20 September 2019

New toolkit launched to safeguard children who miss dental appointments

A new toolkit supporting safeguarding of children and young people who miss healthcare appointments, often for reasons beyond their control, has been launched by the British Dental Association.

The new ‘was not brought’ toolkit, which was first piloted and developed by community and special care dentistry experts at Sheffield Teaching Hospitals NHS Foundation Trust, aims to encourage healthcare professionals to consider the child’s perspective when they are not brought for healthcare appointments, including dental appointments.

Representing a break from the traditional “did not attend” approach, the new pathway recognises that children do not ‘call the shots’ on whether they attend appointments, and although there could be ordinary reasons why they are not brought to an appointment, in some cases it could be a sign of neglect.

The toolkit, which has been published in the British Dental Journal and is now available for all dentists and teams to use via the British Dental Association’s website (bda.org/safeguarding), is a step-by-step guide to managing the pathway in dental practices.

It offers a flowchart for action and downloadable template letters to help the team follow a standardised approach which will keep young patients safe. It will help practices to identify at each stage of the process, which other healthcare professionals they need to communicate and share information with if they are worried about patients facing dental neglect.

The ‘was not brought’ pathway was developed by Jenny Harris, Consultant in Paediatric Dentistry working in Community and Special Care Dentistry at Sheffield Teaching Hospitals, who was recognised in 2018 as an NSPCC Honorary Member of Council for pioneering work in safeguarding children, including developing Child Protection and the Dental Team, and Jen Kirby, Leadership Fellow and Speciality Registrar in Paediatric Dentistry at Sheffield Teaching Hospitals, whose work on the project was funded by Health Education England.

Jenny Harris, Consultant in Community Paediatric Dentistry Community & Special Care Dentistry and Paediatric Dentistry Charles Clifford Dental Services, Sheffield Teaching Hospitals NHS Foundation Trust and Honorary Senior Clinical Lecturer in Paediatric Dentistry at the University of Sheffield, said: “Every child has a fundamental right to healthcare. When children miss healthcare appointments, including dental appointments, it may be a sign of neglect and should be followed up rigorously as part of safeguarding and promoting their welfare. We are delighted that our work has been recognised nationally and is now being shared widely with dental practitioners by the British Dental Association.”

Charlotte Waite, Chair of the BDA’s England Community Dental Services Committee said: “Young children do not call the shots on attending appointments, so for many health professionals treating them the term “did not attend” has never been applicable.

"This ‘was not brought’ toolkit is designed to help the whole dental team, and provide practical help on making this important distinction. The toolkit supports the whole dental team to work together on implementing this pathway, empowering them to be alert, when children are not brought to appointments.

"We are proud to offer a framework that will help any colleagues treating all children and young people. From primary to secondary care, high street to community practice, it provides everything needed to prompt dental teams to look out for children who miss appointments who may be victims of neglect.”

A pilot undertaken by Sheffield Teaching Hospitals in 2016 using the new pathway showed that out of 1,238 dental appointments, 134 were missed by 91 children. By using the new approach, three-quarters of missed appointments were rebooked within three weeks after communication with parents. Written information was shared in 25 cases with general medical practitioners and other health and social care professionals.



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