South West Dental LDN Meeting Date: Friday 3 rd June 2017 Venue: Peninsula House, Saltash VC with

Transcription

1 ` South West Dental LDN Meeting Date: Friday 3 rd June 2017 Venue: Peninsula House, Saltash VC with South Plaza Bristol Time: 14:00 16:40 Chair: Peter Howard-Williams Attendance Peter Howard-Williams Clinical Chair, South West Dental LDN PHW Amanda Fisk Director of Assurance and Delivery AF Andrew Harris Dental Contract Manager AH Paul Harwood Consultant Dental Public Health PH Sarah McFarlane Primary Care Support Lead, Devon SM Jane Luker Postgraduate Dental Dean JL Rob Mew Devon LDC RN Andrew Taylor Chair, Cornwall LDC AT Tim Hodges Devon LDC TH Joe McGill MCN Chair, Orthodontics JM Jane Foggin Somerset LDC JP Debbie Freeman Primary Care Support Officer Lead DF Tony Brooke MCN Chair, Special Care TB Chris Bell MCN Chair, Oral Surgery CB John Cantwell Avon LDC JCa Apologies Rachel Coke Assistant Contract Manager RC Matt Jerreat MCN Chair, Restorative MJ Lynn Combes Primary Care Support Lead, Cornwall LC Martin Fulford Dental Adviser, NHS England MF Minute taker Fiona Clace Admin Support, Dental Team FC 1 Welcome and Apologies Action 1 P a g e

2 PHW welcomed the group and let them know that AF was listening in on the meeting via the phone, AF greeted everyone and informed the meeting that she would have to leave after 30 minutes and that AH would update her on the rest of the meeting. AF explained that the NHS England South region has been split in to two due to its size, complexity and level of challenge; it has been spilt into south east and south west which covers Gloucestershire, Wiltshire, Swindon, Bath, Bristol, Somerset, Devon, Cornwall and Dorset. As you may be aware we are on our way, through Sustainability and Transformation Plans ( STPs) to Accountable Care Systems, although this hasn t happened yet. The NHSE SW region will be sub divided into Cornwall, Devon, Somerset and Dorset on one hand and Bristol, Gloucestershire, Wiltshire, Swindon and Bath on the other. AF suggested this would not affect the day to day running of NHSE in the near future. 2 Report from LDN conference PHW was unable to attend due to personal circumstances and RC has sent a report in: Sarah Hurley gave presentation about a step change on dental check up s for children under 2. This has been driven because of the constant publication about the amount of young children who are receiving general anaesthetic in hospital. She has set up a scheme about dental practices having some extra capacity for treating children under 2. PH- W has full power point presentation which he will circulate to all. This will be driven by the CDO. PH-W advised that if the members of the LDC wished to give feedback to the CDO that would be welcomed. Starting well A smile for life initiative - targeting families with children under 5 who currently do not access dental care in 13 areas with high oral health needs. None of the selected areas are in the SW. Public health - We should have 3 WTE consultants in Dental Public Health but only have 1.4. Nicholas Taylor from NHS England stressed that training needs to be in line with commissioning guides, LDN s and MCN s need to work together with NHS England so this can be planned for the future. There is a stakeholder event in September that will be looking at issues. Jeremy Wallman of the NHS England London region said that there has recently been a London wide procurement of Special Care and Paediatric dentistry across the whole of London and the main driver was the consistency of contracts and services. With an option of 5 2 P a g e

3 years. Oral surgery in Lancaster looking at referral and referral management and consistency of triaging. Dental contract reform, two blends are currently being piloted and from the feedback it looks like it needs to be a blend of both. Adults in practice survey by Public Health England, the protocol is still being developed and PH is going to a meeting in 3-4 weeks time, where the protocol will be unveiled. 3 Minutes of last meeting 31 st March 2017 Minutes from previous meeting - slight changes were made on pages 3, 4 and 6 and then they were accepted as an accurate record. 4 Matters Arising No matters arising please refer to action log. 5 Action Log Action: Conflict of interest forms are coming into FC FC to those that still haven t sent theirs in. Action: Updating list for circulation Ongoing In light of the difficulties experienced obtaining nhs.net accounts, there is a piece of work underway where the CDO Office have secured Accenture to become responsible for managing all NHS mail addresses for all of the dental team so going forward all of the dental teams will be able to have an nhs mail account and this will be set up by Accenture. A pilot will commence in Cheshire/Merseyside, the NE and an area of London in Jul Further rollout will commence in Nov 17 ensuring an NHS mail account for all dentists and dental students. Succession planning- The advert and job specification has been circulated for LDN chairs job and there has been one or two expressions of interest but no applications as yet.. 6 Review LDN Work plan Not a lot of progress with LDN work plan except with the MCN s who are now making a lot of progress. 7 MCN Reports Each MCN chair gave an overview of their work plan (copies of those 3 P a g e

