Think Enter and View Visits

THINk Enter and View Visits

July 2009

DENTAL PRACTICES

Key visit objectives

To gather more information on:

Access to NHS care
Disability access
Promotion of prevention

Format

Observation of the service and conversation with the service users

Comments from THINk members and the public that informed the visit

There is a perception within the community that Tower Hamlets does not have any places for NHS patients.
There was a wide spread agreement that there needs to better publicity as to the availability of NHS Dental services (where practices are and who has current NHS vacancies) in the borough, how to access them and on the importance of good dental care generally.

Some of the so called dental care providers (claiming to receive NHS funding) have provided awful services to the community
I come from a minority community, there is a language barrier. We feel we do not get our problems solved because of that. My experience is if the client speaks different language they have little access in terms of using the service properly
Some dental care providers have charged too much for minor dental work and they also have failed to diagnose the problems.
My mother was joined to a private practice and she was told to look for an NHS practice because they didn’t ‘have to keep her on their registration list’ – I think it may have something to do with the fact that she chews betal nuts...
The dentist I am registered with only sees me as a private patient, never as an NHS one (THINk Survey)

Some dental nurses could adopt a more friendly bedside manner
Make dentists more affordable – Why are dentists so expensive?
Dentists should treat BME with dignity
I come from minority community – please, Interpretations would do a lot as they bridge the gap.
NHS staff should make more of an effort in attending to those vulnerable who cannot express their needs. E.g. those who do not speak English very well.
More dental practices in Tower Hamlets (28 is NOT ENOUGH)
It would help if staff actually responded to written/telephoned communication
I would like to receive more information on NHS dental care (THINk Survey)

Visit Programme

Visit Date: 6 July 2009

Tower Hamlets NHS Lead Contact: Vivienne Cencora, Associate Director,

Primary & Community Care Commissioning

Dental Practice 1: East India Dock Road

Lead visitor: Peter Nichol

With: Te Maari Gardiner

Contact at Dental Practice:Dr. Pradeep S. Bagga

Tel No.:0207 987 2763

Email Address:

Address 61 East India Dock Road, E14 6JE

Dental Practice 2:Abbey Dental Practice

Lead visitor: Myra Garrett/Dianne Barham

With:Rose Spencer

Contact at Dental Practice: Ms Tilly Zucker

Tel No: 0207 247 0964

Email Address

Address Abbey Dental Practice, Whitechapel Road, E1 1BJ

Dental Practice 3: Family Dental Practice

Lead visitor:Sybil Yates

With:Dianne Barham

Contact at Dental Practice: Dr. K. Ali and Dr. J.M Christy

Tel No.: 0208 980 9838

Email Address

Address 211 Roman Road, E2 0QY

Tower Hamlets Involvement Network

Enter and View Visit

Abbey Dental Practice

Monday July 6 and Tuesday July 14 2009, 10.30 am

Lead visitor: Myra Garrett/Dianne Barham

With: Rose Spencer

Contact at Dental Practice: Ms Tilly Zucker

Address Whitechapel Road, E1 1BJ

The visit was undertaken over two separate days as there were no patients available to interview at the time of the first visit. The comments relating to premises and staff relate to the first visit undertaken by Myra Garrett and Rose Spencer and the patient comments were gathered on the second visit conducted by Dianne Barham and Rose Spencer.

Patients

Patient 1

Had moved to the practice as his old one was too expensive and they provided poor care (Surrey Quays Dental Practice). He felt that they were doing work that they didn’t need to do and they cancelled his appointment frequently. It was costing him £60 for a check up where as it only cost £16.50 here and the fillings were cheaper here too. He felt it was good value for money.

He didn’t have any problems getting an appointment, the dentist explained everything to him about his treatment plan, and the reception staff were friendly and efficient. His friend had recommended the practice to him.

Patient 2

The patient had been referred from the hospital for problems with his wisdom tooth. He said that he had to pay £16.50 for his treatment and he was very clear on what was included within this. He had an x-ray at the practice so it could be sent to the hospital for his further treatment.

This was his first time to the practice, when asked if he would return he said he would in an emergency; however he would use his own dentist in Spain as he does not trust NHS dentists generally.

He reported that the receptionists were nice and polite.

Patient 3

We spoke to the mother of a 5 year old girl who had been in for a check up. Both the mother and the little girl were happy with the treatment and the little girl said she would come back again. Both her and her brother had been given tooth stickers. The mother said she had had no problem getting an appointment and chose the practice because it was the closest to their home. She had a clear plan of her daughter’s treatment and understood what was happening. She said everything about the practice was fine and she couldn’t think of anything she would change.

Patient 4

We spoke to the grandson of an elderly Bangladeshi woman who had come in for treatment. He said they came all the way from Ilford as his grandmother had been coming for a long time and liked the practice. He was able to go in with her when she had her treatment and translated for her when necessary. The dentists and staff always explained things clearly and gave him time to ensure his grandmother understood what was happening and was happy. He had now started coming to the Practice himself, as he had had a bad experience with a dentist in Ilford, and liked the people here.

