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News Article
Bupa to cut 85 dental practices in staff shortage
Patient Safety Learning posted a news article in News
Bupa is set to cut 85 dental practices amid a national shortage of dentists, in a move that will affect 1,200 staff across the UK. The group said patients at some practices were unable to access the NHS dental service they need. Bupa, which provides NHS and private care, said the 85 practices would be closed, sold or merged later this year. The healthcare group's boss said the industry faced "systematic challenges" and the decision was a "last resort". In August the BBC revealed 9 in 10 NHS dental practices across the UK were not accepting new adult patients for treatment under the health service. Bupa has not been able to recruit enough dentists to deliver NHS care in many practices for months and in some cases years, it said. Read full story Source: BBC News, 30 March 2023- Posted
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News Article
Three-year wait for Essex girl, 8, to have tooth removed
Patient Safety Learning posted a news article in News
An eight-year-old girl waiting three years to have three teeth removed has been left in "agony". Ella Mann, from Dovercourt in Essex, first went to the dentist with an issue with a baby tooth in December 2019. She was given a temporary filling and told it needed to be removed but has still not had the NHS procedure. The youngster has now been placed on an NHS waiting list for the tooth extraction. Ella's dad Charlie Mann, 54, said his daughter was sometimes in "agony". Healthwatch England last year warned of people struggling to get dental treatment as increasing practices closed to new patients. A BBC investigation identified cases of people driving hundreds of miles in search of treatment and pulling out their own teeth without anaesthesia. Read full story Source: BBC News, 23 March 2023- Posted
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- Children and Young People
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News Article
A staffing crisis in children’s dentistry has prompted the urgent removal of junior doctors from Great Ormond Street Hospital NHS Foundation Trust (GOSH. GOSH has struggled to recruit consultants for its paediatric dentistry services for at least two years, which has led to trainee doctors going unsupervised, according to a new report by regulator Health Education England. A report seen by The Independent said the service was running with just one part-time consultant but needed at least two. The news comes amid a national “crisis” in dentistry, with the latest data from the government showing that half of all children’s tooth extractions in 2021-22 were due to “preventable tooth decay”. GOSH told The Independent it was struggling with a “limited pool” of paediatric dentists and, as a result of shortages, many patients were waiting longer than the 18-week standard. Read full story Source: The Independent, 8 February 2023- Posted
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News Article
The national dentistry budget is set to be underspent by a record £400m this year, due to a shortage of dentists willing to take on NHS work, HSJ has learned. The situation is understood to have prompted major concerns in the senior ranks of NHS England, and calls for a “fundamental rethink” of the much-maligned primary dental care contract. The unspent funding is due to be used to plug budget deficits in other services and comes as patients in many areas struggle to access NHS dentistry. Healthwatch England described the estimated underspend as an “absolute scandal”. Read full story (paywalled) Source: HSJ, 21 February 2023 -
News Article
NHS faces ‘alarming’ exodus of doctors and dentists, health chiefs warn
Patient Safety Learning posted a news article in News
The NHS faces an alarming mass exodus of doctors and dental professionals, health chiefs have said, as a report reveals 4 in 10 are likely to quit over “intolerable” pressures. Intense workloads, rapidly soaring demand for urgent and emergency healthcare and the record high backlog of operations are causing burnout and exhaustion and straining relationships between medics and patients, according to the report by the Medical Defence Union (MDU), which provides legal support to about 200,000 doctors, dental professionals and other healthcare workers in the UK. In an MDU survey of more than 800 doctors and dental professionals across the UK, conducted within the last month and seen by the Guardian, 40% agreed or strongly agreed they were likely to resign or retire within the next five years as a direct result of “workplace pressures”. Medical leaders called the report “deeply concerning”. There are already 133,000 NHS vacancies in England alone. NHS chiefs said it laid bare the impact of the crisis in the health service on staff, and MPs said it should serve as a “wake-up call” to ministers on the urgent need to take action to persuade thousands of NHS staff heading for the exit door to stay. Read full story Source: The Guardian, 29 January 2023- Posted
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News Article
Dentists warn of permanent damage from clear braces ordered online
Patient Safety Learning posted a news article in News
Dentists have told the BBC that demand for Instagram smiles has left people with damage from wearing clear braces or "aligners" ordered online. One man said aligners weakened his front teeth, leaving him unable to bite into an apple. Smile Direct Club, the largest company selling clear aligners remotely, says they straighten teeth faster and cheaper than traditional braces. Its aligners have been successful for the majority of users, it says. But some dentists and orthodontists believe customers of so-called remote dentistry are unaware of harm that can be caused by aligners if not fitted by a dentist in person. The General Dental Council (GDC), responsible for regulating UK dentists, says for some cases remote dentistry can be "provided safely". It urges consumers to consult its guidelines. However, Dr Crouch of the BDA believes such guidelines are insufficient compared with "rules and regulation to protect patients". Otherwise, dentists will be left picking up the pieces when "patients have undergone wholly inappropriate treatment". The UK's health watchdog, the Care Quality Commission (CQC) announced last summer any company providing remote orthodontic services will have to register with it. Read full story Source: BBC News, 20 January 2023- Posted
