Sally Eapen-Simon, Consultant in Dental Public Health in NHS England – North East and Yorkshire’s Healthcare Public Health Team describes how a recent paediatric dentistry pilot has made a positive impact on dentists and young patients.

 Supporting young patients in Wakefield and Hull

In 2022/23, NHSE led the review of YH Community Dental Services, and this set out several key recommendations. This included the need to support workforce development to help support waiting list management of referred children, dentist career development and potential retention in Yorkshire and the Humber.

In 2021, NHS England Workforce, Training and Education Yorkshire and Humber (formerly Health Education England) led an innovative level 2 dentist paediatric training programme, and for the first time nationally, NHSE developed a level 2 accreditation programme. In 2023, 12 dentists across Yorkshire and the Humber were successfully accredited as level 2 paediatric dentists through the scheme, with three dentists delivering commissioned services.

 A new model for paediatric dentistry

Introduced in 2024, working in partnership with NHSE – Dental Public Health and providers, West Yorkshire and Humber and North Yorkshire Integrated Care Boards (ICBs) have supported the development of commissioned level 2 paediatric primary dental care-based service models in Wakefield and Hull.

Accredited level 2 dentists and their dental teams are currently piloting a service in three practices, where comprehensive treatment, inhalation sedation and evidence-based prevention and advice is provided. The pathway is facilitated by effective collaboration with Paediatric Dental Consultant led CDS dental teams.

This service is being fully evaluated and includes a piece of work being led by the University of Sheffield to provide some valuable insight into care experienced by children, parents and carers.  While the final report will be completed by early Spring 2025, emerging findings demonstrate a reduction in numbers of patients waiting for treatment and waiting times, improved patient outcomes and positive feedback from both dental teams and patients/parents.

Positive feedback from dentists and patients

Kate Waldon, one of the dentists accredited via the initiative has told me that working on a Level 2 Paediatric Dentistry contract has made a big, positive impact on her working week. She says:

“My nurse and I look forward to our paediatric clinical sessions, it’s a wonderful opportunity for us to work in a different way to our usual general practice sessions and that variety through the week has improved my job satisfaction and enthusiasm for my role. My dental nurse has enjoyed the opportunity to develop additional skills managing the higher needs children we see on these sessions and used it as a springboard for further development of her career.”

Kate Waldon and Rachael Bale

Her colleague Charlotte Rowles who has been working in the Hull area is equally enthusiastic. She also feels increased job satisfaction working in general practice now she can deliver Level 2 sessions alongside general dentistry and added:

“As a general dental practitioner working in a high treatment needs area. I felt I needed to enhance my skills in managing my paediatric patients. I have found the Level 2 training program a very supportive training environment as I have been able to upskill while maintaining my commitments in general practice and to my own young family.

“Undertaking this training has benefited my general dentistry as well as allowing me to undertake sessions treating paediatric patients that have been referred into community. It has allowed me to enhance my treatment planning and practical skills”

Charlotte also feels the training has improved her confidence as a clinician, saying:

“General practice can be isolating, and it has allowed me to work alongside other local organisations and be part of a support network. It has also allowed me to appreciate the challenges faced and hard efforts made in secondary care to manage these patients.”

It’s not just about the dentists, the training has benefitted the whole team including the dental nurses. who have enjoyed having the level 2 sessions within the practice as it has given them the chance to learn new skills.

Charlotte described the increased job satisfaction across the team as follows:

“Me and my nurse have been able to undertake our inhalation sedation training. Nurses have enjoyed undertaking paediatric nurse training and utilising previous skill obtained in radiography. It has given the nurses the chance to undertake their Oral health education training. These are also skills they can utilise in treating the general population.”
The team have found it rewarding helping to reduce the waiting times in Hull and would like to continue assisting with this.

Patient feedback has been overwhelmingly positive around the service. Comments gathered from post- treatment questionnaires revolved around specific experience around putting children at their ease and included:

“Very good with children at explaining things that helps them understand what is happening and remain calm”

“Excellent service to complete this specialist dental care. Child at ease throughout procedures. Child happy to come to appointments. Happy to come again for future care if required”

Future training opportunities as a result of the pilot

Since 2021, NHSE Workforce Training and Education have delivered additional courses, and two additional cohorts will have completed the course by December 2024.   Led by the YH ICBs’ YH Paediatric Dentistry Managed Clinical Network, applications for accreditation are now invited with the ICBs’ accreditation panel meeting at the end of January 2025.

Together with the evaluation findings, this will inform the future commissioning of services and roll out across Yorkshire and the Humber including application to other dental speciality pathways. Humber North Yorkshire ICB are piloting a General Dental Practitioner Fellowship, and this 5-year programme will include level 2 training which could include paediatric dentistry.

Jason Atkinson, Associate Postgraduate Dental Dean, WTE NHSE Yorkshire and Humber described the new programme as follows:

“The pilot General Dental Practitioner (GDP) Fellowship programme has been designed to support early years dentists in their role as an NHS GDP following Dental Foundation Training (or via equivalence routes). The programme provides opportunities for generic development with General Medical Practitioners (GMPs) and a more focused support provision, provided in collaboration with WTE NHSE. The five-year programme will include development and training towards Level 2 skills in the latter years of the programme, as well as generic training to support primary care practice ownership aspirations and mentoring and coaching development for fellows”

This ongoing work is potentially laying the foundation for future paediatric dental services across the West Yorkshire and North Yorkshire and the Humber areas.

Sally Eapen-Simon