Childsmile Practice

This section provides information for Coordinators setting up Childsmile Practice in their Health Board.

Setting up Childsmile Practice

The following pages explain how to introduce the Childsmile Practice component of an integrated Childsmile model within an NHS Board.

Childsmile Practice will operate at a population level (universal access) with additional support targeted towards children and families most in need. Ideally, implementation within an NHS Board should concentrate on deprived communities first.

It is suggested that communities may be considered within the same geographic coverage as public health nursing teams.

Working with primary care dental services

It is envisaged that every child will have access from birth to the Childsmile Practice component of the programme via primary care dental services (which may be a mix of general, public dental services depending upon availability in the area).

Training

Dental nurses will be responsible for booking a place on the NHS Education Services (NES) training. Coordinator should be able to advise on forthcoming dates.

Booking forms are available on the NES website (external link) or the dental portal (external link).

NES should be advised in advance of any large recruitment drives planned. As primary care dental services come on board, the Childsmile Coordinator must inform NES of potential numbers for the next available training course.

On completion of training, Dental Nurses become Extended Duty Dental Nurses (EDDNs).

NES will advise the Practitioner Service Division (PSD) of staff who have completed the full training programme. This will allow payment to be made to the dental practice.

Mentoring of EDDNs for Direct Operational Procedures (DOPs)

After successful completion of the course, the EDDNs require further mentoring for DOPs for fluoride varnishing in their own workplace, by a nominated dentist, therapist or hygienist.

DOPs mentoring should be delivered by the coordinator to the person mentoring the EDDN within the practice prior to (or within two or three weeks of) the fluoride varnish training day with NES.

This can be delivered on a one-to-one basis which provides another opportunity for contact. If a large number of mentors are to be trained, it may be possible to deliver this as a session.

Verifiable Continuous Professional Development (CPD) is available for attending these sessions. Further guidance is available in our training section.

Working with Community Health Partnerships (CHPs) and Public Health Nursing

CHPs should be approached to discuss implementation and structures.

Identify examples of best practice during the initial demonstration phase, when Dental Health Support Workers (DHSWs) are placed within the public health nursing teams.

Workloads and supervision should be agreed amongst stakeholders and directed by the health visitor.

This should be discussed with appropriate local leads within the CHP.

Who benefits from Childsmile Practice?

It is envisaged that every child will have access to Childsmile Practice with additional support targeted to the children and families most in need.

The following model is suggested:

Universal programme

Oral health promotion advice and clinical prevention provided by an appropriately trained member of the dental team. Clinical prevention must include six-monthly fluoride varnish application from two years of age.

Intensive programme

Primary care dental services: intensive programme of care delivered by an appropriately trained member of the dental team, incorporating dedicated oral health promotion sessions and clinical preventive care including six-monthly fluoride varnish application from two years of age.

Home support: provided via the DHSW in the home and community, working with families under the direction of the health visitor prior to facilitation into dental services.

Reaching every child

Every child should have access to at least one element of Childsmile care. All births within a Childsmile area should be recorded for monitoring purposes, this information may be provided by the local Child Health Department, extracted from the ‘Birth Book’ within the health centre or advised by the health visitor.

Facilitation into dental services or intensity of home support will be directed by the health visitor as the caseload holder. Further development of referral pathways is being undertaken nationally.

Appropriate systems and training should be put in place for DHSWs to record in the Personal Child Health Record (Red Book). This ensures that all health professionals in contact with a family record in a chronological order within the notes held on the family.

It is also recommended that the DHSW has access to record their contacts with the family in the record system used by the health visitor, either in paper or electronic form. This should again be discussed and agreed locally.

The Childsmile Coordinator will support the public health nursing team manager or leader (or local equivalent) to facilitate the promotion and introduction of Childsmile and skill mix within the public health nursing team.

This is best achieved at a small team level to allow discussion.

Requirements for DHSWs

New DHSWs will be required to book on to the NES training. Additional local induction should be set up.

This may include:

  • details on how Childsmile works locally
  • recording systems (e.g. HIC)
  • protocols
  • community profiling
  • introduction to primary care dental services delivering Childsmile
  • mandatory training
  • any needs identified by local management structures e.g. record keeping, local infant feeding training, etc.

DHSWs will also require a period of shadowing public health nursing staff and other professionals as appropriate. Further guidance is available in our training section.

New DHSWs are required to complete and sign an Allocation of Childsmile Code form. The Coordinator must collate these and return to the HIC for code allocation and system access. The Coordinator is also responsible for arranging to remove these if staff leave.

Communications

It is important to consider feedback and communication mechanisms within the NHS Board between public health nursing teams, DHSWs, oral health promotion and health improvement and primary care dental services.

This may include strategic and operational groups for children’s oral health and Childsmile implementation.

Resources for Childsmile Practice

Childsmile DHSW practice form
Paper copy of screen for recording DHSW childsmile activity to be uploaded onto HIC system (previously referred to as the 'peach form').

GP17 Guidance
This document has been developed by PSD to ensure that GP17 forms can be processed appropriately for Childsmile monitoring and payment purposes.
**The GP17 form has been updated June 2013, however, as there are no new codes the process is exactly the same. The codes that are used for claiming this are all non-tooth specific therefore would only be claimable using the right hand side of the form.**