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Dentistry

Dentistry myth busting

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Healthwatch teams across the North East have seen a significant increase in concerns around patients getting to see their local dentist. This is also a big problem across the rest of the country.

These concerns have been made worse by some common myths and misunderstandings around how dentist practices work. Here, we take a look at some of those myths.

1. ‘Registering’ at a practice

‘I saw my dentist a few years ago and now they say they can’t see me on the NHS. Aren’t I registered?’

Dental practices are set up within the NHS in a completely different way to GP practices so there is no formal patient registration within dentistry.

A patient is only ‘registered’ with a practice while undergoing treatment. So, you are free to approach any NHS dentist for treatment at any time.

2. They only want to work with private patients

‘My dentist said they could not see me on the NHS but offered me a private consultation.’

There is no formal patient registration within dentistry – NHS dental practices are commissioned to deliver a number of Units of Dental Activity (UDA) which they spread out over the year.

The number of UDAs used per day will depend on the treatment needs of the patients who contact the practice, for example, simple treatments like fillings and extractions equate to 3 UDAs, more complex treatment like crowns and bridges: 12 UDAs.

Whilst NHS provision must be available across the practice’s contracted opening hours, demand for NHS treatment may be so great that on any given day, depending on demand and the treatment needs of the patients who contact them, they could have used up all their NHS appointments when a patient rings.

They may, therefore, offer a private option to patients as an alternative, as they will have separate NHS and private appointment books, with separate clinical staff time allocated accordingly.

In line with national guidance all dental practices are required to prioritise patients based on clinical need and urgency into their available NHS appointments – this is called Triage. It is therefore important when you contact the practice that you fully explain the nature of your dental problem so that a clinical assessment can be undertaken to determine how quickly you need to be seen.

3. They are not doing routine work such as check-ups or scale and polish on the NHS

‘It’s impossible to get a routine check-up despite the fact I’ve not had one for over a year.’

All practices are currently working to national standard operating procedures which means that they have to prioritise patients based on clinical need and urgency. Therefore, their ability to take on patients for routine treatment such as check-ups is likely to be limited with the reduced capacity they are able to deliver, because of infection prevention control guidance.

However, if you have healthy teeth and gums, a routine check-up may not be needed for up to two years between appointments.

4. They are not doing emergency appointments.

‘I broke my tooth, but my dentist wouldn’t take me as an emergency appointment to fix it.’

Lost fillings, crowns or bridges, broken teeth or braces are not usually deemed to be clinically urgent, which means you may need to wait a little longer for an appointment.

Access to NHS urgent dental appointments is based on an individual clinical assessment of need. It is therefore important that you fully explain the nature of your dental problem to the practice or NHS 111 when you call, so they can correctly triage you.

 

Download the Dentistry Myth Busters PDF

If you have any further concerns about a dental service in your area, please visit the dental section of the NHS website where you can find further advice and an official complaints procedure.

why are GP services different

Why are GP practices working differently?

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The NHS has given the following information and guidance about what to expect from your GP practice.

In order to keep staff and visitors safe during the Covid-19 pandemic, GP practices have had to adapt how they work. Like the rest of the health service, practices have made use of technology by introducing additional telephone and video appointments.

As the Covid-19 pandemic is still ongoing, practices are continuing to keep robust infection prevention measures in place, and telephone triage continues to be the first point of contact. However, face-to-face appointments are being offered and you can still visit in person should you need to.

If you need to you visit your GP practice, your temperature may be taken on arrival and you will also need to sanitise your hands. We would appreciate your co-operation in ensuring you observe social distancing while in your GP surgery. There is clear signage to help guide you and chairs in the waiting room are positioned apart from each other. You should wear a face covering (unless exempt) if you need to attend the surgery in person.

Please be mindful that at times, workforces may be affected by Covid-19, so teams may be smaller than usual. Whilst we appreciate that this can be a frustrating and unsettling time, please rest assured that practices are doing all they can to manage patient needs during a time of increased demand. Thank you for your patience.

Although it remains a challenging time for all NHS services, you should not put off getting the care you need. Your GP practice is open and is here for you and your family.

