A quality assurance review of the patient referral process and user satisfaction of outpatient general anaesthesia services for dental treatment.

In many parts of the United Kingdom the Community Dental Service (CDS) receives a consistently high level of referrals for general anaesthetic (GA) provision from general dental practitioners (GDPs), predominantly for the treatment of pain in young children. To provide a safe and effective service it is essential to have an appropriate and satisfactory referral process. As part of the established quality assurance programme in the East Kent CDS two surveys utilising self-complete postal questionnaires were conducted, the first to assess GDP's opinions and to examine their referral procedure, the second to gauge user satisfaction with the overall care provided by the CDS-GA service. The main findings suggested a lack of effective communication both between health professionals and with their patients. Over 80 per cent of the GDPs considered either the existing CDS referral guidelines needed clarification or did not even know such guidelines existed. Parents of referred children reported a high level of satisfaction with the service provided by the CDS, but some were critical of a lack of immediate access for children in pain. The finding of greatest concern was that 50 per cent of the parents stated their child's GDP did not explain the possible risks of general anaesthesia prior to referral and 70 per cent were offered no alternative form of treatment to a general anaesthetic. The results of this study should be fed into the continuing quality assurance programme to enable the effective and appropriate development of the CDS-GA service.