“So what does PHE do?” Sandra White BDS, FDSRCS, MPH, FDS(DPH)RCS, FFPS, MBA, PGCMedEd
Summary • Who we are and where are we? • Vision to delivery • Story so far • W hat’s next?
• Who we are and where are we? • Vision to delivery • Story so far • What’s next
National team Sandra White National Lead for dental public health Vacant Jenny Godson Kate Jones Matt Gill* Gill Davies Semina Makhani National Consultant in National Consultant in National Consultant in Policy Lead DPH & National Consultant in National Dental Public Dental Public Health Health Consultant Dental Public Health Dental Public Health Population Healthcare* Dental Public Health Julia Csikar Hayley Stripling Andrew Wood Janet Neville Senior DPH Manage r Business Manager Fluoridation Business DPH Analyst Manager Diane Seymour Joanne Sumner Satveer Kour Senior DPH Manager Epidemiology Support Operational Support
Centre North East Network 2 Consultant North West 5 (4.1) workforce in Yorkshire and the England by centre Humber 3 (2.8) PHE is the sole provider of dental public health advice locally. There are no dedicated dental public health Consultants in East Midlands West East Anglia 3 (1.6) LA, CCGs or Midlands London 3 (3) 4 (2.7) elsewhere in England. 3 (3) South West South East 3 (1.4) 4 (3.4)
How we work….
• Who we are and where • Vision to delivery • Story so far • What’s next
A national 5 year plan 2015-2020 We protect and improve the nations health and wellbeing and reduce inequalities System Starting well support Living well Our A generation free our Better oral health vision of organisation, for all dental disease our workforce, our partners Securing our future - Dental Public Health proposals
High Level objectives 1. System leadership to co-ordinate the approach to oral health improvement and reduction in health inequalities, particularly through a focus on children and vulnerable adults. 2. Ensure that an appropriate range of evidence based information is available for dental public health purposes and for a range of stakeholders including the findings from the dental epidemiology programme and descriptions on inequalities 3. Carry out PHE’s water fluoridation responsibilities and those responsibilities carried out on behalf of the SoS and ensure adequate support to our workforce and partners. 4. Support the health protection role of PHE including the AMS agenda. 5. Support the work of the DH, NHS England and HEE to encourage high quality, safe and effective oral healthcare that is preventive focused, equitable and sustainable 6. Ensure professional and system leadership and research for dental public health, develop the future workforce and undertake corporate responsibilities
• Who we are and where are we? • Vision to delivery • Story so far • What’s next
Water fluoridation All our COHIPB Health Oral health DBOH CBOH improvement Smoke free Sugar and smiling reduction Brief intervention -Alcohol
Health Matters Menu of interventions Action plan (maternity and early years) Supervised Return on toothbrushing Investment toolkit tool COHIPB Toothbrushing Workforce feasibility resources report Blogs, The ‘red book’ launches, media
Performance management of Schemes PQs, FOIs, Research Support to Water Paying the new and existing bills! fluoridation schemes Water Capital fluoridation schemes toolkit Water fluoridation monitoring report
3 and 5- year-old Surveys Local and National Adult bespoke surveys data Dental epidemiology and Children intelligence. attending Prescribing special data schools GA figures Epi toolkit
DH e.g. Contract reform Healthcare NHS CQC, Supporting Commissioning HEE, e.g. Starting our LPNs well partners OCDO e.g. DCby1
Intelligence to select the ‘13’ Evidence Support base for launch interventions and DBOH and support to develop training them Starting Well Develop Local needs the audit assessment tool Develop Develop the care safeguarding flowchart pathway
Health protection e.g. AMS ESPAUR ESPAUR Dental Subgroup 4. Multi-system 2. Secondary 1.Primary care 3. Education AMS care collaboration Resources for primary e.g. BNF Prescribing data National ADH audit care (SCRIPT) Metronidazole Resources for Secondary care secondary care Resources for practices guidelines (Scenario training) Clinical audit Implementation
Research • Relationships between oral health and • Dementia • Cardiovascular disease • Pulmonary disease • Diabetes • Obesity • Oral health of vulnerable adults (CBOH) • Water fluoridation – fluorosis and horizon scanning Working towards>>>> • Workforce – wellbeing of GDPs • ICDAS and child surveys • Multivariate analysis and child dental health surveys • GAs – variety of research!
• Who we are and where are we? • Vision to delivery • Story so far • What’s next?
Further work of the COHIPB Ongoing delivery plan 2017/18 • Community based FV toolkit- PHE • Update e-den DBOH- PHE/RCS/HEE • Work to increase FV Rx- NHSE • Support -DcBy1- NHSE/BSPD • Support - Starting Well- NHSE • Support Health for all children 4 th Ed - RCPCH • SACN – breastfeeding and tooth decay • Best Beginnings – Baby Buddy app • LA hotspots- identifying 30 where challenges remain • Further work with Change4life
Other oral health improvement work • Stocktake LA’s on OHI • Smoke free and smiling – update and implementation • Commissioning better oral health – vulnerable older people • Development of a vulnerable adult steering group and actions • Work on homelessness / dementia / prisons ( survey) / migrant health
Support to partners Healthcare Public Health BSA data • Complimentary dashboard on access to and use of dental service • Report on equity of access to dental services • Starting well • Interventions and prevention care pathway • Training for the dental teams • Data and evaluation • Health inequalities report • Supporting dental contract reform • Sustainability • Dental noticeboard • Recall Matters • Patient and public engagement
Epidemiology and intelligence. • oral cancer profiles • decennial adult dental health survey – the case • prescribing data at provider level • new website • mildly dependant adults survey • 5 year old survey • A survey of adult oral health to provide local information to assist with commissioning 2017/2018 Survey
Aims of survey of adults To inform commissioning of treatment services for adult patients and oral health improvement strategies by collecting information about oral health and service use from adult patients attending general dental practice To establish baseline learning about the feasibility of collecting information from general dental practice patients and assess the validity and utility of this.
Plans for a local survey of adults Planning group with NHSE, LDNs, BDA, GDPA, LAs, fieldwork provider, FGDP Developing - principles to guide the survey, workable method – national protocol and communications strategy Regional training Random sample of 10 practices per local authority – NHS, mixed, independent. Fieldwork teams contact sampled practices and ask them to host for 1 day or 2 sessions at convenient times Adult patients asked to take part Simple questionnaire – self-administered with support from fieldwork team Simple clinical examination – by trained clinician in fieldwork team Extraction of some information from patient’s FP17 (with their consent) National collation, analysis and reporting at local authority level
How can LDNs help? • Speak in support of the survey • Encourage local committees to provide resources to incentivise practices • Assist with forewarning of practices and reassurance of purpose • Liaise with local fieldwork teams • Other suggestions?
Summary • Who we are and where are we? • Vision to delivery • Story so far • What’s next ? • What else could we do? Thank you
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