dental care in a safe environment. The guidance aims to raise performance progressively, and wherever possible gives options in terms of approach to meet the necessary requirements. The aim is that all practices will have met the “essential requirements” within 12 months of receiving the guidance. This will include having a detailed plan showing how practices will work towards achieving “best practice” guidelines contained within the document.

Registration of Dental Care Professionals

Dental nurses and dental technicians were required to register with the General Dental Council (GDC) from July 2008. This is a requirement that already applied to dentists, dental therapists, hygienists and orthodontic therapists. This is conditional on holding a registerable qualification and maintaining professional fitness to practice including providing evidence of continuing professional development.

2010-2012 Dental action plan

This updated action plan has been developed in partnership between dental public health, primary care development, contracting and performance, the dental advisor, clinical governance and contractor services. The plan has been endorsed by the Oral Health Advisory Group on which all branches of the local profession are represented. The plan includes proposals for action under the following headings:

·     Provide accessible routine dental care for all groups of the population including those with high levels of dental need through dental access service and General Dental Services.

·     Ensure vulnerable groups can access care

·     Maintain access to in-hours and out-of-hours urgent care.

·     Monitor access to care and use data to maintain access to services within agreed standards. Ensure robust systems in place to monitor demand for dental care and capacity to meet demand.

·     Improve oral health and address inequalities.

·     Provide specialist services including sedation, special needs, paediatric services, Tier 2 services, restorative dentistry, minor oral surgery, orthodontics.

·     Develop strategic approach to development of dental workforce.

·     Develop initiatives to recruit and retain dentists and professional complementary to dentistry in order to maintain access to dental care.

·     Develop dental centre of excellence through use of Ashton Primary Care Centre as a centre for training and professional development of the whole dental team.

·     Support GDPs in implementation of clinical governance agenda.

·     Develop effective communication with the local profession and community.Develop IMT systems to support communication with general practice.

Action for PEC

PEC is requested to comment on and endorse the 2010-12 dental action plan.  
 

Draft updated dental action plan 2009-12

 
 

 

 

¹ DH 2009 Gateway no: 12087

 

² DH 2009 Gateway number 11548

 

 

 

 

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