Dental Public Health Intelligence Programme (DPHIP) Survey Fieldwork 3 year old Nursery / Pre-school Children

Oral health is an integral part of overall health. A significant proportion of the population in England experience very good levels of tooth decay.

Successive oral surveys have shown that child and adult oral health has been improving over the past 30 years. The proportion of children who participated in the first 3-year old oral health survey in 2013 varied at regional and upper and lower-tier local authority level and this probably reflects the provision of child care in different areas which impacts upon the ability to access children.

Across the regions, representation varied from 5% in Yorkshire and the Humber and in London to 14% in the North West. The 2012 Health and Social Care Act conferred responsibility for oral and general health improvement to Local Authorities (LA's).

Local Authorities are now statutorily required to provide or secure oral health surveys. The oral health surveys are carried out by the suppliers in line with the Office for Health Improvement and Disparities (OHID) (formerly Public Health England) dental public health intelligence programme (DPHIP, formerly the national dental epidemiology programme).

OHID provides a protocol for the population group under scrutiny describing the standardised methods that fieldwork teams should use when undertaking the main survey. The initial Service requirement is to undertake the DPHIP surveys as a minimum; however, it is recognised that this may require changing by agreement over the lifetime of the Contract following review of oral health needs assessment and analysis of data.

The Authorities may require the Supplier to carry out surveys, to meet local needs, which are not part of the DPHIP. In these circumstances the Authorities will give sufficient notice to the Supplier and negotiate any variations to the Contract and associated costs.

This aim of the service is to undertake epidemiology fieldwork activity to enable accurate collation of dental data in respect of 3-year old children in pre-school / nursery for submission in line with the Dental Public Health Intelligence Programme (DPHIP) annual survey programme and in accordance with the survey protocol. The objectives of the service are to: • Engage with commissioners and local authority leads to consider each forthcoming survey • Agree the sample size with the commissioners and use agreed sampling methods.

A minimum sample size of 250 examined children is required per lower-tier local authority, from a minimum of 20 nursery / pre-schools. • Obtain agreement to participate and examine the minimum number of participants as required in the national dental survey protocol • Ensure that the method for data collection is in line with national protocols • Use appropriate staff with enhanced DBS checks and ensure all clinical examiners are trained and calibrated in line with national standards to undertake the surveys. • Work in collaboration with dental epidemiology co-ordinators (DEC) and dental epidemiology trainers • Engage with local suppliers and stakeholders to access potential participants for examination • Undertake the required fieldwork to collect the specified information according to the national protocol • Provide and submit a complete, cleaned set of data on behalf of the eight local authority areas direct to the DEC in a timely manner, to enable the data to be analysed and dental health surveys to be populated within agreed timescales. • Provide at its own expense all suitable information and communication technologies (ICT) systems (hardware and software) that are required to support data collection and reporting with the capacity to transmit data securely in line with policy and national standards. It will also ensure secure storage of confidential Service User data preferably using a computerised system and shall be registered with the Information Commissioners Office (ICO)

The national programme of dental surveys are co-ordinated by OHID. The surveys are conducted according to a national standard protocol and examiners are trained and calibrated to a national standard.

The sampling procedure conforms to the national standard and is agreed with the DPHET survey co-ordinator before fieldwork is carried out. DPHIP epidemiology co-ordinators are employed by OHID .

They work on a regional basis and are responsible for quality assurance of the fieldwork carried out in their area. This quality assurance and standardisation allows local, regional and national comparisons of the data.

The OHID DPHIP incorporates all aspects of the former NHS Dental Epidemiology Programme. This programme supports the collection, analysis and dissemination of reliable and robust information on the oral health needs of local populations.

Every LA in England is responsible for monitoring the health needs of their population. Through a Statutory Instrument, local authorities are specifically required to provide, or make arrangements to secure the provision of, oral health surveys (as part of their dental public health functions) to facilitate the: • Assessment and monitoring of oral health needs, • Planning and evaluation of oral health improvement programmes, • Planning and evaluation of NHS dental services and • Monitoring and reporting of the effect of water fluoridation programmes (when appropriate).

OHID is responsible for organising, coordinating, facilitating and providing overall quality assurance of the production of standardised, comparable information relating to the oral health of whole population and population sub-groups, based on the fieldwork data collection at local authority level. OHID will analyse data and produce published reports and information on each survey conducted.

The service is an opt-in service where acceptance of the Dental epidemiology (3-year old children screening) offer is obtained from the parents/carers/guardians. The Provider will minimise the risk of a child being screened when their parents have opted-out).

Suitable clinical examiner(s) will be identified by the supplier, along with sufficient support staff for administration, sampling, recording and data entry, cleaning, and submission. The supplier will: • Provide the required number of staff with the appropriate skills, qualifications (dental examiners will be registered dentists, therapists, or hygienists on the General Dental Council Register) and competencies to carry out the fieldwork operating within their scope of practice as determined by the General Dental Council . • Ensure staff carrying out clinical examinations participate in training and standardisation and/or calibration events as required and have calibrated against the standard of the regional trainer (where required by the protocol).

Examiners who do not conform to the accepted diagnostic standards will need to be retrained and recalibrated or replaced. • Provide the administrative support required to enable the fieldwork to take place in accordance with national protocols The fieldwork team must undergo local regional training and be familiar with, and comply with, the standards and procedures laid down in the relevant national protocol, including the use of specified equipment. This will include but not be limited to: • Disclosure and Barring Service (DRB) check and must have valid certificate available, usually dated with in the last three years • Compliance with the sampling process (to be agreed with the DEC) • Approach to specified target populations • Gaining of agreement to participate • Examination method • Application of measures for clinical recording • Questionnaire administration • Data entry and storage • Back-up and handling of data including appropriate disposal • Submission of data before deadline noted nationally - the fieldwork team will make the anonymised, cleaned survey data available to the dental epidemiology co-ordinator in a secure way.

The process will be planned, executed and completed in the nationally agreed time frames. Staff should be up to date with training in data protection, child and adult safeguarding and other relevant information governance issues; and conform to their employing organisation and local authority's protocols.

The supplier will be service user focussed, ensuring good communication, clear service user information and working to national standards on agreement to participate and confidentiality. Communications should be designed to be accessible and to reduce barriers for participants.

The supplier will deliver the survey in a manner that gains greatest co-operation with institutions and increased agreement to participate to take part by potential volunteers; and to work with the commissioner and authority to improve participation and agreement to participate. Additional information: These services will be procured under The Health Care Services (Provider Selection Regime) Regulations 2023 under The Most Suitable Provider Process