‘Local voices improving local health and social care services’
Tell Healthwatch Ealing About NHS Dental Services Event Report April 2014
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[email protected] You can download this publication from www.healthwatchealing.co.uk
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Contents
Contents 2 About Us 4 The Event 10 Feedback - Attendees 12 In Pictures
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Introduction
About Us Healthwatch Ealing is all about local voices being used to influence the delivery and design of our health and social care services. Not just for people who use them now, but anyone who might need to in the future.
The work of Healthwatch’s Ealing’s Dental Group has been carried over from Ealing LINk which has focused on improving dental care services within the Borough of Ealing and promoting good oral health to the public. This work led to production of a good practice guide for dental practices from the patient’s point of view, which was prompted by issues raised relating to access to dental services in the borough This event was an opportunity to gather feedback of experiences and identify gaps in NHS Dental Services Healthwatch Ealing is the independent consumer champion for the public to promote better outcomes in health and social care for all in Ealing. Whether it’s improving them today or helping to shape them for tomorrow. We are all about local voices being used to influence the delivery and design of our health and social care services. We have a statutory right to be listened to by commissioners and providers of services. Our job is to argue for the consumer interest of all those who use health and social care services. Our starting point is people’s experiences, needs and wants and
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we base our work on solid evidence and intelligent analysis. We work with individuals and organisations including voluntary and community groups to help build a local, regional and national picture of trends and issues that matter most to the people. Our role is to state where changes are most needed and also be realistic in such way from a view point of a ‘critical friend’ with a pragmatic view. We use the evidence we gather to identify local and national trends and issues, and to influence national policy. We advise the Health and Wellbeing Board, Overview and Scrutiny Committees, Secretary of State for Health, Monitor, NHS England, Ealing Clinical Commissioning Group and London Borough of Ealing about our findings and report to Department of Health every year.
known to decision makers, local stakeholders, Healthwatch England and the Care Quality Commission
Write reports and make recommendations about how those services could be improved
Promote and support the involvement of people in the monitoring, commissioning and provision of local services
Provide information to help people access and make informed choices about services
Healthwatch Ealing as a registered charity is governed by a Board of Trustees and chaired by Ms. Carmel Cahill.
The members of Healthwatch Ealing have been amazingly supportive and have committed a lot of time, energy, expertise and experience to ensure that the voice of Healthwatch Ealing is established under the the public is heard in relation to Health and Social Care Services in Ealing in the Health and Social Care Act 2012 and we: North West London Sub-Region and Collect the views of local people about Nationally. their needs for and experience of Hestia is the parent company for local health and social care services Healthwatch Ealing and more information We also have the power to ask the health and social care regulator, the Care Quality Commission, to take action.
Make these views and experiences
on Hestia can be found at www.hestia.org.
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“Tell Healthwatch Ealing About NHS Dental Services”
The Event
On the 9th April 2014 Healthwatch Ealing held an information gathering meeting to hear people’s experiences of NHS Dental Services in the borough. The meeting was attended by 40 people The meeting was opened by a presentation by Dr Bal Kaur, Director of Public Health, she presented information about the dental health of the borough and the important link between dental health and overall health. Dr Kaur outlined the Public Health focus in relation to dental health, which is on children
Making Oral Health Everybody’s Business’ & ‘Every Contact Count’
Healthy Public Health Policy will contribute to improvements in oral health eg. Town planning restriction on fast food outlets around schools; Safe landing areas in recreational facilities; access to free drinking water in leisure facilities.
Ambition is to train children’s workforce (health, education, social care and voluntary sector ) with consistent messages
Opportunistic brief oral health intervention by professionals
The meeting divided in to small groups, facilitated by Healthwatch Dental Group members, supported by staff and volunteers The first session focused on getting people to share positive, negative experiences and to identify gaps in services
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Positive experiences: Overall there was positive feedback reporting, having very caring and understanding dentists who communicate the treatment with patients.
There was a lot of feedback from those at the event, saying that they found surgeries to be clean and that people said they had no problems with the appointment system. These people are comfortable with their dentist and who listens to their needs.
One participant said that her surgery has a reminder system that sends her a text for appointments. A couple participants reported they have stayed with their respective dentists for many years. One for over 20 years
A participant shared that because she is a carer, the surgery understands if she gives short-notice cancellation of her appointment
Others shared experiences of the community dentist of catering to the needs of a patient with severe autism – the dentists worked out a way to examine patient who did not want his teeth to be touched, the dentists good practice led to one person eventually allowing dentist to regularly check his teeth.
A parent also shared that when her children were growing up, they had annual school dental checks which she found very helpful.
Negative experiences: For people who had difficult or poor experiences, there was strong feedback that the cost of NHS Dental treatments is too high. The majority of participants who had these concerns, felt that dentists’ focus is on money by recommending unnecessary treatments, suggesting that private treatments are better than NHS ones. A person shared an experience, they missed the 6-month check-up, when they next went to the dentist with a problem, they were told that they have been removed from 5
April
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“Tell Healthwatch Ealing About NHS Dental Services”
the NHS list and all treatments would have to be privately done.
Lack of a range of interpretation services – people don’t know how to access dentist services and to receive treatment.
Dentist services more ambiguous than GP, many do not understand what services are available.
