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Implementing and evaluating a primary care service for oral surgery: a case study.

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A new primary care oral surgery service offers convenient, safe care comparable to secondary care. Improved communication with dental practices is key for optimal patient access to this integrated service.

Keywords:
Demand managementOral surgeryOrganisational case studiesPatient satisfactionPrimary health careReferral management

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Area of Science:

  • Oral surgery
  • Primary care medicine
  • Health services research

Background:

  • Rising demand for oral surgery in secondary care prompted the establishment of a primary care service in England.
  • An electronic referral management system was implemented alongside the new service.
  • Ensuring quality, safety, and stakeholder acceptability was crucial for the new service.

Purpose of the Study:

  • To conduct an in-depth case study of a new primary care oral surgery service.
  • To explore the safety, quality, acceptability, and implementation of the service.
  • To evaluate treatment outcomes and patient experiences.

Main Methods:

  • A case study approach utilizing multiple sources of evidence.
  • Analysis of audit data and patient interviews.
  • Evaluation of the commissioning process and service implementation.

Main Results:

  • Referrals primarily involved tooth extractions of suitable complexity.
  • Initial challenges included low awareness among referring practices and patients.
  • Over time, the service became well-integrated, with low reported complication rates.

Conclusions:

  • Patients reported positive experiences due to convenience (shorter wait times, location).
  • Patient-reported outcomes were comparable to secondary care.
  • Oral surgery can be safely delivered in primary care for patients without complex medical needs, provided clinical governance is robust.
  • Enhanced communication with general dental practices is vital during implementation to ensure appropriate patient referral pathways.