Recall Matters – Communication Strategy

Introduction

This paper describes the communication work that is planned as part of the “Recall Matters” project. It sets out the aims of communication work, key principles, the target audiences, core messages, the planned activities, budget and evaluation. It also includes draft briefings providing two versions of the wider background for the project and a draft press release. This paper provides more detail in support of the communication interventions set out in the Recall Matters Project Initiation Document, October 2017. An earlier draft of this strategy has been circulated to and commented on by the Project Board, with detailed comments received from Public Health England. This is the amended final version.

Aim

To deliver a co-ordinated set of communication activities to a range of target audiences to support the delivery of the Recall Matters project. The overall purpose of the project is to work with dental practices and the public to ensure dental recall intervals between routine dental check-ups fit with the guidance the National Institute for Health and Care Excellence and to explore whether additional capacity can be released in NHS general dental services in West Yorkshire.

Communication principles

All communications and engagement activity carried out by and on behalf of the dental recall project group partners will be:

Accessible and inclusive – to all our audiences Clear and concise – allowing messages to be easily understood by all Consistent and accountable – in line with our vision and purpose set out in the PID Flexible – ensuring communications and engagement activity follows a variety of formats,

tailored to and appropriate for each audience Open, honest and transparent – we will be clear from the start of the conversations what

aim is, the reasons why and ultimately, how decisions will be made Targeted – making sure we get messages to the right people and in the right way Timely – making sure people are kept updated on a regular basis Two-way – we will listen and respond accordingly, letting people know the outcome of the

project.

Target audiences

The targets for different communication requirements are:

Patients of general dental services Patient and carer groups

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The wider public, stratified and using appropriate communications channels The dental profession, including individual practitioners, the Local Dental Committee and the

Local Dental Network Other dental staff, for example dental nurses, hygienists, reception staff, practice managers Community and voluntary sector organisations (as a conduit to their memberships or

communities) Healthwatch organisations in West Yorkshire (as a channel to target specific patient groups) MPs and Councillors Overview and Scrutiny Committees with health responsibilities Health and Wellbeing Boards Local Authority leadership, including Public Health departments GPs (via Clinical Commissioning Groups, CCGs) CCGs’ public engagement and communication teams Medical / Dental Indemnity Organisations

Messages

Underpinning all of the communications and engagement will be the following overarching messages:

National guidance (NICE) says we don’t necessarily need to attend the dentist every 6 months for a check-up, the recall interval should be based on the dentist’s assessment of each individual’s oral health and risk of developing disease;

Patients should be involved in and understand the clinical reasons for the recall interval. This conversation between clinician and patient is key;

Guidance states that the recall period can be up to 24 months for adults with healthy teeth; A small research study by the General Dental Council has indicated that 90% of patients

would find a longer recall interval of 9 months acceptable; The messages in the Healthwatch video encourage people to ask for a longer interval period

when the dentist deems this is appropriate; Emphasise the time and money saved, a “reward” for patients for looking after their teeth

and taking care with their diet and health choices; Increasing the dental recall interval for people at low risk of developing oral disease could

give dentists more capacity and increase the availability of dental services.

Communication channels

Stakeholder group

Requirements and communication products

Channels of communication

Responsibility

Patients of general dental services

Patient leaflet on Recall Matters, using same branding as animated film, produced in January 2018. (Product 1 in list below)

Delivered to dental practices by NHS England

Healthwatch Kirklees produced, NHSE distributed Jan.18

Patient and Patient leaflet on Recall Matters Email to patient Distributed by

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carers groups (product 1), distributed electronically with short version briefing (product 2) on the project as a whole

groups and organisations in West Yorkshire

Local Healthwatch organisations

Members of the public

Social media posts (in Social Media Toolkit, product 4)

the Healthwatch animated film (product 3) to raise the issue of asking for longer recall intervals where appropriate

News reports in conventional media, via media briefing pack (product 5), radio interviews, TV interviews

Facebook Twitter Paid

advertising News websites Local papers Local radio Local TV National

media (potentially)

Healthwatch Kirklees, working with other Healthwatch organisations

Dental practitioners

Introductory letter (product 6) explaining the project, sent November ’17

Checklist of modifying factors (product 7, sent Nov. ‘17)

