5 year wait - but 14% of young people still miss dental appointments

Wednesday 13 December 2017

The number of under 18s failing to show up for their scheduled dental appointments hit a four-year high in 2016, with 2,088 appointments missed - nearly 14% of the total - despite some having to wait five years to be booked in.

And figures released following an Express Freedom of Information (FOI) request show that 15% of adults also missed their appointments in 2016, the highest number since 2012.

The figures relate to appointments made with the Community Health Services Dental and Orthodontics and show that the percentage of missed appointments fluctuated between 13% in 2013, 11% in 2014 and 12% in 2015. In 2012, 14% of appointments for under 18s were not attended.

While there are fewer adults booking in for dental appointments - on average there are 1,633 appointments every year compared to 14,478 for under 18s - the proportion of those not showing up is greater. 2013 saw the smallest number of appointments being missed out on with 168 out of a total of 1,432. Other years, numbers have been between 12% and 13%.

It was reported earlier this year that parents reported having resorted to paying thousands in private practices to avoid waiting up to five years to access States services. In July,  the Health and Social Services Department (HSSD), stated it took 18 months on average for a new patient to be seen by an Orthodontic consultant following a referral by their dentist, with the patient facing a potential further three-year wait before treatment can begin.

An Express FOI request subsequently revealed that a struggle to recruit dentists to the island had pushed appointment waiting times to their highest level in five years after the only orthodontic consultant cut back hours last year.

Pictured: A struggle to recruit dentists pushed appointment waiting times to a five-year high in 2017.

The waiting period for children quadrupled, going from 16 weeks in 2012 to over 60 while it rose from 15 weeks to six months for adults. Still, people are missing their appointments: so far this year, 14% of under 18s and 15% of adults have failed to attend their scheduled appointment.

One islander wrote to Express in September noting that she had attended the hospital community dental department for a routine appointment with her 10 year old son. She explained that whilst there, she overheard the dentist, "...annoyingly note to her colleague that two other children allocated appointments that morning were no-shows!"

"When leaving I read the statistics publicized on a laminated poster behind the reception desk which highlighted the number of appointments awaited, made and missed each year. I was actually angry to note that so many people don’t show up, cancel or reschedule appointments that they can no longer make or just can’t be bothered to make. This selfishness contributes to the long waiting lists and eats away at the funding for an already struggling department."

Pictured: One mother wrote to Express to call for families to cancel their appointments to help the department be more efficient.

The mother of two explained that her daughter had been put "on a waiting list to go on the waiting list," meaning that she first had to be assessed, which could take up to 18 months before being put on the waiting list to see the consultant orthodontist. "My daughter will need to wait until she is 16+ before she is likely to get the braces she needs, that is unless there is a further delay and she reaches 17 years when she may then become ineligible due to her age."

After inquiring about the price of braces with a private orthodontist, which came up to £2,500 to £3,000, she added: "Myself and my husband have paid maximum social security contributions, income tax and the more recent social care levy for 25+ years so it really feels as if middle Jersey are being asked again to cough up. We both pay for private medical care insurance so are not a burden on the hospital but still it is expected that we pay privately for our children to have dental treatment?

"For those who do make the choice to go privately for lots of reasons and not necessarily because they 'can afford it' (they usually borrow & make sacrifices to pay for it) can we please ask that they call to remove their child from the community orthodontic waiting list so the figures are more accurate and we can see if the dental department can run more efficiently and actually end up seeing more patients!"

A spokesman for the Health and Social Security Department said that the rates of patients failing to attend appointments were much higher than the department would like. He added they had "...a significant impact on the dental department’s ability to manage waiting lists. If we are advised that someone will not attend, we can re-book the appointment slot for another patient, but this is not possible if we are not advised."

To reduce the numbers of unattended appointments, the department will soon be introducing some measures. This will include text message reminders sent three to four days prior to an appointment. In addition, should an adult with capacity fail to attend two appointments the patient will be discharged, with a letter sent to their referring clinician, either their GP or Dentist). The spokesperson noted: "It is also important to emphasise that HSSD has a duty to keep careful records about health appointments for children. Should a child fail to attend an appointment without the parents or guardian making contact with the Department in advance to cancel and reschedule, our policy is to notify the nurse for safeguarding. From the start of 2018, this important point will be included in all appointment letters for children."

More measures designed to improve the patient experience and help reducing waiting times could be introduced as the dental department is currently the focus of a Rapid Process Improvement Workshop, which will conclude early next year.