What organisation/body is responsible for commissioning Primary & Secondary dental care?
NHS England
What are the 6 key components of a Health Care System?
- Structure
- Function
- Target population
- Personnel (workforce)
- Funding
- Reimbursement
Student Finance Treats People For Real
Where does NHS England recieve funding from? (2)
What are 4 main roles?
Finding from Department of Health & Public Health England
4 main roles:
- Set priorities and direction of NHS
- Responsible for Primary and Secondary dental care
- Support development of Sustainability and Transformation Partnerships (STPs)
- Support Intergraterd Care Systems (ICS)
What are CCG’s?
Where do they recieve their funding from?
CCG’s = Clinical Commissioning Group
191 CCGs - Plan and Commission hospital care, community and mental health services
(All GP practices must be part of CCG)
What are the aims of Public Health England? (2)
What do they work with local authorities and partners to do? (3)
Aim = Protect and improve propulation health, Reduce health inequalities
- Study epidemiological datae on health/illness
- Deliver and support health improvements
- Design and deliver public health protection measures
What is Healthwatch?
Community-led organisation within each Local Authority.
Commitee member of CQC - Role in finding out public opinion on local/social care services, identifying concerns and reporting these to CQC for review
What is meant by:
- PRIMARY Care?
- SECONDARY Care?
- TERTIARY Care?
- Local healthcare (e.g. GPs, dentists, community pharmacists)
- Consultant-led healthcare, emergency or referal from primary care (usually in hospitals)
- Consultant-led healthcare, usually in-patients referred from primary or secondary care, with advanced staff and facilities
What are the 5 main functions of the NHS?
(IF DAD)
Improve health status of individuals, famlies and communities
Financial - Protect people against financial consequences of ill-health
Defend population against health threats
Access - Provide fair access to care
Decisions - Make possible for people to take part in decision making affecting their health system
How is NHS England funded?
Public taxation, supported by National Insurance contributions
Who is except from paying dental charges on NHS? (3)
- Children under 18 years or 19 if in full-time education
- Unemployed - Low income benefits
- Pregnant women (or had child within 12 months)
What are the 4 factors influencing a healthcare system (PEST)?
[Big Exam Q]
1) POLITICAL
- Increased patient involvement in decision making
- Increased choice and competition
2) ECONOMICAL
- Financial crisis → Temporary loss of finance but permanent loss of output
- Slow recovery → Impact on health and health behaviours
3) SOCIAL
- Increasingly aging population
- Change in housing (increased lone housing)
- Increase in certain ethnic groups
4) TECHNOLOGICAL
- Increased access (cheaper)
- Change in setting (home vs. hospital)
- Increased digitalisation
- Increased ability to work flexibly
- May become more personalised
What is meant by Collaborative Practice?
A dynamic process where multiple health workers from different professional backgrounds work together with patients, families, carers and communities to deliver the highest quality of care.
Inter-professional practice/education → Better understanding, shared values and improved respect
What are 5 reasons why we want to have collaborative practice in dentistry?
(CQC AT)
- Common Risk Factor approach
- Quality of life (improved through improved OH)
- Cost (reduced from avoiding duplication in efforts)
- Access (improved)
- Trust (mutual trust and accountability leads to better care coordination)
Who is involved in collaborative care within elderly home? (3)
- Adult social care within Local authority
- Care home service provider
- Health/Social care providers (e.g. nurses or HCAs)
What are the 3 NICE Guideline recommendations for Oral Health Care in Care Home?
(and give rationale)
1) All new residents to have oral health needs assessed upon arrival (nurse-led)
- Often self-care deterioration before moving into care home
- Oral health often missed
- Early assessment ensure tailor care can start asap
2) Oral health to be made part of regular assessment and recorded in personal records
- Requires regular review
- Ensures actions taken to meet patient needs
- Allows collaborative practice with NHS dentist
3) Adults in care home should be supported in maintaining oral health
Poor OH → Social deterioration (self-confidence, function, speech) and general QoL
What are 6 separate organisations making up NHS?
- NHS England
- Public Health England
- Clinical Commissioning Groups
- Local Authorities
- Healthwatch
- Health Education England
Explain (breifly) funding and structure of NHS…
What are 5 main causes of health inequalities?
- Financial - Unemployment + financial means of nutrition or healthcare
- Education
- Lack of prevention
- Individual lifestyle factors (e.g. smoking, diet or alcohol)
- Living condidions (e.g. sanitation, housing and healthcare)
What is meant by a “non-communicable disease”?
Name 4
Chronic diseases resulting from a combination pf environmental and genetic factors; cannot be passed on from person to person.
- Heart disease
- Diabetes
- Cancer
- Respiratory disease (e.g. Asthma)
N.B. Obesity is NOT a non-communicable disease…
What is meant by the “Common Risk Factor Approach”?
How can this be implemented for Oral Health?
Give 3 examples
A method used to create cross-disciplinary health promotion programmes based on the premise that many non-communicable diseases (e.g. cancer, diabetes, heart disease) share common risk factors (e.g. diet/obesity, smoking or stress).
Implemented via: Integrated or Collaborative Approach
Target shared risk factors, in OH include: Smoking, Diet , OH, Alcohol, Stress and Trauma.
- Government taxations
- Improved food labelling (allow consumer choice)
- Health promoting schools - Education
What is meant by “Social Determinants of Health”?
Give 5 examples
The economic and social conditions under which people live and which dermine their health.
E.g.
- Education
- Employment
- Access to healthcare
- Housing (and surrounding areas)
- Water and sanitation
What is meant by VBA?
What are the 3 steps?
VBA = Very Brief Advice
Simple opportunity (5-10 mins) for dental professionals to give patient advice on stopping smoking and refer them for necessary help.
- ASK - Establish and record patient tobacco status
- ADVISE - Personal benefits to smoking (health and finance)
- ACT - Offer help and refer/signpost
What are the 4 key recommendations of Public Health England (PHE) regarding tobacco cessation advice
- Tobacco users should recieve advice to stop and support in referal to a local service
- Dental schools, postgrads and other teaching institutes should ensure adequate tobacco cessation training
- Dental teams should stay proactive in engaging tobacco users
- Commissioning bodies should implement appropriate measures to support the above
What is a key phrase to use during VBA?
“We know that the best way of quitting is with a combination of medication and support. We have a free, friendly local stop smoking service that lots of my patients have found useful. I can refer you if you’d like?”
