Linking Clinical Audit in General Dental Services to Primary Care Trust Clinical Governance—Progress Report of an Approach Used in Southend

2005 ◽  
Vol os12 (1) ◽  
pp. 23-26 ◽  
Author(s):  
Phillip Cannell

Clinical audit has been defined as the systematic, critical analysis of the quality of dental care, including the procedures and processes used for diagnosis, intervention and treatment, the use of resources and the resulting outcome and quality of life as assessed by both professionals and patients.1 The aim of clinical audit is to encourage dentists to self-examine different aspects of their practices, to implement improvements where the need is identified and to re-examine, from time to time, those areas that have been audited to ensure that a high quality of service is being maintained or further improved. Since 1st April 2001, all general dental practitioners (principals and assistants) working in the General Dental Services (GDS) have been required to participate in a rolling programme of at least 15 hours of clinical audit or peer review every three years.2 The first three-year cycle ended on 31st March 2004. By the end of December 2003, 96% of dentists had either undertaken or committed to undertake clinical audit/peer review activities.3 This initiative, in conjunction with the voluntary clinical audit and peer review schemes which preceded it, has provided opportunities for dentists and their practices to use these activities to assist in quality improvements in their practices, for the benefit of their patients. However, there are other methods for carrying out clinical audit and, in the NHS, there is a need to link it to clinical governance. This paper gives a progress report on an approach that has been piloted by Southend Primary Care Trust (PCT). It deals with the rationale for the project and outlines the methods used. It does not report results. These will follow in a subsequent paper.

2009 ◽  
Vol os16 (4) ◽  
pp. 137-142 ◽  
Author(s):  
Nick Kendall

This paper describes the innovative use of National Health Service (NHS) dental commissioning powers to develop specialist primary care based oral surgery services. The outcomes, after one full year of the scheme, have been substantial improvement in access and reduced waiting times for patients, further development of NHS primary care dental services through commissioning processes, increased use and engagement of oral surgery specialists outside of a hospital setting, and considerable ongoing savings to the NHS. Collaborative working between hospital consultants and managers, Primary Care Trust dental commissioners, general dental practice providers, specialist oral surgeons and a dental public health consultant has resulted in sustainable benefits to patients and the NHS within the World Class Commissioning framework.


2021 ◽  
Vol 10 (1) ◽  
pp. 40-45
Author(s):  
Adam Shathur ◽  
Samuel Reeves ◽  
Faizal Sameja ◽  
Vishal Patel ◽  
Allan Jones

Introduction: The COVID-19 pandemic enforced the cessation of routine dentistry and the creation of local urgent dental care systems in the UK. General dental practices are obligated by NHS guidance to remain open and provide remote consultation and referral where appropriate to patients having pain or problems. Aims: To compare two urgent dental centres with different triage and referral systems with regard to quality and appropriateness of referrals, and patient management outcomes. Methods: 110 consecutive referrals received by a primary care urgent dental centre and a secondary care urgent dental centre were assessed. It was considered whether the patients referred had access to remote primary care dental services, fulfilled the criteria required to be deemed a dental emergency as mandated by NHS guidance, and what the outcomes of referrals were. Results: At the primary care centre, 100% of patients were referred by general dental practitioners and had access to remote primary care dental services. 95.5% of referrals were deemed appropriate and were seen for treatment. At the secondary care site, 94.5% of referrals were direct from the patient by contacting NHS 111. 40% had received triaging to include ‘advice, analgesia and antimicrobial’ from a general dental practitioner, and 25.5% were deemed appropriate and resulted in treatment. Conclusion: Urgent dental centres face many issues, and it would seem that easy access to primary care services, collaboration between primary care clinicians and urgent dental centres, and training of triaging staff are important in operating a successful system.


2012 ◽  
Vol os19 (1) ◽  
pp. 11-21 ◽  
Author(s):  
Alison D van den Berg ◽  
Nikolaus OA Palmer

