Publication - Strategy/plan

An Action Plan for Improving Oral Health and Modernising NHS Dental Services in Scotland

Published: 17 March 2005
Topic: Health and social care
ISBN: 0755945778

Executive response to the Children's Oral Health Consultation and Moderning NHS Dental Services in Scotland

AN ACTION PLAN FOR IMPROVING ORAL HEALTH AND MODERNISING NHS DENTAL SERVICES IN SCOTLAND

ACTION PLAN SUMMARY 2005-2008 APPENDIX

This summary shows the main actions from the Action Plan, together with key milestones, responsibilities and impact. Together these actions are intended to deliver the overall health improvement targets listed below, as well as the specific targets outlined in the more detailed Action Plan.

Health Improvement Targets

By 2010

For 5 yr olds (Primary 1)	60% with no signs of dental disease
For 11 yr olds (Primary 7)	60% with no signs of dental disease (in permanent teeth)
for adults	90% of adults with some natural teeth 65% of adults aged 55-74 yrs with some natural teeth
By 2015 oral cancer	Reverse current declining trends in oral cancer 5 year survival, for males, by 2015

The summary actions are shown under the following headings which refer back to the main Action Plan.

1. Oral Health and Prevention

(a) Children
(b) Adults

2. Workforce and Workforce Development

(a) Dentists and PCDs
(b) Supporting the Team

3. Modernising Dental Services

(a) NHS Dental System
(b) Patients, Standards and Quality Assurance

Oral Health and Prevention: (a) Children
Target Groups: Pre-school and School Children
Actions	Milestones	Responsibility	Impact
Implement comprehensive programme for 0-2 yrs initially in areas of greatest need thereafter to the rest of Scotland	2005 Health Visitor referral scheme starts in areas of greatest need 2006 Scheme reviewed and rolled out nationally	SEHD NHSBs	Improved oral health Increased registrations 40% target
Implement nursery and schools preventive programmes Initiate salaried children's dental service	2005 Nursery and school expansion programme starts in areas of greatest need 2006 Programme reviewed and rolled out nationally 2007 Expand children's local /mobile dental services	SEHD NHSBs Local Authorities	Improved prevention in 3-12 yrs
Implement changes to children's services in general dental services	2005 New childrens allowances 2006 Child friendly practice allowance introduced for those allowing open access to children 2006 Extend the use of fissure sealants to children aged 12-14 yrs	SEHD	Family dentists motivated to deliver patient/child friendly services Child registrations increase
Expand oral health programmes	2006 90,000 nursery children and 250,000 primary school children brushing daily 2007 Local or mobile clinical services available to all high need schools 2007 All schools supporting healthy eating and drinking (water) policies 2007 All secondary schools will have an oral health promotion programme	NHSBs Local Authorities	Registrations increase in Scotland on an annual basis from 2006 0-2 35% 40% 50% 55% 3-5 66% 70% 75% 80% 6-12 75% 80% 85% 90% Reduction in oral disease across school age and future adult population

Oral Health and Prevention: (b) Adults
Target Group: Adults including those with Special Needs
Actions	Milestones	Responsibility	Impact
Health Boards develop oral health promotion programmes for adults (Workplace, prisoners, homeless and special needs)	2007 New health promotion packages in use at NHS Boards	NHS Health Scotland NHS Boards Prison service	Better understanding of dental health issues by those in most need
Changes to structure of dental services for adults including extending registration	2005 Phase one of programme 2006-2007 Further changes in line with proposals	SEHD	Increase registration especially in the elderly/special needs 65-74 yr olds from - 40% to 60%; 75 yrs and over from 28% to 40 %
Oral examination free for those 60 and over All NHS dental examinations free	2005 60 + Free examinations 2007 All adults	SEHD	Better preventive advice and support, and surveillance of oral cancer

