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NHS orthodontic services in Wales: orthodontic workforce distribution and primary care commissioned activity in 2021

British Dental Journal (2022)Cite this article

Abstract

Objectives 1) To ascertain the volume of primary care orthodontic activity commissioned within Wales and compare this to the 12-year-old population; and 2) To ascertain the orthodontic workforce undertaking NHS orthodontic provision within Wales and their distribution.

Methods Information was gathered between September and November 2021 from multiple sources within Wales, including: Freedom of Information requests; Welsh Government statistics; orthodontic professional networks; orthodontic provider websites; health boards (HBs); and directors of primary care/contracting/commissioning.

Results The HBs had varying levels of orthodontic need and commissioned activity with a significant amount of cross border activity in South Wales. Overall, it indicated that Wales was only commissioning orthodontic activity to meet 76% of the annual orthodontic need. Overall, 97.9% of commissioned primary care orthodontic activity was being used to provide treatment for 9,500 patients per year. Furthermore, 112 GDC-registered clinicians provide NHS orthodontic care within Wales - 52 orthodontic specialists; 32 orthodontic therapists; 24 DwSIs; and 4 orthodontic trainees (StR 1-3). NHS orthodontic care is provided at 47 sites within Wales - 32 sites in the GDS/Specialist Practice, 6 sites within the CDS and 9 secondary care settings.

Conclusions NHS commissioned primary care orthodontic activity within Wales is 76% of the potential orthodontic annual need. Primary care orthodontic services are efficient with 97.9% of commissioned activity being used to provide treatment. In total, 112 GDC-registered clinicians provide NHS orthodontic care across 47 sites within Wales, with 29.5% of clinicians working at multiple sites. The distribution of the orthodontic providers is predominately in areas of high population density, resulting in some rural communities being a significant distance from any orthodontic provider.

Key points

  • The amount of NHS commissioned primary orthodontic activity within Wales is 76% of what is potentially required to meet the annual need.

  • Primary care orthodontic services are efficient, with 97.1% of commissioned activity being used to provide treatment.

  • There are 112 GDC registered clinicians who provide NHS orthodontic care within Wales: 52 specialists, 24 dentists with a special interest, 32 orthodontic therapists and 3 orthodontic trainees (specialty registrar 1-3), providing 694.4 sessions of NHS orthodontic activity per week over 47 locations.

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References

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Author information

Authors and Affiliations

  1. Consultant Orthodontist, Besti Cadwaladr University Health Board, Orthodontic Department, Glan Clwyd Hospital, Rhuddlan Road, Rhyl, LL18 5UJ, UK; Orthodontic Department, Department 8, Wrexham Maelor Hospital, Croesnewydd Road, Wrexham, Ll13 7TD, UK

    Benjamin R. K. Lewis

  2. Consultant Orthodontist, Maxillofacial Unit, Morriston Hospital, Heol Maes Eglwys, Treforys, Cwmrhydyceirw, Swansea, SA6 6NLE, UK

    Meryl E. Spencer

  3. Consultant Orthodontist, Orthodontic Department, University Dental Hospital, Heath Park, Cardiff, CF14 4XY, UK

    Sarah J. Merrett

  4. Consultant Orthodontist, Maxillofacial Department, Prince Charles Hospital, Gurnos Road, Merthyr Tydfil, CF47 9DT, UK

    Nasreen A. Yaqoob

  5. Consultant Orthodontist, Maxillofacial Department, Royal Gwent Hospital, Cardiff Road, Newport, NP20 2UB, UK; Maxillofacial Department, Nevill Hall Hospital, Brecon Road, Abergavenny, NP7 7EG, UK

    Nizar A. Mhani

Authors
  1. Benjamin R. K. Lewis
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  2. Meryl E. Spencer
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  3. Sarah J. Merrett
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  4. Nasreen A. Yaqoob
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Contributions

Benjamin R. K. Lewis: conceptualisation; methodology; investigation; data curation; writing - original draft; writing - review and editing; visualisation. Meryl E. Spencer, Sarah J. Merrett, Nasreen A. Yaqoob and Nizar A. Mhani: methodology; investigation; writing - review and editing.

Corresponding author

Correspondence to Benjamin R. K. Lewis.

Ethics declarations

This study was devised to calculate the volume of primary care orthodontic activity commissioned and comparing this to the 12-year-old population and ascertain the orthodontic workforce undertaking NHS orthodontic provision within Wales along with their distribution. The information gathered was via the use of publicly available information, freedom of information requests, liaising with primary care directors and contractor managers within Health Boards, along with the established orthodontic clinical networks within Wales. All received data was anonymised to ensure that it is non-identifiable, only summary data at an All Wales and Health Board level is presented within this article. As such, the study did not require ethical approval as it was not considered research as per the Medical Research Council/NHS Health Research Authority assessment tool (hra-decisiontools.org.uk).

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Lewis, B., Spencer, M., Merrett, S. et al. NHS orthodontic services in Wales: orthodontic workforce distribution and primary care commissioned activity in 2021. Br Dent J (2022). https://doi.org/10.1038/s41415-022-5251-1

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