How you can access support

There are a number of ways to get the help you need in a way that suits your needs.

  • Go online to nhs.uk or call NHS 111
  • e-consult service on your practice’s website and get a reply within two working days. You can also request medication, sick notes and bloods results through this service
  • Call your practice to discuss the most appropriate appointment
  • Visit your GP practice website and complete a confidential online form
  • Download the NHS App to order repeat prescriptions, book appointments or check your symptoms
  • For life-threatening emergencies, please call 999 or go straight to A&E

For healthcare needs regarding children, urgent problems or for those patients who are unable to access our online services, we ask that you telephone your practice and your call will be answered as soon as possible.

What to expect when you contact your GP practice

Practice reception teams will conduct an initial assessment over the phone to make sure that those with the greatest need are seen first. The receptionist will ask you some questions so that they can get you the right care, in the right way, by the right professional. This may not necessarily be a GP.

They will consider:

  • Who is best to help you.
  • What type of appointment best suits your needs.
  • Whether help from another health service is more appropriate. For example, a pharmacy or urgent treatment centre.

Practice reception teams and are trained to know about the care and services available to you.

  • They will know whether self-referral is available for certain services.
  • They can make appointments for your care.
  • They can direct you to new services you may not be aware of.

They are skilled in assisting with triage and treat all information in confidence. All staff operate according to strict guidelines and work under clinical supervision. You can trust them to treat all information confidentially. They are a vital part of your practice team. Please treat them with respect. Any form of abuse towards staff will not be tolerated.

Who might you see at your GP practice?

GPs work as part of large multidisciplinary teams (MDTs) who all support the physical, psychological, emotional, social, spiritual, cultural and economic aspects of a person’s care. Although these will vary depending on your practice, some professionals you may see at your practice include:

  • GP: a highly skilled doctor who support patients throughout their lives.
  • GP registrar: a qualified doctor who is training to become a GP.
  • Locum/sessional doctor: a fully qualified GP who works at the practice on a temporary basis.
  • Practice nurse: a qualified and registered nurse who can help with health issues such as family planning, healthy living advice, blood pressure checks and dressings.
  • Nurse practitioners: a trained specialist nurse who has undertaken additional medical education in order to provide advanced nursing care and to prescribe medication. Nurse practitioners can provide treatment and advice for many problems for which you may have seen a doctor for in the past.
  • Healthcare assistant: supports the practice nurse with their daily work and helps to carry out tasks such as phlebotomy (drawing blood), blood pressure measurement and new patient checks.
  • Pharmacist: a highly qualified expert in medicines who can help carry out structured medication reviews for patients with ongoing health problems as well as a range of other treatments.
  • Mental health practitioner: a first point of contact to give patients guidance, advice and treatment for mental health symptoms such as low mood, anxiety and depression.
  • Health visitor: a registered nurse who has received training particularly related to babies, children and pregnant women.
  • Podiatrist: treats abnormal conditions of the feet and lower limbs.
  • Social prescribing link worker: connects people with local community activities and services that can help improve their health and wellbeing.
  • Practice managers: manage the business aspect of the practice.
  • Receptionists and administration staff: provide an important link for patients with the practice and are your initial contact point for general enquiries.
What else do GPs do?

GP services remain very busy, providing more appointments than ever before whilst also delivering the winter vaccination programme.

In addition to this, their work can include:

  • Reviewing and acting upon letters from hospital specialists and patients
  • Signing repeat prescriptions
  • Immunisations
  • Processing referrals
  • Medication reviews and pharmacy liaison
  • Learning Disability reviews
  • Mandatory training
  • Death certificates and coroner reports
  • End-of-life care
  • Statements of fitness for work
  • Home visiting
  • Care home ward rounds
  • Managing national and local targets
Other important information

Tell us your experiences of using GP services through the pandemic

COVID-19: What people are telling us

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Each month, thousands of people share their experiences about NHS and social care services with Healthwatches across the country. During the COVID-19 pandemic, this has ranged from the effect lockdown has had on carers, to the problems getting emergency dental treatment.

