Article Text
Abstract
Colnbrook Immigration Removal Centre (CIRC) is a secure detention facility. Persons detained less than 12-months could only access urgent dental care; persons detained more than 12-months could also access routine dental care. A large detainee population and the once-a-week availability of dentistry could cause some patients to visit CIRC’s medical services, and a lengthy dental waiting list. The British Medical Association advocates that detainees should be entitled to the same range and quality of services, as received by the general public.
The author was inspired by Hydebank Prison’s triage approach, and the existing triage systems: NHS 111 and the Scottish Emergency Dental Service. With the unavailability of dental nursing between October and November 2018, a contingency plan was made: to devise a triage screening tool and implement triage clinics at CIRC to help reduce its dental waiting list. Triage appointments were booked and conducted. 20-patients were seen: 12-patients required urgent care; eight patients, detained less than a year, required routine care. All urgent problems were booked appointments. The 20-patients were removed from the waiting list. This led to a reduction of patients, therefore, reduced waiting times.
Quality improvement and its use in enhancing practice performance; decision-making theories within triage systems and screening tools; the value of evidence-based dentistry, and the importance of evidence-based management and strategic decision-making were significant learning points. Working with healthcare, administrative and officer teams encouraged collaborative leadership. In medical and secure establishments, dental teams may not always be present. Thus, some sort of triage system and screening tool should exist, so that patients can receive dental advice or emergency first-aid care from suitably trained staff. This will be of particular importance to medical staff, in perhaps, preventing inappropriate antibiotic prescribing.