Maori Dental Service

All District Health Boards

MAORI DENTAL SERVICE

STATUS: NON-MANDATORY 

Review History Date

Published on NSFL July 2002

Amendments July 2012 changed to non-mandatory

Consideration for next Service Specification Review

Note: Contact the Service Specification Programme Manager, National Health Board Business Unit, Ministry of Health to discuss the process and guidance available in developing new or updating and revising existing service specifications. Web site address of the Nationwide Service Framework Library: http://www.nsfl.health.govt.nz/ Maori Dental Service

1 Definition

The Ministry of Health identified oral health as one of the eight Maori health gain priority areas. The aim of the dental service is to maintain and improve the dental health status of those Maori who live in the area.

2 Service Objectives

2.1 General The service will seek to assist the improvement of oral health for Maori in <> . Key outcomes expected of service delivery include:  establishment of a Maori Dental Service  delivery of a basic dental service to adults at an affordable cost  support measures designed to reduce further the incidence of dental caries  a focus on how the service can contribute to Maori health gain objectives.

2.2 Maori Health The service is expected to contribute to the reduction in health inequalities, the 13 priority Population Health Objectives, as well as the Maori health gain objectives, in particular, targeting services to impact on asthma, diabetes, injury prevention, smoking, hearing, mental health, oral health and immunisation, including violence prevention.

The Maori Health Strategy: He Korowai Oranga is referred to and Maori Health requirements are outlined in the General Terms and Conditions and Provider Quality Specifications. In addition the provider arm of the DHB is to develop and implement a Maori Health Plan that outlines how it will contribute to improving outcomes for Maori for the services contained in this service specification.

The Plan should include the following objectives as a minimum:

 How you will ensure that Maori utilisation is at least equal to the Maori population in the provider's catchment.  How you will ensure your effectiveness and the acceptability and accessibility of services to Maori  How links with primary care - general practice, community providers and Maori providers will be effective for improved outcomes in Maori health';  How discharge planning and rehabilitation processes will meet the needs of Maori;  Links with the DHB provider arm's Maori Health Plan and other contractual quality specifications, especially consultation with Maori.  How these objectives will be monitored and measured for Maori health outcomes. 3 Service Users

The service will target service delivery to Maori in <>.

4 Access

4.1 Entry and Exit Criteria Anyone who presents to the dental clinics needing dental care is eligible. People are eligible for essential dental health services whenever they need help. The targeted groups for the services are low-income adults.

You will ensure and demonstrate that Maori access services are based upon an accurate needs analysis of the Maori population within your service coverage area.

An urgent access criterion needs to be developed in order to ensure that those Maori most in need are prioritised.

4.2 Time The maximum waiting time is expected to be one month from the time of referral/ assessment. It is expected that the dental service will be able to respond to urgent referrals.

5 Service Components

5.1 Service Delivery Time The adult dental service is available to the community from 9 am until 5 pm Monday to Friday, although the service delivery tine may be altered to reflect the needs of the community.

5.2 Processes The provider will establish a comprehensive patient register using a recognised ‘patient management’ system. Patient registrations are to be properly documented and where the patient transfers to the provider’s register from another dental practice that dental practice is to be formally notified and the notification properly recorded.

The provider will take all reasonable steps to ensure the business-like development of the dental practice and recognise that the financial support offered in this agreement is only available for the period of the agreement. No ongoing funding will be available and business income will need to be derived from normal dental practice flows.

The provider will deliver basic dental service to adults at an affordable cost. The delivery of essential dental care, giving relief to pain and infection is covered within the basic care service to adults. Ongoing Evaluation and Review of Service The provider will ensure that all processes consider and meet the needs of Maori and are reviewed in conjunction with your requirements to consult with Maori and to agree a plan with us for implementation by yourselves.

The provider will agree to ongoing evaluation and review of service.

5.3 Settings The dental service will be provided in the <>.

5.4 Support Services

 Local dental practitioners  Local general practitioners  Hospital dental service.

5.5 Facilities The service is expected to be mainly provided within the dental practice facility. The service is expected to ensure the facility will be accident proof and free of all hazards and unsafe features.

5.6 Key inputs Staff will be appropriately qualified or experienced in:  dental practice  Maori health issues and priorities  working with family/whanau.

Staff will be able to access ongoing training at a professional level.

6 Service Linkages

The service will demonstrate how co-ordination, communication and co- operation with these services occur. Linkages will be proactively established, maintained and improved with the appropriate Maori, primary and community providers, including:  dental practices  general medical practices  Maori providers  nga runanga  maatua whangai.

You will have written protocols and systems in place to facilitate these linkages.

7 Exclusions

School Dental Services, other than referral services, are excluded from this service. 8 Quality Requirements

Services will be provided within a culture of continuous quality improvement. Although quality improvement systems will be the responsibility of the provider organisation, each practitioner will be responsible for efforts to improve the quality of resources, processes and outcomes of the service that they provide.

The service is required to comply with the Ministry of Health General Contract Terms and Conditions and the Ministry of Health Provider Quality Specifications. The following specific quality requirements also apply.

8.1 General The service is required to demonstrate how it is acceptable to:  families/whanau  Maori.

8.2 Effectiveness The service will work with the Ministry of Health to determine how to evaluate the effectiveness, efficient resource utilisation and improved health outcomes of service delivery, especially for Maori.

8.3 Staff Training – Disability, Violence and Abuse 8.3.1. Disability

Staff training must be given specifically in:

a) disability awareness to ensure disabled clients and their carers are given appropriate access and support b) specific issues in the patterns and identification of abuse and interpersonal violence for these groups.

8.3.2 Violence

Staff must have training in how to identify, support and refer victims of abuse and interpersonal violence. The agency must have protocols in place to support staff in this intervention.

9 Quantitative Reporting

Collect and report ethnicity data which demonstrate Maori utilisation of services as specific to the service specification. Minimum level of reporting to be discussed.

Number of clients per quarter by ethnic group* Maori Pacific Other (includes number of other groups)

Number of new clients per quarter by ethnic group Maori Pacific Other

Number of clients exiting the service per quarter.

Ethnicity is recorded as is perceived by the family/whanau. People may therefore perceive themselves as belonging to more than one ethnic group. Ethnicity is to be reported according to the following priority system, if perceived ethnicity includes Maori, report as Maori; Pacific, report as Pacific; Other, report as Other.

10 Reporting Requirements

Quarterly report covering a period of three months Please return to: (Due 1 October, 1 January,1 April, 1 July) Dental Monitoring Unit From...... to......

Numbers of: Treatment items SDB GDB Adult Adult New Ethnicity basic emergency referrals care care only M PI Other Consultations (eg, emergency treatment) Examinations (basic dental care) X-Rays: (i) Bitewings (ii) PA (iii) Panex - occlusal film Extractions: Routine Surgical Amalgams: 1 Simple 2 Two-surface 3 Three surface 4 Cusp restorations Non-metallic: 1 Simple 2 Compound Dressings Scale and polish Dentures: 1 FU and/or FL 2 Relines 3 Partial a Plastic b Metal Inlays or gold crowns Crowns: 1 Acrylic or composite 2 Porcelain or porcelain fused to metal Endodontic: 1 Single root 2 Multi roots Other treatments Number of patients Referrals to hospital or practitioners