Abstract:Aim: This paper describes a newly created primary care oral surgery specialist service operating in a managed clinical network caring for the United Kingdom military population. It aims to review its outcomes and to consider the structure of the service in relation to the recommendations of the 2010 NHS sponsored 'Review of Oral Surgery Services and Training' by Medical Education England which made recommendations for the delivery of UK oral surgery services. Materials and methods: A retrospective audit of pat… Show more
“…Over the last few years, primary care trusts in England have established referral pathways for treatment by oral surgeons in primary care. The findings of our study are consistent with the studies reported in this literature …”
Section: Discussionsupporting
confidence: 93%
“…One patient had persistent pain post‐extraction who was referred to oral and maxillofacial surgery unit locally and diagnosed as osteomyelitis. Overall complications were consistent with a standard practice of oral surgery.…”
Section: Discussionsupporting
confidence: 71%
“…Davies et al . concluded that the benefits of a specialist‐led service in primary care setting include an efficient, effective and fiscally economical patient‐centred service with referral to treatment timings and complication rates that compare favourably to current alternatives and with the structures and processes that facilitate the achievement of quality outcomes.…”
Section: Discussionmentioning
confidence: 99%
“…Davies et al . carried out a service review of minor oral surgery specialist referrals in a managed clinical network. There are many studies analysing the impact of minor oral surgery delivery in primary care in the UK supporting the process and evaluating its benefits.…”
This article evaluates the benefits of specialist-led minor oral surgery service in Scottish primary care dental practice. Objectives: The aims of the study were to: 1 Study practice-based minor oral surgery service delivery. 2 Estimate waiting times for these patients. 3 Explore complications. 4 Evaluate cost allocated for procedures in minor oral surgery in primary and secondary sector. Materials and Methods: Retrospective analysis of procedures carried out, waiting times, complications and comparative cost in minor oral surgery from two NHS dental practices located in Lothian health board area. Results: A total of 1896 procedures in 982 patients having minor oral surgery were analysed across two sites. Of procedures, 51% (971) were simple extractions; 31% (580) of the procedures were surgical removal of non-third molar teeth; 15% (275) of the procedures were surgical extraction of third molars; and 3% (70) of the procedures were complex procedures such as surgical exposure of canines, removal of simple cysts and closure of oroantral communication. Two hundred and nine procedures were carried out under intravenous sedation. It was difficult to estimate waiting times although all patients were treated within 4 weeks. The overall complication rate was 8.1%. There is a considerable difference in cost allocated to similar procedures in primary and secondary care and the money allocated for carrying out minor oral surgery in primary care is not cost neutral. Conclusions: It is cost efficient to treat minor oral surgery patients in primary care. Like for like procedures in minor oral surgery are expensive and potentially wait longer before receiving treatment in secondary care.
Clinical RelevanceOral Surgery practice is multifaceted and a significant amount of its clinical activity can be safely carried out in a primary care setting. We analysed the procedures delivered in two Scottish NHS dental practices and studied the wait times and complications. We evaluated the cost differential between similar procedures in a Scottish primary and secondary care setting. The proposed model of delivery of minor oral surgery in Scottish primary care appears useful and needs further evaluation.
