National Dental Specialities’ Task and Finish Group Output Report and Key Messages 3 February 2011 Mike Lyon Deputy Director, Health Delivery Scottish Government Health & Social Care Directorates

Task & Finish Group Identifying key risks and triggering a range of focused actions to address them Driving a critical path for target delivery Performance management, redesign and pathway development supporting the concept of shifting the balance of care

“ a whole journey waiting time target of 18 weeks from…referral to treatment… by December 2011” Cabinet Secretary for Health and Wellbeing, Scottish Parliament – Official Report, 28 June 2007

Six Dimensions of Quality

11 months to go Timeliness is 1 of 6 dimensions of quality Challenging financial circumstances Focus on developing clinically effective and resource efficient pathways that deliver waiting times and quality care within 18 weeks

Measuring Achievement against 18 weeks RTT 1.Achievement will be measured against a standard of 90% combined admitted & non- admitted pathways within 18 weeks. 2. Allows flexibility both clinically and managerially.

Performance MMI – November 2010 Specialty summary – combined admitted & non-admitted NB Data Accuracy Considerations

All dental specialities must deliver against the 18 weeks Referral To Treatment standard from 31 December 2011 – there are no exceptions.

Dental Specialities Orthodontics Restorative Surgery Oral Medicine Oral Surgery Paediatric Dentistry All Dental GAs

High Organisational Profile Delivery Expectations Robust Data Capture (Data Information Intelligence Action) Minimising pathway variation Influencing referral thresholds Optimizing workforce opportunities Reviewing systems and processes Who’s doing what matrix Dental Specialities: Key Commendations

Data capture Especially return out patient setting Clinical outcome recording Completion of dental MMI Accurate recording of clock starts/stops See dental definitions and scenarios

Patients should not be added to a waiting list unless they are ‘fit’ to commence treatment.

Pathways Understand and reduce variation - standardise Reduce waste – delays – handovers Treat patients in the correct care setting, with the right person first time.

Oral Surgery Pathway Orthodontic Pathways Collaborative process with group members across primary, community and secondary care Local Pathways

Make the most of your workforce Extended roles Dental Support Worker Orthodontic Therapists Freeing up consultant time for new patients Dental Workforce Review

High quality, well designed services, making the best use of capacity to deliver equity of care to patients. Effective and Efficient.

Is rationing by waiting not the cruellest, crudest, and most wasteful form of rationing?

What should we do? What can we do? How can we do it best?