Presentation to AVON LDC Dental Commissioning Peter Howard-Williams BDS Clinical Chair South West Local Dental Network – NHS England South West Rachel Coke Assistant Contracts Manager, Dental – NHS England South West Tuesday 15 th March 2016 www.england.nhs.uk
The new CDO Sara Hurley www.england.nhs.uk 2
• The new Chief Dental Officer, Sara Hurley toured the SW region on a fact finding exercise for three days early this month. She met with all branches of the profession to ask them how we can improve oral health in the SW. My impression was that she will be a strong advocate for denEstry in an NHS where we are oGen an aGerthought and is someone who gets things done! www.england.nhs.uk 3
Commissioning guides • The Dental SpecialiEes Commissioning Guides for oral surgery, orthodonEcs and special care denEstry have now been published hJps://www.england.nhs.uk/commissioning/ primary-care-comm/dental/dental-specialiEes/ • It will help to understand the guides if you read the introductory guide first. • The guides are not "wriJen in stone" and are intended as a guide to clinicians and commissioners to help improve paEent outcomes. www.england.nhs.uk 4
Malcolm Pendlebury Memorial Lecture, delivered by the Chief Dental Officer for England, Sara Hurley, to the Faculty of General Dental PracAce (UK) on 26 February 2016. This theme recurs throughout the new guides for the commissioning of dental specialEes, with the recogniEon that there are a range of paEents and an equally complex range of oral health needs. Many of the care pathways outlined in the guides will call upon the skills of specialists or Consultants, who may be operaEng in either primary care or secondary care seQngs. However, the guides recognise that many General Dental PracEEoners develop interests, skills and competence with increasing years in pracEce, and that these experienced GDPs are very capable of confidently and competently handling level 2 complexity case loads. NHS England desires to use the skills of these individuals, and the detail of how to validate and contract these highly skilled individuals is vital on-going work. www.england.nhs.uk 5
Managed Clinical Networks We are hoping to appoint Chairs for MCNs in Oral Surgery, • OrthodonEcs, Special Care and RestoraEve denEstry in the near future. MCNs have been defined as ‘ linked groups of health professionals and • organisa2ons from primary, secondary and ter2ary care working in a coordinated manner, unconstrained by exis2ng professional and organisa2onal boundaries to ensure equitable provision of high quality, clinically effec2ve services’ . An MCN is a way of working where clinicians from all seQngs across a • clinical pathway can focus on paEents and services rather than being constrained by organisaEonal boundaries. Importantly the MCNs will ensure that any new commissioning • arrangements will be quality assured with paEent reported outcomes PROMs and paEent reported experiences PREMs feedback from providers. LDCs will play an important part in MCNs • www.england.nhs.uk 6
Future of The Local Dental Network • A joint meeEng with both LDNs in the South West is planned for May 18th to discuss the strategic direcEon of dental commissioning in the SW and the role of LDNs and MCNs. • I sincerely hope that by then the formaEon of the MCNs will be well under way. • I want to explore how we can have a consistent approach across the region with paEents having access to the same high quality services across the whole patch and combine it with a "local" flavour which involves clinicians at all kinds. • There is currently a move towards co commissioning with more of the pharmacy and eye health commissioning moving towards the CCGs and I feel it is important for denEstry to have a robust commissioning strategy and system in place for us to keep control of our own profession. • WHAT DO YOU THINK ?? www.england.nhs.uk 7
Unscheduled Care and Out of Hours • NHS England is looking to improve unscheduled and OOH dental care throughout the SW. • A consistent dental helpline throughout the SW which will integrate with 111 and be able to signpost paEents to the most appropriate care and give advice. The first draV service specificaAon follows and I would like your feedback www.england.nhs.uk 8
Proposed Service Specification • The same service should be available to all residents of the NHS England South ( South West) area and should be available as locally as possible. • The in hours and out of hours access to urgent and emergency dental treatment and dental help lines should be an integrated service with preferably one provider for call handling and triage throughout the patch . • One telephone number covering the whole patch for paEents to contact, or be transferred to from 111, which can: www.england.nhs.uk 9
