Friday, April 4, 2014

ACT Dental Health Forum 28 March 2014

On the 28th of March HCCA hosted a Dental Health Forum.
Yelin , Loretta Bettiens and the DHP team
This was presented by Loretta Betteins, Director Dental Health Programs (DHP) and her team.
 Loretta, provided an overview of the public dental program which involves at combination of dentists, dental therapists, prothetists and technicians who make dentures. More recently this expanded to include the oral health and hygienist role. The DHP is a very busy service, taking 4000 phone calls per week making this one of the busiest phone lines in the ACT Government.
Since the last dental forum held 3 years ago, staff numbers have increased from around 90 to 120 people, allowing the DHP to address previously long waiting times and unmet needs of the ACT community.

Darlene and Khalia, getting excited about oral health.

The DHP now operates from 5 community health centres across Canberra.
·         6 Chairs in Gungahlin
·         10 Chairs in Civic

Who can use the services?
·         Child and Youth dental service – all children under 14 in school in the ACT
·         Young people 14 – 18 need a Centrelink card or heath care card
·         Adults who have a  Centrelink card concession or health care card
There is no waiting time for children who need general treatment. Adults who require general treatment, place their name on a waiting list at a community health centre and will be seen within 3-6 months.

Emergency needs

Emergency Services are available for all adults and children out of The Canberra Hospital, People can present to the emergency department after hours, were they are triaged, if deemed to be a high priority i.e facial swelling, infection or trauma to face and mouth they will be seen within 24 hours.  The DHP are looking to increase this capacity of this service through the Emergency Department.

Where are other DHP services delivered?
·         Alexander Maconochie Centre 
      Limited nursing home clinics
·         Some small community groups
·         General anaesthetic work at The Canberra Hospital
·         Calvary Hospital
·         John James Hospital,
·         CC Cares in Stirling
The DHP acknowledged that access to appropriate dental care to people who do not have concession cards but do not have much expendable income is an issue, currently being investigated by the National Oral Health Group. The DHP is also not able to do in-home visits yet and is expanding its reach in nursing homes and residential care communities through the development of the mobile dental clinic.

External funding sources
·         Health Workforce Australia received 500K in 2012 to support dental students. Previously ACT Health did not have a relationship with dental students. Recently the DHP developed a relationship with University of Adelaide dental program, these students do graduate years with the ACT and the program has been very positive with many students returning to work within the DHP in Canberra.
·         The DHP have recently purchased an OPG (Orthopantomogram) machine which is set up Civic. The machine provides a 3D panoramic view of the mouth, teeth and bones of the upper and lower jaws and is similar to a CT Scan in the image that can be created.
·         Federal Budget announcement 2012-3 National Partnership Agreement (NPA) 1 January 2013 over three years.
·         National Oral Health Promotion Plan is being developed – to fund health promotion activities.
·         Child Dental Benefit Schedule voucher system as of 1 January. If a child is receiving Family Tax Benefit Part A or a range of other income support payments they are eligible for this. Private dentist are also participating in this program.

Our wonderful forum participants
What does this mean for the ACT?
From January 2013 the ACT will receive a total of $5.5 million dollars over three years under the NPA plan to reduce public dental waiting lists. At the end of Feb 2014 the ACT has met all the targets set out in the agreement.

Waiting Time
Actual waiting time is currently 2.93 months, compared to February last year where it was 8.49 months. During this time the DHP have removed 2985 clients from the list, and have more than doubled the amount of people they currently see.  Denture waiting list has also seen significant improvements. Wait time is currently 3.06 months compared to 13 months in February of last year.
This data comes from an electronic database, all waiting times are on this database and this is audited annually. Time shown reflects the time from putting your name on the waiting list to when you are sitting in the dental chair.
DHP acknowledges that communication with a transient population like Canberra is difficult and hopes that when The Titanium system will link with ACTPAS and they will be able to update data and improve communication.

Improvements on the way!
·         DHP are looking to improve their informed consent processes. DHP says the electronic client record helps with this and that consent changes being made are consistent with the overarching consent policy from the Canberra Hospital. Using an electronic checklist that the clinician fills in also encourages communication with the consumer to insure they understand, before signing consent forms.
·         DHP have introduced technology that tracks a sterilisation pack of instruments to a particular client to insure safety and quality.
·         DHP have introduced intra-oral cameras that can show clients what teeth are affected, level of decay and conditions on a screen above chair. These images can then be saved on the system.

Mobile Dental Clinic
In the last budget (June 2013) the ACT Government committed 1.6m over 4 years to establish and operate a mobile dental clinic.  This includes $600 thousand to buy the mobile clinic and $250 thousand to run it with a (dentist and dental therapist).
DHP are in the process of developing a model of care for this, involving input from HCCA . Their main focus is providing this service to those living in residential care programs within the ACT, before expanding their scope. They are aiming to see all residents in a two year rolling program.

Partnering with Consumers and Health Literacy
At the forum there were many discussions around the importance of communication with consumers and the development of written materials. DHP was also keen to develop and improve partnerships with consumers about delivery management and policy around these services. HCCA is looking to convene a consumer group about the use of the DHP and is currently in the process of beginning involvement in the development of the mobile dental clinic.
HCCA thanks everyone who attended and Loretta and her team for coming to discuss their program and future consumer involvement.

Eleanor Kerdo
Policy Officer

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