Short written updates accompanying monthly distribution of data (at discretion of NHSE)

Verbal briefings and updates British Dental Association Bulletin Written update to all practices

(project mid-point) Final report and evaluation (January

2019)

Emails to all practices in West Yorkshire from the NHSE Dental Commissioning Team

NHSE staff attending meetings of the Local Dental Network and the Local Dental Committee

BDA Bulletin distributed direct to dentists

NHS England staff, (with the support of PHE, Healthwatch, CDO)

BDA with the support of Healthwatch Kirklees

Other dental staff

Recall Matters leaflet for members of the public (pdf)

Short version briefing giving wider context of project (pdf)

Emails to practice staff including receptionists

NHSE with the support of Healthwatch Kirklees

Community and voluntary sector organisations

Recall Matters leaflet for members of the public (pdf)

Short version briefing giving wider context of project (pdf)

Distribution through VCSOs’ newsletters, mail shots, websites

Healthwatch Kirklees

Healthwatch Recall Matters leaflet for members of the public (pdf)

Short version briefing giving wider context of project (pdf)

Social Media toolkit

Healthwatch mailing lists and newsletters

Healthwatch websites

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Copy of media briefing pack for media

MPs and Councillors

Targeted letter More detailed information sheet

giving wider context of project (product 8)

Written briefings Face-to-face

meeting at their request

Healthwatch Kirklees and STP

Overview and Scrutiny Committees for Health

Targeted letter More detailed information sheet

giving wider context of project (pdf)

Written briefings Attendance at

meetings at their request

Health and Wellbeing Boards

Targeted letter More detailed information sheet

giving wider context of project (pdf) Updates as required

Email distribution of material

Attendance at meetings at their request

Healthwatch Kirklees Healthwatch

The West Yorkshire and Harrogate Health and Care Partnership (formerly the STP)

Targeted letter More detailed information sheet

giving wider context of project (pdf)

Presentations at an STP leadership meeting

Healthwatch Kirklees (RD to seek agenda item)

LA council leadership, Public Health

Targeted letter More detailed information sheet

giving wider context of project (pdf) Updates as required

Email distribution of material

Presentation and meetings if required

RD, RW through WY STP & KC

GPs (CCG member practices)

Targeted letter More detailed information sheet

giving wider context of project (pdf) Updates as required

Through communications leads in each CCG

Comms. leads

CCGs in West Yorkshire, engagement and communication teams

Targeted letter accompanied by short version briefing, patient leaflet and link to film for distribution by CCGs

Public engagement video and adverts to be sent to local communication and engagement contacts

Healthwatch Kirklees

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Summary list of communication resources:

1. Patient leaflet on Recall Matters, (produced January 2018) https://healthwatchkirklees.co.uk/patient-leaflet/

2. Shorter (more accessible) version briefing (aimed at VCSOs and their communities, dental practice staff, receptionists)

3. Healthwatch animated film on recall for patients (produced and updated 2017) 4. Social media toolkit (including sample website copy, Facebook and Twitter posts etc.)5. Media briefing pack containing press release, background information, link to film6. Introductory letter about the project accompanying first data set sent to all dental

practitioners (sent November 2017 by NHSE)7. Checklist of modifying factors, (sent to dentists by NHSE November 2017)8. More detailed and technical information sheet giving wider context of project (aimed at

CCGs, STP, Public Health and Local Authority leaders) 9. West Yorkshire media contacts

Some materials listed in the table above are not categorised as “communication products” as they will be produced as appropriate and at the discretion of PHE, NHSE, Project Manager or the SRO. These include the written update to all practices (project mid-point) and the final report and evaluation.

Timeline

The timeline for these communication activities is embedded in the main project GANNT chart. The timing for the main activity on public communication, social media, press releases etc will be in May to July 2018. The social media marketing campaign is due to run for 3 months.

Budget

Healthwatch Kirklees will assign a budget of up to £1,000 for social media marketing and the production of leaflets. Other costs will be carried by individual partner agencies or absorbed within existing budgets.

