All District Health Boards
ORAL HEALTH SERVICES ADOLESCENT ORAL HEALTH COORDINATION SERVICE
TIER LEVEL TWO
SERVICE SPECIFICATION
(previously Regional Oral Health Coordination Services)
STATUS: This nationwide service specification
describes the national minima of services to be
funded or provided by a DHB.
MANDATORY
Review History
Date
First Published on NSFL
June 2001
Administration Review. Updated DHB references and
aligned content with the suite of Oral Health service
specifications.
June 2015
Consideration for next Service Specification Review
within five years
Note: Contact the Service Specification Programme Manager, National Health Board,
Ministry of Health to discuss the process and guidance available in developing new or
updating and revising existing service specifications.
Nationwide Service Framework Library website http://www.nsfl.health.govt.nz
ADOLESCENT ORAL HEALTH COORDINATION SERVICE
TIER TWO
SERVICE SPECIFICATION
D01009
The tier two service specification for Adolescent Oral Health Coordination (the Service)
must be used in conjunction with the overarching tier one Oral Health Services service
specification.
This service specification was previously known as ‘Regional Oral Health Coordination
services’.
The service specification for Adolescent Oral Health Coordination Services is related to, but
distinct from the Service Agreement for the Provision of Oral Health Services for
Adolescents and Special Dental Services for Children and Adolescents (commonly known
as the ‘Combined Dental Agreement’ or CDA).
1.
Service Definition
The Service is a community based, population targeted service that coordinates the
interaction of the groups that deliver, or are involved with, adolescent oral health services,
such as, dentists, community oral health services, and Māori health service providers.
For the purposes of this service specification, the term ‘adolescent’ means a young person
from School Year 9 up to and including age 17 years (ie, <18 years of age).
Each District Health Board (DHB) plans, develops, implements and maintains a populationbased service for improving the uptake and ongoing participation of adolescents in publicly
funded oral health services. The Service does not directly deliver oral health assessment
or treatment services.
In addition, there may be an educational or public health component to meet the Service’s
objective, specified by the Funder.
The Service will work with oral health providers to improve the uptake of adolescent oral
health care within a specified DHB region.
The Service is developed with a focus on mutual benefits for both adolescents and dental
service providers. Within that scope, other stakeholders, eg, the Community Oral Health
Services for Children and some Adolescents service (Community Oral Health Service), and
providers contracted under the CDA will also use and benefit from the Service.
2.
Exclusions
The Service is independent of the contractual relationship between oral health providers
(private practitioner dentists) and the DHBs that hold their contract. The Service does not
directly deliver oral health assessment or treatment services.
3.
3.1
Service Objectives
General
The purpose of the Service is to improve the health and wellbeing of all adolescents,
particularly those in at risk groups, by providing coordinated services that will enhance the
uptake and ongoing participation rates of adolescents in oral health care services.
Oral Health Services- Adolescent Oral Health Coordination Service, tier two service specification June 2015
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Māori Health Objectives
3.2
Refer to the tie one Oral Health Services service specification for general requirements.
In addition, the Service will take into account the Funder’s strategic direction for Māori
health, that are based on the Ministry of Health’s Māori health policies for DHBs, the DHB’s
Māori Health Plan, and specific local objectives.
3.3
Service Outcomes
The Service will coordinate with stakeholder groups to ensure that adolescents are:

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

aware of the availability of publicly funded oral health care
enrolled with a dentist
completing their annual oral health treatment
reporting for their dental appointments
continuing to access publicly funded oral health care during their adolescence
benefiting from a well-functioning relationship and transfer process between the
providers and other services such as the Community Oral Health Service.
3.4
Performance Outcome Measures
Performance of the Service will be measured as follows.



the number of adolescents enrolled in publicly funded oral health care (absolute
numbers, percentages) including children transferring to adolescent oral health care
from the Community Oral Health Service.
the number and percentage of adolescents using publicly funded oral health services in
each year ended 31 December (absolute numbers, and percentage of age cohort)
number and percentage of local/regional dental practitioners holding CDA agreements.
4.
Service Components
4.1
Processes
The Service includes:
4.1.1




Facilitation and Liaison:
liaising with secondary schools to promote the uptake and ongoing participation in
oral health care by adolescents
creating links between the local Community Oral Health Service, oral health service
providers and adolescents to maximise the uptake of oral health services by
adolescents entering Year 9
developing links with local Māori organisations to improve the uptake and
participation in oral health services by Māori adolescents, and endeavouring to
incorporate Māori principles/tikanga in to the coordination services
liaising with schools and dental providers to ensure that adolescents are keeping
their scheduled appointments, and that initiatives focused on ensuring adolescents
are able to attend appointments are developed and implemented (in consultation
with the dental service providers).
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4.1.2 Development of an Adolescent Oral Health Coordination Service Plan

