Previous Exam Qs

Question 1

Define the term ‘collaborative practise’

Answer 1

= dynamic process when “multiple health care workers from different professional backgrounds work together w/ patients, families, carers & communities to deliver the highest quality care”

(WHO 2010)

Question 2

Give five reasons why collaborative practice may be important in improving health

Answer 2

• CP increases efficiency, quality of service delivery and access to care
• CP improves mutual trust & accountability from providers & results in better conditioned care
• CP reduces costs & saves time from preventing the duplication of efforts (e.g. prevents a patient from repeating the multiple blood tests or consultations with health care practitioners)
• CP takes a common risk factor approach (e.g. many non-communicable diseases share common risk factors with oral health conditions, dentists are front line medical professionals in the prevention & early detection of disease)
• CP can impact oral health related quality of life (e.g. poor oral health leads to decreased academic performance & adversely affect social development)

Question 3

Who would you collaborate with to organise training on oral health in nursing and care homes?
Please name 3 stakeholders

Answer 3

1. Adult Social Care w/in the local authority / Commissioners of care home services
2. Service providers (care homes)
3. Health & social care practitioners (managers, nursing staff, HCA)

Question 4

RECOMMENDATION #1

NICE Guidance 2017 ‘Oral Health in Care Homes’

Answer 4

Adults who move into care home should have their MOUTH NEEDS ASSESSED on admission (i.e. oral health assessment)

Rational:

1.1) self-care may deteriorate before a person moves into a care home (so may be admitted w/ poor oral health)

1.2) mouth care can be missed if not specifically assessed

1.3) allows tailored care to start straight away (nurse led assessment)

Question 5

RECOMMENDATION #2

NICE Guidance 2017 ‘Oral Health in Care Homes’

Answer 5

Adults living in care homes have their MOUTH CARE NEEDS RECORDED in their PERSONAL CARE PLAN

Rational:

2.1) makes sure action is taken to meet the person’s needs

2.2) mouth care needs are regularly reviewed

2.3) referral to local NHS dental services (collab w/ local dental services)

Question 6

RECOMMENDATION #3

NICE Guidance 2017 ‘Oral Health in Care Homes’

Answer 6

Adults living in care homes are SUPPORTED in MAINTAIN THEIR ORAL HEALTH

Rational:
Adults w/…

3.1) …natural teeth should brush w fluoride toothpaste 2x day

3.2) …full dentures should carry out daily care + remove dentures overnight

3.3) …natural + partial dentures should carry out daily care to both (collab w nurses / HCAs)

Question 7

Please provide a legal definition of Homelessness.

Answer 7

A household that does not have a house in the UK or anywhere else in the world that is available and reasonable to occupy

Question 8

What are the challenges in maintaining good oral health?
(5 marks)

Answer 8

1. Difficulties maintaining daily OH + poor habits
2. Neglect due to substance mis-use
3. Low OH expectations
4. Attitudes of dental teams
5. Lack of mobile, limited access to internet, travel issues + assume fixed address is needed to access services

Question 9

Which aspects of health promotion would you recommend to improve oral health outcomes?
Please justify your answer for each activity reasons and the evidence.
(8 marks)

Answer 9

1 - HOUSING & ONGOING SUPPORT BY COLLABORATION BETWEEN HEALTH, HOUSING & SOCIAL CARE
(e.g. GROUNDSWELL, which works w homeless population to offer opportunities to contribute to society, creates solutions to homelessness & advocates for healthcare access & policy changes)

2 - SUPPORT CONSISTANT EVIDENCE INFORMED ORAL INFO & INCREASE AVAILABILITY OF FLUORIDES
(e.g. training of front line staff on dental health by WTE)

3 - INTEGRATING ORAL HEALTH W/IN GENERAL HEALTH
(taking a common risk factor approach by REDUCING INTAKE OF SUGARY FOOD & DRINK, implementing higher taxation of sugary foods & SSBs & OFFER VBA ON TOBACCO & ALCOHOL to improve general health & combat other non-communicable diseases that share the same risk factors of dental disease)

4 - SIGNPOST TO LOCAL NHS SERVICES. PREVENSION & OUTREACH.
(e.g. PATHWAY, a homeless healthcare charity which helps NHS create hospital teams that support homeless pts: helping with housing/benefits advice, GP registration & linking w community services)

Question 10

Which aspects of health promotion would you recommend to improve oral health outcomes?

Answer 10

1) Housing + ongoing support

2) Collaboration between health, housing + social care

3) Support consistent evidence informed oral health information
E.g. Training of front-line staff on dental health

4) Integrating oral health within general health

5) Reduce intake of sugary food & drinks

6) Increase availability of fluorides, VBA on tobacco & alcohol

7) Signpost to local NHS dental services

8) Prevention & outreach

Question 11

How you design dental services locally for those experiencing homelessness?
(6 marks)

Answer 11

1. Flexible appointments
2. Friendly staff w/ positive attitude
3. Working within the benefits system
4. Service provision for homeless &/or hard-to-reach patients needs to be proactive with outreach
5. More collaborative & holistic care where dental services are communicating with hospitals, local councils and borough services to assist homeless patients
6. Organise transportation from shelters to health care services, including dentalpractices