1

Making it work – learning from the pilots

2

Learning from the Pilots

• Practices have improved the efficiency of operating the pathway through– Increased opening hours– Patient communication– Skill mix– Leadership in practice – clinical and practice

management

3

Increased Opening Hours

• One practice started doing one late night a week, closing at 7pm. This was later extended to 4 late nights per week.

4

Patient Communication• Self-check in screens, web based access• Innovative contact with patients, ‘no objection to contact

written agreement’ using mobile telephone, text messages and email communication including messages about appointment times, educational leaflets and instructions

• Podcasts and waiting room video• Written contract:

‘What you can expect from us’ (included understanding roles of dental team skill mix)

and‘What we expect from you’

5

Dental Team Skill Mix

Some practices have found they can be more efficient with their time by using a skill-mix within the dental team:

•Practices noted that the only way they found the pathway worked was for the whole practice to engage with the philosophy.

•One practice introduced a full time dental therapist, in addition to a hygienist and up-skilled two dental nurses to take on extended duties, meaning that patients could see any number of practice staff when returning for an IC appointment.

•Receptionist completed as much administration as they could before the patient entered the surgery.

6

Dental Team Skill MixExamples

•EDDN and receptionists who had been suitably trained, recorded background information about the patient before the patient presented to the dentist

•Another practice extended this, information was then pre-populated before the patient entered the surgery, presented by the EDDN and was checked by the dentist with the patient

•If the patient required OHI and/or diet advice then this was delivered by the EDDN at the OHA including how the RAG score related to the Self-Care Plan

(Band 1 number of days interval for completion was much shorter in this practice)

7

Dental Team Skill Mix• One practice

– extended this process using EDDNs and Therapists for IC appointments within their scope of practice; therapists completed background information for urgent appointments, the dentist was then being bought into the surgery to complete the clinical assessment and treatment plan and/or provide treatment

– extra EDDN sessions when dentist was not using surgery during holidays

– short notice list of patients for EDDN sessions when a surgery became available at short notice through illness

8

• The leader is not always the practice principle!• Back-office practice manager:

– Co-ordination of Clinical Governance– Co-ordination of dental surgeries– Co-ordination (Performance Management) of the

dental team of reception, dental nurses, hygienist, therapists and dentists

• Training, Peer Review and Peer Clinical Audit

Leadership in practice – both clinical and practice management

9

Learning from the Pilots

• Practices have improved the efficiency of operating the pathway through– Patient communication– Skill mix– Increased opening hours– Leadership in practice – clinical and practice management

• One size does not fit all, blend what works for you and your patients

• The result was that practices managed to either maintain, increase or significantly recover their patient numbers over the course of the pilots.