“…Over the last few years, primary care trusts in England have established referral pathways for treatment by oral surgeons in primary care. The findings of our study are consistent with the studies reported in this literature …”
Section: Discussionsupporting
confidence: 93%
“…One patient had persistent pain post‐extraction who was referred to oral and maxillofacial surgery unit locally and diagnosed as osteomyelitis. Overall complications were consistent with a standard practice of oral surgery.…”
Section: Discussionsupporting
confidence: 71%
“…Davies et al . concluded that the benefits of a specialist‐led service in primary care setting include an efficient, effective and fiscally economical patient‐centred service with referral to treatment timings and complication rates that compare favourably to current alternatives and with the structures and processes that facilitate the achievement of quality outcomes.…”
Section: Discussionmentioning
confidence: 99%
“…Davies et al . carried out a service review of minor oral surgery specialist referrals in a managed clinical network. There are many studies analysing the impact of minor oral surgery delivery in primary care in the UK supporting the process and evaluating its benefits.…”
This article evaluates the benefits of specialist-led minor oral surgery service in Scottish primary care dental practice. Objectives: The aims of the study were to: 1 Study practice-based minor oral surgery service delivery. 2 Estimate waiting times for these patients. 3 Explore complications. 4 Evaluate cost allocated for procedures in minor oral surgery in primary and secondary sector. Materials and Methods: Retrospective analysis of procedures carried out, waiting times, complications and comparative cost in minor oral surgery from two NHS dental practices located in Lothian health board area. Results: A total of 1896 procedures in 982 patients having minor oral surgery were analysed across two sites. Of procedures, 51% (971) were simple extractions; 31% (580) of the procedures were surgical removal of non-third molar teeth; 15% (275) of the procedures were surgical extraction of third molars; and 3% (70) of the procedures were complex procedures such as surgical exposure of canines, removal of simple cysts and closure of oroantral communication. Two hundred and nine procedures were carried out under intravenous sedation. It was difficult to estimate waiting times although all patients were treated within 4 weeks. The overall complication rate was 8.1%. There is a considerable difference in cost allocated to similar procedures in primary and secondary care and the money allocated for carrying out minor oral surgery in primary care is not cost neutral. Conclusions: It is cost efficient to treat minor oral surgery patients in primary care. Like for like procedures in minor oral surgery are expensive and potentially wait longer before receiving treatment in secondary care.
Clinical RelevanceOral Surgery practice is multifaceted and a significant amount of its clinical activity can be safely carried out in a primary care setting. We analysed the procedures delivered in two Scottish NHS dental practices and studied the wait times and complications. We evaluated the cost differential between similar procedures in a Scottish primary and secondary care setting. The proposed model of delivery of minor oral surgery in Scottish primary care appears useful and needs further evaluation.
“…2018;7(3): [30][31][32][33][34][35][36][37] Existing UK data from oral surgery services based in primary care report acceptable referral systems, better accessibility, shorter waiting times and lower costs than those provided in hospital services, yet with comparable outcomes. [8][9][10][11][12][13] However, with few exceptions, previous evaluations have been narrow in focus and assessed certain aspects of the quality of care and undertaken before the publication of recent commissioning guidance. 4 Service evaluations can take a range of forms, 14 but they broadly assess whether the aims of a service are being met and analyse the reasons for any discrepancies.…”
Section: Thomas Anthony Dyer Jessica Ga Lai Laumentioning
Aim To report the findings of a service evaluation of an NHS practice-based minor oral surgery service. Method A service evaluation including a retrospective analysis of activity and outcome data and assessment of patient and practitioner satisfaction. Results 623 appointments were arranged, with a mean waiting time of 43 days. Treatment provided included: surgical removal of third molars and non-third molars, surgical endodontics and other surgical and oral medicine cases (29.7%, 44.1%, 3.0% and 23.4% of cases respectively). Antibiotics were prescribed at 16.1 % of treatment appointments and 1.9% required appointments for post-operative complications. All participants reported overall satisfaction with their care and strongly agreed/agreed with positive attitudinal statements about the oral surgeon's communication/information giving, technical competence and understanding and acceptance; 77.5% were seen on time and none were seen more than 15 minutes late; 87.5% felt the standard of the service was better than expected than at a hospital and none felt it was worse. Over 80 of practitioners agreed that waiting times were better than expected at a hospital, urgent problems were seen quickly and the referral process was easy and understandable. All practitioners strongly agreed/agreed they that they were happy with the service provided. Conclusions A range of minor oral surgery procedures can be provided with low complication rates, acceptable waiting times and accessibility, and high patient and referring practitioner satisfaction from a practice-based specialist oral surgery service.
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