East & West Kent Community Health Referrals

Community Health Referrals

Referrals in East & West Kent for the Community / Salaried Dental Services are now fully electronic and can be made in Practice using the Dental Electronic Referral System (DERS)

The Community/Salaried Services no longer can advise around acceptance criteria as all referrals from dentists are made via REGO and as a result will be directed via the algorithm – multi-faceted questions that are set against various agreed criteria.

Referrals that pass the REGO algorithm successfully received by the Community Service are triaged and accepted for care if appropriate. West Kent (Medway Community Healthcare CDS) does not have a domiciliary contract for example so would be refused.

Things that should be included:

• All treatment required on the mouth grid not just in random “free text”
• Suitable radiographs must be attached (not random holiday snaps if no radiograph is available!) Remember you can refer for an extra-oral radiograph at the local hospital if you can’t get an intra-oral x-ray done. This is particularly important if referring for extraction of first permanent molars.
• Updated medical history
• Drugs taken entered in the correct part of REGO (as otherwise the algorithm will not direct appropriately) i.e. not just listed in “free text”
• Orthodontic letters
• Rejection letters from sedation services / other services e.g. Guys Hospital or similar

A few things that will not be accepted:

• No tier 2 complexity extractions /oral surgery
• Specialist periodontal care. There is no contract for this in West Kent (Medway Community Healthcare CDS) however there is one for Kent Community HFT CDS (ie East Kent).
• Patients on bisphosphonates that SDCEP guidance states are suitable for treatment in primary care unless they have an additional co-morbidity
• Patients on NOAC’s that SDCEP guidance states are suitable for treatment in primary care unless they have an additional co-morbidity
• No complex tier 2 paediatric trauma (need London hospitals)

Once accepted, appropriate referrals will be offered an appointment once they reach the top of the waiting lists which are advertised on REGO at the time of making a referral and allow the GDP to make an informed choice of provider in terms of waiting times for care.

Please note that you can select your CDS provider of choice (yours and the patients). Kent Community HFT CDS (ie East Kent) is listed first and many Medway dentists are selecting this in error , please scroll down until you see Medway Community healthcare CDS if your patient lives in West Kent , North West Kent, Swale and Medway .

Bariatric/Larger Patients? – In terms of patients that are over 21 stones, GDPs will need to have professional responsibility to ask larger patients for their weight. Despite this being a difficult conversation, it is a necessary one. Practices need to have scales / access to scales to be able to safely record accurate weight. We are warned that no dental chair manufacturer will advise that a person of such a weight can even safely sit on a dental chair. So even for an examination this may not be appropriate in your day to day practice – you need to be asking and checking and not just for referrals!

Community clinics are able to accommodate patients with weights over 21 stone in 3 of their clinics. One is suitable for up to 35 stone (Dartford) and the 2 others 70 stone (based at Ashford MASH and Sevenoaks Hospital) – but as yet a full bariatric service is not provided contractually. In order for any referred larger patients to be provided with safe care the Community Service would expect a weight to be included on the REGO referral rather than just a BMI so that arrangements for referred patients can be made to only attend the appropriate clinic.

NHSE is working around future contracting / purchasing of this type of service and it has been intimated that all new GDP set ups will need to have a bariatric chair in one of their surgeries. As yet the General Practice (Mandatory Services) re-commissioning has not been published so there is no formal clarity on this.

Prepared by Julian Unter Hon Sec KLDC with thanks to Sarah Davies (Medway Community Care) & June Willis-Lake (E Kent Community NHS Foundation Trust) – February 2019

East & West Kent Community Health Referrals KLDC website v4 FINAL Updated April 2023