Oral surgery schematic guidelines - NHS Cumbria

NHS ORAL SURGERY REFERRAL PACKCUMBRIAORAL SURGERY CLINICAL NETWORKMAY 20121

CONTENTSIntroduction 3Responsibilities of Referring GDP 4Responsibilities of Service Providers 4Service Providers 5Service Provider Pages:-Minor Oral Surgery Service Providers- Oasis Dental Care, Barrow-in-Furness 6- Community Dental Services, Workington and Whitehaven 7- Eden Dental Practice, Carlisle 8- Horn Hill Care Services Ltd, Millom 9- Sandes Avenue Dental Practice, Kendal 10Oral Surgery and Maxillofacial Providers- North Cumbria University Hospitals NHS Trust 11- The Cumberland Infirmary, Carlisle- West Cumberland Hospital, Whitehaven- University Hospitals of Morecambe Bay NHS Trust 12- Furness General Hospital, Barrow- Westmorland General Hospital, Kendal- Royal Lancaster Infirmary, LancasterAppendicesAppendix 1: Referral Guidelines Schematic DiagramAppendix 2 : Oral Surgery Referral ProformaAppendix 3 : Patient Information LeafletAppendix 4 : Discharge ProformaPage2

CUMBRIA ORAL SURGERY CLINICAL NETWORKNHS ORAL SURGERY REFERRAL GUIDELINESIntroductionThis referral pack has been further developed to support practitioners in makingappropriate referrals to oral surgery services following the development of new Minor OralSurgery (MOS) Services and the establishment of the Cumbria Oral Surgery ClinicalNetwork.The service model has been designed to ensure that relatively straight forward minor oralsurgery, above the competence level of GDPs but not requiring the advanced skills ofhospital consultants, can be done by accredited Dentists with Special Interests in aprimary care setting in a more convenient location for patients.Across Cumbria there are two Oral Surgery and Maxillofacial providers and a number ofMOS service providers.The care pathways and guidelines have been reviewed and agreed by the network,following a formal review of the initial six month period of the service, and this packcontains an outline of the clinical conditions suitable for treatment by the different providersand the revised process and documentation to be used in making referrals.The overall pathway is shown at Appendix 1 and the agreed referral guidelines are asfollows:-GDP MOS Service Provider Oral Surgery andMaxillofacial ProvidersRoutine extractions andsimple dento alveolarsurgery within thecompetency of a GDPGeneral Dentistry in linewith NICE GuidelinesManagement of minordental traumaComplex extraction of singleand multi-rooted erupted teethExposure of teeth if palpableRemoval of buried roots andfractured or residual rootfragmentsRemoval of simpleimpacted/ectopic/supernumaryteethRemoval of simple mucocoeleSurgical endodontics (practicedependent)The above possibly requiringsedation (practice dependent)Advice onlyRemoval of compleximpacted/ectopic/supernumaryteethExposure of teethManagement of soft tissueproblemsManagement of cranio-facial painRemoval of simple fibro-epithelialpolypsRemoval of uncomplicateddenture induced mucosalhyperplasiaThe above possibly requiringsedation or GAAny other oral or maxillofacialconditions3

Within this pack each provider is assigned a page where there is a description of theservices offered and the clinical conditions for which they will accept referrals. It should benoted that, as this is a developing new service, reference should be made to the providerspecific pages in this referral pack before making the referral. The referral pathways andprocesses in this pack will become operational from 1 November 2011.From this date there is a change to the current system and referrals should be sentdirectly to the address specified on the referral form.The Oral Surgery Clinical Network will continue to monitor and review the care pathway,referral guidelines, the documentation and the referral processResponsibilities of Referring DentistsThe referring dentist should:-assess any potential referral to these services using the guidelines provided anddetermine the most appropriate provider.discuss the referral with the patient – the patient information leaflet may helpanswer questionscomplete the referral proforma providing appropriate clinical information to supportthe referral and send direct to the chosen provider.submit an FP17 for the NHS Course of Treatment which includes the referredactivity. The responsibility for ongoing patient care remains with the referringdentist throughout this process and therefore the banding of that Course ofTreatment should be based on all the primary dental services activity carried outwithin that Course irrespective of the provider and the appropriate band chargemade to the patient.Responsibilities of Service ProvidersThe service provider should:-accept the referral direct from the service provider.for the MOS Service, offer the patient an appointment within 4 weeksfor all services, ensure compliance with the 18 week Referral to Treatment pathwayundertake the clinical procedure or refer to another provider within the network ifappropriatecomplete admin, accounting and discharge process, including completion of FP17for MOS providers.provide appropriate communication to referring GDPnot offer private treatment to patients referred for NHS Oral Surgery Servicesthrough this referral process.4