to reflect the agreed local or regional approaches, where these benefit service
development, the Service must develop an Adolescent Oral Health Coordination
Service Plan that:
- profiles the adolescent population
- identifies areas or populations of special need
- identifies the most effective means of targeting the population segments
- indicates specific Māori health objectives and an action plan to improve uptake
and ongoing participation by Māori adolescents
- indicates the programmes or services that will be implemented for the purpose
of meeting the objectives of this Service
- provides the action plan and timelines that will achieve the effective
implementation of the service
- uses effective and meaningful ways of measuring the effectiveness of the
coordination service.
4.1.3 Provision of support for the Community Oral Health Service (as required)
including:



assisting with the review, in collaboration with the local Community Oral Health
Service, of existing systems for transfer of patients form the Community Oral Health
Service to CDA dentists at the end of school year 8 or the beginning of school year 9
assisting the local Community Oral Health Service to upgrade its student transfer
system (as required)
assisting with a review the existing methods of patient recall operated by
local/regional oral health service providers with a view to strengthening the recall
systems (as required).
4.1.4 Provision of information:
Provide consistent and correct information regarding the services associated with this
service specification, to inform all oral health service providers, CDA-holders, the
Community Oral Health Service and other relevant stakeholders in the Service’s region.
4.1.5 Monitoring
Development and maintenance of monitoring and reporting systems that accurately
measure the rate of adolescent participation in oral health care in the Service’s region.
4.1.6 Recruitment
The Service must have a role in assisting the recruitment of oral health practitioners to
provide publicly funded oral health care for adolescents (in conjunction with DHB
Funding and Planning Managers and the New Zealand Dental Association).
4.2
Settings
The Service is provided in a range of age and culturally appropriate contexts and settings
such as: primary and secondary schools, tertiary institutes, workplaces with large
adolescent workforces, marae, churches, community events, sports clubs and youth
groups, alternate education services, Private Training Enterprises and teen parent units.
4.3
Key Inputs
Inputs include, but are not be limited to:

appropriately trained, culturally competent, motivated staff
Oral Health Services- Adolescent Oral Health Coordination Service, tier two service specification June 2015
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

vehicle(s)
educational materials and presentation tools.
5.
Service Linkages
The Service must develop and maintain linkages with the following regional and
community-based services and stakeholders (as required or appropriate):






Oral health providers, ie, private dental practitioners and their staff
‘Approving Dental Officers’ of the CDA
Intermediate schools (and primary schools in some instances)
Secondary schools (and primary/intermediate schools in some instances)
Kura Kaupapa
School dental services, especially the Principal Dental Officers and Community
Oral Health Service Managers
Tertiary institutes
alternate Education Services, Private Training Enterprises
teen parent units (and Lead Maternity Carers)
Māori and Pacific Peoples’ organisations and groups
Hospital-based dental services
Other DHB Adolescent Oral Health Coordination Services
Other locally or regionally coordinated (national) child and youth services, eg,
Immunisation programme
Health promotion organisations
Consumer advocacy services, including Māori advocacy services
Dental profession organisations such as local New Zealand Dental Association
network, Te Aō Marama - The New Zealand Māori Dental Association.
Other Government Departments, including Work and Income, Ministry of Justice
and Department of Corrections.