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News Article
Action needed as A&Es overflow with patients in severe dental distress
Patient Safety Learning posted a news article in News
Ask any MP or local Healthwatch what health issue sits at the top of their inbox, and there is a good chance it will be the public’s access to NHS dentists. The launch of a Health and Social Care Committee inquiry into dentistry is therefore welcome news. The inquiry is well timed, coming after a recent BBC investigation showing that 90% of practices across England were not accepting new adult NHS patients. The severe access problems stem from several factors. Longstanding issues relating to the dental contract not offering high enough rates for dentists to provide NHS care, for example, have contributed to a decline in the availability of NHS dentistry. This has led to thousands of people across the country going private or, very concerningly, turning to self-care. Accident and emergency departments are over-flowing with people in severe dental distress, with tooth decay being the most common reason for hospital admission among children aged five to nine in recent years. Read full story (paywalled) Source: HSJ, 19 January 2023- Posted
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News Article
Children’s oral health is “national disgrace,” says head of royal college
Patient Safety Learning posted a news article in News
The poor state of children’s teeth is a damning indictment of widening inequalities in child health in England, the president of the Royal College of Paediatrics and Child Health has said. In an interview with The BMJ Camilla Kingdon said that paediatricians were seeing the effects of longstanding health inequalities widening as the cost of living crisis affects the types of ill health that children are presenting with. She further told The BMJ, “There are lots of examples. One that we often forget about is oral health and the state of children’s teeth, which is actually a national disgrace. The commonest reason for a child having a general anaesthetic in this country is dental clearance. That’s a terrible admission of failure.” In her interview with The BMJ, Kingdon identified asthma and nutrition as other major areas of child health where the UK was failing. She said that these trends were partly being driven by social factors and expressed concern at the lack of focus in policy on fixing them. She warned, “Our worry, with the health disparities white paper being kicked into the long grass, is that without that intention, without a clear signal from the government that this is a priority, all these ideas [for tackling child health inequalities] just won’t be prioritised and we will miss an opportunity to really intervene.” Read full story Source: BMJ, 4 January 2023- Posted
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Content Article
Articles and themes in this issue Speak up... a powerful psychological safety indicator (Amy Edmonson) Empty bags or to be filled? An article about medication safety by the mother of a person with autism living in adult residence Patient safety report: Medstar health quality and safety vision A bird in the hand is worth two in the bush. By a mobile intensive care unit composed of a nurse, an ED doctor and a driver A vision of the health system in 10 years (Johannes Wacker) Implementation of an innovative training program promoting checklists in intensive care Mindfulness and patient safety (Rhona Flin) A bone to pick with me. An account of wrong site surgery in dental surgery (Franck Renouard) Patient safety at the heart of the turmoil of excellence (Rene Amalberti) Hospitals in 2031 (Martin Bromiley) Hopes for Human Factors in healthcare (Steven Shorrock) A letter from the year 2030 (Sven Staender) Pracically, how can we do better? (Guillaume Tirtiaux) Grounding and solidifying safe care (Anthony Staines) -
News Article
Orthodontist advised treatment with risk of harm to children, tribunal told
Patient Safety Learning posted a news article in News
An orthodontist whose methods around shaping the jawline have gone viral advised treatment to young children that “carried a risk of harm”, a tribunal has heard. Dr Mike Mew, whose “mewing” techniques have racked up nearly 2 biillion views on TikTok, faces a misconduct hearing at the General Dental Council (GDC). Opening the hearing in central London on Monday, Lydia Barnfather, representing the GDC, said comments made by Mew, who claims to help “alter the cranial facial structure” on his YouTube channel, were “pejorative” about orthodontists. Barnfather told the professional conduct committee that Mew seeks to treat children with “head and neck gear” and “lower and upper arch expansion appliances” to help align teeth and shape the jawline. “The GDC alleges this is not only very protracted, expensive, uncomfortable and highly demanding of the child, but it carries the risk of harm", Barnfather said. It was heard that between September 2013 and May 2019, advice and treatment were provided to two children, referred to as Patient A and Patient B. Mew was accused of failing to “carry out appropriate monitoring” of their treatment and “ought to have known” this was liable to cause harm. Barnfather said: “The GDC allege you are not to have treated patients the way you did.” She argued that both children had “perfectly normal cranial facial development for their age” before treatment took place. She added that the treatment was “not clinically indicated” and that Mew “had no adequate objective evidence” it would achieve its aims. Read full story Source: The Guardian, 14 November 2022- Posted
