Evaluation of an intermediate minor oral surgery service in Plymouth, England and implications for future commissioning

OBJECTIVE: To evaluate a new primary-care based oral surgery service in Plymouth, England using Maxwells' Dimensions of Quality framework. METHODS: A retrospective observational study of referral, service and treatment outcome data. RESULTS: Over a 35-month period the service received 1165 referrals, with 89% of patients referred receiving treatment within 63 days. Treatment provided was predominantly dento-alevolar surgery accounting for 82% of treatment provided, and soft tissue lesions accounting for 17%. The re-attendance rate for complications was 4%, and antibiotic use was 2%. Sedation was required for 17% of treatment cases. Cost analysis indicated a cost per case of between £138-196. CONCLUSION: The service meets the national clinical standards in oral surgery. High ongoing demand for referral of medium-complexity oral surgery cases from primary dental care to specialist providers/services is likely to continue. The opportunity to develop more primary care capacity has the potential to improve accessibility and convenience for patients and optimise use of NHS resources.