North Yorkshire and Humber Area Team Dental Newsletter – ISSUE 2
Introduction
There are a number of issues that I am attempting to let you know about to help with updating your paperwork and queries arising in the brave new era of the Area Team. I hope you will find these items useful and I welcome feedback, or, if you would like any issue clarified please don’t hesitate to contact me. My email is c.bolland@nhs.net
This newsletter has lots of topics:
- Revised protocols for complaints.
- Safeguarding referrals.
- Audit cycle of HTM0105 and monitoring.
- Occupational Health information.
- LDC Meetings across the Area.
- Structure of Area Team and Contact Information and new Local Dental Network
- New anti-coagulants and their potential effects on post-operative haemorrhage.
- New approach in Hull to Clostridium Difficile management
- Amendments to make to your Business Continuity/flu plans and significant event reporting.
- Nurses’ deadlines for CPD cycle and Indemnity Insurance Issues
Complaint Handling
It may have slipped your notice but you need to alter in house paperwork. As the PCT no longer exists it will be necessary to change the information in your practice information leaflet. Any complaint not resolved in house should now be addressed to the Complaints Manager at
NHS England
PO Box 16738
Redditch
B97 9PT
EMAIL england.contactus@nhs.net
Telephone number 0300 311 2233
Additionally to your practice leaflet you need to have a note/poster displayed in your waiting area or reception area, visible to the patients with the in house complaints procedure and the above set of contacts displayed. I would always recommend you try and resolve complaints internally.
I have also been advised to tell you that the complaints system may be changing again in the near future but for now to use the above contacts.
Safeguarding referrals
Local joint safeguarding policy and procedures will exist by local authority area and will be available from the safeguarding board’s website, and these will indicate contact points to report concerns. In this regard, nothing has changed with the recent reorganisation of the NHS. So whichever area you are inquiring about, you need to refer to the LA’s safeguarding website. For health providers there will be a lead professional within each CCG (Clinical Commissioning Group)
Audits of HTM0105 and monitoring
HTM0105 now no longer requires 3 monthly audits for cross infection purposes; this has now changed to only being required at 6 monthly intervals. Practices are required to continue to carry out these audits. Records of these are now required to be stored in house and may be requested at CQC inspection or practice visits by personnel from the Area team. There will no longer be a requirement to forward audits routinely to the Area Team
Occupational Health Services
Just to confirm that Occupational Health services have been re-established across the area with the previous providers. The interim arrangement is on a cost per case basis to cover the immediate needs that are starting to occur.
The providers are:
Humber NHS Foundation Trust for Hull and East Riding of Yorkshire
SKIDBY HOUSE
WILLERBY HILL BUSINESS PARK
BEVERLEY ROAD,
WILLERBY
HULL
HU10 6ED
Tel: 01482 389335/389333
Fax: 01482 303945
North East Lincolnshire Council for North East Lincolnshire
Cleethorpes Civic Offices – (Premises from June 24th 2013)
Knoll Street
Cleethorpes
DN358LN
Tel – 01472 324073
Doncaster and Bassetlaw Hospitals NHS Foundation Trust for North Lincolnshire
Doncaster Royal Infirmary
Armthorpe Road
Doncaster
DN2 5LT
Tel – 01302 381377
York Foundation Trust for North Yorkshire
YORK SITE
The Occupational Health and Wellbeing Centre
Centurion House
Centurion Park
Tribune Way
Clifton Moor
York YO30 4RY
Email: occhealth-clerical@york.nhs.uk
Tel: 01904 725099 (Reception)
SCARBOROUGH SITE
The Occupational Health and Wellbeing Centre
Scarborough Hospital
Woodlands Drive
Scarborough
YO12 6QL
Email: occhealth-clerical@york.nhs.uk
Tel: 01723 342168 (Reception)
LDC Meetings across the area
I very much want this not to be just a newsletter from the Area team, but also a means of sharing information with all local dental professionals. I hope it will encourage attendance and participation at LDC meetings so that they in turn can reflect a representative and clear voice for their members. I have dates for the following LDC meetings and would suggest you contact the secretary if you wish to attend
Hull and East Riding LDC
Next meeting is to be held on the 2nd July 2013 at 7.30pm at Brantingham Sports Park (Ionians), Elloughton.
Chair is Simon Hearnshaw
Email : alexhearnshaw2@hotmail.com
Secretary is Chris Groombridge
Email: Chris@543dentalcentre.co.uk
North Yorkshire and York LDC
Next meeting is the AGM on Friday June 28th at the Golden Fleece, Thirsk
Places are limited due to meal reservations involved, but the LDC would, I am sure, welcome new members’ long term to other meetings if space is unavailable at this event
Chair is Ian Gordon
Email: Iangordon1@nhs.net
Secretary is Mark Green
Email: markpgreen@aol.com
The newly proposed local Dental network
The following was contributed to the newsletter by Julie Wilson, Assistant Director Clinical Strategy.
