NHS ORAL SURGERY REFERRAL PACK
CUMBRIA
ORAL SURGERY CLINICAL NETWORK
NOVEMBER 2011
1
CONTENTS
Page
Introduction
3
Responsibilities of Referring GDP
4
Responsibilities of Service Providers
4
Service Providers
5
Service Provider Pages:Minor Oral Surgery Service Providers
-
Ardent Dental Care, Barrow-in-Furness
Community Dental Services, Workington and Whitehaven
Eden Dental Practice, Carlisle
Horn Hill Care Services Ltd, Millom
Sandes Avenue Dental Practice, Kendal
6
7
8
9
10
Oral Surgery and Maxillofacial Providers
-
North Cumbria University Hospitals NHS Trust
- The Cumberland Infirmary, Carlisle
- West Cumberland Hospital, Whitehaven
11
-
University Hospitals of Morecambe Bay NHS Trust
- Furness General Hospital, Barrow
- Westmorland General Hospital, Kendal
- Royal Lancaster Infirmary, Lancaster
12
Appendices
Appendix 1: Referral Guidelines Schematic Diagram
Appendix 2 : Oral Surgery Referral Proforma
Appendix 3 : Patient Information Leaflet
Appendix 4 : Discharge Proforma
2
CUMBRIA ORAL SURGERY CLINICAL NETWORK
NHS ORAL SURGERY REFERRAL GUIDELINES
Introduction
This referral pack has been further developed to support practitioners in making
appropriate referrals to oral surgery services following the development of new Minor Oral
Surgery (MOS) Services and the establishment of the Cumbria Oral Surgery Clinical
Network.
The service model has been designed to ensure that relatively straight forward minor oral
surgery, above the competence level of GDPs but not requiring the advanced skills of
hospital consultants, can be done by accredited Dentists with Special Interests in a
primary care setting in a more convenient location for patients.
Across Cumbria there are two Oral Surgery and Maxillofacial providers and a number of
MOS service providers.
The care pathways and guidelines have been reviewed and agreed by the network,
following a formal review of the initial six month period of the service, and this pack
contains an outline of the clinical conditions suitable for treatment by the different providers
and the revised process and documentation to be used in making referrals.
The overall pathway is shown at Appendix 1 and the agreed referral guidelines are as
follows:GDP
MOS Service Provider
 Routine extractions and
 Complex extraction of single
and multi-rooted erupted teeth
 Exposure of teeth if palpable
 Removal of buried roots and
fractured or residual root
fragments
 Removal of simple
impacted/ectopic/supernumary
teeth
 Removal of simple mucocoele
 Surgical endodontics (practice
dependent)
 The above possibly requiring
sedation (practice dependent)
simple dento alveolar
surgery within the
competency of a GDP
 General Dentistry in line
with NICE Guidelines
 Management of minor
dental trauma
Oral Surgery and
Maxillofacial Providers
 Advice only
 Removal of complex







impacted/ectopic/supernumary
teeth
Exposure of teeth
Management of soft tissue
problems
Management of cranio-facial pain
Removal of simple fibro-epithelial
polyps
Removal of uncomplicated
denture induced mucosal
hyperplasia
The above possibly requiring
sedation or GA
Any other oral or maxillofacial
conditions
3
Within this pack each provider is assigned a page where there is a description of the
services offered and the clinical conditions for which they will accept referrals. It should be
noted that, as this is a developing new service, reference should be made to the provider
specific pages in this referral pack before making the referral. The referral pathways and
processes in this pack will become operational from 1 November 2011.
From this date there is a change to the current system and referrals should be sent
directly to the address specified on the referral form.
The Oral Surgery Clinical Network will continue to monitor and review the care pathway,
referral guidelines, the documentation and the referral process
Responsibilities of Referring Dentists
The referring dentist should:



assess any potential referral to these services using the guidelines provided and
determine the most appropriate provider.
discuss the referral with the patient – the patient information leaflet may help
answer questions
complete the referral proforma providing appropriate clinical information to support
the referral and send direct to the chosen provider.
submit an FP17 for the NHS Course of Treatment which includes the referred
activity. The responsibility for ongoing patient care remains with the referring
dentist throughout this process and therefore the banding of that Course of
Treatment should be based on all the primary dental services activity carried out
within that Course irrespective of the provider and the appropriate band charge
made to the patient.
Responsibilities of Service Providers
The service provider should:






accept the referral direct from the service provider.
for the MOS Service, offer the patient an appointment within 4 weeks
for all services, ensure compliance with the 18 week Referral to Treatment pathway
undertake the clinical procedure or refer to another provider within the network if
appropriate
complete admin, accounting and discharge process, including completion of FP17
for MOS providers.
provide appropriate communication to referring GDP
not offer private treatment to patients referred for NHS Oral Surgery Services
through this referral process.
4
Minor Oral Surgery Service Providers





