An Action Plan for Improving Oral Health and Modernising NHS Dental Services in Scotland

Executive response to the Children's Oral Health Consultation and Moderning NHS Dental Services in Scotland


AN ACTION PLAN FOR IMPROVING ORAL HEALTH AND MODERNISING NHS DENTAL SERVICES IN SCOTLAND

ACTION PLAN SUMMARY 2005-2008 APPENDIX

This summary shows the main actions from the Action Plan, together with key milestones, responsibilities and impact. Together these actions are intended to deliver the overall health improvement targets listed below, as well as the specific targets outlined in the more detailed Action Plan.

Health Improvement Targets

By 2010

For 5 yr olds (Primary 1)

60% with no signs of dental disease

For 11 yr olds (Primary 7)

60% with no signs of dental disease (in permanent teeth)

for adults

90% of adults with some natural teeth
65% of adults aged 55-74 yrs with some natural teeth

By 2015 oral cancer

Reverse current declining trends in oral cancer 5 year survival, for males, by 2015

The summary actions are shown under the following headings which refer back to the main Action Plan.

1. Oral Health and Prevention

(a) Children
(b) Adults

2. Workforce and Workforce Development

(a) Dentists and PCDs
(b) Supporting the Team

3. Modernising Dental Services

(a) NHS Dental System
(b) Patients, Standards and Quality Assurance

Oral Health and Prevention: (a) Children

Target Groups: Pre-school and School Children

Actions

Milestones

Responsibility

Impact

Implement comprehensive programme for 0-2 yrs initially in areas of greatest need thereafter to the rest of Scotland

2005 Health Visitor referral scheme starts in areas of greatest need

2006 Scheme reviewed and rolled out nationally

SEHD

NHSBs

Improved oral health

Increased registrations 40% target

Implement nursery
and schools preventive programmes

Initiate salaried children's dental service

2005 Nursery and school expansion programme starts in areas of greatest need

2006 Programme reviewed and rolled out nationally

2007 Expand children's local /mobile dental services

SEHD

NHSBs

Local Authorities

Improved prevention in 3-12 yrs

Implement changes to children's services in general dental services

2005 New childrens allowances

2006 Child friendly practice allowance introduced for those allowing open access to children

2006 Extend the use of fissure sealants to children aged 12-14 yrs

SEHD

Family dentists motivated to deliver patient/child friendly services

Child registrations increase

Expand oral health programmes

2006 90,000 nursery children and 250,000 primary school children brushing daily

2007 Local or mobile clinical services available to all high need schools

2007 All schools supporting healthy eating and drinking (water) policies

2007 All secondary schools will have an oral health promotion programme

NHSBs

Local Authorities

Registrations increase in Scotland on an annual basis from 2006

0-2 35% 40% 50% 55%

3-5 66% 70% 75% 80%

6-12 75% 80% 85% 90%

Reduction in oral disease across school age and future adult population

Oral Health and Prevention: (b) Adults

Target Group: Adults including those with Special Needs

Actions

Milestones

Responsibility

Impact

Health Boards develop oral health promotion programmes for adults

(Workplace, prisoners, homeless and special needs)

2007 New health promotion packages in use at NHS Boards

NHS Health Scotland

NHS Boards

Prison service

Better understanding of dental health issues by those in most need

Changes to structure of dental services for adults including extending registration

2005 Phase one of programme

2006-2007 Further changes in line with proposals

SEHD

Increase registration especially in the elderly/special needs

65-74 yr olds from - 40% to 60%; 75 yrs and over from 28% to 40 %

Oral examination free for those 60 and over

All NHS dental examinations free

2005 60 + Free examinations

2007 All adults

SEHD

Better preventive advice and support, and surveillance of oral cancer

Workforce: (a) Dentists and PCDs

Target Group: Dentists and Professionals Complementary to Dentistry

Increase number of dentists by at least 200 over present number, at an average rate of 50 per year

2005 Allocate new salaried posts to boards

2006 Revised recruitment and retention package

2006 Revised rural/remote recruitment package

NHS Education

SEHD

NHSBs

Service better able to meet patient needs across Scotland

Increase dental student numbers to achieve dental graduate increase to target of 135

