Remote consultations in dentistry

SusQI project completed by the Dentistry team as part of The North East London Health & Care Partnership Green Team Competition, 2023.

Summary:

Video and telephone consultations were introduced at the Royal London Dental Hospital during the COVID-19 pandemic when access to dental services had completely ceased nationally. Even in the ensuing months where dental practice had resumed, access remained limited, especially for vulnerable populations who were at a greater risk of contracting the virus, who form the majority of our patient cohort in secondary care.  To date, there has not been a service evaluation ascertaining the extent of use, frequency, economic, social or environmental impacts. 

Part of the focus will be on Special Care Dentistry (SCD), a specialty that provides dental care for adult patients with additional medical, social, psychological, physical, or sensory needs (e.g., dementia, bed bound patients, learning disabilities).  Being a secondary care specialist referral centre, the clinicians in the service currently treat only the most complex patients within these groups, and for many patients access to dental services is challenging. 

Team members: 

• Zahra Shehabi, Consultant in Special Care Dentistry
• Alessandra Booth, DCT2 in Dental Public Health

Aim:

To evaluate the sustainable value use of remote consultations (via video or phone) at Barts Dental Hospital over a two-year period.

Method & Impact;

165.5 special care patient consultations and 1,674 ‘other specialty’ consultations took place across one year.

This is a saving of 10,807 kgCO2e, equivalent to driving 31,916 miles driven in an average car, from a reduction in patient travel and consumables used for a standard dental examination.

£163,943 based on reduced consultant time and average costs of an outpatient face to face consultant. £9,271 will be saved from consumable use per year.

Clinically, most staff agreed remote consultations have improved access to dental care; contributed to positive patient outcomes and facilitated care more efficiently.  Over two thirds felt they were able to pick up dental problems more promptly using remote consultations.

Socially, the change increases accessibility to dental care. 94% patients preferred remote consultations over face-to-face consultations for their initial assessment.

Each year remote clinics at Royal London Dental Hospital save the equivalent of the working of a 0.5 WTE (whole time equivalent) of a dental nurse. This time can be redirected to higher value work.

Future work is therefore planned to roll our remote consultations across all specialities in the Dental Hospital using the Special Care Dentistry department as a case study to highlight the positive impact this can have in relation to patient feedback, staff wellbeing and sustainability

Click here for more information on the Green Team Competition (including organisation impact reports).