Minor Oral Surgery Service ProvidersOasis Dental Care, Barrow-in-FurnessCommunity Dental Services, Workington and WhitehavenEden Dental Practice, CarlisleHorn Hill Care Services Ltd, MillomSandes Avenue Dental Practice, KendalOral Surgery and Maxillofacial ProvidersNorth Cumbria University Hospitals NHS Trust- The Cumberland Infirmary, Carlisle- West Cumberland Hospital, WhitehavenUniversity Hospitals of Morecambe Bay NHS Trust- Furness General Hospital, Barrow- Westmorland General Hospital, Kendal- Royal Lancaster Infirmary, Lancaster5

MOS ProviderPractice Name: Oasis Dental Care LtdAddress:Units 5 & 6 Furness House, Duke Street, Barrow-in-FurnessPostcode: LA14 1HNTelephone No: 01229 829096Fax No: 01229 827593Email address: barrow@oasis-healthcare.comClinician:Mr Mark Knagg (formerly Ardent Dental Care)Referrals accepted Complex extraction of single and multi-rooted erupted teeth Exposure of teeth if palpable Removal of buried roots and fractured or residual root fragments Removal of simple impacted/ectopic/supernumary teeth Removal of simple mucocoeleReferrals not acceptedAdvice onlyRemoval of complex impacted/ectopic/supernumary teethExposure of teethManagement of soft tissue problemsManagement of cranio-facial painRemoval of simple fibro-epithelial polypsRemoval of uncomplicated denture induced mucosal hyperplasiaThe above possibly requiring sedation or GAAny other oral or maxillofacial conditionsProvider specific informationArdent Dental Care will contact all referred patients directly on receipt of referrals toarrange appointments. All patients will be returned to the care of referring dentist oncompletion of treatment.Mr Mark KnaggOasis Dental Care6

MOS ProviderCommunity Dental ServicesCommunity Dental ServicesNHS CumbriaNHS CumbriaDental DepartmentDental Outpatients DepartmentWorkington Community HospitalWest Cumberland HospitalPark LaneHensinghamWorkingtonWhitehavenCumbria CA14 2RW Cumbria CA28 8JGTelephone No: 01900 705064 Telephone No: 01946 693181 Ext 4286Fax No: 01900 606014 Fax No: 01946 523506Email address: robert.kenning@cumbria.nhs.uk (for both sites)Clinicians:Robert KenningReferrals accepted Complex extraction of single and multi-rooted erupted teeth Exposure of teeth if palpable Removal of buried roots and fractured or residual root fragments Removal of simple impacted/ectopic/supernumary teeth Removal of simple mucocoele The above possibly requiring sedationReferrals not acceptedAdvice onlyRemoval of complex impacted/ectopic/supernumary teethExposure of teethManagement of soft tissue problemsManagement of cranio-facial painRemoval of simple fibro-epithelial polypsRemoval of uncomplicated denture induced mucosal hyperplasiaThe above possibly requiring sedation or GAAny other oral or maxillofacial conditionsProvider specific informationThe Community Dental Service will contact all referred patients directly on receipt ofreferrals to arrange appointments. All patients will be returned to the care of referringdentist on completion of treatment.Mr S G JonesClinical Director, Specialist and Special Needs Dental Service7

EDEN DENTAL PRACTICEMOS ProviderPractice Name: Eden Dental PracticeAddress:99 Warwick Road, CarlislePostcode: CA1 1EATelephone No: 01228 525285Fax No: 01228 526122Email address: edendentists@btconnect.comClinicians:Mr. J HarkesMiss. E. MatherReferrals accepted Complex extraction of single and multi-rooted erupted teeth Exposure of teeth if palpable Removal of buried roots and fractured or residual root fragments Removal of simple impacted/ectopic/supernumary teeth Removal of simple mucocoeleReferrals not acceptedAdvice onlyRemoval of complex impacted/ectopic/supernumary teethExposure of teethManagement of soft tissue problemsManagement of cranio-facial painRemoval of simple fibro-epithelial polypsRemoval of uncomplicated denture induced mucosal hyperplasiaThe above possibly requiring sedation or GAAny other oral or maxillofacial conditionsProvider specific informationEden Dental Practice will contact all referred patients directly on receipt of the referral.Please ensure all patient telephone contact details are included in the referral.Please ensure that appropriate radiographs are included with all referrals.The practice is located opposite Our Lady & St. Joseph’s Church on Warwick Road. Streetparking is available in the immediate vicinity where a disc parking scheme is in operation.Bus and train services are located within walking distance.Please note surgeries are located on the first floor and are unsuitable for wheel chairaccess.8

