AQW 16743/22-27
Ms Claire Sugden
Independent
East Londonderry
Tabled Date: 15/10/2024
Answered On Date: 30/10/2024
Priority Written: No
Question:
To ask the Minister of Health to detail (i) the current waiting time for dental surgery which requires general anaesthetic; and (ii) the steps he is taking to reduce waiting lists for dental treatments which require general anaesthetic.
Answer:
(i) Children requiring dental extractions, particularly those below 10 years of age, will often not cooperate sufficiently to allow the teeth to be removed under local anaesthetic alone. General Dental Practitioners refer patients of this type to the Community Dental Services (CDS) of the Health and Social Care (HSC) Trusts. The CDS specialises in providing routine dental care to patients who, for various reasons are not suitable for treatment in the primary care setting. In 2023-24, the CDS saw over 3,000 children for extractions under general anaesthetic. To ensure that the most urgent cases are treated as quickly as possible, CDS teams within HSC Trusts across Northern Ireland operate a strict triage and prioritisation process which is based on clinical need. Each HSC Trust CDS team has provided responses as detailed below for the current average wait from the time of initial referral, indicating the clinical need to be urgent, to the treatment appointment (referral to treat time). Southern Health and Social Care Trust: < 1 month. South Eastern Health and Social Care Trust: 1-2 months. Belfast Health and Social Care Trust: > 1 year. Northern Health and Social Care Trust: 6-12 months. Western Health and Social Care Trust: 1-2 months. It should be noted that the average waiting times for acute patients would be less than those stated for urgent as they are given a higher priority grading; those with a routine grading would have a longer waiting time. (ii) The CDS waiting lists for dental treatment under general anaesthetic were severely impacted by the COVID-19 pandemic and associated infection prevention and control restrictions. Across all HSC Trusts, CDS access to dental theatre lists have yet not returned to pre-pandemic levels. Throughout the later stages of the pandemic some waiting list initiatives were undertaken by some of the HSC CDS Trusts. These included additional lists (including weekends), as well as a successful cross border initiative in the Southern Health and Social Care Trust for children requiring timely extraction of permanent teeth. Attempts were also made to maximise the use of alternatives to general anaesthetic. These included the use of inhalation sedation (twilight sleep) and advanced sedation techniques (Penthrox). The advantage of these approaches is that they can be administered in a dental surgery thereby overcoming the issue of lack of theatre availability. Another method that has been successfully utilised by some Trusts is to have a general anaesthetic team and patient list on standby to take advantage of any free theatre space that becomes available at short notice due to list cancellation by another specialty. The Southern Health and Social Care Trust have also successfully changed their model of delivery of paediatric theatre services recently. They have invested/ trained a Paediatric Perioperative Nurse for the Paediatric theatres in Daisy Hill Hospital as well as undertaking international recruitment to increase the number of theatre nurses. Last year, my Department consulted upon the Oral Health Improvement Plans for Children and Older Persons. This document made a number of strategic recommendations to prevent dental decay among children. If these recommendations were implemented it would be expected that over the next three to five years there would be a reduction in the need for dental treatment under general anaesthetic.
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