Evaluation

There is an evaluation plan for the project as a whole. Specific evaluation will be carried out on our communications activity, evidencing whether the projects has achieved communication objectives by engaging successfully with target audiences. Communications activity will be constantly monitored. Through social media monitoring we will assess daily reach, posts, likes and through evaluation we will gain valuable insight into public behaviour, enabling us to tailor our communication methods as appropriate.

Andrew JonesProject Manager, Health and Social Care

26 April 2018

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Appendices – Communication Products

PRODUCT 1 – Patient Leaflet

Side 1

Side 2

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PRODUCT 2: Shorter (and more accessible) version of briefing (for VCSO partners, patient groups, carers groups, dental reception staff etc)

“Recall Matters” – appropriate dental recall intervals for people with healthy teeth

We have high quality dental services in many parts of West Yorkshire but people will know how difficult it is to find an NHS dentist in some areas. In parts of Bradford and Kirklees for example, people have found it impossible to find a dental practice taking on new NHS patients. This has been a longstanding issue in some places despite the best efforts of dentists and NHS England who plan and pay for NHS services. Healthwatch organisations in West Yorkshire, who represent patients and hear about public experiences, have been campaigning for more dental services, along with local voluntary organisations, MPs, Councillors and local media.

An innovative project in West Yorkshire is working to try and free up some appointments for people without a dentist. “Recall Matters” is a partnership project that is working with dental practices and the public to ensure that the time between routine dental check-ups (the dental recall interval) for adults with good oral health meets national guidance in every practice across West Yorkshire. The aim is to try and release more capacity in NHS general dental services in West Yorkshire and ultimately improve access for patients. The project is supported by the Chief Dental Officer for England, NHS England, Public Health England, the General Dental Council and Healthwatch organisations in West Yorkshire.

Attending the dentist every six months has been a widely disseminated health message for many years. But if your dentist says your teeth and mouth are healthy, you look after your teeth and have a healthy lifestyle, guidelines from the National Institute for Health and Care Excellence (NICE) say the time between your dental check-ups could be up to a maximum of 24 months for adults. If the times between routine check-ups for adults with healthy mouths were increased in line with the NICE guidelines, dentists could potentially be freed up to treat more people in need of dental care who are struggling to find a dentist.

In West Yorkshire as a whole, on average the time between dental check-ups is slightly below the England average, but there are significant differences between practices. If all practices could drive up the interval between seeing people with healthy teeth, (as appropriate and based on an individual assessment,) potentially many more thousands of appointments could be made available.

A survey by the General Dental Council has shown that, when given the facts, a majority of patients would welcome an increase in recall intervals up to 12 months. This increase would save patients time and money.

Since September 2017 we have been working with dental practices across West Yorkshire, sharing information on recall and re-attendance of patients needing a routine check-up with every dental practice in West Yorkshire.

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We have produced a leaflet called, “How often do I need to see my dentist”, giving patients information so that they can discuss with their dentist what is right for them. These have been sent to dental practices. We are now spreading the message with a public information campaign so that everyone understands if and when it is possible to increase the check-up interval. We have produced leaflets, a short animated film and are getting the word out through local organisations, mailings, websites and social media. The message to the public is, if you have a healthy mouth and teeth, clean your teeth well with fluoride toothpaste and have a healthy lifestyle you may not need to have a check-up every 6 months. We want people to talk to their dentist about this – it could save them time and money and free up appointments for others.

We hope that you can help share this message through your networks and organisation. By working together we aim to improve access to dental services for everyone in West Yorkshire.

PRODUCT 3 – Animated film

The short patient video can be viewed via this link: https://youtu.be/_RKOXfQ2ZlQ

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PRODUCT 4 – Social Media Toolkit

The aim of this social media toolkit is to share key messages via social media platforms, which inform the public in West Yorkshire on how the appropriate length of time between their routine dental check-ups may be determined, in line with NICE guidance.

The main period for the social media activity will be from early May, through June to the end of July 2018. Whilst Healthwatch Kirklees will be taking the lead on producing materials and co-ordinating the work, local Healthwatch organisations in Bradford, Wakefield, Calderdale and Leeds will play a key part in delivering the social media messages using their own networks, websites and email address lists.

