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  1. 1. Dentistry in Plymouth Regular NHS dentists Plymouth PCT contracts with 27 dental practices and this includes our PCT salaried practice based at Ernesettle. Additionally we have a Dental Access Centre, which is part of our PCT Dental Service (PCTDS) contract. Dentists are contracted to carry out a fixed number of Units of Dental Activity (UDAs) for a fixed contract sum. Dentists are not obliged to take new patients. ‘Registration’ ceased to exist from 1st April 2006. PCT database Patients can add their name to the PCT database. This is a list of names of those who wish to access a regular NHS dentist. It is run on a ‘first come first served’ basis. Patients should write stating name, address, telephone number and date of birth to: Plymouth PCT FREEPOST NAT 22278 Plymouth PL6 5ZQ We cannot routinely write to patients to tell them that they are on the database but we currently hope to be able to place patients with an NHS dentist within 8 to 12 weeks. When a place becomes available the PCT informs people by letter. To note – dentists may wish to offer one off courses of treatment to patients who have not been their regular patients in the past and patients should be advised that they can ask at their local dental practices if they have the capacity to do this. To find where local NHS dental practices are in your area go to: or call NHS Direct on 0845 46 47. Child and exempt patients Although children and those with certain exemptions are entitled to free NHS dental treatment, we can only provide this treatment if there are dentists taking on additional NHS patients. Therefore, if a regular dentist cannot be found, patients should be advised to add their names to the database. There is currently no preferential place on the database for child or exempt patients – the ‘first come, first served’ basis applies for all. Please note, any child who attends the Dental Access Centre for emergency treatment is always offered ongoing routine care. Emergency Care at Dental Access Centre Plymouth has a Dental Access Centre, based at the Nuffield Clinic in Lipson, that NHS patients who are suffering from dental pain, who do not have a regular NHS dentist, can access for emergency NHS treatment and appointments can be made by telephoning 0845 155 8070. 1
  2. 2. Out of Hours (OOH) emergency care OOH dental care is the responsibility of Plymouth PCT. After 18:30 weekdays and over the weekends, patients who are in pain can get advice by telephoning Devon Doctors on Call on: 01392 823682. Clinics are run at the weekend from Scott Hospital although OOH is a separately commissioned service. Patients are triaged into true dental emergencies (defined as haemorrhage, swelling liable to interfere with breathing, subluxed permanent anterior teeth in children) and patients in pain. The former will be advised to attend the nearest A+E department; the latter will be advised re analgesics and to contact either their regular dental surgeon or a Dental Access Centre the following morning for further advice. Private patients and patients covered by dental insurance will be advised to contact the number that appears on the practice leaflet or insurance policy for further advice. However, they are not excluded from accessing NHS OOH services. New Patient Charges Please refer to Patient Leaflet – go to s/mar_06_what_you_need_to_know_about_changes_to_nhs_dentistry_in_englan d.pdf Domiciliary Care Primecare Oral Health and Plymouth teaching PCT launched a new NHS dental service on 8th October 2007. This new service aims to at maximize oral health specifically for people who are housebound and either living in their own homes or residing within a care home. This is a domiciliary service that will offer individual oral assessments and regular NHS dental care for this group of patients. Primecare is pleased to accept self referrals or referrals from care homes and from health care providers for individuals living in their own homes in the Plymouth area. This service is specifically for those patients who are unable to attend an appointment at a general dental practice. For an appointment, Primecare should be contacted on 08447 368547. Usual NHS charges and exemption rules will apply with no additional call out charge. If a housebound patient is in pain or has a dental emergency before they become a regular patient of Primecare then they should call the Dental Access Centre for an appointment on 0845 155 8070. There is often a slightly longer wait for this service but the DAC will inform patients when they ring. Dentures and other appliances Anyone who is in pain because of a problem with their dentures or other appliance and who does not have a regular dentist can get an appointment at the DAC for emergency treatment. Those patients who need new dentures or have broken dentures that are not causing them pain, can add their names to the PCTs database and will be treated on a ‘first come first served basis’ as anyone requiring a regular NHS dentist. Special care dentistry e.g. children with special needs, phobic patients Patients with special needs should contact the DAC on the number above. The DAC hold their own waiting lists for these specialties. 2