2006 136 graduates

2008 143 graduates

SEHD

Universities

NHS Education

Increased workforce for future

Vocational training post for all dental graduates

2005 135 posts funded

2006 145 posts funded

2007 155 posts funded

SEHD

NHS Education

Maximum numbers trained

Increase PCD (therapist/hygienist) student numbers

2005 30 student intake

2006 35 student intake

2007 45 student intake

SEHD

NHS Education

NHSBs

Increased workforce for future

Introduce dental therapist vocational training places

2006 match posts to student places

SEHD

NHS Education

NHSBs

More trained support staff

Expand dental nurse training to 250/year

2005 National dental nurses teaching pack for 150 nurses

2006 Increase to 250 nurses

NHS Education

NHSBs

More trained support staff

Introduce a bursary scheme for dental

students linked to NHS commitment

2006 Implementation of first phase

SEHD

Encouraging and supporting recruitment into dental careers

Workforce: (b) Supporting the Team

Target Group: Dental Teams

Actions

Milestones

Responsibility

Impact

Develop a career structure for primary care dentists and PCDs

2006 Identify new career structure including rewards for practitioners with special interests

SEHD

NHSBs

Reduce referrals to specialist services

Deliver services closer to patient

Reduce waiting lists

Return to work programmes

Retain older dentists

2006 Identify clear routes for both to contribute to dental services with appropriate recruitment incentives and education

SEHD

NHSBs

Retain more dentists and dental team members

Develop the role of the team members

§ Nurses to health promotion

§ Therapist to adult and elderly care as well as children

§ Practice managers and receptionists

2006 Launch dental team programme for education development and support of all members of the dental team

NHS Education

Whole team contribution to workforce

Develop proposals for better incentives for dental staff to be part of the NHS

2006 NHS pension scheme for practice staff

SEHD

Whole team contribution to workforce

Develop outreach training in Aberdeen and other locations

2005 Outreach in Community clinics Aberdeen Glasgow and Argyll and Clyde

2006 New Outreach centre Aberdeen

2007/08 Outreach centres Inverness/Dumfries

SEHD

NHS Education

NHSBs

Encourage dental service expansion in rural/remoter parts of Scotland

Extension of the remote areas allowance

2006 Introduce extended remote areas allowance scheme

SEHD

Support remote practices

Develop further incentives for dentists to open up new facilities in areas of high need /demand

2006 Introduce new incentives

SEHD

Encourage expansion of dental services in areas of greatest need/demand

Modernising Dental services: (a) NHS Dental System

Target Group: Dental Professionals; NHS Boards

Actions

Milestones

Responsibility

Impact

Implement new remuneration system for dental practices

2005 New reimbursements for premises, IT and services.

Changes to general dental practice allowance

2006 Changes to registration system and capitation payments

Simplification of Statement of Dental Remuneration

Guidance on local contracting by Boards

SEHD

NSS

NHSBs

Fairer reward system for dentists

Programme of premises improvements

2005 New reimbursement scheme to meet rental or equivalent costs

New improvement grant scheme

2006 Updated premises development scheme

2006 Scheme to support financially the move of practices to new premises

SEHD

NHSBs

NSS

Fairer reward system for dentists

Premises of required standard to meet professional and patient requirements

Implement programme of IT improvements

2005/06 Connection of practices to NHS net

2005 Specification of approved clinical systems

2006 New reimbursement system for practices

SEHD

NHSBs

NSS

Improved clinical communications within dentistry and with rest of NHS

Modernising Dental Services: (b) Patients, Standards and Quality Assurance

Target Group: Patients; Dental Professionals; NHS Boards

Actions

Milestones

Responsibility

Impact

Improve access for patients to routine and emergency care

2005 Increased funding to Boards to provide out-of-hours services

Revised dental access scheme

Boards given authority to support salaried practitioners

Boards provide help-line for local people

2006 Integrated NHS24/NHS Boards system for out-of-hours/emergency care

SEHD

NHSBs

By 2008, 400,000 additional patients with access to NHS dental services

Implement quality improvement programme for dental services

2005 Develop accreditation scheme with support to practices

2006 Develop quality award scheme

Implement support programme for dentists with special interests

2006/07 Publish clinical guidelines for range of services

SEHD

NHSBs

Standards in dental practice quality assured

Introduce new system of patient charges

2005 Review current system

2006 Implement new system

SEHD

Patient Groups

Professional Groups

Fairer and simpler system

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