Missed appointments prompted review of dental services

Friday 06 July 2018

The high number of missed appointments - sometimes up to eight a day - has prompted the community dental service to review its processes and tighten the way it deals with patients who fail to attend.

The review also brought to light gaps in the department's safeguarding processes and contact will now be made with the Safeguarding Team if the department has concerns about the welfare of a child or their dental health - a process that can sometimes be triggered when parents don't bring their children to scheduled check-ups.

An Express Freedom of Information (FOI) request revealed in December that the number of under 18s failing to show up for their scheduled dental appointments hit a four-year high in 2016, with 2,088 appointments missed - nearly 14% of the total - despite some having to wait five years to be booked in.

The figures relate to appointments made with the Community Health Services Dental and Orthodontics and show that the percentage of missed appointments fluctuated between 13% in 2013, 11% in 2014 and 12% in 2015. In 2012, 14% of appointments for under 18s were not attended.

Pictured: 2,088 dental appointments for under 18s were missed in 2016.

The Dental Department’s very high DNA (did not attend) rate, which is equivalent to six to eight appointments lost each day, and its "unacceptably high waiting lists of up to five years prompted a review of the community dental service appointments process. 

This led to a new process being put in place in February this year. Now every child up to the age of 17 receives a routine appointment by letter. This is then followed by a text message reminder to all those who have provided a mobile phone number to the department. If the child does not attend, a second letter is sent requesting the parent to contact the department within 30 days to make a new appointment.

If no contact is made, the child is discharged from the service and a discharge letter is sent to the referring dentist (if there is one). The department has an 'open door policy' meaning the child can be referred again.

Pictured: The Dental Department will now contact the safeguarding team and Family Nursing and Home Care if they have concerns over a child's welfare.

A Health Department spokesperson explained: "The reason for this is because a number of parents decide to go private or leave the Island and we are keen to optimise and ensure as many appointments are provided as possible."

The service review also identified some gaps in the department's safeguarding processes, which have now tightened, "as HSSD recognises the importance of protecting the welfare of the child."

The spokesperson added. "If there is an existing safeguarding concern and/or a concern regarding a child’s dental health, the process is the same as above, but copies of letters are sent to the safeguarding team and Family Nursing and Home Care to review."

The department said that the new process is now well-established, but that they are continually reviewing and evaluating it.