The NHS Model Hospital deals with a range of departments, a focused look at the oral & maxillofacial aspects made sense.
Our London clinic is not an NHS facility, although our team of consultants have connections with departments in NHS hospitals. They may act as advisors, or teach surgeons who will work within the NHS.
Taking an interest in NHS progress is natural and the Model Hospital is an interesting, digital initiative. Open to staff at all levels, from board level to carers, to help them see improvement opportunities.
The Getting It Right First Time (GIRFT) program is part of the initiative, focused on cost savings and best care. They have been working through a range of departments, including oral & maxillofacial surgery.
The Maxillofacial Outlook
The GIRFT team identified savings of up to £25 million, which would also notably improve the experience of patients.
Fewer hospital admissions, or shorter stays when admitted were highlighted, along with fewer repeat visits. These save money and help patients, by freeing up resources to implement shorter waiting times.
Whilst planning and procurement would also benefit from changes, they were not seen as primary causes. Inconsistencies in skill levels were seen as the main cause of inefficiency, especially for more advanced work.
Registered oral & maxillofacial surgeons are qualified in medicine and dentistry. To try to ensure patient cover, NHS services were being staffed by general dentists, with an interest in oral surgery but variable experience.
A case where trying to help achieved the opposite, in an increasingly complex field, in terms of equipment used and most importantly, surgery itself.
Maxillofacial surgeons should be able to effectively carry out complex operations and apply the same skill levels to less serious cases. Otherwise, patients will stay in the system, an extra cost and not the best outcome for them.
We are not in any sense trying to apportion blame, there are fine oral & maxillofacial surgeons working within the NHS. The points raised by the GIRFT report are never the less valid and important.
Maxillofacial care requires high level knowledge, for diagnosis, which may follow a GP’s assessment, and surgical, or non surgical management of conditions.
The field deals with facial pain, oral disease and infections, craniofacial surgery, facial cancers, restorative microsurgery, complex dental needs. Alongside these, preserving sensory ability and facial aesthetics is vital.
Patient confidence also matters and is heightened by medical planning which identifies the best path. Reducing hospital stays is helpful, or organising alternatives which can bring the best outcome with minimal intervention.
With the right skills and understanding of when local, or general anaesthesia will suit, much can be achieved through day surgery. A blessing for patients in terms of far more than cost and a decision to get right.
The maxillofacial profession is essential to the NHS and we will do all we can to support them. Lessening skill gaps and at the same time, repeated care for patients, is a rational and valuable objective.