  3. 3. Complaints from patients If the complaint is about the service/ treatment received from a patient’s NHS dentist then the complaints procedure dictates that the patient should complain to the dentist directly in the first instance. Patients can use the Patient Advice & Liaison Service on Tel: 211818. The PCT’s Dental Lead works in conjunction with PALS/Complaints to help resolve locally any patient complaints. If any clinical governance issues arise then the PCT Dental Lead refers to the appropriate people/body as described below – Clinical Governance. PALS supply the dental lead and clinical governance lead with a log of the number and types of patient queries taken and identify any trends that may need following up. If a patient does not get a satisfactory response through PALS then the patient can complain to Dawn Walbridge via the PCT complaints team. If needs be, the patient to the Healthcare Commission. If the patient is complaining about not being able to get regular NHS dental care then they should be directed to PALS who will direct to PCT Complaints Department if unable to resolve. If the patient is complaining about the PCT not commissioning the service that they require an official complaint should again be directed through the PCTs official complaints system. General Dental Practice Advisor (GDPA) The PCT employs a GPDA on a sessional basis and he is a support for both the PCT and Practices and speaks directly with patients around resolving complaints about clinical issues. Oral Health Advisory Group (OHAG) The PCT has an OHAG on which sit local GDPs, LDC members, Clinical Director of Dental Services, Dental Lead, Secondary Care Consultants. Minutes are circulated to PEC and Public Health. Clinical Governance issues are discussed at this meeting. PCTs current Clinical Governance routes If any issues relating to a dentist’s performance are highlighted to the PCT then there are several ways that the PCT can deal with the situation: GDPA – ask GDPA to support practitioner and explain guidance and contractual obligations as well as main clinical governance obligations Refer to the local Practitioner Advice and Support Service (PASS) - Any issues of Poor Performance can be in the first instance referred to the PAS Scheme. Dentists can self refer and can refer their colleagues to this service. Dental Reference Service – ask the local Dental Reference Officer to inspect the premises or give a second opinion of a patient’s treatment. DRO also carry out new practice inspections 3
  4. 4. Occupational Health Service (OH) – refer dentists with any OCC Health issues including psychotherapy available Complaints about Private Dentists Patients should be directed to the Dental Complaints Service by telephoning their helpline on 08456 120 540 or going to The General Dental Council (GDC) is the professional body responsible for granting dentists the right to practice and patients can also contact them on 0207 887 3800 or emailing Patients requesting a refund for the NHS part of the private work that they have had done Patients’ contributions for dental care are not made through National Insurance as is commonly believed. Government funding for dental services is paid for through general taxation. Therefore the Department of Health says that there is no mechanism for PCTs to be able to refund the NHS contribution to what a patient may have had done privately. Patients requesting a second opinion If patients are unhappy with the NHS dental treatment they have received they can request to be seen by a Dental Reference Officer who is an independent NHS dentist. However, the patient’s dentist must refer the patient themselves for a DRO check. If a dentist refuses to do this then the PCT can, in exceptional circumstances, request this on behalf of the patient. Private treatment We cannot advise patients regarding private treatment. What’s happening now with dental services? Plymouth PCT supports local dentists in increasing their NHS capacity wherever this fits in with Plymouth's local strategic plan. Indeed, since April 2006 we have offered places for regular NHS care with an NHS dentist to over 18,000 people from our database. In the past six months, six practices across Plymouth, in the areas Plymstock, Ernesettle, City Centre, Crownhill & Milehouse, have been taking on new NHS patients from our database. Other plans are in place to increase access in Plympton. A Consultant in Dental Public Health is employed by the PCT on a sessional basis in conjunction with other local PCTs and the new Peninsula Dental School. Peninsula Dental School (PDS) The PCT is working closely with the dean, Liz Kay, of the new dental school to ensure the benefits to both students and patients alike in our area. The PDS will comply with local PCT clinical governance standards. 4