Abstract
Background: Community Dental Services (CDS) provide an NHS safety net for people with complex needs including people living with dementia (PLwD). However, no service evaluation has reviewed the dental care pathways, service provision or the providers’ view of the quality of care.
Objectives: To assess current dental care pathways, geographic differences, and key characteristics of PLwD referred into the CDS in England and Wales.
Methods: A service evaluation methodology and key informant sampling was used to distribute an online survey to 23 clinical directors and clinical leads of CDS across England and Wales from 20th April to 26th May 2023. The online survey with 21 questions collected information about existing care pathways, access to care, the key characteristics of referred patients, service provision and geographical and staffing questions. Descriptive data was produced using SPSS. Ethical approval was not required for this service evaluation.
Results: Forty-one responses were collected. Seventy-six percent of respondents were based in NHS trusts and 24% in Community Interest Companies (CICs) or Social Enterprises. Although all CDS accepted PLwD in their acceptance criteria, only 44% could state the average number of referrals routinely received. Only a quarter of CDS used a specific referral pathway. The main reasons for referrals were toothache and loose teeth. Over 40% of respondents felt that having a designated referral pathway for PLwD would improve access to care. The most common service providers were Senior Dental Officers; 60% felt that they had insufficient staff to provide services.
Conclusion: Effective commissioning and Special Care Dentistry workforce planning for an ageing population requires a detailed assessment of the number of PLwD in England and Wales referred to and using the CDS, to improve access for this vulnerable patient group.
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