Structure of NHS Dentistry

Question 1

Dental service organisations - types of care?

Answer 1

Primary care:
Salaried
General dental

2ndry care: General hospitals
Tertiary care: Dental hospital

Question 2

What is primary care?

Answer 2

First point of contact for the public
Locally based
Includes GMP, GDP, opticians, pharmacists

Question 3

What is secondary care?

Answer 3

Specialist care = specialist services, based mainly in hospitals
E.g ambulance trusts, foundation trusts

Question 4

Role of salaried primary dental care services?

Answer 4

Provide full range of tx to pts who are unable or unwilling to obtain tx from GDS including:

• Children and adults with learning disabilities
• Anxious pts
• Pts requiring domiciliary care
• Other problems including homeless, drug/alcohol problems

= Require extra time and expertise

Specialist service for provision of GA for children and adults

Care provided by

• Dental officers
• Specialists
• Consultants in special care dentistry and/or paediatric dentistry

Staff = salaried
Adult pts pay NHS charges for tx

Monitor level of dental disease through NHS dental epidemiology surveys
OH promotion - toothbrushing clubs, toothpaste packs

Also includes dental access centres

• Provide NHS tx/advice to pts unable to access care from GDS
• NHS charges applied
• Salaried staff
• Usually one course of tx

Question 5

Hospital dental services?

Answer 5

Access to 2ndry care if referred from primary care
General hospitals - oral surgery, ortho, sometimes restorative
Dental hospitals - teaching and highly specialised services

Question 6

How to get to tertiary care?

Answer 6

Go through primary care and 2ndry care

Question 7

General dental services (GDS)

Answer 7

April 2006:

• Pt charges changes
• Registration of pts removed
• Monitoring of contract

Question 8

Patient charges?

Answer 8

Band 1:
- Exam, radiographs, diagnosis, F varnish, scaling and polishing if needed, provision for OH advice £22.70
Band 2:
- Simple tx e.g. fillings, extractions, RCT £62.10
Band 3:
- Complex tx - bridgework, crowns, dentures £269.30

Will only pay one of 3 bands
e.g pt needing a filling = band 2 covers cost of initial exam and filling
But pt needing 5 fillings and endos will pay same as above pt (band 2)

Question 9

How is practice activity monitored?

Answer 9

Provide no of units of dental activity performed in each financial year
Band 1 - 1 unit
Band 2 - 3 units
Band 3 - 12 units
e.g. pt needs 1 filling = 3 UDAs, and pt needing 8 fillings = 3 UDAs
To get more UDAs do simple tx first to stabilise dentition and later do crowns/complex work = pt pays twice BUT do not do this regularly on same pt

Question 10

New contract?

Answer 10

Assess pts OH and risk factors

Red, amber or green criteria