4 presented are included with the minutes). Oral Surgery MCN CB now has now had the first committee meeting and thanked DF for her help in getting everything sorted. Service provision document has gone back out to committee members for it to be filled in locally. For the first time we may have an idea of who is providing what in the whole of the south west. Proms and Prems exercise outcome measurements to be looked at. Triage and referral guidance is largely the same, just locally there is a small difference. If the committee can agree the guidance and put it on the website for a resource and signpost for the whole of the south west. Inappropriate referral and their management, De-skilling of primary care is difficult to reverse. There is a lack of information on patients who were referred and rejected or were bumped to 111, a survey will be done to look at this information. A road show for the south west was given a lot of support; it is now felt that they need to take to roadshow around the SW to introduce the MCN members to the practitioners. PH-W praised CB and the MCN for all the hard work in moving forward but asked that they look at developing a pathway approach for the tier 2 type patients. CB is looking at the referral triage system as a whole but has made a note to look at that next. PH-W is really happy about the fact that there will be a standardised approach for all practitioners. Skill audit has been sent out to everyone now. 8 Special Care and Paediatrics MCN 3 meetings so far coming up to 4 th meeting on 12 th July Core membership sorted out Inviting paediatric consultants to make membership a bit more robust despite their wish for a separate paediatric MCN. TB thanked DF for help with the excel action log Adopted the generic Terms of Reference. Special Care Mapping exercise from NHS England Commissioners. Scoping Exercise regarding provision of Conscious Sedation in the 4 P a g e

5 PCDS services in the SW MCN region. Generic Referral Form. For everyone to use across the SW. Review of provision for Adults, Special Care and Paediatrics mapping across SW to give us some idea of the facilities we do have. Now linked in with HEE with Sam Braddock who is attending. Electronic drop box now in operation to collect documents and allow sharing. Secretarial support - DF asked where are we with this today and there seems to be none, RC is going back to them advising that they have had the money so must provide the service needed, AH advised that they will be going to UHB on 27 th July so will wait to hear what comes back from this talk. DF explained some back ground work needs to be done by the commissioners with providers to show what financial element for each area is, as the scoping exercise that has been done for special care shows that most of those services sit within a block contract and shows it is being lumped together with unscheduled dental care and minor oral surgeries 9 Orthodontic MCN An updated list of members is being collected, once verified it will be passed onto the Lynn Combes. Hopefully a system can be put in place where NHS England updates the MCN when new performers join the region. DF explained that this could be really difficult now that providers can put their own changes on COMPASS. The first MCN roadshow took place in April and the first regional MCN meeting took place in May. Ambitious plans are afoot for next year in this regard. JM has also met with colleagues in Devon at their local MCN meeting. PH-W asked JL if she could help and contact people, giving them the information about the MCN, she said she would be happy to put it out to any of the large group meetings she is doing to get the information out. Standardised referral form has been agreed and has completed its first pilot in Devon. A second trial in Bristol is about to begin. Waiting list data from referral practices has now been electronically realised and hopefully will be used for reporting this quarter. Audit - a regional audit has been agreed and will be conducted by one 5 P a g e

6 of the incoming senior SPr. The subject will be the standard of oral hygiene of referred patient s pre and post E- referral. Also, we are also in the process of electronically realising the previously piloted audit an discontinued and abandoned treatment. Waiting list protocol. Agreed at MCN executive level but issues have arisen in the Cornwall area due to geographical reasons. JM and AH are to visit the region shortly. Education. One of our MCN team delivered a talk to foundation dentists on referral protocols which hopefully will be an annual event. Options are also being considered regarding the format of an IOTN course which will form part of compulsory measures prior to inclusion in the regional performers list for non-foundation trained dentists. Speaking to such dentists in the region, it is quite clear many only know of IOTN once on the list and this has an impact on inappropriate referrals. A few options are available but costs are to be considered. MCN website. Currently the LAT website is being updated and we have been assured of a page which can be used for educational purposes and indicated waiting list times etc. until the E- referral is in place. This is also an option for the described IOTN course for non-foundation dentists described but is cost sensitive. 10 Restorative MCN No report and MJ not in attendance AH gave a brief update and said they are looking at the same issues as the other MCN s, referral guidelines and common referral form, looking at identification of enhanced skilled practitioners. MJ is looking identifying a deputy and there is a work plan in place. AH to ask MJ to update the LDN after this meeting. PH-W pushing to have consultant to triage the cases and then the work to go out to GDP s that have a special interest in restorative dentistry. AH said that he has asked MJ and the network to identify what the system should look at in the SW given the issues we have around access to consultants in restorative work, let s have a network solution which means we have more local access for fulfilling the restorative need. 11 Unscheduled Care Group PH-W asked DF if the SW survey is live now and DF explained that it has gone out to as many areas as she could get it out to. Presentation from Cumbria and the North East about unscheduled dental care at the LDN conference and RC seemed to think that they 6 P a g e

