Abstracts from Poster Presentations at the Scottish Dental Practice-Based Research Network's Symposium held in Edinburgh in November 2001

Symposium Report

Abstract of poster presentation

The Cost of Out-of-Hours emergency Dental Provision in Tayside:An assessment of the current situation and a proposal ofa more cost effective system.

June D Fraser*; C. Tilley; J. Clarkson; J. Newton Part time MDSc in Primary Dental Care.

Background

The General Dental Services (GDS) contract of 1990 formalised the provision of emergency, out-of-hours treatment for NHS patients. If contacted outside normal surgery hours by a registered patient the GDP is required to offer advice and reassurance by telephone or to reopen the surgery. If seen out of hours, the GDP is paid a recalled dental attendance fee for re-opening the surgery at no cost to the patient.

At present, for non-registered patients in Tayside, an emergency dental service (EDS) clinic runs at Ninewells Hospital over weekends and public holidays. During working hours on weekdays they can attend the Dental Hospital in Dundee. There is no dedicated out-of-hours dental provision for non-registered patients in Tayside.

Throughout the region these people may also be seen by local Community Dental Offcers (CDOs), dental/medical practitioners, or at the A&E dept at Ninewells Hospital or Perth Royal Infirmary.

Aim:

The aim of this project is to compare two different models of delivery of emergency (out-of-hours) dental treatment, and suggest which would be more cost effective and appropriate to the providers of this service.

Objectives:

The project's objectives are to:

1. Compare the cost of two strategies:
   1. The current situation.
   2. A proposed model whereby all emergency treatment for both registered and non-registered patients is provided at a central point.
2. Assess the opinion of the service providers and users towards these models.

Methods:

1. Demographic picture of Tayside. Obtained from Scottish Dental Practice Board (SDPB) and Dental Health Services Research Unit (DHSRU).
2. Cost of current system identified from data from SDPB annual reports, Management Information and Dental Accounting Systems (MIDAS).
3. Cost of alternative strategy, estimated from projections of fixed and variable costs, of providing a service from a central point.
4. A short postal questionnaire to obtain the current practice of patients and GDPs and their opinions towards a dedicated service.

Findings:

Data collected to date are being analysed and results are in the process of being presented.

Relevance for Policy & Practice:

• "Investing in Dentistry (1997)", the Minister of State for Health says "The government is committed to NHS dentistry- We intend to reduce the inequalities of oral health status and improve accessibility."1
• In evidence based heath care there is a need for a cost efficient and practical service, i.e., there has to be a "determination of the mix of those services and procedures that maximise benefits and reduce risks for the available resources"2

References:

1. Alan Milburn (Minister of State for Health) in a letter "Investing in Dentistry" 9th September 1997
2. A.Cochrane; From Effectiveness to Efficiency.

Correspondence address: