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Care pathways for paediatric dentistry services in England: a mapping study
Emma Morgan1, Deborah Moore2, Louise Oni3
1School of Dentistry, University of Liverpool, Liverpool, United Kingdom. Emma.Morgan@liverpool.ac.uk.
Insights
Paediatric dentistry services in England show significant regional variations, leading to inconsistent care pathways for children. Recommendations aim to improve equitable access to specialist dental care across all regions.
Area of Science:
- Pediatric Dentistry
- Healthcare Management
- Public Health
Background:
- National Health Service (NHS) England has a clinical standard for specialist pediatric dental care.
- Evidence indicates national inconsistencies in delivering pediatric dentistry services.
- Existing care pathways for accessing pediatric dental services require evaluation.
Purpose of the Study:
- To evaluate current pediatric dentistry care pathways for children in England.
- To identify variations in service delivery across different regions.
- To inform recommendations for equitable service provision.
Main Methods:
- Qualitative study utilizing semi-structured interviews with Managed Clinical Network (MCN) chairs.
- Virtual interviews were conducted, audio-recorded, and transcribed.
- Process mapping was used to visualize care pathways from Level 1 to Level 3b services.
Main Results:
- Most English regions have an active MCN.
- Few regions utilize centralized, specialist-led triage or electronic referral systems.
- Service complexity varies significantly, often due to limited specialist availability.
Conclusions:
- Significant regional disparities exist in pediatric dentistry care pathways.
- Few regions align with the established clinical standards for pediatric dentistry.
- Recommendations are proposed to ensure equitable delivery of services nationwide.
Abstract:
Aims National Health Service (NHS) England's paediatric dentistry clinical standard outlines what specialist paediatric care is and how it should be delivered. Current evidence demonstrates that there are national inconsistencies in the delivery of paediatric dentistry services. Considering this, this study aimed to evaluate the present care pathways available for children in England to access paediatric dentistry services.Methods A qualitative study was undertaken using semi-structured interviews. All paediatric dentistry Managed Clinical Network (MCN) chairs were invited to participate. Interviews were undertaken virtually using a topic guide, audio recorded and transcribed. A process map was created to visually demonstrate the care pathways from Level 1 - Level 3b services in each MCN region in England.Results Nearly all regions of England have an active MCN. Not all regions have an electronic referral management system, with only two having a centralised specialist-led triage system. There is variation in the level of complexity provided within services, often dictated by the limited availability of paediatric dentistry specialists and consultants.Conclusions There are significant regional variations, with few regions in England delivering a pathway consistent with the illustrative care pathway produced in the paediatric dentistry clinical standards. Recommendations have been produced to facilitate equitable delivery of paediatric dentistry services across England.
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