NHS general dentistry in Wales: evaluation of patient access and budget expenditure

Owen, Christie; Seddon, Caroline; Clarke, Katrina; Bysouth, Tom

doi:10.1038/s41415-019-0407-3

Cited by 5 publications

(6 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Living in rural locations may make dental access challenging, where practices report difficulties in recruiting and retaining dentists ( Owen et al 2019 ). In addition, people living in rural areas are more likely to consider oral health as being less important ( Heaton et al 2004 ) and not attend a dentist regularly, but they are just as likely to seek care from their GMPs as their urban counterparts ( Khan et al 2017 ).…”

Section: Discussionmentioning

confidence: 99%

Dental Attendances to General Medical Practitioners in Wales: A 44 Year-Analysis

et al. 2021

View full text Add to dashboard Cite

One-third of the UK population is composed of problem-oriented dental attenders, seeking dental care only when they have acute dental pain or problems. Patients seek urgent dental care from a range of health care professionals, including general medical practitioners. This study aimed to identify trends in dental attendance at Welsh medical practices over a 44-y period, specifically in relation to dental policy change and factors associated with repeat attendance. A retrospective observational study was completed via the nationwide Secure Anonymised Information Linkage (SAIL) Databank of visits to general medical practice in Wales. Read codes associated with dental diagnoses were extracted for patients attending their general medical practitioner between 1974 and 2017. Data were analyzed with descriptive statistics and univariate and multivariable logistic regression. Over the 44-y period, there were 439,361 dental Read codes, accounting for 288,147 patient attendances. The overall attendance rate was 2.60 attendances per 1,000 patient-years (95% CI, 2.59 to 2.61). The attendance rate was negligible through 1987 but increased sharply to 5.0 per 1,000 patient-years in 2006 (95% CI, 4.94 to 5.09) before almost halving to 2.6 per 1,000 in 2017 (95% CI, 2.53 to 2.63) to a pattern that coincided with changes to National Health Service policies. Overall 26,312 patients were repeat attenders and were associated with living in an area classified as urban and deprived (odds ratio [OR], 1.22; 95% CI, 1.19 to 1.25; P < 0.0001) or rural (OR, 0.84; 95% CI, 0.83 to 0.85; P < 0.0001). Repeat attendance was associated with greater odds of having received an antibiotic prescription (OR, 2.53; 95% CI, 2.50 to 2.56; P < 0.0001) but lower odds of having been referred to another service (OR, 0.75; 95% CI, 0.70 to 0.81; P < 0.0001). Welsh patients’ reliance on medical care for dental problems was influenced by social deprivation and health policy. This indicates that future interventions to discourage dental attendance at medical practitioners should be targeted at those in the most deprived urban areas or rural areas. In addition, health policy may influence attendance rates positively and negatively and should be considered in the future when decisions related to policy change are made.

show abstract

Section: Discussionmentioning

confidence: 99%

Dental Attendances to General Medical Practitioners in Wales: A 44 Year-Analysis

et al. 2021

View full text Add to dashboard Cite

show abstract

“…It has been reported that the number of contract holders who are also delivering NHS treatments across Wales have halved between 2010 and 2018, from 418 to 155. 1 In Wales, following the review of dental services, pilot contracts have been managed and delivered. 21 The number of pilot contracts have been expanded from 23 in January 2018 to 95 in April 2019.…”

Section: Redmentioning

confidence: 99%

“…This is demonstrated clearly in Wales where the British Dental Association (BDA) published a paper demonstrating problematic access to dental care for lower socio-economic groups. 1 The solution to this tension from the viewpoint of the BDA is increased resources, whereas the Welsh Government is not in agreement for increases. 2,3 The BDA view this as a missed opportunity to improve oral health.…”

Section: Introductionmentioning

confidence: 99%

General dental practice and improved oral health: is there a win-win for both the professional establishment and government?

2020

View full text Add to dashboard Cite

show abstract

“…6 However, a recent paper reported that almost half of all dental practices 'rely on regular check-ups for those in good oral health to achieve [contractual] targets' . 7 This study, which is reported in two parts, sought to explore how decisions about dental recall intervals are made in general dental practice. Part one will describe the facilitators and barriers experienced by NHS general dental practitioners (GDPs) working in Wales towards the implementation of riskbased recall intervals.…”

Section: Introductionmentioning

confidence: 99%

A qualitative exploration of decisions about dental recall intervals - Part 1: attitudes of NHS general dental practitioners to NICE guideline CG19 on the interval between oral health reviews

et al. 2022

View full text Add to dashboard Cite

Introduction The National Institute for Health and Care Excellence (NICE) Guideline CG19 recommends that the intervals between oral health reviews should be tailored to patients' disease risk. However, evidence suggests that most patients still attend at six-monthly intervals.Aim To explore facilitators and barriers to the implementation of CG19 in general dental practice.Methods Semi-structured telephone interviews were conducted with 25 NHS general dental practitioners (GDPs) in Wales, UK. Transcripts were thematically analysed.Results Dentists described integrating information on clinical risk, patients' social and dental history, and professional judgement when making decisions about recall interval. Although most GDPs reported routinely using risk-based recall intervals, a number of barriers exist to recall intervals at the extremes of the NICE recommendations. Many practitioners were unwilling to extend recall intervals to 24 months, even for the lowest-risk patients. Conversely, dentists described how it could be challenging to secure the agreement of high-risk patients to three-month recalls. In addition, time and workload pressures, the need to meet contractual obligations, pressure from contracting organisations and the fear of litigation also influenced the implementation of risk-based recalls.Conclusions Although awareness of the NICE Guideline CG19 was high, there is a need to explore how risk-based recalls may be best supported through contractual mechanisms.

show abstract

NHS general dentistry in Wales: evaluation of patient access and budget expenditure

Cited by 5 publications

References 3 publications

Dental Attendances to General Medical Practitioners in Wales: A 44 Year-Analysis

Dental Attendances to General Medical Practitioners in Wales: A 44 Year-Analysis

General dental practice and improved oral health: is there a win-win for both the professional establishment and government?

A qualitative exploration of decisions about dental recall intervals - Part 1: attitudes of NHS general dental practitioners to NICE guideline CG19 on the interval between oral health reviews

Contact Info

Product

Resources

About