Novel tier 2 service model for complex NHS endodontics.

Area of Science:

• Dental Public Health
• Endodontics
• Healthcare Workforce Management

Background:

• Tier 2 practitioners offer intermediate care for moderate dental cases, reducing secondary care referrals.
• Endodontic service provision varies across specialties and local commissioning priorities within the NHS.
• Evaluating NHS tier 2 endodontic services is crucial for optimizing patient care and resource allocation.

Purpose of the Study:

• To investigate the reasons for endodontic referrals to an NHS tier 2 service.
• To evaluate the outcomes of these endodontic referrals.
• To assess the effectiveness of tier 2 practitioners in managing endodontic cases.

Main Methods:

• A service evaluation analyzed 401 endodontic referrals to an NHS tier 2 service in Powys, Wales.
• Data collected included reasons for referral, referral outcomes, and requests for consultant support.
• Results were analyzed using frequencies and percentage distributions.

Main Results:

• Post-treatment disease management (56.4%) and root canal negotiation issues (26.9%) were primary referral reasons.
• Mandibular molar teeth were most frequently referred.
• Tier 2 practitioners successfully treated 44.1% of referred patients, with consultant support needed for only 3.5% of complex cases.

Conclusions:

• NHS tier 2 practitioners demonstrate capability in managing and treating the majority of endodontic referrals.
• Remote consultant advice effectively supports tier 2 practitioners with complex cases, ensuring successful treatment delivery.
• This model optimizes endodontic care delivery within the NHS framework.