Patient 5

The patient did not initially want to talk but thanks to the receptionist who translated our purpose he spoke to us for a few moments in English.

He said this was his first time here and he would come back. He understood his treatment and that everything was explained to him. He had a positive experience with the receptionists and staff.

Patient 6

The patient had been coming on and off for ten years (she had moved away and returned). She had made an appointment for the coming Friday but had been in extreme pain so had come in for an emergency appointment that morning. She was very happy to be able to come in on an emergency appointment and had had to wait less than an hour. The dentist was friendly, explained the treatment and her future plan together with the costs. She felt that she understood both the treatment and payment plan clearly. If she could change anything she said the reception staff could be a bit more welcoming and friendly. She understood that the practice could get busy and they were being efficient but they were the first people you see and many people were nervous and they could do a lot to make you feel a bit more relaxed.

Premises

There are six surgeries, four on the ground floor and two up stairs which have recently been refurbished with the latest equipment. The recent refurbishment has ensured that the Practice is fully Disability Discrimination Act (DDA) compliant. There is wheelchair access, and a lower reception desk, and disabled toilets on the ground floor together with a fully DDA compliant treatment room. There are stairs to further surgeries on the upper floor with a smaller waiting room which although quite compact was still light and airy. There is CCTV footage to see both waiting rooms.

Upon arrival there were seven or eight patients waiting in the waiting room, the receptionists were friendly and helpful and the waiting room seemed welcoming and the area looked fresh. There is a small television with information on health care and healthy living; the information seemed simple and easy to follow with pictures, translations, no jargon etc. The patients have reported that they have found the information useful.

Everything was tidy and organised, with several notice boards. The main notice board was full of posters and information on the practice, clearly stating that they are taking on new patients who are not registered, and a NHS poster with details of the pricing bands. A practice leaflet is available which provides details of the services available, disability access and language info, patient rights and responsibilities and the practice team.

Complaints/suggestion forms and a suggestion box were available on the reception desk and the receptionists said they did get used.

Staff

We spoke to the Practice Manager Tilly Zucker. The Practice is predominately NHS treatment, around 90-98% and they are always able to take on new patients. They are keen on preventative treatments and maintaining teeth e.g. not just taking a tooth out but doing full root canal treatments.

There are six dentists of which four are women and four can speak Bengali (three women and one man). This seems very impressive and appropriate given the local population and the significant number of Bangladeshi Muslim women patients they have. Other languages spoken at the Practice include Hindi, Urdu, Arabic, Bulgarian, Greek, Romanian, Nepalese, Hebrew, Italian and French. They also access the advocacy service from the PCT which helps communication with other patients, i.e. had a signer for a deaf patient. Recovering alcoholics and substance abusers are also recommended to the practice on a regular basis.

As thePractice is on street level a lot of people do walk past and come in, and can be seen that day. A minimum of five patients are referred from the hospital per day for emergency treatment, patients can be seen that day or the next day although they may need to wait for patients with appointments to be seen first.

The Practice Manager said that most patients are happy with and understand the NHS charges. Where people sometimes get confused is thatalthough they can get their teeth cleaned on the NHS this doesn’t mean they’re going to come out with a new white smile. They have to explain that cosmetic processes such as whitening are not something the NHS will pay for.

We were impressed that patients receive a phone call or a text message to remind them of their appointment and that non attendances have been reduced as a result. A patient will be kept on file and will be prompted for a check-up as well as their household. This aims to combat entrenched negative attitudes of dentists as a place where you go when you in pain but as places for children and parents to go to prevent oral decay and pain.

The Practice Manager highlighted that there seemed to be two types of NHS patients, firstly those who make full and extensive use of treatments and preventative care and secondly those who don’t know what they’re entitled to it and only come when their in pain. People are coming when there are problems not for regular checkups and oral hygiene.

Complaints received are responded to in writing within 10 days and dealt with within the practice where possible. There were two complaints made to the PCT in the last year, neither was related to a serious issue and were resolved quickly.

Summary and recommendations

This is one of the biggest dental practices in Tower Hamlets working in a very busy area and undertaking a significant level of emergency care with a diverse client group.

Patients appreciated the inclusive nature of the practice with access to dentists and staff from both genders and who could speak a variety of community languages.

The majority of the patients we talked to were very happy with their dental treatment and with the attitude and competence of the staff. They all understood their treatment plan and how much they would be paying.

Given the pressure on the staff in such a busy and diverse practice it is perhaps understandable that efficiency may take precedence over approachability but patients will always value a friendly face and a chat when time is available.

Given the good transport routes to the practice, excellent disability access and treatment facilities it would be great if the practice could be promoted better to people with disabilities and disability groups.