Download West Sussex Oral Health Communication Forum meeting

Communication Forum
Thursday, 20 November 2014 – The White Horse, Storrington
Attendees: Jo Clark, Agi Tarnowski, Toby Hancock, Matt Botha, Rob Emmanuel, Emmanuel
Lazanakis, Nikki Mardell, Jenny Parry and Steve Walsh
Apologies: Cherie Young, Jill Graham, Pural Patel and Sharan Thillainathan
Introduction
Agi summarise the function and purpose of the communication forum
Orthodontics (Jo Clark)
Secondary care has a new specialist trainee for 3 years. There is a minimal number of referrals being
received via the referral management service (RMS), the majority are being received directly from
primary care special orthodontic providers. Jo has received notification of a West Sussex specific
policy which states that there is a low priority procedure (LPP) for IOTN 4 and 5 cases which are
irrespective of age. It was felt that as the national pathway/guidance was due to be published from
April 2015, this West Sussex specific policy was not to be promoted into the public domain. There is
hope that at the same time as the orthodontic pathway is published, restorative will follow at the
same time.
There is an orthodontic needs assessment being run by our consultant in dental public health (Brett
Dwane). There is a general sense of worry that 2016 will be a procurement of all orthodontic
contracts within primary care with a new 5 year PDS contract being issued depending on areas of
need.
Paediatrics (Jenny Parry)
Paediatrics has seen an increase in referral numbers even with the tight criteria it has, most cases
are being passed on to special care community dentistry where appropriate. The department now
has shared use of a paediatric trainee who is on a KSS deanery/Kings 5 year consultant program.
Paediatric pathway is not due for publication in April 2015 but is likely to follow in the second wave
of pathways. However the Eastman is already looking into a level 2 training scheme for dental
practitioners with an interest in paediatric dentistry. At the moment there is consultation within a
working group due to be published within the next couple of weeks that the recommended
minimum age for paediatric sedation is to increase from 3 years old to 8 years old. This is likely to
have a substantial impact on the numbers of case referred for general anaesthetic as a result.
Mental Capacity Act (Nikki Mardell)
Nikki is the lead professional for the CCG in regards to the mental capacity act. She would like to
reach dental professionals to explain the importance of this act in regards to consent. It was
recommended that Nikki publishes her PowerPoint hand-out on the LDC website and the Area Team
managers are introduced into her for the benefit of addition to their new letter due over the coming
months.
Rob suggested that the dental defence literature available to all members already covers the mental
capacity act within its consent advise documents.
Special care dentistry ( Rob Emmanuel)
The service is expecting its CQC visit shortly. Sue Ward (safeguarding and child protection) is retiring
but will still be available for privately funded lecturing in this speciality. Special care has access to the
same trainee that paediatrics have and is benefitting from this increased service provision. Two
recent dental officers have been successfully achieved training posts within orthodontics following
on from their positions within the special dental service. There is a new dental officer (DO) position
within Worthing and the service is recruiting a two day a week DO at the jubilee dental centre with
one day in clinic and one day on domiciliary visits. The department is exploring research
opportunities with the Chailey Heritage and BSMS. There is integration of the clinics from East
Grinstead and Hayward Heath. Special care trust has applied for Trust Foundation status. The
department is developing a training programme for posterior composites from an in house
perspective. Sarah Crossbie has been invited to represent special care dentistry on the local
professionals network (LPN)
The emergency dental service (EDS) is continuing to audit the prescribing habits of the dentists and
John Forrester will be approaching dental practices who have a disproportionately high level of
registered patients attending the EDS due to not being able to acquire appointments within the
working week. This was thought to be the a high proportion of the corporates within West Sussex
(eg IDH)
Area Team (Matt Botha)
Due to the absence of the area team managers, Matt spoke on their behalf. There is a
reconfiguration of the area team to include Kent and rename to become “South East” area team.
Practice visits will continue for Surrey due their historic lack of them, West Sussex is unlikely to be
visited unless prompted. There is a dramatic and noticeable increase in the number of complaints
that are coming to the area team.
Maxillofacial (Steve Walsh)
There is a backlog of patients being seen at Worthing and more cases are being referred directly to
the hospitals rather than through the RMS. This has resulted in some tension in the system which
governs that pay for the treatment these patients receive. National guidelines and pathways are due
for publication in April 2015. St Richards has been approved as a minor oral surgery (MOS) supplier
but there are awaiting the implementation of the contract.
It was recommended that “lumps and bumps” should be able to be referred directly to the
maxillofacial department rather than through RMS. However, as national guidelines are so close, it
was felt to leave this for the meantime.
The phantom head room at the CMEC is being under used and Rob suggested that they could use it
for his in-house composite course. It was agreed that it needs to be utilised more to prevent the
chance of it being lost.
The musculoskeletal contract has been won by BUPA and is worth about £350 million. It is felt that it
will subcontract the local hospitals for the actual work but there is concern over how much it is likely
to top slice for administration costs. Presently this contract is on-hold as it is being challenged by the
hospitals
The next meeting was proposed to be held in May 2015
Toby Hancock
20/11/14