Establishing a Local Dental Network – Your Chance to Get Involved in Service Planning
Clinical leadership is at the centre of the new NHS reforms. One of the approaches for securing increased clinical leadership is the establishment of Local Professional Networks for primary care services, covering Dental, Optometry and Pharmaceutical services.
A Local Dental Network will provide local clinical leadership and work with key stakeholders on the development and delivery of local priorities. The network will work alongside the primary care commissioning team within the local Area Team of NHS England (North Yorkshire and Humber) to provide clinical advice to help inform commissioning priorities and decisions. Some of the specific functions of the Local Dental Network include:
• Cover the whole dental pathway, including secondary care and out of hours
• Key role in supporting the development of quality measures for dental secondary care
• Will need to work closely with local authorities and Public Health England to deliver and develop cohesive Oral Health Strategies and associated commissioning plans
Much of the success of the network will depend on how well it engages with clinicians and professionals working ‘on the ground’. The Area Team will therefore be looking to recruit a Chair for the network who has the leadership skills, and credibility, to engage effectively with local clinicians and existing clinical networks (e.g. the Orthodontic Managed Clinical Network).
Based on discussions to date, it is envisaged that the work of the network will be overseen by a small governing body, which will cover the entire geography of the North Yorkshire and Humber patch (to align with the commissioning team). However, we envisage that the network will hold stakeholder events within more localised areas, e.g. separate events for the North Yorkshire and Humber areas, to ensure that there is real engagement.
The governing body will include the Chair, three other local clinicians, patient representation and Public Health input. Places on the governing body will be secured through a formal appointment process, and these roles will be advertised on the NHS Jobs website (www.jobs.nhs.uk). Notification will be sent out through the LDC when the roles are ready to go out to advert.
Engagement with existing networks and groups has been taking place over the last two months and a proposal as to how the Local Dental Network will be established will be sent out for wider comments before the end of June 2013. We hope to appoint to the Chair role as early as possible in July 2013.
If you would like more information about the establishment of the Local Dental Network across the North Yorkshire and Humber area, please contact Julie Wilson, Assistant Director Clinical Strategy, NHS England North Yorkshire and Humber Area Team, on 01338 251847 or 07900715488.,
Email: Julie.wilson25@nhs.net
Useful information for contacts in our Area
As you will be aware, as part of the recent changes to the NHS, Primary Care Trusts (PCTs) ceased to exist from 31 March 2013. The responsibility for primary care commissioning was taken over by NHS England with Area Teams responsible for commissioning services and managing contracts at a local level. Your PCT has been replaced with the North Yorkshire and Humber Area team.
I have listed below some contact details for some of the more relevant personnel working within the Primary Care Department of the North Yorkshire and Humber Area team.
Head of Primary Care Geoff Day
Primary Care Contract Manager Constance Pillar
Primary Care Commissioning Support Jane Ollerton
Primary Care Support David Iley
Commissioning Support Nichola Adcock
The Area Team are now based in offices in York with a second office in Willerby. The addresses for the offices are set out below
NHS England (North Yorkshire and Humber Area team),
Alpha Court
Monks Cross
York
YO32 9WN
NHS England (North Yorkshire and Humber Area team),
Health House,
Grange Park Lane,
Willerby,
HU10 6DT
Alternatively you can enquire via email to england.primarycare@nhs.net and a member of the Area Team will get back to you. If you need to contact the Area Team via telephone please ring:
Nichola Adcock – 011382 51910
If one of your patient’s wishes to contact NHS England they should do so through one of the following methods.
Write to:
NHS England, PO Box 16738, Redditch, B97 9PT
Telephone:
0300 311 22 33 (Monday to Friday 8am to 6pm, excluding English Bank Holidays)
Email: england.contactus@nhs.net
If one of your patient’s wishes to make a complaint or a freedom of information request please direct them to the NHS England website below
Dental Advisors contacts details
Alister – alisterweightman@nhs.net
Roger – bhdp@btinternet.com
Myself (Caroline) – c.bolland@nhs.net
New drug information to watch out for
New Oral Anti-Coagulants and Their Implications for Dental Treatment
All dentists should be alerted to two recently licensed oral anti-coagulant drugs that have been approved by the National Institute for Health and Clinical Excellence (NICE) for the prevention of stroke and systemic embolism in people with atrial fibrillation. The drugs are dabigatran etexilate (Pradaxa®), which is a thrombin inhibitor, and rivaroxaban (Xarelto®), which is an inhibitor of activated factor X. This article highlights the importance of appropriate dental management of patients who are taking these newer oral anti-coagulant agents and undergoing surgical or invasive procedures.