Aims The overall aim of this study was to determine whether general dental practitioners (GDPs) in West Sussex were aware of and followed National Institute for Health and Clinical Excellence (NICE) guidelines on dental recalls. The study also aimed to identify factors in the GDPs’ practice of dentistry that could affect their adherence to NICE guidelines and to gain some insight into their views on this topic and how these might affect their adherence. Methods A postal questionnaire, which had previously been piloted, and an explanatory letter were sent to a random sample of 195 GDPs representing 50% of the GDPs contracted to the West Sussex Primary Care Trust. Those who did not respond were sent the questionnaire and letter for a second time. The questionnaire consisted of 50 questions that covered awareness of, attitudes towards and adherence to the NICE guidelines on dental recalls, risk factors, and the GDPs’ practising profile. Resulting data were entered into a database and, where appropriate, statistically tested with the chi-square test, with the level of statistical probability set at P<0.5. Results Data were obtained from the 50 questions in the questionnaires. Only key results are presented in this abstract. Ten of the 195 GDPs had either moved away from the area or were orthodontists. The final sample was therefore 185, of whom 117 returned questionnaires, a response rate of 63%. Seventy-three per cent of the respondents had qualified in United Kingdom. Sixty-five per cent were male. The mean age of respondents was 43 years. Seventy-one per cent worked as GDPs within the General Dental Services (GDS) or Personal Dental Services. Concerning NICE recall guidelines, 94% stated that they were aware of them, 61% said they agreed with them, and 64% that they adhered to them. Female GDPs were statistically far more likely to state that they followed NICE guidelines ( P=0.0043). Seventy per cent of GDPs reported that they still recalled their patients at six-month intervals and only 3% that they recalled their patients according to need. Eighty-five per cent reported taking radiographs at two-year intervals and/or according to patient need, and 68% that they gave oral hygiene advice six monthly or at every recall. Risk assessments were reported as being always carried out by 65% of responding GDPs for caries, 83% for periodontal disease, and 81% for oral cancer. Ninety per cent reported that they thought risk factors were relevant when setting the recall interval and 82% thought that six-monthly recalls allowed appropriate screening to take place. Conclusions Only 3% of responding GDPs recalled their patients according to patient need, in line with NICE recall guidelines, although the majority of GDPs agreed with the guidelines and stated that they adhered to them; however, this was in contrast to the 70% of GDPs who continued to recall at six-month intervals. The majority of GDPs thought that less frequent recalls would not allow for early caries, periodontal disease and oral malignancy diagnosis, and did not think that access to NHS dentistry would be improved. They also did not believe that excessive NHS money was spent on over-frequent dental examinations. There would appear to be significant obstacles to altering the recall habits of dentists because of the way that dentists practise.


2001 ◽  
Vol os8 (1) ◽  
pp. 27-32 ◽  
Author(s):  
J Tim Scott ◽  
Ian R Massie

Rumour and speculation abound within the dental profession about practitioners withdrawing from the NHS to deliver more private dentistry. Due to an absence of effective monitoring or research into this issue the real situation is unclear. We decided to find out what proportions of the gross incomes of general dental practitioners in the East Riding Health Authority were generated by private dentistry. We also sought to establish if they perceived any differences between the quality of their private and NHS work. Our findings and the issues raised are considered for general dental practitioners, for people residing in the authority, and for managers and policy makers. We conclude that the effective management of the supply of NHS dentistry should include a method of systematic monitoring of trends in the delivery of private dental services and the impact on the availability of NHS care. Effective measures are also needed to influence the number and location of dentists in health authorities in England and Wales to ensure adequate and equitable access to NHS dentistry.


2009 ◽  
Vol os16 (4) ◽  
pp. 168-178 ◽  
Author(s):  
Phillip J Cannell

Introduction A new dental contract was introduced in the National Health Service (NHS) General Dental Services (GDS) in April 2006. Responsibility for clinical audit activities was devolved to Primary Care Trusts (PCTs) as part of their clinical governance remit. In July 2003, an NHS Modernisation Agency pilot scheme for clinical audit was launched by Southend PCT. Aim The aim of this study was to evaluate this scheme. Methods A qualitative research method was used. It used audiotape recorded semi-structured research interviews with eight general dental practitioners (GDPs) who had taken part in the scheme. The evaluation focused on dentists’ experiences of the scheme. Results Dentists appreciated the central PCT-based coordinator for the scheme and found that the streamlining of design, analysis and report writing within the audit projects enabled efficient use of time. The design by an outside agency appeared to add credibility to the scheme. Participants felt that comparability of data derived from clinical audit was enhanced by the scheme and could lead to comparison across PCT patch, regional or even national levels. The use of feedback mechanisms within the scheme was appreciated and thought to help produce maximum value from a clinical audit project. There was evidence of beneficial change occurring within practices and for patients. Conclusions This study provided an evaluation of a particular clinical audit scheme, several aspects of which differed from the traditional GDS scheme. Organisations proposing to undertake clinical audit activities in conjunction with dentistry in the future may benefit from incorporating elements of this scheme into their project design.


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