An Evaluation of London's Intermediate Minor Oral Surgery Service

ABSTRACT Background Oral surgery as a speciality has traditionally experienced significant demands, representing one of the largest volume and cost of referrals from primary to secondary care. The IMOS service was created with the objective to increase the efficiency and accessibility of oral surgery services to the public, as well as reduce pressures within hospital settings. Aims To assess: The quality of the service provided. The waiting times. If the service met needs. Patient‐reported outcome and experience measures. Method A random sample of patients referred to London Tier 2 IMOS providers were selected, 10 from each provider, totalling 180. They were evaluated to ascertain waiting times, treatment delivered, quality of documentation and level of complexity, level 1, 2, and 3. Patient‐Reported Experience Measures (PREMs) and Patient Reported Outcome Measures (PROMs) were also carried out to assess satisfaction. Results 38.3% of referrals were classed as Level 1 and the remaining Level 2 and Level 3 were 60% and 1.67%, respectively. 37.2% of patients were seen within 0–49 days, and 72.3% of patients were seen and treated within 18 weeks. 90.8% of these cases were non‐surgical, 17.9% involved mandibular 3rd molar extractions, of which 46.6% were surgical. 313 PREMs and 321 PROMs were collected, the experience survey revealed over 98.7% of patients felt anxiety and pain were managed well, with any concerns addressed. PROMs showed that 94.3% of patients did not require further calls or assistance post‐treatment. 72.4% of patients felt recovery was completed within 3 days of the treatment. 1.87% of patients required further assistance such as for dry socket and infection. Conclusion The London IMOS service is an economical, safe and effective environment to provide minor oral surgery to the vast majority of patients, who would have otherwise been seen in secondary care. Development of pan London triage and communication pathways will further enhance the service and ensure smooth and efficient patient journeys.