Aim:
The aim of this service evaluation was to investigate the output, complexity, and referral pathways of root canal treatments (RCTs) and retreatments (RCreT) at the Royal London Dental Hospital, specifically focusing on cases referred from different service providers within NHS England.
Methods:
Data was gathered and analyzed on non-surgical RCTs conducted between 1 April 2021 and 31 March 2022. Key areas examined included the number of completed treatments, reasons and origins of referrals, referral-to-treatment timelines, and the complexity of treatments.
Results:
A total of 339 teeth met the inclusion criteria. The data revealed the following:
Referral Sources: External referrals (198 cases) had an average referral-to-treatment time of 47 weeks, significantly longer than internal referrals (141 cases), which averaged 16 weeks.
Commonly Referred Teeth: Maxillary incisors and first permanent molars were the most frequently referred teeth.
Reasons for Referral: The most common reasons for referral included:
- Anatomical challenges (33.5%)
- Root canal retreatments (32.2%)
- Trauma-related cases (18%)
Treatment Complexity and Completion: Treatments were completed with an average of 2.7 appointments. A significant proportion of cases were designated as complexity Level 2 and Level 3, suggesting that more challenging cases were being treated.
Conclusions:
The evaluation found that the output of root canal treatments at the Royal London Dental Hospital has been increasing. However, a notable delay was observed in external referrals, with these taking much longer (an average of 47 weeks) to be seen and treated compared to internal referrals (16 weeks). This delay did not meet the NHS targets for referral-to-treatment timelines.
The complexity of cases appeared to match the clinician’s skill set, and treatments typically took an average of 2.7 appointments. To gain a deeper understanding of the service’s efficiency and pressures, more data is needed on the number of referrals, available consultations, and clinic space. This additional information could help address the current delays in treatment and enhance service delivery.
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