6.
Quality requirements
Refer to the tier one Oral Health Services service specification for generic Quality
Requirements including requirements of the Vulnerable Children Act 2014.
In addition the Service will use both age and culturally appropriate means of reaching
adolescent and specific at-risk populations.
7.
Purchase Units
Purchase Units are defined in the joint DHB and Ministry’s Nationwide Service Framework
Purchase Unit Data Dictionary. The following Purchase Unit applies to this Service.
PU Code
PU Description
PU Definition
Unit of
Measure
D01009
Oral Health Regional Coordination Services
Co-ordination of oral health services in the
region for adolescents with particular focus on
ensuring all adolescents are enrolled for oral
health services.
Service
Oral Health Services- Adolescent Oral Health Coordination Service, tier two service specification June 2015
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8.
Reporting Requirements
In addition to the local DHB reporting requirements, the following information for each year
ended 31 December will be reported to the Ministry of Health as part of the annual DHB
Quarter 4, Policy Priorities Reporting requirements. Please see the reporting template in
Appendix One.
Parameter
(Reported per DHB)
Measures
Minimum
Frequency
Number of adolescents resident in the DHB
Number
Annual
Number of adolescents receiving services under the CDA
Number
Annual
Number of adolescents receiving basic dental care from
hospital dental service or the Community Oral Health
Service
Number
Annual
Utilisation rate for the DHB
Percentage
Annual
Utilisation of DHB-funded dental services by adolescents
from school year 9 up to and including age 17 years
broken down by ethnicity, (Māori, Pacific, other) and
deprivation
Numbers
Annual
Oral Health Services- Adolescent Oral Health Coordination Service, tier two service specification June 2015
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Appendix One: Annual reporting template (PP12)
Policy Priority 12
Utilisation of DHB-Funded Dental Services by Adolescents from Year 9 to 17 Year-Olds - National Target: 85%
____ [calendar year] Data
2004
Result
2005
Result
2006
Result
2007
Result
2008
Result
2009
Result
2010
Result
2011
Result
2012
Result
Northland
Auckland
Waitemata
Counties Manukau
45%
26%
60%
44%
45%
57%
32%
45%
46%
44%
58%
53%
42%
58%
52%
54%
40%
62%
56%
56%
50%
67%
61%
62%
59%
72%
61%
68%
59%
81%
61%
71%
Midland
Midland
Midland
Midland
Midland
Waikato
Lakes
Bay of Plenty
Tairawhiti
Taranaki
47%
44%
56%
56%
55%
59%
40%
52%
56%
52%
61%
45%
56%
65%
58%
60%
46%
56%
68%
72%
61%
48%
56%
63%
70%
66%
55%
63%
67%
73%
70%
57%
68%
72%
71%
Central
Central
Central
Central
Central
Central
Hawke's Bay
MidCentral
Whanganui
Capital and Coast
Hutt
Wairarapa
57%
61%
41%
34%
52%
64%
56%
65%
52%
38%
53%
73%
63%
76%
62%
34%
61%
79%
67%
69%
58%
36%
57%
76%
74%
79%
58%
39%
52%
74%
79%
78%
67%
42%
59%
78%
Southern
Southern
Southern
Southern
Southern
Nelson Marlborough
West Coast
Canterbury
South Canterbury
Southern
70%
65%
69%
85%
78%
64%
65%
70%
88%
78%
68%
57%
67%
90%
72%
70%
68%
67%
88%
72%
75%
70%
66%
84%
76%
Total NZ
53%
54%
58%
59%
Waitemata/Auckland combined
Auckland Metro combined
45%
44%
43%
49%
52%
53%
Northern
Midland
Central
Southern
45%
50%
49%
72%
44%
54%
53%
72%
Total NZ
53%
54%
Region
DHB
Northern
Northern
Northern
Northern
Total
Adolescent
Population
yyyy
Jul - Sep
yyyy
Oct - Dec
yyyy
61%
84%
64%
74%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
#VALUE!
#VALUE!
#VALUE!
#VALUE!
0
0
0
0
73%
71%
71%
63%
78%
73%
65%
70%
63%
77%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
0
0
0
0
0
77%
79%
71%
51%
59%
82%
81%
82%
79%
62%
68%
82%
81%
83%
77%
70%
70%
70%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
0
0
0
0
0
0
80%
76%
67%
88%
80%
84%
77%
67%
91%
82%
87%
81%
65%
91%
82%
85%
77%
65%
89%
85%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
0
0
0
0
0
60%
65%
68%
72%
73%
0
0
0
0
0
0
0
0
0
#DIV/0!
#VALUE!
0
55%
54%
58%
57%
63%
63%
66%
67%
69%
70%
72%
73%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
#DIV/0!
#DIV/0!
#VALUE!
#VALUE!
0
0
52%
57%
58%
70%
53%
59%
56%
70%
56%
59%
59%
71%
61%
65%
64%
74%
66%
68%
66%
75%
69%
72%
73%
75%
72%
71%
76%
75%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
0
0
0
0
58%
58.7%
60%
65%
68%
72%
73%
0
0
0
0
0
0
0
0
0
#DIV/0!
#VALUE!
0
DHBs need to include in the "extra volumes" those adolescents who were seen by the community oral health service or elsewhere. However, DHBs need to exclude from the “extra volumes” those adolescents
who were first seen by a dentist under the CDA but subsequently referred to the hospital dental department for secondary dental services.
2. The assessment is made with an allowance of 0.50% tolerance level between the actual result and target.
The ratings are determined as follows:
Where…
Actual > DAP Target+0.5%
DAP Target-0.5% ≤ Actual ≤ DAP Target+0.5%
Actual > Previous Year's Actual (with 0.5% Tolerance)
Actual < Previous Year's Actual
3. Unique adolescent counts are based on their last appointment during the year. For some DHBs, the final report may show a decline in adolescent numbers for the first quarters. This is because these
adolescents have used the DHB-funded dental services at a later quarter - either with the same DHB or with another DHB.
4. The DAP Target % for Total NZ shows the weighted average of individual DHB targets and may not be the same as the national target.
Oral Health Services- Adolescent Oral Health Coordination Service, tier two service specification June 2015
Nationwide Service Framework
0
yyyy Result
yyyy DAP
Target %
Shortfall in
Adolescents
Served i.e.
Volumes Needed
to Meet Target
Apr - Jun
yyyy
yyyy Total
yyyy Target
Volume
Assessment of
yyyy Result
Against
DAP Target
(See Note 2)
Jan - Mar
yyyy
Notes:
1. For the purposes of this performance measure, we count all the individual adolescents ("adolescents" are defined as individuals from and including their Year 9 of schooling to the day before they turn 18) who
accessed publicly funded oral health services. Proclaim payments data from Sector Services provide a count of individuals who attend dentists contracted under the Combined Dental Agreement (CDA).
Therefore, "extra volumes" are those adolescents who receive publicly funded oral health services other than under the CDA.
Rating is…
Outstanding
Achieved
Partially Achieved
Not Achieved
Extra
Number of
Volumes Adolescents
yyyy
Served in
(See Note 1)
yyyy