Scotland's oral health plan consultation: analysis of responses

WEBINARS

The purpose of the roadshow events was to engage with a range of dental professionals across the country. Following our initial analysis of these events it became clear that we had not managed to reach many dentists in remote and rural areas and dentists who have been qualified for under ten years.

Engagement with both of these groups is particularly important. We recognise that the challenges faced in remote and rural areas are often different to what we see in other parts of Scotland. The involvement of young professionals is also crucial, given our intention that the Oral Health Improvement Plan will shape NHS dentistry for the next decade.

The CDO hosted three webinar sessions, which followed a similar format to the roadshow events; one with dentists in remote and rural areas and two with dentists who have qualified within the last ten years. However, it must be remembered that these views are not necessarily representative of the wider population.

The table below illustrates the number of attendees at each webinar.

Remote and Rural	24 January 2016	29
Young Dentists	18 April 2017	3
Young Dentists	19 April 2017	5

Summary of Key Findings - Remote and Rural

Theme 1 - Prevention and Risk

Participants were asked for their views on a preventive care pathway and were largely supportive of this proposal, however, they would like more detail on what a preventive care pathway would look like.

The proposal to introduce an OHRA was also discussed. Participants were in favour of this, however suggestions were made that this should be introduced at age twelve.

Theme 2 - Payments and Charges

Participants were asked to discuss the proposal of a simpler system of payments and charges. There was general agreement that the range and volume of items of service treatments is what makes it complex.

Participants were asked to discuss the proposals to expand the role of dentists in providing domiciliary care. It was noted that domiciliary visits in remote and rural areas can be problematic for GDS dentists, particularly when travel to other islands is required.

The proposal to develop an enhanced service model was also discussed. Participants stated that for an enhanced service model to meet the needs of remote and rural areas, consideration would need to be given to the existing service range of the PDS.

Theme 3 - Organisation and Management

For this section, participants were asked to discuss a range of proposals under the broad headings of contractual arrangements and locality planning.

Views were expressed regarding the variations between HSCPs, with strong agreement that local planning is important in remote and rural areas.

Participants expressed mixed views regarding the proposal of patients registering with a practice.

Participants also expressed mixed views regarding practice owners providing a minimum number of hours of clinical care. Whilst participants could see the potential benefits of this, for practice owners who have multiple practices this may not be practical.

The proposal to introduce a Director of Dentistry would be helpful to promote oral health priorities within the NHS Board area.

Theme 4 - Quality, Improvement and Scrutiny

Participants were asked to discuss a range of proposals under the broad headings of monitoring a future preventive pathway; use of quality indicators and direct access to DCPs.

Participants felt there was a need for clarity on quality indicators and any link to SDCEP guidance.

Participants discussed training for dentists who are coming to work in remote and rural areas to prepare for both professional and geographical isolation.

Participants were of the view that recruitment in remote and rural areas can be challenging.

Summary of Key Findings - Young Dentists

Theme 1 - Prevention and Risk

Participants were asked for their views on a preventive care pathway and were largely in agreement that the focus should be on prevention.

The proposal to introduce an OHRA was also discussed. Participants suggested that age eighteen was perhaps too late to introduce an OHRA.

The frequency of check-ups was discussed. There was broad consensus that six to twelve months was sensible for most patients, however, for patients who were at a higher risk this may be more frequent.

Theme 2 - Payments and Charges

Participants were asked to discuss the proposal of a simpler system of payments and charges. Suggestions were made that the SDR should be simplified and encourage prevention.

The proposal to introduce an enhanced service model was also discussed. Views were expressed that training for domiciliary visits could be done at undergraduate level by linking universities to care homes.

The proposal for dentists to offer more complex treatments was also discussed. Participants were concerned that referring patients to another practice runs the risk of losing the patient.

Theme 3 - Organisation and Management

For this section, participants were asked to discuss a range of proposals under the broad headings of contractual arrangements and locality planning.

Participants expressed concern regarding the involvement of HSCPs.

Mixed views were expressed regarding the proposal for patients to register with a practice, particularly around the issue of patient care.

Participants agreed that the proposal to introduce a Director of Dentistry would be useful.

Participants discussed the proposal for practice owners to be required to deliver a minimum number of hours of clinical care. It was suggested that this would be helpful in relation to DBsC.

Theme 4 - Quality, Improvement and Scrutiny

Participants were asked to discuss a range of proposals under the broad headings of monitoring a future preventive pathway; use of quality indicators; and direct access to DCPs.

Participants were supportive of the proposal to introduce PLT.

Participants discussed the prospect of DCPs carrying out certain procedures and were of the view that this should be done under the dentist's prescription.

Participants discussed the DRS and highlighted the poor attendance rate from patients. Feelings were also expressed that many find the system punitive.