Guide for Commissioning Oral Surgery and Oral Medicine

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CLASSIFICATION OFFICIAL,NHS England INFORMATION READER BOX. Directorate, Medical Commissioning Operations Patients and Information. Nursing Trans Corp Ops Commissioning Strategy,Publications Gateway Reference 03083. Document Purpose Guidance, Document Name Guide for Commissioning Oral Surgery and Oral Medicine Specialties. Author Resource Author NHS England Chief Dental Officer team. Publication Date 29 September 2015,Target Audience NHS England Dental Commissioners.
Additional Circulation Dental Public Health Team Local Dental Network Local Dental. List Committees Clinical Directors CDS Health Education England Dental. Leads Dental Schools Deans Local Authority Directors of Public. Health British Dental Association Leads National Dental Associations. and Organisations NHS England Regional Directors, Description This document is to be used by commissioners to offer a consistent and. coherent approach They describe the direction required to commission. dental specialist services They will improve dental care and outcomes. for patients ensure they receive the highest quality dental care in the. most appropriate setting by professionals with the required skills whilst. ensuring value for money, Cross Reference This is part of a suite of documents including Guide for Commissioning. Specialist Dentistry Services Introduction Guide for Commissioning. Orthodontics Guide for Commissioning Special Care Dentistry. Equality Health Inequalities supplement,Superseded Docs. if applicable,Action Required,Timing Deadlines,By 00 January 1900. if applicable,Contact Details for Dionne Hilton,further information Area 6 B.
Skipton House 80 London Road,07919 573 382,Document Status. This is a controlled document Whilst this document may be printed the electronic version posted on. the intranet is the controlled copy Any printed copies of this document are not controlled As a. controlled document this document should not be saved onto local or network drives but should. always be accessed from the intranet,1 Foreword 5,2 Equality and Health Inequalities Statement 6. 3 Executive Summary 7,4 Introduction 10,5 Description of the specialties 11. 5 1 Oral Surgery Oral Medicine 11,5 2 Related specialties 11. 5 3 Description of the current national picture 11. 5 4 Description of training and the current workforce 12. 5 5 Description of the complexity levels 15,6 Summarised Illustrative Patient Journeys 20.
6 1 Oral Surgery 20,6 2 Oral Medicine 21, 7 Commissioning Oral Surgery Oral Medicine services 22. 8 Understanding need and current service provision 24. 8 1 Local population profile 24, 8 2 Needs assessment data specific to the commissioning of Oral Surgery and. Oral Medicine specialist services 24, 8 3 Tools which enable more precise Oral Surgery and Oral Medicine needs. assessment 27,8 4 Service analysis 28,8 5 Oral Surgery and Oral Medicine referrals 33. 9 Transforming Oral Surgery Oral Medicine services 38. 9 1 Current models and challenges 38,9 2 Workforce implications 39.
9 3 Service redesign 41, 10 Illustrative journey of a patient elective Oral Surgery care 44. 11 Illustrative journey of a patient Oral Medicine 54. 12 Procuring Oral Surgery Oral Medicine services 63. 12 1 Minimum standard specification 63,13 Quality and outcome measures 68. 13 1 Quality and Outcome Key Assessment Areas 68, 13 2 Oral Surgery and Oral Medicine Patient reported Experience Measures. 13 3 Patient Reported Outcome measures PROMs 69,13 4 Clinical Outcome Measures 72. 13 5 Value and Impact 72,13 6 Quality Assurance 73.
14 Contracting 75,14 1 Regulation 75,14 2 Enablers for delivery 76. 14 3 Minimum standard data collection and reporting 76. 15 Next steps 81, Appendix 1 Membership of the Oral Surgery and Oral Medicine Working. Appendix 2 Glossary of Terms 83, Appendix 3 Oral Surgery Specialty Training Learning Outcome90 87. Appendix 4 Outcomes91 88, Appendix 5 Competency Framework for Oral Surgery practitioners 89. Appendix 6 Specialist Dental Services Referral Form Examples 91. Appendix 7 Example of Primary Care Based Specialist Oral Surgery Services. Appendix 8 Example of Transformation of Services 95. Appendix 9 Coding used by Secondary Care Oral Surgery OMFS departments. 1 Foreword, NHS England produced the Five Year Forward View to set out a shared view of the.
challenges ahead and the choices about health and care services in the future it. applies to all services including dentistry, This consensus on the need for change and the shared ambition for the future is the. context in which these Commissioning Guides for Dental specialties have been. produced Clinicians commissioners and patients have contributed to this work to. describe how dental care pathways should develop to deliver consistency and. excellence in commissioning NHS dental services across the spectrum of providers. to benefit patients, In order to deliver this vision and implement the pathway s a coalition of the willing. NHS England partners HEE and PHE specialist societies and others who have. contributed to their development will need to respond in the implementation phase by. unlocking structural and cultural barriers to support transformational change in dental. service delivery, It s a future that will dissolve the artificial divide between primary dental care and. hospital specialists one that will free specialist expertise from outdated service. delivery and training models so all providers can work together to focus on patients. and their needs, These guides set out a framework and implementation and the pace of change will. vary across England This will be an iterative process therefore it will be necessary. to review and update these guides regularly However implementation will require. energy brave decisions and momentum together with a willingness to share good. practice innovation and learning as it emerges to accelerate the speed and impact. of change to improve patient care,2 Equality and Health Inequalities Statement.