7 are looking to get 111 to work in a better way with dentistry. PH-W thinks that the SW survey will give good base line information and that using the experience of other areas will give the most information on how to move forward. There are some service specifications for 111 and clinical hubs that are being developed that can be used. 12 Locality Reports Cornwall - An open meeting has been postponed so if there were any dates or information on roadshows that would be a great time to promote them. JM asked if he could be ed the dates for the meetings, it was agreed that it would be circulated through the LDN group. Recruitment to workforce problems at the moment for providers, there has been no applicants to advertisement in the last 9-12 months. Cornwall setting up a young dentist group to try to get more interest for NHS dentists. Devon - Lack of bariatric treatment for bariatric patients. Bristol - Bariatric chair in Bristol but the practice will need converting as the waiting room chairs, toilet facilities are not set up for bariatric patients. PH-W would like the MCN s to consider having some regional centres for bariatric treatment and asked for it to be put on their agenda s. 13 Patient Participation PH-W was expecting someone from Cornwall health watch to come but no one has turned up. 14 Access to NHS Dentistry Seeing a difference in the South West for patients, the further west you go the worse it is. Commissioners are looking to procure extra capacity from providers this year in areas where we have a need and targeting providers who have delivered their contracts in the last two years. They will be offered but providers who have not delivered will not be. This is a short term solution while we have to look at the needs of areas. JL asked if therapists could do some of the work as she has 9 graduating and was wondering if they could be encouraged to stay in the South West. It was explained that they are doing it in private but not in NHS. 15 Oral Health Steering Group Still meeting on a quarterly basis agreed every six month the membership will be widened to include PDSW which is good for sharing good practice, sharing ideas, next meeting in September when this will happen. Extra LDN representatives needed for the steering 7 P a g e

8 group, DF asked if it needed to be a clinician and she would have a conversation with RC to see if she could sit on the group, JL asked if it would be appropriate if one of her tutors attended, as a deputy for JL. It was agreed that PH to drop JL an about this. PH asked if the sugar smart newsletter could be sent out to as many dentists as possible, it was agreed that this could be sent to FC to send out with the dentist bulletin. PH-W asked if the LDN thought sugar smart needs to be prioritised then he was happy to put it into the work plan but there was only so many things that could be prioritised, PH advised the chair that he was working on a piece of work looking at some of the themes into a draft for everyone to see so that there could then be looked at to prioritise as part of the oral health promotion. PH-W said it would be added to the agenda for the next meeting. 16 Antimicrobial Resistance Strategy MF has identified some my dental practices that have abnormal prescribing protocols and he is working on a system where he will do an audit on their current prescribing and the he will be going in to the practice and doing an educational session working with the dentist. Once that is over after a small amount of time re-auditing to see if there is any change in the dentist s behaviour. If it does it could be rolled out to other areas. JL said that they have been working on some data on prescribing and she is happy to share the results with MF. JL said that there an educational tool that could be used to validate training on prescribing, where there is a certificate given at the end. 17 Improving access for patients with dementia and learning difficulties. 18 AOB JL has an event being put on in Plymouth which she is opening up for some more practices. PH-W said that he has spoken to CP and she is happy to go out to practices to give them advice on patients with dementia. JL said there is an excellent free e-learning video called Barbara s story. PH-W asked if GDP s want OPT taken will JL do them in her trust, she said yes but they will charge for it. PH asked about the electronic referral system, AH explained that the deadline of Oct 2018 doesn t refer to dentistry. He is going to discuss with AF next week if we can procure a bespoke system, PH-W explained that he is happy for AH to make it know to AF that as an LDN we would be very disappointed if this doesn t go ahead. CB discussed the new commissioning of services dentist for conscious 8 P a g e

9 sedation is out. AH, RC and CB to meet and discuss. 19 Future Meetings Friday 29 th September, , Video Conference - AT2, South Plaza or Meeting Room 1 Peninsula House Friday 15 th December, , Video Conference - AT2, South Plaza or Meeting Room 1 Peninsula House 9 P a g e