Workforce: (a) Dentists and PCDs
Target Group: Dentists and Professionals Complementary to Dentistry
Increase number of dentists by at least 200 over present number, at an average rate of 50 per year	2005 Allocate new salaried posts to boards 2006 Revised recruitment and retention package 2006 Revised rural/remote recruitment package	NHS Education SEHD NHSBs	Service better able to meet patient needs across Scotland
Increase dental student numbers to achieve dental graduate increase to target of 135	2006 136 graduates 2008 143 graduates	SEHD Universities NHS Education	Increased workforce for future
Vocational training post for all dental graduates	2005 135 posts funded 2006 145 posts funded 2007 155 posts funded	SEHD NHS Education	Maximum numbers trained
Increase PCD (therapist/hygienist) student numbers	2005 30 student intake 2006 35 student intake 2007 45 student intake	SEHD NHS Education NHSBs	Increased workforce for future
Introduce dental therapist vocational training places	2006 match posts to student places	SEHD NHS Education NHSBs	More trained support staff
Expand dental nurse training to 250/year	2005 National dental nurses teaching pack for 150 nurses 2006 Increase to 250 nurses	NHS Education NHSBs	More trained support staff
Introduce a bursary scheme for dental students linked to NHS commitment	2006 Implementation of first phase	SEHD	Encouraging and supporting recruitment into dental careers

Workforce: (b) Supporting the Team
Target Group: Dental Teams
Actions	Milestones	Responsibility	Impact
Develop a career structure for primary care dentists and PCDs	2006 Identify new career structure including rewards for practitioners with special interests	SEHD NHSBs	Reduce referrals to specialist services Deliver services closer to patient Reduce waiting lists
Return to work programmes Retain older dentists	2006 Identify clear routes for both to contribute to dental services with appropriate recruitment incentives and education	SEHD NHSBs	Retain more dentists and dental team members
Develop the role of the team members § Nurses to health promotion § Therapist to adult and elderly care as well as children § Practice managers and receptionists	2006 Launch dental team programme for education development and support of all members of the dental team	NHS Education	Whole team contribution to workforce
Develop proposals for better incentives for dental staff to be part of the NHS	2006 NHS pension scheme for practice staff	SEHD	Whole team contribution to workforce
Develop outreach training in Aberdeen and other locations	2005 Outreach in Community clinics Aberdeen Glasgow and Argyll and Clyde 2006 New Outreach centre Aberdeen 2007/08 Outreach centres Inverness/Dumfries	SEHD NHS Education NHSBs	Encourage dental service expansion in rural/remoter parts of Scotland
Extension of the remote areas allowance	2006 Introduce extended remote areas allowance scheme	SEHD	Support remote practices
Develop further incentives for dentists to open up new facilities in areas of high need /demand	2006 Introduce new incentives	SEHD	Encourage expansion of dental services in areas of greatest need/demand

Modernising Dental services: (a) NHS Dental System
Target Group: Dental Professionals; NHS Boards
Actions	Milestones	Responsibility	Impact
Implement new remuneration system for dental practices	2005 New reimbursements for premises, IT and services. Changes to general dental practice allowance 2006 Changes to registration system and capitation payments Simplification of Statement of Dental Remuneration Guidance on local contracting by Boards	SEHD NSS NHSBs	Fairer reward system for dentists
Programme of premises improvements	2005 New reimbursement scheme to meet rental or equivalent costs New improvement grant scheme 2006 Updated premises development scheme 2006 Scheme to support financially the move of practices to new premises	SEHD NHSBs NSS	Fairer reward system for dentists Premises of required standard to meet professional and patient requirements
Implement programme of IT improvements	2005/06 Connection of practices to NHS net 2005 Specification of approved clinical systems 2006 New reimbursement system for practices	SEHD NHSBs NSS	Improved clinical communications within dentistry and with rest of NHS

Modernising Dental Services: (b) Patients, Standards and Quality Assurance
Target Group: Patients; Dental Professionals; NHS Boards
Actions	Milestones	Responsibility	Impact
Improve access for patients to routine and emergency care	2005 Increased funding to Boards to provide out-of-hours services Revised dental access scheme Boards given authority to support salaried practitioners Boards provide help-line for local people 2006 Integrated NHS24/NHS Boards system for out-of-hours/emergency care	SEHD NHSBs	By 2008, 400,000 additional patients with access to NHS dental services
Implement quality improvement programme for dental services	2005 Develop accreditation scheme with support to practices 2006 Develop quality award scheme Implement support programme for dentists with special interests 2006/07 Publish clinical guidelines for range of services	SEHD NHSBs	Standards in dental practice quality assured
Introduce new system of patient charges	2005 Review current system 2006 Implement new system	SEHD Patient Groups Professional Groups	Fairer and simpler system

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AN ACTION PLAN FOR IMPROVING ORAL HEALTH AND MODERNISING NHS DENTAL SERVICES IN SCOTLAND

ACTION PLAN SUMMARY 2005-2008 APPENDIX

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