In Healthwatch England’s latest briefing they outline the issues over 19,700 people have raised, as well as taking an in-depth look at how technology has been used in response to the pandemic.

You can find a summary of the key points below or click the following link to read the full report:

Read the full report here

The impact of COVID-19

At the start of lockdown, people told us how the measures introduced to help control the spread of coronavirus were affecting their care.

Changes to routine and planned care – In many cases, people were unable to find the information they needed to understand what they should expect from services and were unclear about what the next steps for their treatment or care would be – leaving them feeling stressed and frustrated.

Shielding measures – Those who were shielding told us about problems in getting transport to their hospital care. For some people, the cost of attending one or more hospital appointments was too expensive to arrange private transport, especially if the hospital was far from home.

Access to prescription medicines – Initially people were struggling to get through to their GP or pharmacy by phone, and others experienced delays in getting their medication. This caused anxiety for people running out of supplies, particularly for those with long term conditions.

What can services learn?

  • People need clear, accurate and consistent information about their care and the services they use.
  • People’s experiences of hospital appointments do not start and end at the hospital doors – their journey begins at home, so transport arrangements must be considered.

Lockdown begins to ease

As lockdown restrictions began to reduce, we started to hear new concerns from people.

  • Worries about the future – People raised questions with us about how services can reopen safely, reported problems using services that are supposedly already open for business and expressed frustration at some NHS services being slow to reopen compared to other areas of the economy.
  • Testing for COVID-19 – While some people found visiting a testing centre easy, we also heard that the online booking process was difficult to use and there were concerns about the accessibility of testing centres.

What have people been telling us throughout?

  • Lack of accessible information – Throughout the pandemic, we have heard about the difficulties of finding up-to-date information in the languages or formats people need – especially when advice from the Government was frequently changing.
  • Emergency dental care – People did not know how to access emergency dental care – causing them extra stress while experiencing acute dental pain or other symptoms. Many others have felt they have no option but to go private if they want to receive treatment for what their dentist considered to be non-emergency treatment.
  • Access to B12 injections – Although some people received injections, either as normal or at a different GP practice, we also heard that in many areas there was an inconsistent approach to providing this treatment.
  • Care homes – People’s feedback highlighted that while family and friends were unable to visit their loved ones in care homes, timely and regular communication from care home staff really mattered.
  • The hidden effect on families and carers – The lack of respite has left many carers feeling stressed, isolated and forgotten about. We also heard about the difficulties some people faced helping the person that they care for to understand and remember the lockdown measures.
  • Praise for health and social care workers – Throughout the pandemic, we have heard about how much people appreciate the hard work of health and social care professionals during this time of unprecedented challenges.
  • The impact on people’s mental health – Since the start of lockdown, we have heard about the effects of the pandemic on people’s mental health and wellbeing. For some people, the changes to the services they would usually access have left them feeling abandoned – with infrequent telephone appointments not meeting their needs.

What can services learn?

  • Accessible information and meeting people’s communication needs must be considered from the start and should not be an afterthought. The information must also be shared through trusted sources, such as community centres and groups.
  • Families and carers have been providing even more care than usual during the pandemic – but this often goes unnoticed, and many need more support.
  • Good communications between care homes staff residents and their family and friends is key, especially while visiting restrictions are in place. Where appropriate, this should include involving residents’ families or next of kin in decision making about their care.
  • The mental health impacts of the pandemic are affecting both existing service users and non-service users. Mental health services will require investment to support people in both the short and long-term.

Digital healthcare

The pandemic has seen the digitisation of many health and social care services overnight. While digital appointments don’t work for everyone, and services should not be exclusively digital, it’s important healthcare services embrace technology for those who find it an efficient way to communicate. Our recent work in this area demonstrates how services are embracing this shift to digital healthcare:

The doctor will zoom you now

How the new NHS COVID-19 tracing app offers better data privacy

Read the full briefing to find out what we can learn from the rapid roll-out of virtual NHS consultations, and the importance of involving patients from the start when setting up new services.

 

If you would like to share your own experiences of health and social care services during the pandemic you can do so here:

Tell us your coronavirus story