King's College London

Introduction A multi-practice collaborative audit assessing the record and delivery of preventive interventions for children in a primary care setting, with an objective of exploring the relationship between reported preventive practice and submitted NHS claim forms. Methodology Following a pilot audit and examiner calibration, retrospective analysis of 600 records relating to completed courses of treatment for paediatric patients was completed over two cycles, across four NHS dental practices. Between cycles, a best practice guidance document for caries-susceptibility (risk) assessment and susceptibility-appropriate prevention was distributed to GDPs in the practices, and a summary flow-chart placed in each surgery. Best practice in prevention was revised using clinical scenarios, and customisable pop-ups and take-home advice sheets were also developed. Results Caries-susceptibility identification improved in three of the four practices. There was an improvement in all six preventive domains assessed for patients identified as high/moderate susceptibility and in five domains for those as low susceptibility, although the threshold of 75% was not reached across all of them. The cases where the 'Best practice prevention' box was completed appropriately, according to the clinical record, increased from 18% to 27% at cycle 2. Results were analysed using the chi square test. Conclusion While claim form completion did not necessarily indicate that there was recorded provision of all the susceptibility-appropriate preventive interventions indicated, following the implementation of changes there were statistically significant improvements in the recorded provision of preventive care. Difficulties in objectively measuring the delivery of prevention based on the clinical record alone were highlighted.