Resources

Resources to be provided to local Healthwatch for the social media campaign:

- Press release and briefings (appendix 5, Media Briefing Pack)- Animated film (appendix 3)- Patient leaflet (appendix 1)- Email copy (below)- FAQs (below)- Website copy (below)- Social media post examples (below)- Social media images (below)

The first three resources are already included as part of the main Recall Matters Communication Strategy. The remaining resources are here:

Email copy – details in red to be amended for each local Healthwatch

Join our campaign “Recall Matters” – new dental check-up intervals for people with healthy teeth

For the past four years, Healthwatch across West Yorkshire have heard stories from patients about difficulties in accessing NHS dental care. In some areas/Kirklees/Bradford/Leeds/Wakefield/Calderdale people have found it impossible to find a dental practice taking on new NHS patients.

From 1st May 2018, Healthwatch (area) would like your support to launch our new campaign “Recall Matters”. The campaign works to free up NHS dental appointments for people currently without access to a dentist.

The campaign/idea asks for the public and dental practices to work together to ensure that the times between routine dental check-ups meet the national guidance. If your dentist says your teeth and mouth are healthy, you look after your teeth and have a healthy lifestyle, guidelines state that dentists could be recommending longer times between check-ups, up to a maximum of 24 months for adults. If intervals between check-ups increased in

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line with this guidance, dentists could be freed up to treat more patients in need of appointments.

Recall Matters is already supported by the Chief Dental Officer for England, NHS England, Public Health England and the General Dental Council as well as lots of organisations locally, just like yours.

How can you help?Please share our leaflet (attached) and video https://www.youtube.com/watch?v=_RKOXfQ2ZlQ with your service users/mailing lists and via your social media accounts to ensure that the public are aware of the campaign, which could save people time and money.

Most importantly encourage people to have a recall matters conversation with their dental professional today.

You can also join our thunderclap here: xxxxxxxxxxxxxxx

Website copy

“Recall Matters” – new dental check up intervals for people with healthy teeth

For the past four years, Healthwatch across West Yorkshire have heard stories from patients about difficulties in accessing NHS dental care. In some areas, people have found it impossible to find a dental practice taking on new NHS patients.

On the 1st May 2018, West Yorkshire Healthwatch will be launching a new campaign with support from the Chief Dental Officer for England, NHS England, Public Health England and the General Dental Council. The campaign is called “Recall Matters” and works to free up NHS dental appointments for people currently without a dentist.

The idea asks for the public and dental practices to work together to ensure that check-up intervals meet the national guidance provided by National Institute of Health and Care Excellence (NICE). If your dentist says your teeth and mouth are healthy, you look after your teeth and have a healthy lifestyle, guidelines state that dentists could be recommending longer intervals between check-ups, up to a maximum of 24 months for adults. If check-up intervals increased in line with this guidance, dentists could be freed up to treat more patients in need of appointments.

(Image of leaflet with all information)

If the new idea works, it could potentially release thousands of dental appointments to people who do not currently have an NHS dentist but also save patients time and money.

Watch our video below to find out more:

https://www.youtube.com/watch?v=_RKOXfQ2ZlQ

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Start a recall matters conversation with your dentist today.

FAQs examples – answers to be drafted by board

- If my check-up interval is increased to 24 months, won’t I be removed from my dentist’s books?

- What if my dentist says I still need a check-up every six months?- My dentist has removed me from their records, why is this?- Why do we need to increase the amount of time in-between check-ups?- How do I find out if a dental practice is accepting new NHS patients?

Social media post examples – to be posted with images below

“Have you had a Recall Matters conversation with your local dentist? #RecallMatters”

“Would you like to go to the dentist less often? #RecallMatters For more information visit www.healthwatchkirklees.co.uk”

“Contact your local dentist to check if they are accepting new NHS patients. #Findmeadentist #RecallMatters”

“Andrew spoke to his dentist and now his check-up is in 12 months #Seeyouin12months #RecallMatters”

“Rosie hadn’t been able to find a local NHS dentist in 3 years, today Rosie saw a dentist and received the treatment she needed thanks to #RecallMatters #nomorepain”

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Social media images - draft

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Newly drafted social media imagery

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Platforms

The following platforms will be used:

- Facebook - Twitter- YouTube - Instagram- Healthwatch websites

Budget

Healthwatch Kirklees will assign a budget of up to £1,000 for blanket social media marketing throughout West Yorkshire. No additional resources other than staff time are required from local Healthwatch.