Horn Hill Care Services LtdMOS ProviderHorn Hill Dental Practice1 Horn HillMillomCumbria LA18 5DPTelephone No: 01229 772319Fax No: 01229 777262Email address: drdavidmsmith@hotmail.comClinician:Dr David M SmithReferrals accepted Complex extraction of single and multi-rooted erupted teeth Exposure of teeth if palpable Removal of buried roots and fractured or residual root fragments Removal of simple impacted/ectopic/supernumary teeth Removal of simple mucocoele The above procedures only can be provided under sedation for patients within ASACategories 1 & 2. If unsure please ring for adviceReferrals not acceptedAdvice onlyRemoval of complex impacted/ectopic/supernumary teethExposure of teethManagement of soft tissue problemsManagement of cranio-facial painRemoval of simple fibro-epithelial polypsRemoval of uncomplicated denture induced mucosal hyperplasiaThe above possibly requiring sedation or GAAny other oral or maxillofacial conditionsProvider specific informationIf the patient will require care to be provided in a downstairs surgery please can you mark this onthe referral.From the west coastEnter Millom, descend hill with houses on both sides, we are the end of terrace property on theright, the building with disabled access ramp, 200m after the signposted turn off to Haverigg.From the eastEnter Millom, drive pass the school and the train station, turn right at the mini roundabout, we are100m up the hill on your left.Free parking is available between the practice and the garage next to the palladium theatre.Train: exit via stairway to the top of the railway bridge, turn right when on the bridge, walk down thehill towards the BP petrol station. The practice is situated approximately 100 metres, on theopposite side of the road.9

MOS ProviderSandes Avenue Dental Practice5 Sandes AvenueKendalCumbria LA9 4LLTelephone No: 01539 729891Fax No: N/AEmail address: dentalteam@kendal-dentists.co.ukClinician: David FisherReferrals accepted Complex extraction of single and multi-rooted erupted teeth Exposure of teeth if palpable Removal of buried roots and fractured or residual root fragments Removal of simple impacted/ectopic/supernumary teeth Removal of simple mucocoele Surgical endodonticsReferrals not acceptedAdvice onlyRemoval of complex impacted/ectopic/supernumary teethExposure of teethManagement of soft tissue problemsManagement of cranio-facial painRemoval of simple fibro-epithelial polypsRemoval of uncomplicated denture induced mucosal hyperplasiaThe above possibly requiring sedation or GAAny other oral or maxillofacial conditionsProvider specific informationPatients will be contacted directly once we have received the referral.Please ensure all patients have appropriate x-rays taken prior to the referral.Patients for removal of wisdom teeth need to have an OPT taken to enable appropriatetreatment planning.10

North Cumbria University Hospitals NHS TrustMaxillofacial Unit, The Cumberland Infirmary, CarlisleWest Cumberland Hospital, WhitehavenClinicians: secondary care services will be delivered under control of consultantsReferrals accepted Advice only Removal of complex impacted/ectopic/supernumary teeth Exposure of teeth Management of soft tissue problems Management of cranio-facial pain Removal of simple fibro-epithelial polyps Removal of uncomplicated denture induced mucosal hyperplasia The above possibly requiring sedation or GA Any other oral or maxillofacial conditionsReferrals not acceptedComplex extraction of single and multi-rooted erupted teethExposure of teeth if palpableRemoval of buried roots and fractured or residual root fragmentsRemoval of simple impacted/ectopic/supernumary teethRemoval of simple mucocoeleSurgical endodontics11

University Hospitals of Morecambe Bay NHS TrustMaxillofacial Unit, Royal Lancaster Infirmary, LancasterMaxillofacial Unit, Westmorland General Hospital, CumbriaMaxillofacial Unit, Furness General Hospital, CumbriaClinicians: secondary care services will be delivered under control of consultantsReferrals accepted Advice only Removal of complex impacted/ectopic/supernumary teeth Exposure of teeth Management of soft tissue problems Management of cranio-facial pain Removal of simple fibro-epithelial polyps Removal of uncomplicated denture induced mucosal hyperplasia The above possibly requiring sedation or GA Any other oral or maxillofacial conditionsReferrals not acceptedComplex extraction of single and multi-rooted erupted teethExposure of teeth if palpableRemoval of buried roots and fractured or residual root fragmentsRemoval of simple impacted/ectopic/supernumary teethRemoval of simple mucocoeleSurgical endodontics12

Appendix 1: Referral Guidelines Schematic DiagramAppendix 2 : Oral Surgery Referral ProformaAppendix 3 : Patient Information LeafletAppendix 4 : Discharge Proforma13