Agenda item

Orthodontics in South Cumbria

To consider a report by the University Hospitals of Morecambe Bay NHS Foundation Trust (copy enclosed).



The Committee received a report from University Hospital Morecambe Bay NHS Foundation Trust (UHMBT) on Orthodontic provision.  It was explained the service provided care to complex and multi?disciplinary cases as part of a managed clinical network and to two local area providers.  Referrals were received from General Dental Practitioners and Specialist Orthodontic Practitioners.


Members were informed that UHMBT had stopped accepting new referrals in April 2016 and new referrals were now managed through Blackpool Teaching Hospital.  It was explained this was due to the loss of substantive staff and the unsuccessful recruitment of a consultant orthodontic.  It was highlighted the Service was heavily reliant on consultant management, therefore, the service was fragile and became unsustainable.  The Committee noted the lack of recruitment of appropriately trained staff and a consultant was due to a national shortage and the geographical position as a Trust.


The Committee were given an update on the workforce challenges noting that the substantive consultant would leave the Trust in September 2019, it was anticipated the specialist orthodontist at Furness General Hospital (FGH) would have a fixed term contract on a flexi-retirement basis covering both the FGC and Royal Lancaster Infirmary.  Members were informed that support from agency orthodontic consultants had been unsuccessful.  It was explained that an approach had been made by a local orthodontic consultant currently working at Blackpool to join the Service on either a bank position or fixed term contract with the possibility of this being substantive in the future.


Members were informed there were currently 548 patients with the majority of those requiring consultant follow?up to progress and discharge where appropriate.  It was explained that for multiple reasons to date the discharge of patients had not been as large as expected.


A discussion took place regarding the future of orthodontic services within UHMBT.  Members were informed that the NHS specialist commissioners had been informed of the frailty of the service since 2015.  It was explained that a meeting had taken place with all providers and the three Orthodontic Consultants (two at Blackpool and one at UHMBT) to formulate a way forward across informal partnerships.  It was highlighted that partnership working would strengthen safe provision of Hospital Orthodontic services along with sustainable future workforce planning.


The Committee was informed that patient numbers accessing hospital orthodontic services at UHMBT had been too large to sustain with a single consultant.  It was explained that capacity and demand planning would need to identify a future service to manage the numbers receiving treatment in a different way as well as looking to train future consultants if possible.  It was anticipated there would be an improvement in primary care provision in 2020 as a procurement exercise was being undertaken with commissioners, enabling more patients to receive ongoing treatment in primary care, following secondary care advice.


During the course of discussion it was suggested and agreed that service models outside the UK would be looked at.


In conclusion, it was felt that initially the safety of patients was paramount as well as being able to sustain the service in the future and enable patients to receive treatment closer to home.  Members welcomed the request from the Associate Director of Operations for Surgery and Critical Care for a workshop led by Specialist Commissioning to consider the service on a wider (ICS) footprint.


The Chair welcomed the report and asked that the Committee be kept updated on future developments in addressing the issues in the Service and the outcome of the discussions with NHS Specialised Commissioning on the future of the service within the wider Integrated Care System footprint.


RESOLVED,     that


                            (1)       the report be noted;


                            (2)       the Committee be updated on future developments in addressing the issues in the Service.


Supporting documents: