Guide for commissioning oral surgery: the development of a calibration tool

Abstract

Aims In previously published work a calibration tool used within the Department of Oral Surgery, King's College Dental Hospital London, identified a consensus of 68% in classifying levels of complexity of cases as per NHS England's Guide for Commissioning Oral Surgery and Oral Medicine. The authors postulated that the same challenges in triaging patients would be experienced by clinicians working in less supported environments. A pilot survey attempted to ascertain the level of compliance with the commissioning framework on a national scale.

Materials and methods Twenty cases treated at the Department of Oral Surgery, King's College Dental Hospital London, were identified for inclusion. Radiographs and case histories were compiled within an online questionnaire and circulated via NHS email links and online e-questionnaire platforms. Results were analysed by a specialty registrar and consultant in oral surgery.

Results One hundred and fifty-four responses were received. An average of 66.2% responses received were in agreement with the predetermined answers of the survey.

Discussion The results can be interpreted as a consensus of 66.2% nationally, which is similar to previous local results. This study demonstrates shortcomings of the commissioning framework, conflicts between the commissioning framework and the oral surgery training curriculum and ambiguity of modifying factors. Collectively, these may in some cases result in greater inefficiencies of care.