Promoting equality and addressing health inequalities are at the heart of NHS. England s values Throughout the development of the policies and processes cited in. this document we have, Given due regard to the need to eliminate discrimination harassment and. victimisation to advance equality of opportunity and to foster good relations between. people who share a relevant protected characteristic as cited under the Equality Act. 2010 and those who do not share it and, Given regard to the need to reduce inequalities between patients in access to. and outcomes from healthcare services and to ensure services are provided in an. integrated way where this might reduce health inequalities. 3 Executive Summary, It is now widely recognised that the NHS needs transformational change to services. in order to deliver better outcomes for patients and to ensure that we commission. effectively, Progress has been made in improving oral health and access to services in general. However inequality in oral health experience and inequity in access to primary and. specialist care exists These guides focus on the commissioning and delivery of. specialist care pathways however the gateway to specialist care relies on access to. efficient and effective primary dental care services Whilst there has been some. improvement in general access over the past few years commissioners need to. ensure that they continue to meet their duties to commission primary care services. appropriate to the needs of their populations This mean making effective use of. available resources by challenging primary care providers to deliver care to those. who need it most and by adopting appropriate recall intervals for those who can be. seen less frequently freeing capacity for access by new patients Achieving. improvements in access to primary care will widen access to specialist care for those. who need it, NHS England has developed these guides for commissioning dental specialties to be.
used by commissioners to offer a consistent and coherent approach They describe. the direction required to commission dental specialist services This will reflect the. need and complexity of patient care and competency of the clinician required to. deliver the clinical intervention rather than the setting within which the care is. delivered Care will be delivered via a pathway approach which will provide clarity. and consistency for patients the profession and commissioners There will be. nationally agreed minimum specifications for each service including how quality and. outcomes are to be measured which can be enhanced locally. They will ensure there is national consistency in the NHS commissioning offer for. dental specialist services and how they are delivered The pathway will also provide. consistency across England in agreeing at a national level as much of the detail. around commissioning such as referral criteria core data set required on referral. quality of environment and equipment contractual frameworks etc as well as. consistent measures of quality and outcomes The frameworks describe the concept. of clinical engagement and leadership through Managed Clinical Networks MCNs. which will work closely with commissioners Dental Local Professional Networks. LPNs and describe and monitor the patient journey from primary to specialist care. The first phase of this work during 14 15 has included developing frameworks for the. following specialties Orthodontics Special Care Dentistry Oral Surgery Oral. Medicine and Restorative dentistry Further work on restorative mono specialties. Paediatric Dentistry and Supporting Specialties Dental and Maxillofacial Radiology. Oral Microbiology and Oral and Maxillofacial Pathology will follow. NHS England is committed to working and engaging with patients carers and the. public in a wide range of ways Throughout this process we have ensured that. people s views are heard through having patient representatives on every group and. by convening a patient review group who have helped us develop the content This is. outlined in detail in the patient engagement and stakeholder engagement. appendices, Moreover it must be understood that ultimately it is the patient who should make the. decision about what treatment if any to undergo The practitioner s role is to advise. on treatments and options and benefits and risks This discussion between patient. and practitioner should form the beginning of every patient journey and every. specialist care pathway That includes patient consent to the information sharing. needed for their journey along a pathway, The process of developing these patient involvement frameworks has also included. engagement with every stakeholder group that has an interest in dentistry as. outlined in the acknowledgments stakeholder engagement appendix and. governance model in the appendices, This is the beginning of a process Locally commissioners need to undertake work. to understand the specialist services that are currently being provided by who and. where The quality and quantity of those services together with the impact and cost. also need to be identified before any change or procurement takes place Many. commissioners and clinician have already made progress on aspects of this. approach locally However they need to measure themselves against enablers. within each of the guides to understand what needs to happen next and agree local. priorities Commissioners will need support to identify current dental resources so. decisions can be made to ensure flexibility For example establishing MCNs may. require investment or flexibility in contracting such as the use of Commissioning for. Quality and Innovation Payments CQUIN The work of developing the. commissioning guides has identified a number of examples of innovative solutions. and exploiting flexibility in current contracting forms Locally commissioners will. need to consider investment and contractual flexibility to support the implementation. of new care pathways The implementation of care pathways could deliver efficiency. gains in some areas however there may be a need to consider the use of these. savings as investment to pump prime change in other areas of dentistry The next. phase of this work could support the validation and sharing of solutions to harness. and communicate examples of good practice and innovation Some of the identified. enablers will be more difficult to implement at a local level however nationally NHS. England could support identified enablers to become a reality An example would be. expanding the use of the NHS number within dentistry. There will be a particular emphasis on helping commissioners understand the. financial impact of implementing the commissioning guides by providing an estimate. for the associated upfront costs along with any expected financial savings to the. NHS The initial work will involve needs assessment understanding current. provision enabling consistent data collection and coding Implementation support will. also include the development of a commissioning pack to encourage effective and. consistent commissioning to benefit patients Work on an additional set of guides will. also take place during this phase focusing on Paediatrics the Supporting Specialties. Dental and Maxillofacial Radiology Oral Microbiology Oral and Maxillofacial.

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