DWSI document: How can this help a dentist to set up a contract with the PCT?

Dental Public Health

DWSI document: How can this help a dentist to set up a contract with the

PCT?

Eric Rooney

Consultant in Dental Public Health


Outline

The DWSI document PCT Commissioning Building evidence for procurement or

accreditation


Recognition

“Prison dentists have to manage a complex agenda in order to deliver optimum care for their patients, and require a range of skills additional to those needed to practise primary care dentistry in a high street or community setting”


Use

Guidance to Primary Care Trusts (PCTs) PCT should define the competencies required for the

appointment of a DwSI Dentists should match their personal development

portfolios against the requirements of the role. Should assist prison dentists and PCTs in identifying

any training needs Prison governors and healthcare teams


Generalist competencies

Clinical Record Keeping Infection Control Legislation and Good Practice Guidelines Medical Emergencies Radiography Risk Management and Communication Team Training


Competency Domains

Environmental Domain Clinical Domain Leadership and Management Domain Communication Domain


Environmental Domain

Security Ethical issues and safe practice in prison The prison environment Prison dentistry in the wider context


Clinical Domain

History, examination and diagnosis Treatment planning and patient management Medical and dental emergencies Anaesthesia and pain control Therapy, treatment and prevention Management of dental treatment in patients who are

substance misusers Management of dental care in patients with mental

health problems or a learning disability


Leadership and Management Domain

Clinical governance and audit Oral health promotion The role of the dental team Professional networks


Communication Domain

Communication with prisoners, representatives and advocates

Communication with the clinical team, peers and other professionals

Effective management of complaints


PCT Commissioning


PCT Responsibilities

PCT has a duty to provide or secure primary dental services to the extent it considers necessary to meet all reasonable requirements (S.16CA of NHS Act 1977)


PCT responsibilities

PCT has prescribed functions in relation to dental public health discharged by:

• PCT itself• PCTs acting jointly• by arrangements with other agency

(S16CB of NHS Act 1977)

Vision: World class commissioning will deliver Better health and well being for all

People stay healthier for longer – “adding life to years.” People live longer and health inequalities are dramatically

reduced – ”…and years to life” Better care for all

Services are of the best clinical quality and evidence based People exercise choice and control over the services that

they access so they become more personalised. Better value for all

Informed investment decisions PCTs work across organisational boundaries to maximise

effective care.


Commissioning

Dental Team

Prison Health PCT Commissioner

PrisonDentalCare

Model for commissioning prison and detention centre oral health services

Commissioning Prison and

Detention Centre Oral Health Services

or

Review service

Decide priorities-Assuring Minimum Standards

Shaping supply

Managing Performance & Supporting Quality Improvement

Oral Health Needs Assessment

Understand the establishment

Type and numbers

Turnover

Future Plans

Demography

Input from prison service

Use existing research and epidemiology

Develop Service specification

Scope

Prevention and oral health improvement

High quality, safe clinical care:

Urgent

Routine

Specialist

Demand management and referrals

Links to other services

Quality and risk management

Prison Health support

Research

Service Review

Assess against service specification

Work with existing or new providers

Re shape and refocus the existing service to deliver the service specification in partnership with the existing provider

Procurement process

Tendering process through “Supply to Health” or local process

Market Testing

Assess needs-Map the base-line

Strategic decision required

GDS contractPDS agreementPCTDS service statement

Amended to reflect the service specification

Appropriate measures of activity and quality and clear agreements about breaches and sanctions

Regular reviews including feedback from the prison healthcare team and patients

Strategic evaluation and review


PCT Commissioning

“You should have a clear procurement strategy for primary care dental services setting out when you will openly tender for new services and when you will expand the existing market. Under the principles and rules for cooperation and competition, the factors a PCT will consider in reaching this decision must be clear and transparent. The PCT Procurement Guide identifies four generic criteria that PCTs should consider when deciding whether or not to issue a formal tender”


Working with existing providers

Development of SLA Re shape and refocus the existing service to

deliver the service specification in partnership with the existing provider


Market testing

Advert requesting expressions of interest Quality criteria Short list Invitation to present/ interview Final offers Scoring Award Feedback


Service specification

Likely to be based on DWSI document and competencies

Likely to share elements of the new guidance Is the definition of the product, its quality and

the methodology of delivery Is the document which you need to match your

evidence against


Accreditation/ Procurement Panel

Prison healthcare representative Dental public health consultant PCT commissioner Dental practice adviser Dental practitioner contracted as a DwSI in

prison dentistry. PCTs may consider it appropriate to interview

potential candidates/ providers


Evidence for accreditation or procurement


Generalist evidence

The FGDP(UK)’s Key Skills in Primary Dental Care

Diploma of Membership of the Joint Dental Faculties’(MJDF) Portfolio of Evidence

BDA’s Clinical Governance Kit and Smile-on.com’s Clinical Governance Package


Environmental Evidence

Evidence of training undertaken (e.g. induction, breakaway, de-escalation)

Reflection on security issues within the prison Evidence of and reflection on local clinical

protocols Critical incident analyses Reflection on current issues in dentistry and

how they impact on healthcare in prisons


Clinical Evidence

Case reviews Direct observation (testimonial from another suitably

qualified professional) Critical incident analyses Reflection on training and personal development Examples of treatment plans Anonymised patient records Anonymised referral letters Evidence of local protocols (e.g. medical emergencies,

local urgent care pathways, triage)


Management and Leadership evidence

Evidence of a personal development plan Evidence of having undertaken CPD and reflection on its impact

on practice Evidence of participation in audit and peer review Evidence of involvement in the prison clinical governance

committee Evidence of knowledge of the evidence base for best practice Reflection on infection control procedures and infection control

issues specific to the prison setting Evidence of and reflection on oral health promotion in the prison

and the practitioner’s role in this Reflection on the role of the team in the delivery of dental care


Communication evidence

Reflection on cases where there have been potential barriers to communication

Evidence of and reflection on training and CPD in relation to communication with patients with a variety of communication needs

Evidence of written communication Evidence of knowledge of local protocols for dealing

with complaints Reflection on a complaint and what was learned from

it/critical incident analysis


Conclusion

The DWSI document PCT Commissioning Building evidence for procurement or

accreditation


Contacts

[email protected]

DWSI document: How can this help a dentist to set up a contract with the PCT?

Documents

Transcript of DWSI document: How can this help a dentist to set up a contract with the PCT?