AQW 17876/22-27
Ms Kellie Armstrong
Alliance Party
Strangford
Tabled Date: 08/11/2024
Answered On Date: 25/11/2024
Priority Written: No
Question:
To ask the Minister of Health to detail any actions being taken to reduce waiting times for children with learning disabilities, who are living in pain, to access in-patient dental treatment.
Answer:
The Community Dental Service specialises in providing dental care to patients who, for various reasons are not suitable for treatment in the primary care setting. For young children, those with additional needs or particularly complex cases, it may be necessary for the treatment to be take place under General Anaesthetic (GA). Some patients may require all or most of their dental care under GA. The Community Dental Service (CDS) in all five Health and Social Care (HSC) Trusts offer dental treatment under GA to children with additional needs. However, for those children with the most complex needs a GA Daycase in a district general hospital may not be suitable. Instead, for both patient safety and complexity of care reasons, a referral to the regional Paediatric Consultant-led service in BHSCT may be required. The CDS operate a strict triage and prioritisation process which is based on clinical need. This ensures waiting times for acute patients are less than those for urgent patients as they are given a higher priority grading; those patients with a routine grading have the longest waiting times. The CDS waiting lists for dental treatment under GA were severely impacted by the COVID-19 pandemic and associated infection prevention and control restrictions. Regionally, in 2023-24, the number of children receiving dental treatment under GA was approximately 90% of the 2019-20 figure. Trusts currently report that the main barrier to achieving pre-pandemic levels of dental GA activity is theatre access and in particular a shortage of theatre nursing staff. Throughout the later stages of the pandemic some waiting list initiatives were undertaken by some of the Trust CDS teams. 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 to maximise the use of alternatives to GA are in place in some Trusts. These included the use of inhalation sedation (twilight sleep) and advanced sedation techniques (Penthrox). These approaches are 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 GA 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 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 significant reduction in the need for dental treatment under general anaesthetic.
|