LSC secondary care orthodontics collaborative programme: online questionnaire

Yes. The satellite clinic proposed for the Barrow site, at Furness General Hospital, has additional capacity to accommodate patients who choose to attend this location, no matter where they live. It is important to note that the travel time from Lancaster and Morecambe to the Central Lancashire Hub, located at Chorley District General Hospital, is shorter than the travel time from Lancaster and Morecambe to Barrow.

The Orthodontic Collaborative Group, made up of both clinical and operational colleagues, has agreed on a few key points to help decide where future orthodontic services should be located:

• The orthodontics service at East Lancashire Hospitals is working well and is stable, so any changes there will be kept to a minimum.
• Satellite clinics will continue at Blackpool Victoria Hospital (for patients in Central Blackpool) and Furness General Hospital (for patients in Barrow).
• Central Lancashire has the second highest number of referrals for specialist orthodontic care – around 36% - so it has been chosen as the location for a second main hub.
• To make sure patients receive safe and high-quality care, there needs to be at least 10 consultant-led clinics each week, ideally 12 if the wider clinical team includes less experienced staff. This also ensures proper supervision for orthodontic therapists.
• Based on these needs, it was agreed that both Royal Preston and Chorley Hospitals cannot continue to offer orthodontic services, and only one will be selected to host the new hub, which has been decided as Chorley Hospital. Chorley Hospital was selected over the Royal Preston Hospital site due to its more central location and its capacity to accommodate the necessary space and infrastructure requirements.

As part of planning future orthodontic services, several options were considered. Below is a summary of each option and why it was not taken forward:

The current number of sites offering secondary care orthodontic services across the region has made it harder to provide extra staffing support when it is needed. This has led to the service being described as fragile. Placing the second hub in Morecambe Bay would have made it even more difficult to cover staff absences and maintain consistent care, which would lead to a reduction in patient satisfaction.

To help reduce the impact of longer travel times for some patients, an Early Discharge Scheme has been introduced. This allows patients who are clinically ready to continue their treatment with a local primary care orthodontist, transfer into a primary care practice for continuing care. So far, space has been identified for over 250 patients in the Fylde Coast and Morecambe Bay areas, with plans to expand this further in 2026/27.

There is also a national shortage of consultant orthodontists, with both Blackpool Teaching Hospitals and University Hospitals of Morecambe Bay solely reliant on insourcing and locum support to deliver a service. By creating a more centrally located role it is expected to help attract new staff. This is especially important as the service is currently looking to recruit two additional consultants.

The orthodontic service at East Lancashire Hospitals NHS Trust (ELHT) is currently performing at a high level and is considered both stable and sustainable. As a result, many of the proposed improvements to services across the region are based on replicating the successful model already in place at ELHT.

Introducing a single leadership structure across Lancashire and South Cumbria would help standardise how care is delivered, ensuring all patients receive the same high-quality service regardless of where they live. This approach would also strengthen the professional support available to clinicians and improve how resources are used across the region.

By having one team responsible for overseeing services, we can better address current inequalities in access to orthodontic care and work towards a more consistent and fair experience for all patients.

Within the proposed model, care will be delivered exclusively by permanent staff. This means that temporary staff, such as locum clinicians or insourced providers, will no longer be part of the service.

At the beginning of your treatment, you will be assigned a consultant orthodontist who will oversee your care. However, due to the nature of orthodontic treatment, you may also be seen by other specialist clinicians during your pathway - such as an oral surgeon - if your treatment requires it.

In addition, you may be seen and treated by an orthodontic therapist. Therapists work under the supervision and guidance of a consultant, ensuring that your care remains safe, consistent and of high quality throughout your treatment journey.

In the proposed model, once your brace (also known as an orthodontic appliance) has been fitted, you will need to attend regular appointments to monitor your progress and make any necessary adjustments. These review appointments typically take place every 6 to 8 weeks, although the exact timing will be determined by your consultant based on your individual treatment needs.

In some cases, if it is clinically appropriate, your care may be transferred to a local primary care orthodontist via the Lancashire and South Cumbria Early Discharge Scheme. This would allow you to continue your treatment closer to home, making it more convenient for regular follow-up appointments.

Please be assured that any decision to transfer your care will only be made if it is safe and suitable for your specific treatment plan.

As part of the proposed model, all orthodontic consultants - regardless of where they are based - will have secure access to your orthodontic records. This ensures continuity of care and allows any member of the clinical team involved in your treatment to make informed decisions based on your full clinical history.