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- Dentist
- Surgery - Oral and maxillofacial
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News Article
Further cuts will kill off NHS dental services, chancellor told
Patient Safety Learning posted a news article in News
Jeremy Hunt has been told that any cuts to the health budget will in effect “kill” dental services across the UK and deny millions of patients access to a dentist on the NHS. The chancellor has told members of the cabinet that “everything is on the table” as he seeks to find tens of billions of pounds in savings after ditching the economic plan of Liz Truss, who said on Thursday she was standing down as prime minister. Health is one key area expected to be hit. But in an email to Hunt seen by the Guardian, the head of the British Dental Association (BDA) said in plain terms that because NHS dentistry had already “faced cuts with no parallel anywhere in the health service” over the last decade, any further reduction in funding could trigger its collapse. “In blunt terms, NHS dentistry is approaching the end of the road,” Martin Woodrow, the BDA chief executive, wrote in the memo. “There is simply no more fat to trim, short of denying access to an even greater proportion of the population.” In the memo to Hunt, Woodrow wrote: “Recent NHS England board papers confirm officials are euphemistically ‘taking steps to maximise access from existing resources’. We know what that means. Yes, we recognise the unparalleled pressures on public spending. Equally, we cannot escape the hard fact that a service millions depend on materially lacks the resources to underpin any rebuild. “You have also spoken of the need for all departments to seek ‘efficiency savings’. Since the financial crash, NHS dentistry has faced cuts with no parallel anywhere in the health service, going into the pandemic with lower government contributions – in cash terms – than it saw a decade ago. Read full story Source: The Guardian, 21 October 2022- Posted
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Content Article
"Patients are my top priority. Purposefully, this plan is ‘Our plan for patients’. The NHS has rightly been recognised with the award of the George Cross and the admiration of the British people, particularly for getting us through COVID-19. Most of the time, patients have a great experience, but we will not paper over the problems that we face. Some of our challenges have been exacerbated by the pandemic, and we expect backlogs to rise before they fall as more patients come forward for diagnosis and treatment. As we face these immense challenges, I am determined to be the champion of the patient and focus the NHS and social care on how best to deliver for them. My approach is to trust and empower to deliver. I will be proactive, not prescriptive, with a relentless focus on measures that affect most people’s experiences of the NHS and social care. This could be putting more information at the fingertips of patients or freeing up the time of clinicians. We have listened and we are responding by removing various reasons that healthcare professionals say are holding them back from what they do best: caring for patients. This plan sets out a range of measures to help the NHS and social care perform at their best for patients. To succeed, we need a national endeavour. That could involve clinicians who have retired to return to work or opening up opportunities for the million people who volunteered to help during the pandemic, like becoming community first responders or Good Neighbour Scheme leaders. Our plan will sit alongside the NHS Long Term Plan, the forthcoming workforce plan, and our plans to reform adult social care. It shows the concrete steps we are taking across several areas that matter to patients and people who draw on care and support, like creating more appointments in general practice, and getting more staff on the frontline. This plan is a first step on an important journey. It clearly shows our commitment to putting patients first; using insights from data to deliver better services across the country. While we are not being prescriptive, we will share best practice in order to improve outcomes for patients. The data shows that sadly there is too much variation in the care people receive – dental deserts; discharge delays; ambulance delays. I will endeavour, through a powerful partnership with the NHS and local authorities, to level-up and match the expectations that the public rightly have. Whether you live in a city or a town, in the country or on the coast, this government will be on your side when you need care the most." Rt Hon Thérèse Coffey MP Secretary of State for Health and Social Care- Posted
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- Organisation / service factors
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News Article
Parts of England have one NHS dentist for thousands of people, data shows
Patient-Safety-Learning posted a news article in News
Dental patients are still suffering from the fallout of the Covid-19 pandemic, as parts of England are left with only one NHS dentist for thousands of people. In North Lincolnshire, there were just 54 NHS dentists – equivalent to one for every 3,199 people – at the end of March, NHS Digital figures show. This means every NHS dentist in the area would have to work nine-hour days every working day of the year without holidays for each resident to receive one annual checkup on the NHS. Across England, 24,272 dentists treated some NHS patients in the year to 31 March – up 2.3% from the previous year, broadly in keeping with the general population increase in the same period, but lower than pre-pandemic figures for the three previous years. The chair of the British Dental Association, Eddie Crouch, said the service was “on its last legs” and the figures underlined the need for radical and urgent change. “The government will be fooling itself and millions of patients if it attempts to put a gloss on these figures,” said Crouch. “NHS dentistry is light years away from where it needs to be. Unless ministers step up and deliver much-needed reform and decent funding, this will remain the new normal.” Read full story Source: The Guardian (25 August 2022) -
