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Seamless oral surgery—primary care oral surgery in a maxillofacial unit: the first four years
Oral presentations / British Journal of Oral and Maxillofacial Surgery 50S (2012) S1–S41
ranged from 6 to 84 months. A total of 29 (13%) patients failed regionally. Sixteen (7%) were ipsilateral failures; with 2 (13%) N0, 3 (18%) N1 and 11 (69%) N2b respectively. Thirteen patients (6%) failed in contralateral neck. Conclusions: Results show that SND can be successfully ultilized in both N0 and N+ neck disease with reasonable results. http://dx.doi.org/10.1016/j.bjoms.2012.04.183 38 Seamless oral surgery—primary care oral surgery in a maxillofacial unit: the first four years S.R. Challa ∗ , R. Hassan, C. Sunkara, L. Biss, A. Majumdar Milton Keynes General Hospital, NHS Foundation Trust, United Kingdom The NHS reforms of 20061 resulted in devolving of the centrally controlled budgets to PCTs. Reforms to the dental services led to PCTs commissioning of dental services from April 2006.2 This change resulted in PCTs commissioning of services locally aiming to improve patients experience, to have locally commissioned services which match the needs of local population and to improve the quality of care. Milton Keynes PCT was one of the first in the country, to invite expression of interest from providers to commission an Oral Surgery service in the primary care sector. The Milton Keynes General Hospital was selected as one of the four providers after a competitive bidding process. This presentation provides a comprehensive four year overview of this unique primary care minor oral surgery service provided within the consultant led secondary care setting. The advantages and disadvantages of the service and clinical and financial implications for the commissioners and providers and patient experience are presented.
S15
Facial skin malignancies are common, particularly in the elderly population and surgery remains the mainstay of treatment. The vast majority of small or simple lesions are managed by surgical dermatologists. Maxillofacial surgeons providing a tertiary referral service tend to treat relatively large lesions in anatomically complex locations. Concerns about surgical complexity, patient age, comorbidity and possible psychological sequelae of facial surgery may persuade surgeons to allow a delay between initial consultation and definitive treatment. Aim: To audit clinical effectiveness, patient opinion and cost effectiveness of a \“see and treat\” clinic for management of facial skin malignancies. Method: DGH setting. 100 consecutive patients were offered “see and treat” surgery or surgery at a later date. Size, site, histological data, reconstruction, complications were recorded. A postal questionnaire was sent one week after surgery. Patients were asked to give their opinion of the service. Results: 90 patients accepted “see and treat” surgery. 106 lesions were removed. Complete excision rate was 96%. There were no postoperative complications. 95% of patients found the service satisfactory. 95% felt they were given sufficient choice about surgical options and 95% said they preferred “see and treat” surgery. Conclusions: “See and treat” management is safe, cost effective and acceptable to patients. http://dx.doi.org/10.1016/j.bjoms.2012.04.185 40 A study of patient compliance with self-completion of symptoms and outcome data in third molar surgery R.K. Sanghera ∗ , E. Quartey, I. Hutchison Barts and The London NHS Trust, United Kingdom
Reference 1. White Paper, Our Health, Our Care, Our Say. Department of Health; 2006. 2. Reforms to NHS Dental Services; 2006.
http://dx.doi.org/10.1016/j.bjoms.2012.04.184 39 Can you do it now doctor? Can tertiary referrals for management of facial skin malignancies be managed on a “see and treat” basis A. Mckechnie United Lincolnshire Hospitals, NHS Trust, United Kingdom Background: While “see and treat” management of benign skin lesions is accepted, it’s use for management of more complex lesions or malignancies has not been tested or described.