Evaluation

- Overall blanket advertising results including reach and engagement; - Feedback of all social media posts by local Healthwatch organisations (reach and

engagement numbers and what worked well for each area);- Number of posts, likes, re Tweets - Patient feedback on messaging and approaches.

Paid advertising potential reach

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1. Recall matters paid advertising

Healthwatch Kirklees will be providing paid advertising for the recall matters project from May to July 2018, on behalf of all Healthwatch in West Yorkshire. This is so the paid advertising can cover West Yorkshire from one social media account and is easier to manage.

Images/aminations

The main paid for post will be the video animation which can be seen here https://youtu.be/_RKOXfQ2ZlQ

The call to action will be to follow a link to the Healthwatch Kirklees website to a holding page. The holding page will contain the links to local Healthwatch websites and the recall matters copy (mock holding page can be seen below.

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Channels

The paid advertising will be completed via Facebook including third party websites and Instagram, which are owned by Facebook. The reason for this is that previous projects and campaigns such as Change The Conversation have shown that video media is best consumed by the public on the Facebook medium.

Potential

The project will go live on all Healthwatch websites/social media 1st May 2018 for three months. The paid advertising will also run throughout this period with a total budget of £1000.00.

The potential reach for the animation video post is 1,300 – 5,200 people per day which could possibly equate to a reach of over 450,000 people within the three month period. This does not include any results created by individual Healthwatch and their organic social media campaigns.

2. Previous Work

A similar piece of work was completed by Healthwatch in West Yorkshire in July 2016. The Urgent and Emergency Care Vanguard tested new ideas for ambulance services and paramedics called Hear, See and Treat. The same social media approach as that planned for recall matters was undertaken however, an incentive was also offered and the hashtag #HealthyFutures. The posts, budgets and results can be seen below.

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The Hear, See and Treat video can be found here: https://youtu.be/KBUlPn2Eop4

The online social media campaign and adverts were seen by 306,616 people across West Yorkshire with a total running cost of £1,898.90.

137,437 people viewed the information video for more than three seconds and 54,464 people viewed for more than 10 seconds. 3,363 people clicked the incentive Fitbit link to complete the survey. From social media channels alone 1019 surveys were completed.

The results above do not include the organic reach and engagement from local Healthwatch accounts across West Yorkshire who also ran local campaigns. The use of the hashtag enabled the campaign to be tracked and shared by everyone involved in the vanguard.

Below are a summary of the demographics related to the two adverts.

Video:

Image:

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The age bracket of 13-17 does not have any results due to the adverts only being available to people over 18 years old due to the incentive offered.

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PRODUCT 5 – Media Briefing Pack

This will comprise the Press Release below, the various links, the offer of an interview and one of the briefing papers. The press release below is a draft until all contributors have approved the content and quotes.

Headline not included

An innovative project in West Yorkshire is exploring if more dental appointments can be made available by increasing the interval between routine check-ups for adults whose dentists assess to be at low risk of developing dental and oral disease. Current guidelines say that time between dental check-ups should depend on the health of a patient’s teeth and mouth and their level of risk, with intervals of up to two years for those in good oral health.

Attending the dentist every 6 months has long been a health message but NICE guidelines say that this may not be necessary for everyone. The project is working with dentists and the public to extend the interval between check-ups, freeing up more space for people who need an appointment or more complex work. Rory Deighton from Healthwatch Kirklees, one of the partners in the project says, “Some people with healthy teeth are visiting when they don’t need to; it may be possible to increase the check up to 9, 12, 18 or even 24 months, the maximum for an adult. If we can change the system we could transfer thousands of appointments from checking people with healthy teeth to treating patients in pain”.

Sara Hurley, Chief Dental Officer for England said, “The progress of the Healthwatch initiative to tackle the perception and attitudes that surround the outdated model of a one-size-fits-all 6 month dental check-up continues apace. In exploring public attitude and supporting professional adherence to the NICE Guidance on dental recall the prospect of targeting access to those most in need and improving oral health is readily achievable”.