Proposed Service Specification Signpost paEents with a dental problem both in and out of hours. • IdenEfy a true dental emergency and provide an immediate route to treatment • IdenEfy an urgent dental problem, give appropriate advice including pain relief and • guarantee an appointment for treatment within 24 hours Signpost paEents to other healthcare providers as appropriate where pain relief is • advised e.g local pharmacy Book appointments at access centres • Book appointments in GDP urgent care slots • IdenEfy a non urgent dental problem, give appropriate advice, and signpost the paEent • to the nearest NHS pracEEoner. Give up to date informaEon to those seeking to register with an NHS denEst. • Maintain waiEng lists • Supply NHS England with regular data on NHS availability • Maintain NHS Choices • Log inappropriate referrals to OOH from dental pracEces and paEents who are unable to • access care from their own denEst. Work closely with other urgent care services • www.england.nhs.uk 10
Proposed Service Specification The advice should be available 0830 to 2230. Outside these hours a true dental • emergency would be handled by the OOH medical call handlers. Out of hours urgent and Emergency treatment should be available in Emergency • dental clinics at Exeter. Barnstaple, Newton Abbot, Plymouth, Truro, Bodmin, Penzance, Bristol, Taunton, Bridgewater, Yeovil and Glastonbury, on Saturdays, Sundays and Bank Holidays Rather than operate a limited service on weekday evenings it is considered that on • weekday evenings a beJer response would be a guaranteed appointment the following day with appropriate advice including pain management . In hours access to urgent care should be available in emergency dental clinics and • through commissioned urgent slots within general dental pracEces across the area. These in hours urgent slots should be bookable by the out of hours service where a need to see a denEst is indicated. www.england.nhs.uk 11
NHS England bulletins and LDN newsletters • These are available on the following link: • hJps://www.england.nhs.uk/south/publicaEons/ dcis-prof/dental/dental-bulleEn/ • Currently the link from the publicaEons page is " InformaEon for professionals in Devon, Cornwall and Isles of Scilly" but contains the BNSSSG informaEon. I am looking to have this amended as soon as possible. www.england.nhs.uk 12
5 year forward view: • This sets out a vision of a beJer NHS, the steps and acEons we must take to get there. You can see it in more detail on the following link. • hJps://www.england.nhs.uk/ourwork/futurenhs/nhs-five- year-forward-view-web-version/ • In denEstry we cannot ignore the prioriEes of the wider NHS or we will be leG behind. • The BNSSSG LDN work plan has the following prioriEes of the 5 year forward plan which can be applied to denEstry www.england.nhs.uk 13
5 year forward view: • Improve access for paEents with demenEa and learning difficulEes • Enhance diet advice to tackle obesity and diabetes • Redesign urgent and emergency care services • Strengthen primary care services • Ensuring high quality and affordable specialised care • Whole system change/financial sustainability • FoundaEons for Improvement/IT 14 www.england.nhs.uk
BNSSSG LDN work plan • LOCAL DENTAL NETWORK • Consider how the NHS business plan and 5 year forward view is applied to denEstry • Develop a robust system of paEent and public parEcipaEon • Establish a quarterly newsleJer and distribute to all stakeholders • Establish a clear communicaEon policy with the ability to involve all stakeholders in the area with the LPN • establish a web presence for publicaEon of LPN minutes, newsleJers and general informaEon • Develop beJer links with the CCGs www.england.nhs.uk 15
BNSSSG LDN work plan • DENTAL PUBLIC HEALTH • Establish a working group to idenEfy local oral health prioriEes and recommend a strategic approach to oral health improvement to the health and Wellbeing Boards of the BNSSSG area. The LPN to have a representaEve on this group in addiEon to the consultant in Dental Public Health www.england.nhs.uk 16
BNSSSG LDN work plan • PRIMARY CARE • Support the commissioners in idenEfying those areas where access to NHS dental care is insufficient and help plan new provision and provide clinical input to the tendering and commissioning process. • Improve informaEon to primary care denEsts on referral criteria and idenEfy inappropriate referrers. Provide support and guidance for high referrers www.england.nhs.uk 17
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