Development and evaluation of a 'was not brought' pathway: a team approach to managing children's missed dental appointments

Introduction: Children and young people's (CYP) missed healthcare appointments may be an indicator of neglect. Healthcare providers are encouraged to consider the child as 'was not brought' (WNB) and to assess the need for early multidisciplinary information sharing to safeguard and promote welfare.

Method: A new WNB-CYP pathway (flowchart, template patient notes, template letters) for missed appointments was developed. After piloting at one community dental service (CDS) clinic for eight months, a service evaluation was conducted via retrospective review of records and semi-structured interviews with staff.

Results: Of 1,238 appointments for CYP, 134 were missed (WNB rate 10.8%) by 91 children. The WNB-CYP pathway was followed consistently 113 times (84.3%) and, when used, three quarters of WNBs were rebooked after communication with parents within three weeks. Written information was shared in 25 cases with general medical practitioners and other health and social care professionals. Staff reported high levels of engagement and pathway acceptability; it relieved uncertainty and supported decision-making, teamwork and inter-professional communication without increasing daily workload. Following minor amendments, the pathway was rolled out service-wide with similar success.

Conclusion: A new WNB-CYP pathway facilitated early and consistent sharing of safeguarding information with other professionals about missed CDS dental appointments and improved dental team confidence.