With the support of the Chief Dental Officer for England, Healthwatch organisations in West Yorkshire are working with local dentists, the NHS England dental commissioning team in Leeds, and Public Health England. Emma Wilson, NHS England’s Head of Co-Commissioning (Yorkshire & Humber) says, “Since September 2017 we have been talking with local dentists about best practice in recall and sending out monthly information on their practice’s performance. There are many reasons for difference in recall intervals such as the area in which the practice works and the community they serve, but this project is exploring if we can release capacity in general dental services by implementing NICE guidance across the board.”

Rory Deighton from Healthwatch says, “We are starting a public information campaign so that everyone understands if and when it is possible to increase the check-up interval. We have produced leaflets, a short animated film and are getting the word out through local organisations, mailings, websites and social media. The message is, if you have a healthy mouth and teeth, clean your teeth well with fluoride toothpaste and have a healthy lifestyle you may not need to have a check-up every 6 months. We want people to talk to their dentist about this – it could save them time and money and free up appointments for others.”

ENDS

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Notes for Editors

a) Attached briefing note gives more detailed background informationb) Link to short animated film aimed at the public https://www.youtube.com/watch?

v=_RKOXfQ2ZlQc) Sara Hurley’s comments on NHS dental recall rates reported in the Daily Telegraph in

September 2016 http://www.telegraph.co.uk/news/2016/09/07/going-to-the-dentist-every-six-months-is-unnecessary-says-uks-to/

d) The National Institute for Health and Care Excellence guideline referred to is: https://www.nice.org.uk/guidance/cg19

e) For more information and interviews if required please contact Rory Deighton, Healthwatch Kirklees on 01924 450379 or 07950631690 email rory.deighton@healthwatchkirklees.co.uk

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PRODUCT 6 – Letter from NHSE to dentists introducing the project (November 2017)

Ground Floor

3 Leeds City Office Park

Leeds

LS11 5BD

Email: england.yhdentalreturns@nhs.net

10 November 2017

Dear Dental Practice Team

West Yorkshire Dental Recall Pilot

Attending the dentist every six months has been a widely disseminated health message for many years. However, the evidence base behind this message has long been questioned (Sheiham 1977). Guidance produced by the National Institute for Health and Care Excellence (NICE) in on intervals between dental recalls states that these should not be based on a fixed interval that is the same for everyone but should be based on an individual’s level of risk of future disease. Adults at low level of risk may have a recall interval of up to two years.

In 2015/16, the average re-attendance interval across England between band 1 treatments was 8.2 months, ranging from 7.8 months to 9.3 months. Over the same period in West Yorkshire, average re-attendance intervals varied from 5.2 months to 12.0 months. The average re-attendance interval was 8.0 months and the median was 7.3 months.

NHS England, West Yorkshire Local Dental Network and Healthwatches are working together to support dental practices, patients and the public to plan recall interval for adults with good oral health in line with the recommendations of NICE.

As part of this work, dental practices across West Yorkshire will be sent information quarterly on their average band 1 to band 1 intervals for adults and how this compares with other dental practices in the area.

It is interesting to note that fewer than 50% of patients are being recalled every six months or more often.

Whilst we recognise that your practice is implementing the NICE guidance we are asking all practices to review existing protocols for dental recall against the guideline to see if recall attendance intervals for adults at low risk of oral disease are in line with the guidance https://www.nice.org.uk/guidance/cg19 .

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The checklist, taken from the guidance, is attached for ease of reference.

As you will know, for someone with low disease activity, it may be possible to gradually extend the interval towards the 24 month maximum period once the patient and the dental team are confident that this is satisfactory. Patients whose disease activity continues unabated may need a shorter interval and may need more intensive preventive care and closer supervision.

To help you adhere to the guideline recommendations, dentists should take the following actions:

At the end of each oral health review there is a record for each patient of an assessment of disease and disease risk.

At the end of each oral health review, or at completion of treatment, there is a record for each patient of the recall interval recommended by the dentist for the next oral health review.

The interval agreed each time, for each patient is:

3, 6, 9 or 12 months for patients younger than 18 years, or

3, 6, 9, 12, 15, 18, 21 or 24 months for patients aged 18 years or older.