Ardent Dental Care, Barrow-in-Furness
Community Dental Services, Workington and Whitehaven
Eden Dental Practice, Carlisle
Horn Hill Care Services Ltd, Millom
Sandes Avenue Dental Practice, Kendal
Oral Surgery and Maxillofacial Providers

North Cumbria University Hospitals NHS Trust
- The Cumberland Infirmary, Carlisle
- West Cumberland Hospital, Whitehaven

University Hospitals of Morecambe Bay NHS Trust
- Furness General Hospital, Barrow
- Westmorland General Hospital, Kendal
- Royal Lancaster Infirmary, Lancaster
5
MOS Provider
please note that all Minor Oral Surgery referrals for Mark Knagg in Barrow should be sent to the following
address with immediate effect:-
Mark Knagg
MOS Provider
Oasis Dental Care Ltd
Furness House Dental Practice
Units 5&6
Furness House
Duke Street
Dalton Road
Barrow-in-Furness
LA14 1HN
Tel: 01229 829096
Fax: 01229 827593
Clinician:
Mr Mark Knagg
Referrals accepted
 Complex extraction of single and multi-rooted erupted teeth
 Exposure of teeth if palpable
 Removal of buried roots and fractured or residual root fragments
 Removal of simple impacted/ectopic/supernumary teeth
 Removal of simple mucocoele
Referrals not accepted
Advice only
Removal of complex impacted/ectopic/supernumary teeth
Exposure of teeth
Management of soft tissue problems
Management of cranio-facial pain
Removal of simple fibro-epithelial polyps
Removal of uncomplicated denture induced mucosal hyperplasia
The above possibly requiring sedation or GA
Any other oral or maxillofacial conditions
Provider specific information
Ardent Dental Care will contact all referred patients directly on receipt of referrals to
arrange appointments. All patients will be returned to the care of referring dentist on
completion of treatment.
Mr Mark Knagg
Ardent Dental Care
6
MOS Provider
Community Dental Services
Community Dental Services
NHS Cumbria
NHS Cumbria
Dental Department
Dental Outpatients Department
Workington Community Hospital
West Cumberland Hospital
Park Lane
Hensingham
Workington
Whitehaven
Cumbria CA14 2RW
Cumbria
CA28 8JG
Telephone No: 01900 705064
Telephone No: 01946 693181 Ext 4286
Fax No: 01900 606014
Fax No: 01946 523506
Email address: robert.kenning@cumbria.nhs.uk (for both sites)
Clinicians:
Robert Kenning
Referrals accepted
 Complex extraction of single and multi-rooted erupted teeth
 Exposure of teeth if palpable
 Removal of buried roots and fractured or residual root fragments
 Removal of simple impacted/ectopic/supernumary teeth
 Removal of simple mucocoele
 The above possibly requiring sedation
Referrals not accepted
Advice only
Removal of complex impacted/ectopic/supernumary teeth
Exposure of teeth
Management of soft tissue problems
Management of cranio-facial pain
Removal of simple fibro-epithelial polyps
Removal of uncomplicated denture induced mucosal hyperplasia
The above possibly requiring sedation or GA
Any other oral or maxillofacial conditions
Provider specific information
The Community Dental Service will contact all referred patients directly on receipt of
referrals to arrange appointments. All patients will be returned to the care of referring
dentist on completion of treatment.
Mr S G Jones
Clinical Director, Specialist and Special Needs Dental Service
7
EDEN DENTAL PRACTICE
MOS Provider
Practice Name:
Address:
Postcode:
Telephone No:
Fax No:
Email address:
Eden Dental Practice
99 Warwick Road, Carlisle
CA1 1EA
01228 525285
01228 526122
edendentists@btconnect.com
Clinicians:
Mr. J Harkes
Miss. E. Mather
Referrals accepted
 Complex extraction of single and multi-rooted erupted teeth
 Exposure of teeth if palpable
 Removal of buried roots and fractured or residual root fragments
 Removal of simple impacted/ectopic/supernumary teeth
 Removal of simple mucocoele
Referrals not accepted
Advice only
Removal of complex impacted/ectopic/supernumary teeth
Exposure of teeth
Management of soft tissue problems
Management of cranio-facial pain
Removal of simple fibro-epithelial polyps
Removal of uncomplicated denture induced mucosal hyperplasia
The above possibly requiring sedation or GA
Any other oral or maxillofacial conditions
Provider specific information
Eden Dental Practice will contact all referred patients directly on receipt of the referral.
Please ensure all patient telephone contact details are included in the referral.
Please ensure that appropriate radiographs are included with all referrals.
The practice is located opposite Our Lady & St. Joseph’s Church on Warwick Road. Street
parking is available in the immediate vicinity where a disc parking scheme is in operation.
Bus and train services are located within walking distance.
Please note surgeries are located on the first floor and are unsuitable for wheel chair
access.
8
Horn Hill Care Services Ltd
MOS Provider
Horn Hill Dental Practice
1 Horn Hill
Millom
Cumbria LA18 5DP
