NHS ENGLAND DEVON, CORNWALL AND ISLES of SCILLY LOCAL AREA TEAM
MINOR ORAL SURGERY GDP REFERRAL GUIDELINES
FREQUENTLY ASKED QUESTIONS
"When should I refer an extraction?"
As part of their GDS contract NHS providers and performers are expected to carry out extractions of teeth including the removal of retained roots. The patient should only be referred if they present with special difficulties and lie outside the competence of the dentist concerned. Please look through the guidelines carefully. NHS England has identified the inappropriate referral of extractions that should be carried out in practice as an area where improvements are necessary. If an individual performer feels unable to perform a procedure that should be carried out in general practice it is the responsibility of that provider to arrange for the procedure to be carried out in practice by another, more experienced performer.
"To whom should I refer?"
Currently patients referred for oral surgery procedures are treated either in a secondary care setting which means one of the five main hospitals in Devon and Cornwall or by a specialist provider based in a primary care setting.
Secondary Care providers are able to offer the full range of operative and diagnostic treatment including 2 week waits for suspected cancer patients and general anaesthesia.
Primary care providers are able to offer a more limited range of surgical procedures, with or without sedation. (Appendix 3, referral guidelines)
In order to reduce pressure on secondary care providers and free up valuable resources NHS England has a national and local priority to increase the number of cases treated by primary care based providers and changes to the referral guidelines and triaging of patients reflects this priority.
"Where should I send the referral form?"
All the referrals for the Devon, Torbay and Plymouth areas should be sent to Devon Access and Referral Centre DART on the DCIoS oral surgery referral form (Form 1). Their address, e mail and telephone number are on the form.
NOTE: GDPs who currently refer directly to Derriford or Plymouth based primary care should now refer all patients through DART.
All the referrals for the Cornwall area should be sent to Kernow Health Referral management Service RMS on the DCIoS oral surgery referral form (Form 1). Their address, e mail and telephone number are on the form.
"Why can't I do all the referral process electronically?"
It is an ambition to develop an electronic system as soon as possible. One difficulty is the transmission and storage of radiographs.
"How should I refer a suspected cancer case?"
A suspected cancer case should be referred without delay directly to your nearest hospital. The referral should be faxed and the numbers are on the referral forms. A paper copy or telephone call should follow as a backup.
For North Devon and Exeter you should use the Oral and Maxillofacial Surgery Referral Form (Form 1). Fax 01392 402199
For Plymouth the Plymouth 2WW form (Form 3). Fax 01752 430912 phone 01752 437506
For Cornwall use the Cornwall Hospitals Trust urgent two week wait form ( Form 4 or 4a electronic). Fax to 01872 252300, if problems ring 01872 252323
For Torbay book via choose and book if possible otherwise use the South Devon Healthcare Trust urgent two week wait form and fax to the Patient Access Centre number 01803 654981 (Form 5).
"How can I improve my extraction skills?"
There are opportunities with the postgraduate BUOLD course on oral surgery and if there is demand we will arrange some local training and assisted operating.
"What happens if I encounter problems and am unable to complete a surgical procedure?"
Firstly you should ask a colleague in your practice to assist but if that is not possible then you can ring your local secondary care oral surgery department or primary care specialist for advice.
Royal, Devon and Exeter NHS trust: 01392 411611 to the operator and then ask for the on-call SHO on bleep 476. For North Devon District Hospital "daytime" ring the secretary on 01271 322477
Derriford Hospital, Plymouth 01752 202082 and ask for the on call maxillofacial SHO
Plymouth Community Dental Services: 08451558070
Royal Cornwall Hospital, Truro 01872 250000 - switchboard for on call Oral and Maxillofacial Surgery Resident. Daytime urgent requests can also be to secretarial team 01872 253986
Torbay Hospital: The on call SHO via the switchboard 01803 614567 and bleep #6313
"What will happen if a referral is rejected?"
A referral will only be returned to the referring practitioner after a clinician has reviewed it. The referring practitioner will be sent a letter stating the reason for the rejection and the patient will also be informed. (Appendix 5a & 5b) It is then up to the practitioner to provide more details of why the referral is appropriate or undertakes the procedure in practice. The area team will be auditing a number of these cases to ensure that the patient reaches a satisfactory conclusion.
"Will I get my radiographs back?"
We are aware that radiographs have not always been returned in the past but in future every effort will be made to return original radiographs with correspondence. Digital radiographs should be printed on good quality photographic paper.