Abstract
BackgroundThere is a need to improve access to, and the quality of, service delivery in NHS primary dental care. Building public health thinking and leadership capacity in clinicians from primary care teams was seen as an underpinning component to achieving this goal. Clinical teams contributed to service redesign concepts and were contractually supported to embrace a preventive approach.MethodsImprovement in quality and preventive focus of dental practice care delivery was explored through determining the impact of several projects, to share how evidence, skill mix and clinical leadership could be utilised in design, implementation and measurement of care outcomes in general dental practice in order to champion and advocate change, during a period of substantial change within the NHS system.The projects were:1. A needs-led, evidence informed preventive care pathway approach to primary dental care delivery with a focus on quality and outcomes.2. Building clinical leadership to influence and advocate for improved quality of care; and spread of learning through local professional networks. This comprised two separate projects: improved access for very young children called “Baby Teeth DO Matter” and the production of a clinically led, evidence-based guidance for periodontyal treatment in primary care called “Healthy Gums DO Matter”.ResultsWhat worked and what hindered progress, is described. The projects developed understanding of how working with ‘local majorities’ of clinicians influenced, adoption and spread of learning, and the impact in prompting wider policy and contract reform in England.ConclusionsThe projects identified issues that required change to meet population need. Clinicians were allowed to innovate in an evironment working together with commissioners, patients and public health colleagues. Communication and the development of clinical leadership led to the development of an infrastructure to define care pathways and decision points in the patient's journey.
Highlights
There is a need to improve access to, and the quality of, service delivery in NHS primary dental care
Communication and the development of clinical leadership led to the development of an infrastructure to define care pathways and decision points in the patient’s journey
Case study 1: Primary dental care service redesign As this was the first project initiated, there has been a greater period of time to assess the outcomes and the impact of the project
Summary
There is a need to improve access to, and the quality of, service delivery in NHS primary dental care. Public health clinicians understand the wider meaning of innovation and quality and are well placed to stimulate ‘public health thinking’ and awareness of the need for change within clinical teams They understand factors that facilitate and hinder progress in commissioning and contracting systems, to challenge the status quo, and can work objectively with commissioners and clinicians to test new principles and approaches to the delivery and contracting of care to improve quality, value and outcomes to benefit patients. This paper will describe dental public health initiatives, and the impact they have had, through several case studies These projects facilitated in the North of England have stimulated clinicians to become local leaders, they have influenced institutions, organisations and policy makers and most importantly have had an impact on the quality, value and outcomes of care delivery to benefit patients. Clinicians are encouraged to develop leadership skills and be involved in the process of commissioning decisions and service redesign
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