Remote Clinical Consultations in Restorative Dentistry for Primary Care

The NHS provides specialist consultant services to primary care clinicians for decision-making support and planning patient care. The consultation takes place as an 'in-person' event at a secondary care centre where the consultant services are based (Teaching or district hospitals). This model is used ubiquitously for oral health care and other medical services. There is a drive to deliver this service in a more patient-centred, cost-effective, efficient manner, addressing the NHS plan for a 30% reduction of OP visits (NHS Long Term Plan v1.2, August 2019) and in an environmentally sustainable manner by reducing unnecessary patient travel - 31% of NHS-Dentistry carbon foot print. Remote Clinical Consultations (RCC) have the potential to offer this service by linking both the primary care clinician and the patient (co-located in the dental practice) to a remote specialist consultant, using super-fast internet connectivity. This enables all the participants (Patient, GDP and consultant) to hold a live 3-way patient-centred discussion about the patient's care needs. Our research team has recently completed a comprehensive service evaluation that identifies RCC as being technically feasible with a high level of patient acceptability. A further PoC feasibility clinical study to test the RCC concept in a dental primary care setting will be conducted. For this, strong collaborative alliance with AMRC (Digital Design \& Prototyping Group), the Department of Physics and IT Services- STHNHS and a local primary care dental practice consortium (Dental Partners PLC) have been established. Following on from this, a multi-centre randomised clinical trial in a wider range of settings to determine the cost-effectiveness of this clinical intervention will be undertaken