LDN Meeting 23 Mar18

Local Dental Network Meeting 23 March 2018

This meeting involves the MCN chairs, representatives from NHS England, Public Health England and the LDCs in the South West.

Some issues discussed were:

CDO initiative, Dental Check-up By One.

Whilst applauded as a sound introduction of young children and their families to oral health care, the initiative’s funding currently is within the current dental budget. This has implications for the Devon and Cornwall area in particular where there are thousands of people on the waiting list to just see an NHS dentist, many in great need of care. The NHS England team have a dilemma in that they must try to implement the CDO initiative yet serve the needs of the population and maintain access to dental services.

It remains to be seen how the integration of Local Authorities’ Oral Health Strategy Plans with NHS England will be achieved and how other allied professions such as health visitors will be involved.

Oral Surgery MCN

Discussions are ongoing. NHS E SW and the MCN are keen to implement an e-referral system soon. There are commercially available ones which have proven track records and these seem the most appropriate to purchase. However, centrally, NHS Digital have one in development. Timescale unknown and given NHS IT problems in the past, little confidence in its efficacy. The team here in the SW are trying to persuade the ‘powers that be’ that an early move to an existing and successful system would be the ideal move for the South West.

Special Care/Paeds MCN

Piloting referral system which is analogue currently but could easily transfer to the e-system when it is in place.

There are limited bariatric services in the South West.

There are concerns that the increase in elderly patients with complex medical needs and high dental needs will stretch the system severely.

Orthodontic MCN

Again piloting a referral and triage system in Bristol for primary and secondary care.

Restorative MCN

Developing a virtual platform for treatment planning advice.

Needs assessment in progress.

Training places for specialists in development.

Unscheduled Care Group

BNSSG dental helpline developing to give access to urgent care, to begin in the autumn this year.

Bristol Dental Hospital

It has come to the attention of Avon LDC that referrals from Wiltshire and Gloucester are being rejected in what appears to be management by postcode. Correspondence with BDH indicates this has been policy for some time, but without any consultation of knowledge of stakeholders, particularly dentists in primary care referring patients in to BDH. Further investigations will be undertaken by the LDC, the MCNs and NHS England to try and resolve the problem.

Service provision and Access

BNSSG recent figures show 59.5% access and increasing. Devon and Cornwall 57% and reducing steadily with now 30,000 people on the waiting list.

A significant number of NHS contracts have been handed back by providers. It seems that these have been deemed unprofitable in many cases. NHS England are looking to procure new services where there is shortfall.