Where there is disagreement between the dentist and the patient over the recall interval, the reason for this is recorded.

One of the key factors to supporting appropriate recall factors is patient awareness and education. An information leaflet is being developed and will be circulated to support your conversations with patients to help them understand the concept behind the implementation of the guidance.

It is recognised that factors such as depravation and demographics will influence the intervals for practices so we intend to work through the public health data we have to provide a more robust picture for future circulations. However, in the meantime, as this is the first time we have distributed this information, we would welcome your feedback.

It would be helpful if you could use the generic email address listed above to provide your feedback.

Yours sincerely

NHS England – North (Yorkshire & The Humber)

Dental Commissioning Team

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PRODUCT 7 – Modifying Factors (sent by NHSE to Dentists, November 2017)

Checklist of Modifying FactorsName: Date of Birth: ….../....../…...

ORAL HEALTH REVIEW DATE ..….../.. .... ../…..... …...../.. .... ../…..... ..….../.. .... ../….....Medical HistoryConditions where dental disease could put the patient’s general health at increased risk (such as cardiovascular disease, bleeding disorders, immunosuppression)Conditions that increase the patient’s risk of developing dental disease (such as diabetes, xerostomia)Conditions that may complicate dental treatment or the patient’s ability to maintain their oral health (such as special needs, anxious/nervous/phobic conditions)

Yes No Yes No Yes No

Social HistoryHigh caries in mother and siblingsTobacco useExcessive alcohol useFamily history of chronic or aggressive (early onset/juvenile) periodontitis

Dietary HabitsHigh and/or frequent sugar intakeHigh and/or frequent dietary acid intake

Exposure to FluorideUse of fluoride toothpasteOther sources of fluoride (for example, lives in a water-fluoridated  area)

Recent and previous caries experienceNew lesions since last check-up Anterior caries or restorationsPremature extractions due to cariesPast root caries or large number of exposed rootsHeavily restored dentition

Recent and previous periodontal disease experiencePrevious history of periodontal  diseaseEvidence of gingivitisPresence of periodontal pockets (BPE code 3 or 4) and/or bleeding on probing Presence of furcation involvements or advanced attachment loss (BPE code *. BPE code * is used when attachment  loss is ≥7mm  and/or furcation involvements are present)

Mucosal lesions

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Mucosal lesionPlaquePoor level of oral hygienePlaque-retaining factors (such as orthodontic appliances)

SalivaLow saliva flow rate

Erosion and tooth surface lossClinical evidence of tooth wear

Recommended recall interval for next oral health review

.............. months ……..…... months

…..…..…. months

Does the patient agree with recommended interval? If ‘No’, record reason for disagreement in notes (on next page)

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PRODUCT 8 - Briefing (more detailed and technical version) for NHS partners, CCGs, STP, Public Health, Local Authority leaders

“Recall Matters” – appropriate dental recall intervals for people with good oral health

The purpose of the project is to work with dental practices and the public to ensure dental recall intervals between routine dental check-ups for adults fit with the guidance from the National Institute for Health and Care Excellence (NICE) and to explore whether additional capacity can be released in NHS general dental services in West Yorkshire. The project is supported by the Chief Dental Officer for England, NHS England, Public Health England, the General Dental Council and Healthwatch organisations in West Yorkshire.

Background

Attending the dentist every six months has been a widely disseminated health message for many years. However the evidence base behind this message has long been questioned, (Sheiham, 1977). NICE has published evidence based guidelines for dental recall intervals (NICE, 2004, and reviewed in February 2014). In essence this says that the recommended interval between oral health reviews should be determined specifically for each patient and tailored to meet his or her needs, on the basis of an assessment of disease levels and risk of or from dental disease. Adults should be seen for dental recall at intervals from 3 months to 24 months and children should be seen for a dental recall at an interval from 3 months to 12 months depending on their level of risk of oral diseases. Patients should understand the clinical decision making to decide their dental recall interval and feel engaged in this discussion with their dentist. Dental record keeping should support this process.