Warfarin is recognised as the first line treatment option for the safe and effective prevention of stroke in people who have atrial fibrillation. For people who have additional risk factors such as congestive heart failure or who have a poorly controlled international normalised ratio (INR), the newer oral anti-coagulant drugs may be considered by prescribers as a suitable alternative. Unlike warfarin, regular monitoring of the new drugs is not required. However, the drugs do have a number of disadvantages and are contra-indicated for certain groups of people.
Patients prescribed either dabigatran or rivaroxaban are at increased risk of bleeding following surgical or invasive procedures. There are currently no reversal agents and it is more difficult to manage major bleeding in patients prescribed the newer agents. Not all patients may carry a warning card or be aware of the implications of the drug on surgical or invasive dental treatment. The pharmaceutical company Boehringer Ingelheim has issued general guidance for patients undergoing surgical or invasive procedures who have been prescribed dabigatran and advise temporary discontinuation of the drug over a time period that is determined by renal function. This guidance has been circulated to all dentists but does not provide specific guidance regarding appropriate dental management. Wider research and consultation is being undertaken with a view to developing evidence based guidance for dental practitioners. In the meantime, it is advised that where surgical or invasive procedures are planned, a patient’s general medical practitioner should be contacted in the first instance for appropriate advice regarding any necessary adjustment in the anti-coagulant drug regime. Further specialist advice may need to be sought from the prescribing clinician or specialist. This will include interpretation of renal function results.
It remains the responsibility of the dentist to confirm a patient’s drug history.
Sally Eapen Simon (Specialist Registrar in Dental Public Health) has kindly supplied this article for me. If you have any questions please contact Sally.
Email s.eapensimon@nhs.net
New approach in Hull to Clostridium difficile Management
Clostridium difficile ( C.diff) card
Reducing healthcare associated infections is a high priority for the NHS.
From 15th July 2013 C.diff cards are being distributed to patients identified as being positive for C.difficile (colonised or infection). The C.diff cards are sent out free to patients with a Hull GP who have recently tested positive for the infection. The C.diff Card is designed to make it easier for healthcare providers to appropriately treat patients who may be at risk of recurrence/relapse.
The C-diff Card has been developed by City Health Care Partnership CIC (CHCP) and NHS Hull Clinical Commissioning Group (CCG).
What is the card for?
By showing the C.diff card to their doctor, pharmacist, nurse, dentist or any other healthcare provider, patients can quickly alert them to their condition; helping the healthcare provider to make appropriate decisions about medication (particularly antibiotics and ant motility agents) and provide correct advice to patients.
Benefits for patients:
• Reduces the chance of C.diff recurrence/relapse.
• Increases patient involvement in their own care.
• Increases patient understanding of their own condition.
• Assists patients to talk to healthcare providers about their condition.
Benefits for clinicians:
• Improves patient outcomes.
• Reduces episodes of illness and healthcare intervention.
• Complements the communication process between providers.
• Prevent relapses and reduce prescribing budgets.
• Increases knowledge of health care providers on up to date treatments and guidelines.
My thanks to CHCP for sharing this information.
Amendments to Business /Flu Continuity Plans and significant event reporting
This is a gentle reminder to get out these locked away plans and update. PCTs have now been replaced with our Area team so please replace the term ‘PCT’ in your business continuity and flu plans to, to ‘Area Team’.
With regard to significant events the responsible officer is Dr Paul Twomey, however I shall get back to you with a more comprehensive pathway in a later newsletter as the reporting protocol is developed.
Deadline for Nurses for CPD cycle and Indemnity Insurance Issues
On 31 July this year 2013 around 40,000 dental care professionals will reach the end of their first five year cycle of continuing professional development (CPD).
By that date they must have completed 150 hours of CPD. This is a legal requirement and registrants will have until 28 August 2013 to declare the hours that they have completed or risk losing their GDC registration.
As providers you must check NOW your DCP’S have completed the relevant CPD or you may not have any nurses available to go in surgery. ACT NOW AND CHECK
Indemnity insurance
It is a legal requirement of GDC registration to have indemnity insurance; this includes all dental nursing staff in surgery. Please make sure all nurses have indemnity cover of some kind as it has come to my attention that some nurses and providers (!) have not thought it necessary.
Finally may I wish the best to you all and hope you are finding this newsletter informative and helpful.