Interim evaluation of pilot for unregistered patients and asylum seekers (PUPAS) scheme

Abstract

Background: The Pilot for Provision of Urgent Dental Care to Unregistered Patients and Asylum Seekers Scheme aimed to find an immediate solution to an access problem in general dental services, which prevented unregistered patients, including asylum seekers and refugees, with an urgent dental care need from receiving treatment. Dentists received an enhanced fee for provision of emergency care for these groups.

Objectives: Interim evaluation to assess service utilisation during the first 13 weeks, acceptability of the scheme and inform the commissioning of a substantive scheme.

Methods: Quantitative analysis of data - recording number of patients, breakdown of unregistered/asylum seeker/refugee, treatment provided, conversion from unregistered to registered, socioeconomic status of patients. Qualitative analysis - survey of dental professionals involved in the scheme, patients who utilised the scheme and representatives from charitable organisations who assisted clients to access care through the scheme. Ethical approval was not required for this service evaluation.

Results: Eleven dental practices in five Local Commissioning Group areas provided care to 507 patients in the first 13 weeks of the scheme. Eighteen percent were asylum seekers, 50% of patients fall within Northern Ireland Multiple Deprivation Measure deciles 1-3, 82% of patients subsequently registered with the dentist. Ninety-one percent of scheme dental practices would be content to work under a similar scheme, charitable organisations felt the scheme successfully provided access to care for their clients, positive patient feedback.

Conclusion: The interim evaluation showed the scheme successfully provided access to dental services for those who are most in need of it. It tested the capacity within primary care to provide urgent dental services to these groups as well as the demand and cost of this care. The interim evaluation provided evidence that the scheme is needed in the medium to long term to address the issues surrounding access to dental services.