News Article
UK dentists should give antibiotics to patients at risk of heart infection
Patient Safety Learning posted a news article in News
Dentists in the UK should be encouraged to give antibiotics to patients at high risk of life-threatening heart infection before invasive procedures, a study has found. Research suggests bacteria from the mouth entering the bloodstream during dental treatment could explain 30% to 40% of infective endocarditis cases. The rare but life-threatening condition occurs when the inner lining of the heart chambers and valves become infected. Antibiotics could limit the number of cases and reduce the risk of heart failure, stroke and premature death in high-risk patients, the study says. Current guidelines from the National Institute for Health and Care Excellence (Nice) advise against the routine use of antibiotics before invasive dental procedures for those at risk of infective endocarditis. “Ours is the largest study to show a significant association between invasive dental procedures and infective endocarditis, particularly for extraction and surgical procedures,” said Prof Martin Thornhill from the University of Sheffield, who led the study. Nice should review its guidelines advising against antibiotic prophylaxis, the researchers said. Read full story Source: The Guardian, 19 August 2022- Posted
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News Article
Full extent of NHS dentistry shortage revealed
Patient Safety Learning posted a news article in News
Nine in 10 NHS dental practices across the UK are not accepting new adult patients for treatment under the health service, a BBC investigation has found. BBC's research shows no dentists taking on adult NHS patients could be found in a third of the UK's top-tier councils. And eight in 10 NHS practices are not taking on children. The Department of Health said it had made an extra £50m available "to help bust the Covid backlogs" and that improving NHS access was a priority. BBC News contacted nearly 7,000 NHS practices - believed to be almost all those offering general treatment to the public. The British Dental Association (BDA) called it "the most comprehensive and granular assessment of patient access in the history of the service". While NHS dental treatment is not free for most adults, it is subsidised. The BBC heard from people across the UK who could not afford private fees and said the subsidised rates were crucial to getting care. The lack of NHS appointments has led people to drive hundreds of miles in search of treatment, pull out their own teeth without anaesthesia, resort to making their own improvised dentures and restrict their long-term diets to little more than soup. Read full story Source: BBC News, 8 August 2022- Posted
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Content Article
HealthWatch - How can you find an NHS dentist? (6 May 2022)
Patient-Safety-Learning posted an article in Dentist
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News Article
Complex dental care 'threatened by NHS targets'
Patient Safety Learning posted a news article in News
Patients needing complex dental work might have to wait longer under new NHS targets, dentists warn. The British Dental Association (BDA) fears NHS England will impose penalties on practices that fail to reach 45% of their normal activity level, after negotiations broke down. And practices may have to prioritise routine check-ups over more time-consuming treatments. An NHS official said: "The NHS and the government are working to determine a safe and reasonable contractual arrangement with dentists, which recognises the constraints on practices and the need to maximise access for patients to see their dentist." The waiting list for NHS dentistry could reach eight million by New Year's Eve, according to the Association of Dental Groups. Dave Cottam, who chairs the BDA's General Dental Practice Committee, said: "This move will actively undermine patient care. "Ministers are instructing dentists to churn through routine appointments against the clock, rather than deal with a huge backlog of urgent cases. Dentists wanting to do the right thing by their patients will now be punished for it." Read full story Source: BBC News, 16 December 2020 -
News Article
New data indicates the dental crisis shows no signs of slowing, with four in five people (80%) struggling to access timely care during the last COVID-19 lockdown. Access to NHS dental care continues to be a problem for people across England, with Healthwatch recording a 22% rise in calls and complaints about dentistry between January and March 2021. A review of 1,375 people’s experiences shared with Healthwatch found a lack of consistency across the country when it comes to accessing a dental appointment. Whilst some people were asked to wait an unreasonable time of up to three years for an NHS appointment, those able to afford private care could get an appointment within a week. Healthwatch are calling for greater ambition and urgency from NHS dental reform plans to create more equitable and affordable dental care. Imelda Redmond CBE, National Director of Healthwatch England, said: “The twin crisis of access and affordability hitting NHS dentistry means many people are not able to access timely care – and the poorest are hardest hit. Those human stories show that oral health is a social justice and equity issue." Read full story Source: Healthwatch, 24 May 2021- Posted
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