Delivering the 18 Weeks Referral to Treatment Standard Output Report

More documents

Recommendations

Info

Dental Specialties Task and Finish GroupThe Dental Specialties Task and Finish Group had its first meeting in September2008, and ran as a short-life working group until September 2010. Membership islisted as Appendix One.The Task and Finish Group recognises the differences in service delivery betweenthe different dental specialties; however, this output report picks out common themesand approaches which largely apply, as well as specifics for the different specialties.Mythbusting:Fact: All Dental Specialties must deliver the 18 Weeks Referral to Treatment targetby 31 December 2011. There are no exceptions.Dental Specialties included within the 18 Weeks RTT Standard are:• Orthodontics;• Restorative Dentistry;• Oral Surgery;• Oral Medicine;• Paediatric Dentistry; and• All Dental Procedures carried out under General Anaesthetic.Maxillofacial Surgery (in or out of 18 Weeks RTT?)Maxillofacial surgery is technically not classified as a Dental Specialty and thereforeis outwith the remit of the Dental Specialties Task and Finish Group. Much of theactivity within this discipline is linked to Oral Surgery and therefore it is difficult toextricate the two. Clinicians and other stakeholders have therefore adopted anintegrated approach. Regardless, the 18 Week Referral to Treatment target stillapplies.Community and Salaried Dental Services (in or out of 18 Weeks RTT?)The complexities of patterns of service delivery in the different care settings are wellrecognised, influenced by the financial and other drivers which come into play. Theconsequent interaction between the different parts of the service can have asignificant impact on the provision of care.Nevertheless, consultations and treatment carried out by general dentalpractitioners, community dental practitioners or by specialist practitioners workingwithin the community and salaried services are not part of the 18 Weeks Referral toTreatment target.There are, however, two exceptions when community based interventions arepart of the 18 Weeks RTT Standard:Dental Specialties Task & Finish Group – January 2011 8
1. The planned procedure which is being carried out in the community is undertakenby a secondary care specialist.2. The procedure requires a General Anaesthetic.In these circumstances the intervention will be included in the 18 Weeks RTT target.Further clarification is given in the Dental Specialties Frequently Asked Questions:http://www.18weeks.scot.nhs.uk/how-to-achieve-and-maintain-18-weeks/task-andfinish-groups/dental-specialties/Dental Specialties’ Supply and DemandThe Task and Finish Group firmly recognises the variation in service supply indifferent parts of the country and acknowledges the affect that this can have uponmodels of care within different health communities and ultimately, where treatmentsare provided.It is recognised that some parts of the country do not have the same level ofpractitioners across primary and community care as others. In particular there isevidence of variation between central belt and the North of Scotland, such asperhaps more limited independent sector provision in the North.Similarly some parts of the country, often remote and rural areas, find it difficult toattract General Dental Practitioners. Within General Dental Practice itself, serviceprovision varies, for example a high street general dental practitioner may treat eitherNHS or private patients, or both. This creates varying dynamics and patient flowsacross different health communities.As a consequence, in some geographic areas, there is more reliance upon theprimary care salaried dental services (PCSDS) to provide fundamental dentaltreatment.As a result of such variation, alternative approaches to care have been adopted. Forexample, Forth Valley has two specialist orthodontic practices, which has had asignificant impact on keeping secondary care lists shorter, whilst Dumfries andGalloway has established an alternative model of care based around their primarycare centres. In the North of Scotland, a Primary Care Specialist in Oral Surgerytakes referrals directly from General Practice, which creates another different modelof care.Thus, a range of factors impact on the supply of care within the primary andcommunity setting, and can result in a high level of demand for basic dental care tobe provided within acute secondary care. This creates an imbalance of supply anddemand, which can result in long waiting times for some dental specialties.Patient flows are further affected in that currently just under 70% of Scotland’s adultpopulation is registered with a General Dental Practitioner. The remaining 30% aretherefore perhaps more likely to present to secondary care regardless of the severityof their condition.Dental Specialties Task & Finish Group – January 2011 9
Page 1 and 2: Dental Specialties Task and Finish
Page 3 and 4: Demand is not a given 24Effective R
Page 5 and 6: 4. Make the most of your workforce,
Page 7: Context18 Weeks Referral to Treatme
Page 12 and 13: 1. Ensuring high organisational pro
Page 14 and 15: In order to progress these issues o
Page 16 and 17: services. The national targets for
Page 18 and 19: MythbustingFact: Procedures perform
Page 20 and 21: Figure 1: New Outpatients on the Wa
Page 22 and 23: Figure 3: Additions and Removals300
Page 24 and 25: Influencing Referral ProcessesPart
Page 26 and 27: changes to templates will be made,
Page 28 and 29: Referral Management Pathways for Or
Page 30 and 31: implementation of 18 Weeks RTT Stan
Page 32 and 33: • Managed Clinical Networks to pr
Page 34 and 35: Robust evaluation will be carried o
Page 36 and 37: Action Planning - Specialist RolesN
Page 38 and 39: Conclusion: Action Planning and Ong
Page 40 and 41: • Analyse referral practices and
Page 42 and 43: Dental Specialities Task & Finish G
Page 44 and 45: Appendix Four: Oral Surgery Referra
Page 46 and 47: Dental Specialties Task & Finish Gr
Page 48 and 49: Dental Specialties Task & Finish Gr

Delivering the 18 Weeks Referral to Treatment Standard Output Report

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?