Urgent Dental Care Consultation Engagement Report

70 Pages·2015·0.9 MB·English

Urgent Dental Care
Consultation Engagement Report

November 2015
Contents Page

No Contents Page No
1 Introduction 3
2 Executive Summary 4
2.1 Consultees, Distribution and Publicity 4
2.2 The Consultation and Public Meeting 4
2.3 Seldom Heard Groups and Outreach Events 5
2.4 Responses and Consultation Results 5
2.5 Key Stakeholder Response 6
3 The Results: Online and Easy Read 9
3.1 Q1 Have you used urgent dental care services in the last 12 9
months?

3.2 Q2: Where did you access urgent dental care services? 11
Proposed changes and options on improving urgent dental care for
Leicester, Leicestershire and Rutland
3.3 Q3: Your two choices are: 16
3.4 Q4 If ticked option 1. Please put a tick by the times you would like 25
the urgent dental care service to be open.

3.5 Q5: If choosing Option 2 Urgent and Routine Dental Care, please 27
indicate where you would like the new potential service(s) to be
located,
3.6 Q6: If you ticked 'Choice 2' please put a tick where you would like 29
the new services to be?
3.7 Q8: Why did you choose this option? 32
3.8 Q9: Overall how satisfied are you with how you have been 38
consulted?
3.9 Q10: Do you have any further comments on the consultation 39
process?
3.10 Q11: If you would like to comment on ways to improve access to 41
NHS dental services’
4 Conclusion 48
Appendix A: Publicity and Distribution 49
Appendix B ‘Targeted Engagement Events’ 51
Appendix C: Equalities Monitoring (online and easy read) 53

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1. Introduction

The Urgent Dental Care Public Consultation ran from 3 August 2015 – 1 November (midnight)
2015.

The consultation asked for feedback from the key stakeholders but was also distributed more
widely in order to ensure that as wide a population as possible within Leicester, Leicestershire and
Rutland was represented, particularly those from ‘seldom heard groups’.

This document gives a full report of the feedback received during the consultation, including
feedback recorded at public engagement meetings. Feedback was received in the form of minutes
from meetings, answers to questionnaires (both online, hard copy and easy read) and discussions
undertaken at engagement events.

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2. Executive Summary

NHS England is responsible for commissioning NHS dental services to meet local needs.

Currently urgent dental care services within Leicester, Leicestershire and Rutland (LLR) are under
procurement and engagement work surrounding this consultation was commissioned to
understand how patients would like to access urgent dental services in the future.

This consultation focused on two possible options of how this service could be accessed in the
future for the population of LLR.

2.1 Consultees, Distribution and Publicity

Information concerning the consultation was extensively distributed to a wide range of key
stakeholders and other related healthcare professionals and groups. A full list can be found in
‘Appendix A: Distribution and Publicity’. Organisations contacted during this time included the
Leicester Dental Committee, Health and Wellbeing Boards and Health Overview and Scrutiny
Committees, the Local Medical Committee and Clinical Commissioning Groups across LLR

In addition, information and access to the consultation was made available to all LLR dental
practices, GP practices, Pharmacies, Libraries and Local Community Centres. Promotional
material and hard copy surveys were also made available within Leicester Royal Infirmary
Accident and Emergency department and urgent care centres in East and West Leicestershire.

Further publicity through online and social media outlets was also conducted with organisations
throughout the consultation by utilising established networks. For example Healthwatch across all
localities, Voluntary Action Leicestershire and local universities and student unions due to the large
cohort of students that Leicestershire attracts. The consultation was also promoted through the
local press and was publicised in the Leicester Mercury and Hinckley Times.

More detail of the consultation documents, distribution and consultation events is at Appendices A:
Distribution and Publicity and Appendix B: Targeted Consultation Events Distribution.

2.2 The Consultation and Public Meeting

A consultation document was developed containing information such as the availability and
accessibility of the current service, methodology on how the two proposals were reached, local
dental health needs of the population and the consultation survey outlining the two proposals on
how access to urgent care dental services could be potentially provided in the future.

An easy read version of the consultation document including the survey was also produced and
was distributed to ‘seldom heard groups’. This survey was also discussed at targeted consultation
events. A public meeting was organised on 7 October 2015 and although only a small number of
people attended, provided useful feedback.

