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Inner City Innovations 2002
During his year as BDA president, Peter Swiss is visiting a number of interesting – and very different – practices for BDA news. For the third in this occasional series he has visited an inner city pratice in south east London.
In my student days at Guy’s Hospital, over 30 years ago, Jamaica Road, Bermondsey was the heart of inner London’s deprived south east. When better, then, to visit an inner city practice to contrast with my previous practice visits in this series.
Today the signs of its traditional social deprivation are still apparent. However, Bermondsey is also undergoing something of a change, with its modern Jubilee line station emphasising its proximity to both central London and to the Docklands development, and thereby attracting new and more affluent residents.
There has been a dental practice at 186 Jamaica Road for about 20 years which, historically has always been dedicated to providing dental care for a local population in an area with a high incidence of dental disease. In 1996 the practice was taken over by Divyash Patel and Amritpal Marway who have embarked upon a sustained process of change. The first phase saw a major internal refurbishment of the premises, which included the creation of a third surgery, disability access and full network computerisation; this redevelopment was partially funded by the local health authority.
In 1998 the practice was accepted into the newly accepted PDS pilot scheme which comprises seven practices in the local area. A three-year rolling contract was entered into with the Health Authority whereby the practice agreed to meet certain registration and treatment targets, with patients- both adult and children- being registered on a 24- month basis, rather than the traditional NHS fee scale. During the first year of the pilot the agreed targets were achieved and there was a seamless transfer of existing patients from the GDS to PDS.
Another, and significant, innovation during that first year was the integration into the practice of a part-time community dentist together with the transfer of about 200 patients from a nearby community dental clinic which was closing. This enables the majority of children, including those with special needs, to be treated within the practice. A part-time dental health educator was also recruited at that time and every child exhibiting dental decay is now offered an education appointment, and the community dentist can arrange specific oral health education for their high needs patients. The focus on a team approach to dental practice and a strong commitment to postgraduate dental education is evident.
Further practice development has followed, with a fourth surgery being added, and with the provision of intra-oral cameras and ceiling monitors in all surgeries. I was also told that the introduction of the digital x-rays has almost entirely eliminated the previous 25 per cent failure rate where by x-rays where either of inadequate quality or were subsequently misplaced.
But alongside all of this, it is perhaps the practice’s commitment to the local elderly population that is of particular interest. For the past two months the practice has actively supported Age Concern Southwark, initially by attending sessions at the local Early Intervention Centres where dental advice is given and treatment arranged. More recently, when the adjacent ground-floor unit became empty, the practice entered into a joint project with Age Concern to provide a juice bar and internet café, which was opened by local MP Simon Hughes, and where local residents could also obtain advice on aspects of healthy living, insurance advice and other community services. Not surprisingly the practice was a finalist in the recent Focus Awards 2001 for innovations in patient care.
For some in general dental practice, registration and treatment targets, quarterly review meetings with the Health Authority, and increased DPB scrutiny may seem unwelcome intrusions; but for others, like Ash Patel and Amrit Marway, it has provided a stimulating and rewarding partnership. Furthermore, their current VDP will be experiencing how, with imagination and commitment, an NHS practice in the 21st century can provide both a comprehensive dental service for the local community and a rewarding professional challenge for the practice team.
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