Data from NHS Treatment claims that are submitted are collated and provide an overview of the activity and effectiveness of that treatment provided under NHS GDS and PDS regulations.
The data resides in a NHS BSA data warehouse which supplies information to two reporting portals. One is Compass which is accessible to providers and performers and presents the information as Vital Signs and the other is eDen.
eDen is a comprehensive reporting platform that commissioners, providers and practice managers can use to assess activity and clinical data for contracts and performers.
To access eDen as a provider or practice manager you have to register with the NHS BSA for access to the dashboard.
Following on from the above, part of the responsibility of the ICB is, not only, to monitor UDA and UOA activity, but also to monitor quality of treatment provided. This is undertaken through reports, provided by a NHS BSA clinical adviser, looking at the clinical data submitted. These provide information that highlights practices/performers that are outliers and good practise in line with the rest of the ICB and England.
The data warehouse allows for specific items to be reported on and related to other items of clinical data set.
In undertaking an exercise relating to fluoride varnish application and the declaration of best practice in line with delivering Better Oral Health in under 17yrs olds some inferences emerged.
The table 1, below shows were Lancashire and South Cumbria stand with regard to fluoride varnish applications compared to other ICB’s. This is for the last Q2, which is July to September 2024 of this contract year.
The table shows that Lancashire and South Cumbria ICB lies in the upper half with an average of 65.5 %. This compares well with the same metric for England of 62.3%, meaning we are doing better than the England average.
Table 2 shows the situation for fluoride varnish applications for the current year. The lowest and highest percentage of applications.
The 100% of fluoride applications were seen in contracts that were very small for the number of FP17’s submitted and the 0% could be for one of two reasons. Firstly, the data may not relevant to the contract; ie a Minor Oral Surgery contract or fluoride applications are not being entered due operator error or software error not allocating the item.
Looking at the metric for Best Practice for Delivering Better Oral Health showed that there could be up to 100% of FP17’s submitted ticked for that item, however when you look at the number of Fluoride Varnish applications that have Best Practice ticked as well, the average was 36.8%, the highest being 87.5%.
It appears that Best Practice could be being ticked simply as a routine whether or not Best Practice advice and treatment has actually been undertaken. It could mean that Best Practice is being ticked routinely however the application of Fluoride Varnish, if appropriate, is not being ticked on the FP17 or recorded by the computer system. Best Practice, based on risk, doesn’t just relate to Fluoride Varnish only it would include oral hygiene, dietary advice and appropriate recall periods for under 18yrs old.
David Bradley BDS,
ICB Dental adviser.
October 2024
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