A new mandate to NHS England from the Government is due to be published shortly and interested parties were invited to comment on a consultation document. Robin says the general thrust of the document is really good but some opportunities are being missed.
He argues that with improved communication between dentists and opticians and other health professionals such as GPs, children could be better protected. He wants to see dentists and opticians automatically included in the NHS Spine, just as GPs are. The NHS Spine is a secure database which links hospitals and GPs to patients’ NHS numbers. Giving dentists a database field within this software would mean they could check a child was linked to a dentist and thus follow up any concerns about the dental status of a child.
He added that dentist and opticians share a unique position within the NHS in that they are two groups of health professionals that should have regular recall contact with all children and can diagnose serious conditions not always easily detected elsewhere.
Dentists could be helping to care for and protect children as they have a significant role in safeguarding through identifying dental neglect and other child protection issues.
Robin stated: “Providing a child with easy access to a dental surgeon is a safeguarding requirement and not doing so is a failure to protect a child.” He also says that in areas where accessing a dental care service for children is difficult, the salaried dental services should be mandated to pick up these “missing” children.
There is quite rightly a focus in the consultation on the aging population, says Robin, adding: “but getting it right for children in oral health is known to have a beneficial effect later in life with low maintenance and low cost outcomes for the NHS.”
The NHS could also be saving money by addressing the shortage of specialist paediatric dentists, he argues. Transformation of “out of hospital” care is a priority for the Department of Health and this is a reasonable objective as hospital care is expensive.
There are exceptions, however and Robin observes that general anaesthetics for extraction of teeth in children can only take place in a hospital setting as this has been shown to be the safest and most appropriate environment. This is costing the NHS £30m annually in England alone.
He continued: “The shortage of paediatric specialists to carry out treatment planning for this service is not only more likely to lead to more repeat anaesthesia but may leave a legacy of more complex treatment requirements in later life. A substantial reduction in this £30m could be achieved by more specialist care.”
He suggests that there should be a network of specialist centres for treatment of children and planning of their care under general anaesthesia in the existing District General Hospital infrastructure together with a better distribution of specialists around the country.
BSPD would also like to see a preventive programme introduced in England like the successful Childsmile in Scotland which would ultimately reduce the unacceptable number of children requiring dental treatment under general anesthesia in England.
“It cannot be emphasised enough that a programme such as this utilising early and effective prevention has the potential to significantly save on both child and adult treatment costs.”