The recent announcement that NHS England is to look closely at how dental services can be improved for vulnerable patients and individuals failing to access care was widely welcomed.
The initiative, announced last month at the British Dental Association Conference by health minister Earl Howe, will means the setting up of a task group that will report to the new National Dental Commissioning Steering Group on how best to develop the delivery of care outwith traditional surgery settings.
But, it appears, unknown to many involved in policy development, a business model that delivers this domiciliary care to those very patients identified by the government who fall outside provision by local dental practices already exists.
Doncaster-based Alan Wilkinson worked as a dental hygienist in a practice in Harley Street for more than 10 years after graduating from the RAF Dental School and spending several years in the armed forces.
Using a fully equipped wheelchair-friendly mobile surgery, Alan runs Concept Clinics, a unit that delivers oral health care to elderly patients throughout the UK, The concept is simple – he parks in the car parks of care homes and treats needy patients. The mobile surgery is a legacy of his time in London, when he worked on film sets and treated celebrities. For those residents who are bedbound, he also has Trans Care Max, a fully equipped portable dental treatment system, contained in a single rigid case.
In the past, it has been a logistical nightmare for home managers , trying to get a resident dental treatment, he says. If you can find a dentist who will do the treatment it involves at least one care worker accompanying the resident and having to pay for a taxi.
When he began the service, he contacted local care homes to 'dip my toe in the water'. Since then, he has been visiting a number of homes a day – 'I didn’t realise how desperate a need there is,' he explains.
Alan also wrote to the 182 Primary Care Trusts across England to make them aware of the problem, but those that did reply , explained there were 'no funds available'.
With 20-plus years' experience dealing with the elderly mentally infirm, dementia and Alzheimer sufferers on a daily basis, within the care home environment, Concept Clinics (with former BDA president Amarjit Gill as its clinical director and former CDO of Wales Paul Langmaid as its international development director) is committed to developing long-term partnerships with clients and providing the best onsite dental care available, using the latest technology, materials and techniques to maximise efficiency, reliability and overall quality.
Alan says: 'We operate nationally, working closely with nursing homes, residential homes and clients in sheltered accommodation. We have many years' experience dealing with all aspects of medically and mobility compromised patients. We were certainly the first to address the access shortcomings providing all aspects of dentistry on a domiciliary basis.'
The business provides the equipment, recruits the dentists and trains them. Alan says: 'They are given protocols to help guide them through efficiently caring for patients, to keep the fees low.'
Concept Clinics has five mobile units but, Alan explains, 'we are seeking 12 additional suitably ambitious partners throughout the UK in order to expand.'
At a later stage, the team hopes to expand its remit to include schools and homeless centres and eventually it has plans to deliver care into people’s own homes.
Alan is damning of the NHS provision for these hard-to-reach patients, saying 'delivery has, so far, been restricted by the myopic vision of PCTs, so most provision unfortunately is on a private basis. The fees have been tested over time to offer a fair and acceptable cost to the patients.' As an additional service, Concept Clinics also rents out units in order to 'assist dentists with surgery extension, refurbishment, fire or flood damage so they can maintain services whilst their premises and/or equipment are upgraded'.
Working alongside UK Trade and Industry, this care delivery model is also now being offered to less developed nations throughout the world. The incorporation of telemedicine into the service model has improved the diagnostic range of the dental team.
Alan says: 'We are currently in negotiations with the Ministries of Health for Turkey, Nigeria,Malaysia and Albania. However, the model has also commanded interest in China, India and South Africa and these opportunities are to be explored at a later date with collaborative partners.
With eyes being opened within the NHS delivery of oral health care, feedback for Alan's business has, so far, been promising and the fact that so many people now reach old age retaining some or all of their natural teeth, often with complex resorations provided when they were younger, means an ever increasing demand for easy to access yet comprehensive dental care.
He says: 'Several of the main national care home groups that use our service request we expand the reach throughout their whole group. This has led to us starting up replication throughout the UK under licence with existing dental practices or new standalone practices. The exciting part is that this can be DCP led as the protocols and service blueprint are there to follow.'
Alan Wilkinson joined the RAF in 1986 and qualified from its dental training school in 1989. He left the RAF in 1991 to work in practices in London's West End. Recognising the shortfall in domiciliary access for medically compromised patients, he started building and developing equipment to improve treatments available to this sector. Initially adapting military field equipment, he has since progressed to the all-encompassing equipment he uses today.
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