Prior approval waiting times and changes to our dental clinical team

Prior approval performance

As you may be aware, we work to a target of 95% of prior approval requests for general dental treatment receiving a response - approved, declined or further information requested - within 20 working days.

Our performance against this target has been good over the last two years.

The table shows the most recent nine month period in detail, using information from reports given quarterly to the Scottish Dental Practice Board and every six months to the Scottish Dental Practice Committee.

2018/19 performance

 

Expected outcome

Q1

Q2

Q3

Year

Number of general prior approval estimates processed within operational target (20 days)

95.0%

98.4%

99.6%

99.9%

99.3%

 

Since the introduction of electronic prior approval, mandated by the Scottish Government from 1 October 2018, performance against this target has been adversely affected.

This has happened for a variety of reasons including the failure of some Practice Management System (PMS) suppliers to achieve accreditation within the agreed timescale, resulting in many practices being forced to use our webform service instead of direct system-to-system transmission.

We have provided additional and improved guidance online to help practices use the webform for prior approval and in addition have published, and keep updated, a list of frequently asked questions.

During October 2018 we ran four evening roadshows attended by more than 400 dentists and practice staff providing demonstrations of the webform and the process to be followed.

A number of PMS suppliers have completed all stages and are now live with electronic Prior Approval:

  • Dentally
  • Software of Excellence (EXACT) – SOE Connect has been made available to all EXACT users
  • Systems for Dentists
  • Wysdom

Goodteith and Software of Excellence (SOEL Health specifically) have indicated to us and their customers that they will not be carrying out the development. Users will be required to use our dental web form for the purposes of electronic Prior Approval. 

Carestream and  Computer Surgery are understood to be working on the changes for electronic prior approval.  Carestream have indicated a planned "go live" date of July 2019 while Computer Surgery have yet to confirm a "go live" date.

Changes to our clinical team

Derek Logan, one of our Dental Reference Officers, will retire in May 2019 and one of our Dental Advisers, Gordon Coull, has moved his focus from Dental Adviser duties to be predominantly a replacement for Derek.

Knowing that Derek was due to retire, we had initiated the recruitment process for a DA/DRO replacement and this is now complete. Our new clinical team member, Gerard Boyle, will start with us on 11 June 2019 and will focus on Dental Adviser work.

In the interim this means that we have significant decrease in capacity for prior approval in the short term and it is unavoidable that the turnround time for prior approval will increase until normal staffing levels are achieved. 

Whilst no-one at Practitioner Services or in general practice would want a prior approval decision to be delayed, the combination of the unanticipated issues with electronic prior approval at the same time as clinical team resource reduction will mean that there is little alternative to accepting a slower turnaround for a period.

We therefore wanted to apologise in advance of that happening and help make practices aware of that so you can manage patients and their expectations accordingly.

If you have any questions relating to the above, please contact our Customer Services Team by emailing nss.psddental@nhs.net or telephone 0131 275 6300.

Read more