An audit investigating outcomes of referrals rejected from Surrey PCT (now NHS England)'s oral surgery triage service

Abstract

Aim To conduct an audit investigating the treatment outcomes of patients whose referrals were rejected from Surrey Primary Care Trust [now National Health Service (NHS) England]'s Dento-Alveolar Referral Service (DARS – an oral surgery triage service) in order to ensure that the system is safe and effective for patients and dentists. Methods Data about referrals rejected by DARS between September 2011 and February 2012 were collected from the referral management centre. A short questionnaire was sent to the dentists of the patients rejected, requesting details of treatment outcomes for the patients involved. Results Two per cent of all referrals received were rejected during this period. Ninety-one per cent of questionnaires sent out were returned. The majority of dentists (87%) had only one referral rejected. The most frequently rejected teeth were upper third molars. More than half of rejected referrals (55%) were subsequently treated within the patient's own dental practice. Seven per cent of rejections were re-referred to DARS and accepted when extra information was provided. The remaining 38% either did not return (16%), were kept under review (14%), or were treated in other locations (8%). Of 23 extractions attempted by the referring dentist, only two (9%) involved minor complications. Conclusions Patients rejected from DARS are generally being treated successfully elsewhere. This small study suggests that DARS does not put patients at risk. The Local Dental Committee agreed that dentists were not being forced to work outside their competencies. The referral criteria and rejection process should remain the same. NHS England must continue to identify and support training needs amongst referring dentists.