Poor quality of work and type of material used under NHS treatment.
One person had been refused to be on NHS as there is too much work to be done – they were told to go private.
Patients have been removed from the NHS and put into private.
Lack of clarity of the charges – sometimes dentists do not explain the charges.
Some dentists carry out additional treatment without the patient’s consent.
There is a lack of consultation with the patient – no explanation of treatment plan.
Patients are asked to sign forms without an explanation.
People with Long Term Conditions – stroke, epilepsy – people are not confident that dentists are trained to deal with these patients. There was one example given of a dentist making people’s conditions worse as result of understanding a patients physical limitations due to stroke.
There is no easy to read material for people with learning disabilities.
A few have said that they do not go to the dentist because of fear – charges, treatments, bad experiences.
One person, had such a bad experience in the late 1970s, they had not been to dentist since , despite suffering pain and loss of teeth. As a result of attending this meeting ,this person has decided to go to see a dentist. 6
One person had an experience of the head rest of the seat snapping back, causing pain to her neck.
Elderly people who are house bound, don’t get referred to dentists.
GAPS: The following gaps were identified: It was pointed out that for a place with a dense population, Southall, only has 7 NHS dental surgeries. How can more dental services be encouraged to give people choice?
There was view across the meeting, that dentists’ charges should be displayed in reception and waiting areas for the patients’ information.
Lack of clarity on emergency dentist services – where is the information? Maybe this should be available in A&E?
People with long-term conditions feel left out, inadequate services for them - with a lack of interpreter services, easy to read material and understanding their condition.
There was a suggestion to help to deal with this, having a health passport – which indicates the patients’ specific needs (i.e. can’t be touched, crowded waiting room, how their conditions affects their physical movement). Learning can be taken from the Treat me Right Project.
Dental visits for care home residents and housebound people.
There is need to encourage patients to have an annual check-up – especially for mouth cancer. 7
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“Tell Healthwatch Ealing About NHS Dental Services”
The second part of the event focused on experiences of raising concerns or complaints again there were discussions in facilitated groups
Complaints system:
There was a general view that people are not aware of how to make a complaint about their dentist or their treatment and if they do, there was a lack of confidence that something productive would actually happen.
Information about the complaints process and patients’ rights should be more available for patients to peruse and be explained in an easy manner. This information needs to be available in a variety of accessible formats.
Representatives from Treat Me Right project suggested that they can train health professionals on how to deal with patients with learning disabilities.
Those who have complained felt that it didn’t really go anywhere and all they received were acknowledgements.
The people in the work groups discussed the following on What can be done to improve experiences of NHS Dental Services in Ealing? More oral health promotion in schools, more oral health promoters, we currently only have one in the borough.
Costs of treatment and type of materials used to be easily available for patients to see, so that they can have a good discussion about their treatment with their dentist. (i.e. GPs display their fees for certifying passports)
Have a paper version of NHS dentists and their ratings.
Have a ‘How to Complain’ information available in each reception. 8
Dealing with people’s fear of dentist needs to be addressed.
People with disabilities should have easy access to the community dentist. There is a suggestion of the implementing the use of the health passport, which indicates what the patient’s specific needs are. Maybe this should be for all vulnerable patients.
More regulations – NHS England as a commissioner is too far away from the people who use the services. The complaints system too complicated to navigate. This needs to be addressed by NHS England.
Treat Me Right is doing a project soon, offering people with learning disabilities a chance to work with dentists to find out how to look after their oral health in a way they can understand. This work should be supported and promoted.
Going forward 1.
This report from the event will be sent by Healthwatch Ealing to: NHS England Care Quality Commission Ealing Clinical Commissioning Group, Ealing Public Health and Public Health England Ealing Health and Well Being Board
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This report will be available on our website and people can request hard copies
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The Healthwatch Ealing dental group with be reviewing the report and identifying actions they can take forward, including following up with NHS England on actions they need to take in their role as commissioners of NHS Dental services for Ealing.
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Feedback and Evaluation
Feedback Attendees Attendees evaluated the event and some of the responses received are the following :Very well arranged and allowed everyone an opportunity to be heard.
She (Dr Kaur) should do this frequently and more on other public health issues. Obesity linked with tooth decay.
Full of information. Eye opener. Full of advice. Never been to this type of session. Brilliant, keep it up!
This event is very inspiring, lots of information.
Very useful workshops, I have been able to gain a good understanding on how to complain and what to ask when I visit the dentist. 10
Very informative and well-coordinated
A very well presented event has highlighted the oral health needs of the Ealing population. Needs to be more advertised for more people to attend.
We also received comments regarding areas which we need to improve for future events. Examples of these are:-
A little rushed but straight forward and easy to join in.
A little rushed at times, but because lots of people had good things to say and suggest.
Healthwatch Ealing would like to thank all Healthwatch Ealing members and members of the public who attended as well as Dr Bal Kaur and her team from Public Health Ealing as well as Linda Cardona Oral Health Adviser.
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Event In Pictures
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Healthwatch Ealing Lido Centre 63 Mattock Lane West Ealing London W13 9LA Tel: 0208 280 2276 Freephone: 0800 652 7200
[email protected] www.healthwatchealing.co.uk Registered Charity 1153807 Company Number 8479376
