1. MCN Referral Management and development of Surgical Dental Service Maggie Leggate Clinical effectiveness advisor Pittodrie Stadium 2012 MCN Oral Health and Dentistry event 7 th Feb 2012 Terry Lowe Consultant OMFS

2. Referral Management subgroup Origin  Feedback from 1’ care practitioners  Secondary care audit; Quality and effectiveness of referral process  Secondary care service redesign  Government targets  Governance/Good medical practice  ‘Meet the consultants evening’ - 2009

3. Objectives Improve the overall quality of referrals  Triagable  Promote best practice in referral management  Facilitate administration Improve communication/feedback Better utilisation of resources

4. Process  Identified stakeholders for each group  Regular meetings  Each service provided referral criteria  Standard template produced.  Orthodontics formed own referral working group

5. Result  Guidance Document  Referral forms for each specialty  Piloted; ten primary care practices  First edition distributed June 2011

6. More recently….  Document handed to Dental Advice and Referral Centre (DARC)  Islands  Highland  Website support - HI- Net Grampian

7. Benefits  Pre- and post guidance audit ; Quality of Referrals to OMFS  Data collection;  Both administrative and clinical parameters to assess the overall quality of the referral

8. Referral Proforma - OMFS

13. Summary  Development of referral guidance - ongoing  Inclusion, networking, establishing clarity  Updateable, dynamic resource on line - accessible to all  Support for practitioners  Greater understanding of care pathways  Establish electronic referrals – SCI Gateway

14. Primary Care Surgical Dentistry Service

15. Primary care Surgical Dentistry service  OMFS audits 2009/11; 6-10% activity suitable for primary care surgery(LA)  Minor O/P surgery for remote & rural location  Successful model in Islands for many years  Postgraduate Diploma/ MSc in O/S; UCLAN  Extrapolate to provide Intermediate care pathway for Surgical Dentistry

16. Members…so far  Archana Kavi (ABD) – MSc, UCLAN  Andrew McIntosh (ABD)  Bernice McLaughlin (ABD)  Charlotte Nash (Moray) Islands  Pippa Arbon (Shetland Isles) Dip, UCLAN  Nigel Pendry (Orkney)

17. Activity  Minor dentoalveolar surgery/LA  GA exts list RACH/ support from OMFS Criteria ASA I/II  Extractions, retained roots  MOS ; soft tissue/ mod. bone removal  Apicectomy of single rooted teeth with appropriate presurgical endodontics

18. Where next…  First echelon training completed  Top up training support available.  Training for Dental Students.  Service redesign in Moray – supporting primary care practitioners.  Dental anxiety management/sedation service

19. Thank you