NHS chiefs promise improvement in dental care after ‘difficult year’

Senior NHS Shetland officials this week offered assurances that mea­sures are being taken to eliminate a lengthy dental patient waiting list dating back several years.

The organisation’s chief exec­utive Ralph Roberts told The Shetland Times that tackling the four-digit waiting list was the biggest challenge NHS Shetland faced. Some dental patients have been waiting to be registered for up to four years due to a lack of capacity in Lerwick.

Mr Roberts accepted 2011 had been a “difficult year” for the ser­vice. Earlier this year plans to expand the Montfield practice had to be ditched, while long-standing private dentist Alan Owen – who also treated NHS patients – announ­ced his retiral this summer.

Mr Owen’s St Olaf Street prac­tice has been shut since 2nd Sep­tem­ber. The NHS took over the premises and had initially hoped to reopen in the middle of last month, but that has now been pushed back to early December.

Though all public sector organ­isations are feeling the squeeze of cutbacks, Mr Roberts insisted that the dental backlog is not down to a lack of cash. The health board gets to choose how much of its budget to devote to dental services and will spend £3.5 million this financial year.

One of the main stumbling blocks is the continued difficulty in selling the idea of living and working in Shetland to trained dentists, though it is hoped some new practitioners will be recruited shortly. Efforts are also continuing to attract an independent practice to Shetland.

Chief dental officer Pippa Arbon, who replaced the retiring Mike Collins in June, is drawing up a new strategy to identify ways of using the health board’s existing dental chairs more efficiently. That could see surgery hours extended and any short gaps in treatment during the day eliminated.

NHS Shetland was criticised in some quarters for failing to reach agreement to buy chairs and equipment from the St Olaf Street practice. It was instead sold to the private practice run by the Lubbe family at the Toll Clock.

That was the chief reason for the delay in reopening St Olaf Street, but new dental chairs ordered from Germany are now in the UK and should reach Shetland in the next 10 days. Ms Arbon said: “The chairs are in England, they’ll be moving up soon and as soon as we can give a definite [opening] date we will.”

She said Mr Owen’s 4,500 patient records are being computer­ised and checked against NHS records for any duplications, which was “quite a slow process” but would end up providing an accurate overall picture.

Given the waiting list problem is not down to a funding shortage, Shetland MSP Tavish Scott said isles taxpayers “deserve to expect that NHS management can sort it out”. While those on the waiting list can still get emergency treatment in the meantime, Mr Scott said not being able to have regular check-ups left some patients worried that they might develop more serious long-term teeth and gum prob­lems.

“When St Olaf Street opens before Christmas it is incumbent on NHS Shetland to have a very clear strategy as to how they’re going to reduce waiting lists, so that people can see when they’re likely to join the practice,” Mr Scott said.

The MSP has received a steady stream of correspondence on the subject from frustrated constituents for years. Just over two-thirds of adults in Shetland are registered with an NHS dentist, which compares favourably with other remote communities including Orkney but is some way below the 87 per cent registered in the Scottish Borders.

This year’s figure of 68 per cent of adults registered shows a minor drop on last year’s 69 per cent, though Mr Roberts points out that notable progress has been made since 2007, when a dismal 40 per cent were registered: “This is a significant improvement and should be recognised.”

He continued: “We are working extremely hard to put in place the building blocks and capacity so that we can further improve the position over the coming year. We recognise we can do more and the staff are working really hard to make im­prove­ments and we also do recog­nise the importance of this to the local community and partic­ularly to the individuals con­cerned.”

On the plus side, Shetland has the highest proportion of children registered with a dentist anywhere in Scotland at 92 per cent. Mr Roberts said that should mean new generations will have “much better dental health” going into adult­hood.

The waiting list was hovering around the 1,700 mark in June, since when around 350 people have become registered patients. Ms Arbon said the list could well have been eased further were it not for the temporary St Olaf Street closure.

She admitted the situation was “not ideal”, but stressed that anyone on the waiting list continued to get “very good access” to emergency care. “Ideally you’d like to get everyone in and everyone seen,” she said.

“Some [of those coming off the waiting list] have needed a fair amount of work [but] you’ve had others who have reasonably good mouths. Some people on the waiting list have also been patients of Alan Owen’s practice privately, so they’ve actually maintained their mouths in good health.”

Mr Roberts, who took up his post in January, said the need to abort the expansion of Montfield could prove to be a blessing if it transpires that everyone can be treated simply by using the existing capacity more effectively.

“In the long term that may prove to have been helpful,” he said. “It’s been a difficult six months, but where I’m sitting and knowing what’s going on, there’s been a lot of work done behind the scenes – it’s possible that the public haven’t seen that yet. We’re putting good foundations in place that will hopefully bear fruit this time next year.”

For now, officials say anyone living in Lerwick or its surrounding area who is mobile might get seen quicker by registering with one of the NHS’s rural dental practices. It has units in Brae, Yell and Whalsay, and people who register with those practices tend to be seen to within no more than a few months.

But Mr Scott suggested it might be better if the NHS looked at bringing dentists from some of those practices to Lerwick for, say, one day a week to begin clearing the backlog.

“To suggest someone based in Lerwick suddenly has the time to get all the way up to Brae or Yell is unrealistic,” he said. “The managers of the service have got to find a way to make sure that people can obtain that service where they live and work.”