NHS dental services for children and young people in West Norfolk

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Summary of report content

NHS dental services for children and young people in West Norfolk became one of Healthwatch Norfolk’s three priority projects for 2017-18, following local anecdotal intelligence and other external sources of data which highlighted concerns around experiences of and access to local NHS dental services. When scoping this project, RAF Marham and the Norfolk Armed Forces Covenant Board contacted us about similar issues that the military families were facing around difficulties with accessing local NHS dental services, especially given the rural nature of the area. Healthwatch Norfolk carried out a survey to understand the experiences of, and access to, NHS dental services in West Norfolk by surveying parents/guardians about their children’s dental care. Healthwatch Norfolk also conducted a “mystery shopping” exercise to enable us to understand the availability of services in the West Norfolk area and the accuracy of information presented online, compared to the information presented over the phone. Altogether, 314 responses to the survey from parents/guardians were received and analysed, which equated to 606 children and young people. 66% take their children to the dentist every six months (209) and a further 14% take them every year. Interestingly, 15% said their children had never visited the dentist for the following reasons: availability of NHS services, age of children, quality of services and cancellations of appointments. Over a quarter (26%) of our respondents have to travel over 10 miles to get to their children’s dental practice and unsurprisingly, the majority of the respondents have to drive to get there. Sixty-nine percent (69%) of parents/guardians felt that it was easy or very easy to book an appointment for their children. Interestingly, although this rating was predominantly positive, appointments featured heavily in the open questions as a barrier to dental care for their children. The majority of respondents (84%) rated their overall experience of their children’s dentist as good or very good, compared to just 6% who rated the service as one or two stars (very poor or poor). Issues in lower rated reviews related to appointments and quality of service. Appointments remained an issue in some of the higher rated reviews, but areas of good practice featured also. Positives of overall experience included quality of service, involvement of the children and the environment/facilities. Respondents were asked two questions about the barriers to NHS dental care for children and young people in West Norfolk and these were open questions so they could share anything that was important to them. Issues surrounding accessing NHS dental care for their children related to appointments, availability of NHS services, location/transport and information/advice. These categories often interlinked and particular issues for those on the RAF Marham Base and other remote villages were highlighted given that not everyone can drive and the public transport is limited. Unsurprisingly, the most common suggestion for overcoming barriers was around commissioning, predominantly more services in the local area as noted by 24 respondents, with a further 47 simply stating that more practices, spaces or dentists were needed in general. More availability of appointments in general and more out of school or work hours appointments were highlighted specifically as a way of overcoming barriers. Finally, improvements to information and advice was also welcomed. The “mystery shopping” exercise we conducted echoed parents/guardians experiences of inconsistent information provided online compared to when they contacted the dental practices directly. Only three of the 13 NHS dental practices that we identified in the scoping stages, provided information on the telephone that matched NHS Choices and/or their own website. Furthermore, clear issues with availability of services in West Norfolk were noted. Only four out of 13 dental practices were accepting children at the time of the exercise. One of these four would only accept children as NHS patients if their parent/guardian was at the practice as a private patient. Long waits for appointments – another issue identified by parents/guardians in the survey – were apparent also. Of the four dental practices accepting children, the earliest available appointment was in June/July 2018, with the longest wait being until August 2018. To conclude findings showed a positive overall experience in general, especially praise for staff members. Having said that, there are clear barriers to accessing NHS dental care for children and young people in West Norfolk, stemming from key areas such as, the availability of NHS dental services, in particular services in the local area to where the parents/guardians live, which went hand-in-hand with transport problems for some; the availability of appointments, and more specifically fitting the appointments around school or work hours; cancellations and long waits for appointments and finally, information/advice around taking their children to the dentist and availability of services. Particular issues noted by the families in RAF Marham in the survey conducted by the Norfolk Armed Forces Covenant Board last year, seemed to be replicated by the families in this survey, but more importantly, there seems to be a wider issue of access in the civilian population of West Norfolk as well as the military families.

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General details

Report title 
NHS dental services for children and young people in West Norfolk
Local Healthwatch 
Healthwatch Norfolk
Date of publication 
Sunday, 1 April, 2018
Date evidence capture began 
Sunday, 1 April, 2018
Date evidence capture finished 
Sunday, 1 April, 2018
Type of report 
Report
Key themes 
Access
Administration
Booking appointments
Building and facilities
Public involvement
Quality of appointment
Quality of care
Quality of regulation
Quality of staffing
Service delivery organisation and staffing
Healthwatch reference number 
Rep-7186

Methodology and approach

Was the work undertaken at the request of another organisation? 
No
What type of organisation requested the work 
N/A
Primary research method used 
Survey
How was the information collected? 
Survey
If an Enter and View methodology was applied, was the visit announced or unannounced? 
N/A

Details of health and care services included in the report

Primary care services 
Dentist (non-hospital)

Details of people who shared their views

Number of people who shared their views 
339
Age group 
Not known
Gender 
Not known
Ethnicity 
Not known
Sexual orientation 
Not known
Does the information include public's views? 
Yes
Does the information include carer's, friend's or relative's views? 
Yes
Does the information include staff's views? 
No
Types of health and care professionals engaged 
N/A
Does the information include other people's views? 
No
What was the main sentiment of the people who shared their views? 
Mixed

Outcomes and impact

Were recommendations made by local Healthwatch in the report? 
Yes
Does the information contain a response from a provider? 
No
Is there evidence of impact in the report? 
Yes
Is there evidence of impact external to the report? 
No
What type of impact was determined? 
Implied Impact

Network Impact
Relationships that exist locally, regionally, nationally have benefited from the work undertaken in the report
 
Implied Impact
Where it is implied that change may occur in the future as a result of Healthwatch work. This can be implied in a provider  response, press release or other source. Implied impact can become tangible impact once change has occurred.
 
Tangible Impact
There is evidence of change that can be directly attributed to Healthwatch work undertaken in the report.