Telephone No: 01229 772319
Fax No: 01229 777262
Email address: drdavidmsmith@hotmail.com
Clinician:
Dr David M Smith
Referrals accepted
 Complex extraction of single and multi-rooted erupted teeth
 Exposure of teeth if palpable
 Removal of buried roots and fractured or residual root fragments
 Removal of simple impacted/ectopic/supernumary teeth
 Removal of simple mucocoele
 The above procedures only can be provided under sedation for patients within ASA
Categories 1 & 2. If unsure please ring for advice
Referrals not accepted
Advice only
Removal of complex impacted/ectopic/supernumary teeth
Exposure of teeth
Management of soft tissue problems
Management of cranio-facial pain
Removal of simple fibro-epithelial polyps
Removal of uncomplicated denture induced mucosal hyperplasia
The above possibly requiring sedation or GA
Any other oral or maxillofacial conditions
Provider specific information
If the patient will require care to be provided in a downstairs surgery please can you mark this on
the referral.
From the west coast
Enter Millom, descend hill with houses on both sides, we are the end of terrace property on the
right, the building with disabled access ramp, 200m after the signposted turn off to Haverigg.
From the east
Enter Millom, drive pass the school and the train station, turn right at the mini roundabout, we are
100m up the hill on your left.
Free parking is available between the practice and the garage next to the palladium theatre.
Train: exit via stairway to the top of the railway bridge, turn right when on the bridge, walk down the
hill towards the BP petrol station. The practice is situated approximately 100 metres, on the
opposite side of the road.
9
MOS Provider
Sandes Avenue Dental Practice
5 Sandes Avenue
Kendal
Cumbria
LA9 4LL
Telephone No: 01539 729891
Fax No: N/A
Email address: dentalteam@kendal-dentists.co.uk
Clinician: David Fisher
Referrals accepted
 Complex extraction of single and multi-rooted erupted teeth
 Exposure of teeth if palpable
 Removal of buried roots and fractured or residual root fragments
 Removal of simple impacted/ectopic/supernumary teeth
 Removal of simple mucocoele
 Surgical endodontics
Referrals not accepted
Advice only
Removal of complex impacted/ectopic/supernumary teeth
Exposure of teeth
Management of soft tissue problems
Management of cranio-facial pain
Removal of simple fibro-epithelial polyps
Removal of uncomplicated denture induced mucosal hyperplasia
The above possibly requiring sedation or GA
Any other oral or maxillofacial conditions
Provider specific information
Patients will be contacted directly once we have received the referral.
Please ensure all patients have appropriate x-rays taken prior to the referral.
Patients for removal of wisdom teeth need to have an OPT taken to enable appropriate
treatment planning.
10
North Cumbria University Hospitals NHS Trust
 Maxillofacial Unit, The Cumberland Infirmary, Carlisle
 West Cumberland Hospital, Whitehaven
Clinicians: secondary care services will be delivered under control of consultants
Referrals accepted
 Advice only
 Removal of complex impacted/ectopic/supernumary teeth
 Exposure of teeth
 Management of soft tissue problems
 Management of cranio-facial pain
 Removal of simple fibro-epithelial polyps
 Removal of uncomplicated denture induced mucosal hyperplasia
 The above possibly requiring sedation or GA
 Any other oral or maxillofacial conditions
Referrals not accepted
Complex extraction of single and multi-rooted erupted teeth
Exposure of teeth if palpable
Removal of buried roots and fractured or residual root fragments
Removal of simple impacted/ectopic/supernumary teeth
Removal of simple mucocoele
Surgical endodontics
11
University Hospitals of Morecambe Bay NHS Trust



Maxillofacial Unit, Royal Lancaster Infirmary, Lancaster
Maxillofacial Unit, Westmorland General Hospital, Cumbria
Maxillofacial Unit, Furness General Hospital, Cumbria
Clinicians: secondary care services will be delivered under control of consultants
Referrals accepted
 Advice only
 Removal of complex impacted/ectopic/supernumary teeth
 Exposure of teeth
 Management of soft tissue problems
 Management of cranio-facial pain
 Removal of simple fibro-epithelial polyps
 Removal of uncomplicated denture induced mucosal hyperplasia
 The above possibly requiring sedation or GA
 Any other oral or maxillofacial conditions
Referrals not accepted
Complex extraction of single and multi-rooted erupted teeth
Exposure of teeth if palpable
Removal of buried roots and fractured or residual root fragments
Removal of simple impacted/ectopic/supernumary teeth
Removal of simple mucocoele
Surgical endodontics
12
Appendix 1: Referral Guidelines Schematic Diagram
Appendix 2 : Oral Surgery Referral Proforma
Appendix 3 : Patient Information Leaflet
Appendix 4 : Discharge Proforma
13