Northants LDC Guidance
GUIDANCE UPDATES
- Procurement of Advanced Mandatory Services & Additional Mandatory Services
Northamptonshire is currently part of the Southern locality of Central Midlands NHSE along with Bedfordshire, Milton Keynes & Hertfordshire (the old Herts & South Midland Local Area Team region). The Northern Locality of Central Midlands NHSE consists of Lincolnshire and Leicestershire. We now are part of NHS England (Central Midlands) no longer a local area.
The Dental Team (DT) as they would like to be known now (Area Team is a term they would like us to phase out) are looking at commissioning Advanced Mandatory Services & Addition Mandatory Services in a different way. This will currently affect:
Orthodontics
Special Care
MOS, Sedation and Restorative Services
NHS England has a number of contracts of varying sizes and contractual arrangements across the Central Midlands region and acknowledges that access to services for patients is variable and inconsistent. This is not anyone’s fault – it is a result of the differing commissioning priorities of PCTs prior to 2013.
In an attempt to reduce these inequalities and protect the sustainability of its NHS dental services, our NHS England commissioners are looking to standardise the services offered across the whole of the region. These ‘new’ services will become available across the Central Midlands from April 2020.
Their most ambitious undertaking is the procurement of MOS, Sedation and Restorative Services. They plan to commission “bundles” of MOS, sedation and restorative services contained within single PDS Agreements in a number of areas across the Central Midlands. This will replace existing contracts and in many areas improve access to these referral services. For Hertfordshire we are likely to see a drop in MOS sites!
In their May 2018 Dental Bulletin they circulated a outline of the draft service specifications asking current providers, potential bidders, GDPs and other key stakeholders to comment, provide feedback and generally provide input into the design of the service. A Market Engagement event was held on 21 June 2018 which attracted eighty attendees. At this event the concept of the service was outlined and many questions answer. The feedback report is available HERE
The DT are keen to hear from any person or group who would like to make further comments. It’s not too late to have your say. This can be done via e-mail to Jason Wong and Ruwan Wickramasinghe at ldn.centralmidlands@nhs.net
Read more
- New advice on antibiotic prophylaxis
The Scottish Dental Clinical Effectiveness Programme (SDCEP) has published new implementation advice on Antibiotic Prophylaxis Against Infective Endocarditis, which is available to be used by all dentists across the UK.The advice supports the implementation of the NICE Clinical Guideline 64 Prophylaxis against infective endocarditis, which states that antibiotic prophylaxis should not be provided "routinely" prior to invasive dental treatment for patients who have an increased risk of infective endocarditis. The SDCEP implementation advice offers guidance about which individual patients might be at increased risk and consequently should be considered for non-routine management. The SDCEP advice also emphasises the importance of including patients in decisions about their care. It provides support for dentists in discussions with patients and their cardiololgists, who together will identify when there may be a case for special consideration for antibiotic prophylaxis/non-routine management. SDCEP has also produced supporting tools, including a patient information leaflet, for dental teams to download and print.The BDA's Health and Science Committee commented on a draft version of the guidance and requested amendments earlier this year, saying that the BDA believes most dental professionals are aware of the guidance and treat patients appropriately, but SDCEP's guidance will help ensure a more consistent approach to patient care across the UK. The key messages of the original NICE guidance published in 2008 were that antibiotic prophylaxis should not be used for dental procedures to prevent infective endocarditis, and that patients at increased risk should be advised of the importance of oral health. However, in 2016 NICE revised the guidance and clarified that prophylaxis should not be used 'routinely' for dental patients at increased risk of infective endocarditis, and clinicians should apply their clinical judgement on a patient by patient basis.In response to SDCEP's consultation, the BDA expressed concerns at the absence of any reference in their guidance to the risks of antimicrobial resistance, which dentists should discuss with patients if they are considering prescribing prophylactic antibiotics to prevent infective endocarditis. Read the guidance HERENew advice on antibiotic prophylaxis
The Scottish Dental Clinical Effectiveness Programme (SDCEP) has published new implementation advice on Antibiotic Prophylaxis Against Infective Endocarditis, which is available to be used by all dentists across the UK.
The advice supports the implementation of the NICE Clinical Guideline 64 Prophylaxis against infective endocarditis, which states that antibiotic prophylaxis should not be provided "routinely" prior to invasive dental treatment for patients who have an increased risk of infective endocarditis.
The SDCEP implementation advice offers guidance about which individual patients might be at increased risk and consequently should be considered for non-routine management.
The SDCEP advice also emphasises the importance of including patients in decisions about their care. It provides support for dentists in discussions with patients and their cardiololgists, who together will identify when there may be a case for special consideration for antibiotic prophylaxis/non-routine management.
SDCEP has also produced supporting tools, including a patient information leaflet, for dental teams to download and print.
The BDA's Health and Science Committee commented on a draft version of the guidance and requested amendments earlier this year, saying that the BDA believes most dental professionals are aware of the guidance and treat patients appropriately, but SDCEP's guidance will help ensure a more consistent approach to patient care across the UK.
The key messages of the original NICE guidance published in 2008 were that antibiotic prophylaxis should not be used for dental procedures to prevent infective endocarditis, and that patients at increased risk should be advised of the importance of oral health.
However, in 2016 NICE revised the guidance and clarified that prophylaxis should not be used 'routinely' for dental patients at increased risk of infective endocarditis, and clinicians should apply their clinical judgement on a patient by patient basis.
In response to SDCEP's consultation, the BDA expressed concerns at the absence of any reference in their guidance to the risks of antimicrobial resistance, which dentists should discuss with patients if they are considering prescribing prophylactic antibiotics to prevent infective endocarditis.
Read the guidance HERE
http://www.sdcep.org.uk/published-guidance/antibiotic-prophylaxis/
- BNF (British National Formulary)
Paper copies of BNF no longer being distributed free
Paper copies of the BNF (British National Formulary) were always been distributed yearly, each October. This will no longer be the case , instead the BNF will only be available online or through an App. If you want to obtain the App
For iPhone go to your app store and search for the BNF/BNFC app
For an Android phone go to Google play and search for the BNF/BNFC app.
You will need internet access to download the app for the first time but once downloaded you will not need an internet connection to use the BNF content. However you should update the content monthly to benefit from the most up-to-date information.
An online version of the BNF is also available at:-
- Dental visits for children under the age of 3 years.
It is recognised that early visits for children under the age of 3 years are vital for delivering key preventive messages, acclimatisation and beginning a positive, lifelong relationship with NHS dentistry.
Can I claim for Band1 even if I have not been able to complete a full examination?
Yes you can
The chief dental officer has produced an "Avoidance of doubt" letter (here) encouraging dentists to see patients for a dental check as early as possible. In the letter she explains best practice for carrying out and claiming for examination for very young children.