Getting It Right First Time (GIRFT) — the Oral & Maxillofacial Surgery Report: what happens next?

An evaluation of referrer factors for 98,671 referrals made to the West Yorkshire oral surgery managed clinical network over a three-year period

Introduction Patients referred from primary dental care to hospital-based specialists in high volumes can contribute to significant NHS service pressures. Surprisingly, little is understood about what contributes to referral factors.Aims To gain new insight into the referral factors from primary dental care by interrogating the tri-speciality West Yorkshire managed clinical network (MCN) referral pathway data for a 36-month period (2016-2019).Methods Anonymised referrals from the electronic referral management system were collated for analyses.Results There were 98,671 referrals within the 36-month period, 12.3% of which were rejected. Of those accepted for triage, 76% were directed at oral surgery, with >60% accounted for by exodontia. In total, 10% of referrers accounted for 60% of all referrals. Peak referral occurred five years after General Dental Council registration.Discussion This is the first report of referral data from a tri-speciality MCN with exodontia referrals predominating. The data set demonstrates variation in referrer behaviours despite referral guidance. Referrals should be based upon patient need but patterns observed in this study suggested possible associations with high and low referral patterns which warrant further research.Conclusions Interrogation of the referral database suggests that there are interesting patterns of referral which may be associated with characteristics of the referrer as well as their patients' needs. Further investigation could inform improved processes and service design, as well as education delivery and workforce development.

Workforce intelligence: what data do we need to collect to understand trends in substantive oral and maxillofacial surgery consultant posts? A retrospective review and plan for the future

Understanding workforce pressures within surgery is an inexact science. This paper assembles evidence regarding oral and maxillofacial surgery (OMFS) consultant appointments in the UK and plans for prospective data collection in the future. Information about the number of OMFS specialists joining the UK specialist list was obtained from the General Medical Council and compared to a database of substantive OMFS consultant posts. OMFS consultants were asked to contribute information about their training programmes and consultant appointments (date, interview experience, and sub-specialty interest). This information was collated on Excel© and analysed using WinStat©. Data on OMFS consultant posts advertised in 'NHS Jobs' and the British Medical Journal were collected. The mean (SD) number of specialists joining the specialist list per year is 24.1 (5.2) with a median of 24 and a range of 15 - 36. The number of trainees completing training and numbers joining the OMFS specialist list are in balance at present. The median delay between OMFS specialist listing and appointment as a consultant was 72 days and mean of 169 with the 25th centile of five days, standard deviation of 239 days and maximum of 5.2 years. Of those returning data, 135 (47%) candidates were the sole interviewee and 83 (29%) had one other candidate at their successful interview. The mean application ratio for each post was 1.9 and the median number of candidates was one, mean 1.6 and maximum candidates seven. About half of the posts were filled by trainees from their regional training rotation. Prospective data collection on advertised posts, interviews held, expected retirements/new posts, combined with a route for trainees approaching CCT to highlight their availability may streamline recruitment and allow a more rapid recognition of recruitment problems.