A full list of the targeted consultation events and outreach conducted can be found at ‘Appendix B:
targeted consultation events’. This also shows a brief summary of discussions undertaken at each
event.

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2.3 Seldom Heard Groups and Outreach Events

During the consultation a variety of targeted engagement work was carried out with ‘seldom heard
groups’ across Leicester, Leicestershire and Rutland such as travelling family communities, the
homeless within the city and county, Action Deafness and Vista Blind. Outreach was also
conducted within the LLR community, for example within leisure centres, and libraries.

A full list can be found in ‘Appendix B: Targeted Consultation Events’.

2.4 Responses and Consultation Results

In total 322 responses were received through the online and easy read survey.

In addition a further seven responses were received after the consultation in response to
engagement that commenced within the consultation period. Two of the seven are from
professionals providing their opinion on behalf of their service users (homeless shelters) and the
remaining five are from the travelling family community within the county.

Key Summary Points:

 Preferred Option: From the 322 responses in total across both of the surveys available,
approximately 82% selected option 2; just under 20% of the total response chose option
one.
 Preferred second location in addition to Leicester city: Loughborough is the clear choice for
a second location for dental access in addition to Leicester city; approximately 37% chose
this location from 254 responses received from the online or easy read survey.

 Analysing responses received for ‘option 2’ by age and locality of responder indicates there
is a clear preference to have this across all ages and Leicestershire districts and not solely
from those who live in the county.

 Previous access to urgent dental care services preferred option
- Approximately 74% of those who have accessed urgent dental care services within the last
12 months have chosen option two.

 Overall reoccurring themes
- There appears uncertainty from those who completed this survey where to go if requiring
urgent dental care out of hours.
- The majority of people completing this survey do not know what services are currently
available for urgent dental care.

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2.5 Key Stakeholder Responses

In addition to the responses provided via the consultation survey, meetings were held with
committees such as the Local Dental Committee and Health Overview and Scrutiny Committees
minutes of the meetings have been displayed below.

Leicester Health and Wellbeing Board on 27 October

Members of the Board made the following comments:-

a) It was difficult to state a preference between the two options as they were not readily
comparable. The parameters of services in Option 2 were far in excess of Option 1 but at
unknown locations; whereas Option 1 was located in the City where 80% of users of the
urgent care services lived.

b) If there was capacity within the existing dental services, the need to promote and offer
‘routine’ dental services at the urgent care service was questioned. It may be better to
signpost patients to dentists with capacity and encourage registration with them so that on-
going care can be provided.

c) Healthwatch received a number of calls daily from people wishing to go to an NHS dentist
and there was a difficulty recommending a dentist that was known to have spare capacity.
It would appear there was a mismatch of dental services availability and it would be helpful
if NHS England supplied a list of dental practices that had spare capacity.

d) There was evidence that in LE2 and LE5 post code areas there was no capacity as people
were waiting 6-8 months to apply to see a local dentist.

e) As 80% of the users of the urgent dental care services were currently living in the City, it
was queried whether there would be a guarantee that their needs would be catered for in
whichever option was adopted. It was important to have a service where City patients did
not have less access to the service that the current need clearly demonstrated exists within
the City.

f) It needs to be recognised that car ownership in parts of Leicester with low levels of NHS
registration is less than 50% and this has a major effect upon people’s ability to travel,
whereas car ownership in the county is higher. A city centre location is accessible by public
transport, but travel is more difficult across the City and into county areas.

In response to comments made by Members of the Board it was stated that:-

a) Not every patient contacting the services requires treatment as advice may be given.
b) There were parts of the population that don’t engage regularly with dental services until
they have an urgent care need.
c) Part of the rationale for offering ‘routine’ dental care services was to address the pockets
around the County where there was a need to improve access to dental services
particularly in relation to children. Currently only 20% of 0-2 years olds had been seen by a
dentist and NHS England were working with local dental practices to encourage increased
levels of attendance so that preventative advice could be given.
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d) Dental practices have not been required to register patients since 2006, they were however
required to see patients until a particular course of treatment had been completed. Dental
practices now maintained ‘lists of patients’ that they saw over a regular period.
e) A list of dental practices was supplied to Healthwatch on a monthly basis, but it was
recognised that there were pockets of demand where people were reluctant to travel to see
a dentist.
f) There could be more than one provider for the service and the provider would have to
guarantee the service was available during the contracted hours of operation.
RESOLVED:
1) That the Board does not feel able to indicate a preference for either Option 1 or Option 2
on the information currently provided. However, the Board would expect that whichever
model of care was eventually chosen that it would provide as a minimum level of service:-
i) The current urgent dental care capacity provided in the City would be sustained.
ii) The opening hours of access to the service would be a minimum of 9 am to 7 pm
Monday to Friday and 6 am to 6 pm at weekends and Bank Holidays.
iii) That the service would be delivered from a city centre location which was both central
located and easily accessible.
2) That the Board receive a further report in the future focussing on the strategic provision of
dental services and strategies for achieving higher levels of dental registration.