Nationally, in 2015/16, the average re-attendance intervals across England between band 1 treatment (examination, diagnosis and advice) was 8.1 months. In West Yorkshire the interval averaged 7.8 months but with significant differences between practices across the region. At the same time, equity of access to general dental services in parts of West Yorkshire has been raised as an issue by a number of stakeholders including Public Health England. Extending dental recall intervals for people at low risk of oral disease in line with NICE guidance has the potential to increase capacity and improve access to general dental services.

Local anecdotal information suggests that some patients expect a dental recall interval of 6 months regardless of risk. A research study conducted by the General Dental Council found that, when patients are given information about how their dentist decides when their next check-up should be, four fifths of respondents felt comfortable in asking for a recall interval of between 9-12 months. Extending dental recall interval for people at low risk of oral diseases based on the clinical judgement of the dentist in line with the NICE guidance could increase the availability of dental services.

The Project

We are exploring the implementation of the NICE dental recall guidance, examining practice level data across West Yorkshire and sharing this with dental practitioners, seeking to understand the main influences on recall intervals for adults with good oral health, and exploring a range of interventions that might be expected to influence re-attendance intervals. Amongst these is the production of a range of publicity materials communicating information about appropriate dental

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recall to patients and public, including leaflets, social media animations and use of conventional media. We will be assessing if capacity can be made available within existing resources to enable more people to access NHS general dental services.

Since September 2017 NHS England having been talking to West Yorkshire dentists about best practice in recall. The project has been sharing benchmark information on adult recall and re-attendance intervals (band 1 to band 1) with practices on a monthly basis so that they can see their own data along with their peers. This will be piloted until March 2018 with opportunities for dentists to feedback and say how the presentation of these data could be improved. We are also looking at a more detailed set of contextual data to understand the differences between practices, the areas they work in, the health and level of oral health of the communities they serve.

We have produced a leaflet for patients called “How often do I need to see my dentist” giving patients information so that they can discuss with their dentist what is right for them. This lists the factors a dentist will take into account for each individual and gives patients information about the possibility of increasing recall from a standard 6 months if the clinical assessment indicates this is appropriate. These leaflets have been sent to dental practices. We are now spreading the message with a public information campaign, including distribution of these leaflets more widely, press releases, social media and briefings for key partners.

The project is planned to run until December 2018 and will be fully evaluated. The Chief Dental Officer for England is monitoring progress monthly through the CDO Programme Oversight Group, to evaluate progress and impact and assess if the project could be rolled out nationally.

We would be grateful if you could share information about this project through your organisation and help disseminate the messages about appropriate dental recall to patients and the public through your networks, websites and public forums.

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PRODUCT 9: West Yorkshire Media contacts

1. Local Media Opportunities:Bradford:

- Bradford News- Bradford Telegraph and Argus- Keighley News

- Craven Herald & Pioneer- Wharfedale & Airedale Observer- Bradford Asian Radio- Branch FM- Drystone FM- Asian Sunday Newspaper –

info@ansiansunday.co.uk- - Sunrise Radio –

news@sunriseradio.fm- - BCB (Bradford Community Radio) –

hello@bcbradio.co.uk

Calderdale:

- Halifax Courier - Hebden Bridge Times- Todmorden News- Brighouse Echo- Radio Calderdale- Phoenix FM,

Kirklees:

- Huddersfield Examiner- Dewsbury Reporter- Mirfield Reporter - Spenborough Guardian- Kirklees Local TV- Branch FM- Radio Sangam

Leeds:

- Wetherby News- Morley Observer- 96.3 Radio Aire- Fever FM

Wakefield

- Wakefield Express- Pontefract & Castleford Express- Ridings FM

2. Regional Media Opportunities:- Yorkshire Post- Yorkshire Evening Post- Look North- Calendar- BBC radio Leeds - kevin.larkin@bbc.co.uk - Pulse Radio- Radio Yorkshire

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3. National media:- Daily Express- Daily Mail- Daily Mirror- Daily Star- Daily Star Sunday- Daily Telegraph- Financial Times- The Guardian- The Independent - Mail on Sunday- Metro- The Observer- The Sun- Sun on Sunday- Sunday Express- Sunday Mirror- Sunday People- Sunday Telegraph- Sunday Times- The Times- Look North- Calendar

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