Introduction: The Department of Health increasingly questions which treatments the NHS should provide. Third molar surgery, the commonest OMFS operation, is under such scrutiny. In order to determine clinical need, patient symptoms and treatment outcomes must be collected. However, data collection is onerous for the busy surgeon so this study evaluated the co-operation of patients with self-completion of their data in the waiting room; the time taken by the surgeon in evaluating NICE compliance; and ease and patient compliance with follow-up. Methods: A 4-part proforma was used: patient selfcompleted symptomatology (this was placed in the notes and saved surgeon’s time taking a history); surgeon recording of correlation between referral details, actual symptomatology and NICE compliance; a simple operative record; a 3-month follow-up questionnaire on patient-recorded outcome. Results: 80% of patients completed the form in the waiting room. A further 18% completed the form with the
ranged from 6 to 84 months. A total of 29 (13%) patients failed regionally. Sixteen (7%) were ipsilateral failures; with 2 (13%) N0, 3 (18%) N1 and 11 (69%) N2b respectively. Thirteen patients (6%) failed in contralateral neck. Conclusions: Results show that SND can be successfully ultilized in both N0 and N+ neck disease with reasonable results. http://dx.doi.org/10.1016/j.bjoms.2012.04.183 38 Seamless oral surgery—primary care oral surgery in a maxillofacial unit: the first four years S.R. Challa ∗ , R. Hassan, C. Sunkara, L. Biss, A. Majumdar Milton Keynes General Hospital, NHS Foundation Trust, United Kingdom The NHS reforms of 20061 resulted in devolving of the centrally controlled budgets to PCTs. Reforms to the dental services led to PCTs commissioning of dental services from April 2006.2 This change resulted in PCTs commissioning of services locally aiming to improve patients experience, to have locally commissioned services which match the needs of local population and to improve the quality of care. Milton Keynes PCT was one of the first in the country, to invite expression of interest from providers to commission an Oral Surgery service in the primary care sector. The Milton Keynes General Hospital was selected as one of the four providers after a competitive bidding process. This presentation provides a comprehensive four year overview of this unique primary care minor oral surgery service provided within the consultant led secondary care setting. The advantages and disadvantages of the service and clinical and financial implications for the commissioners and providers and patient experience are presented.
S15
Facial skin malignancies are common, particularly in the elderly population and surgery remains the mainstay of treatment. The vast majority of small or simple lesions are managed by surgical dermatologists. Maxillofacial surgeons providing a tertiary referral service tend to treat relatively large lesions in anatomically complex locations. Concerns about surgical complexity, patient age, comorbidity and possible psychological sequelae of facial surgery may persuade surgeons to allow a delay between initial consultation and definitive treatment. Aim: To audit clinical effectiveness, patient opinion and cost effectiveness of a \“see and treat\” clinic for management of facial skin malignancies. Method: DGH setting. 100 consecutive patients were offered “see and treat” surgery or surgery at a later date. Size, site, histological data, reconstruction, complications were recorded. A postal questionnaire was sent one week after surgery. Patients were asked to give their opinion of the service. Results: 90 patients accepted “see and treat” surgery. 106 lesions were removed. Complete excision rate was 96%. There were no postoperative complications. 95% of patients found the service satisfactory. 95% felt they were given sufficient choice about surgical options and 95% said they preferred “see and treat” surgery. Conclusions: “See and treat” management is safe, cost effective and acceptable to patients. http://dx.doi.org/10.1016/j.bjoms.2012.04.185 40 A study of patient compliance with self-completion of symptoms and outcome data in third molar surgery R.K. Sanghera ∗ , E. Quartey, I. Hutchison Barts and The London NHS Trust, United Kingdom
Reference 1. White Paper, Our Health, Our Care, Our Say. Department of Health; 2006. 2. Reforms to NHS Dental Services; 2006.
http://dx.doi.org/10.1016/j.bjoms.2012.04.184 39 Can you do it now doctor? Can tertiary referrals for management of facial skin malignancies be managed on a “see and treat” basis A. Mckechnie United Lincolnshire Hospitals, NHS Trust, United Kingdom Background: While “see and treat” management of benign skin lesions is accepted, it’s use for management of more complex lesions or malignancies has not been tested or described.
Introduction: The Department of Health increasingly questions which treatments the NHS should provide. Third molar surgery, the commonest OMFS operation, is under such scrutiny. In order to determine clinical need, patient symptoms and treatment outcomes must be collected. However, data collection is onerous for the busy surgeon so this study evaluated the co-operation of patients with self-completion of their data in the waiting room; the time taken by the surgeon in evaluating NICE compliance; and ease and patient compliance with follow-up. Methods: A 4-part proforma was used: patient selfcompleted symptomatology (this was placed in the notes and saved surgeon’s time taking a history); surgeon recording of correlation between referral details, actual symptomatology and NICE compliance; a simple operative record; a 3-month follow-up questionnaire on patient-recorded outcome. Results: 80% of patients completed the form in the waiting room. A further 18% completed the form with the