Hinckley and Bosworth Scrutiny Committee: 13 August

During discussion which followed the presentation, the following points were made:

 The current lack of capacity in urgent care dentistry, contributing to the need for this review
along with the forthcoming end of contract
 The reduction in use of the out-of-hours service, perhaps due to lack of awareness
 Poor public transport links to rural areas
 Co-ordinating services with neighbouring areas
 Some practices provided their own out-of-hours services, but this wasn’t a requirement.

Members generally felt that, whilst it wasn’t an option under the consultation, the public would
prefer that their own dentists provided appointments at times convenient for those who worked
‘office hours’. The Chairman asked members to complete the consultation questionnaire and to
encourage others to do so. It was also requested that the Health & Well Being Board be asked to
look at the consultation and co-ordinate a response.

Leicestershire Health Scrutiny Committee: 9 September

The Committee considered a report of NHS England Central Midlands, which provided members
with an opportunity to respond to the dental consultation and pre-engagement process being
undertaken in Leicester Leicestershire and Rutland (LLR) and Lincolnshire to inform dental
procurement programmes in 2016. A copy of the report marked “Agenda Item 15” is filed with tis
minutes.

The Chairman welcomed Andrea Clarke, Senior Communications and Engagement Manager from
GEM, Semina Makhani, Consultant in Dental Public Health and Razia Noormahomed, Support
Contract Manager from NHS England.
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(i). It was noted that the highest numbers of patients accessing urgent dental care in the County
came from Coalville and Market Harborough. It was suggested that consideration be given to siting
one of the 8 to 8 centres in one of those towns. However, members were advised that there were
already two dental practices offering urgent care in Coalville so this might not be appropriate. Site
choice would be based on factors such as transport facilities and what else was available in the
area.

(ii). Members queried how seldom heard groups would be engaged with during the consultation,
as they were most likely to require urgent dental treatment. This would be achieved through
making the consultation available at the Dental Access centre, assuring contacts for seldom heard
groups to cascade the information and asking GPs to publicise it.

(iii). Members were pleased to note that people with severe dementia were treated by special
care dentistry and suggested that this should be clarified in the documentation.

RESOLVED:

(a) That option 2, “8am to 8pm service providing NHS urgent and routine dental care in two
locations” be supported;

(b) That officers be requested to produce a formal response to the consultation on urgent
dental care and forward it to NHS England Central Midlands.

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3. The Results: Online and Easy Read

 Online survey response: 302
 Easy read response: 20
 In addition a further seven responses have been received during the consultation (two from
homeless shelter support workers and five from travelling families)

3.1 Q1: Have you used urgent dental care services in the last 12 months?

Online Survey

 Total response: 287 from 302
 Response rate: 95.0%

Option Total Percent of All
Yes 59 19.54%

No 228 75.50%

Not Answered 15 4.967%

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Q1: Have you used the Urgent Dental Care Service before?
 Total response: 18 from 20
 Response rate: 90%
Easy Read Results

Option Total Percent of All
Yes 1 5.00%

No 17 85.00%

Not Answered 2 10.0%

Data Analysis

From those who responded to the online survey and easy read approximately 20% have accessed
urgent dental care services in the last 12 months.

Engagement

Engagement work undertaken during this consultation revealed a high proportion of people have
not accessed urgent dental care services and were not aware of what services are available. This
consultation provided the opportunity for people who responded to both of the surveys to view
what services are available and how to access them.

Those individuals who were aware of the available current urgent dental care services had either
directly accessed these services or were from professions associated with particular organisations
that require this knowledge to inform their service users. For example support workers at homeless
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