Facilitators for increasing dental attendance of people from vulnerable groups: a rapid review of evidence relevant to the UK

Objective To rapidly review facilitators of access for vulnerable groups and to evaluate their effectiveness.Methods Data sources: MEDLINE via Ovid. Publications in English from 2000. Data selection: Research involving 'vulnerable groups' relevant to UK health systems, with a primary outcome of increasing attendance. Data extraction: One author extracted and tabulated data. These were audited by a second author. Data synthesis: A narrative synthesis was produced.Results Data from 31 studies were available for ten vulnerable groups: people with learning, physical or sensory disabilities (n = 8); people experiencing homelessness (n = 6); prisoners (n = 4); asylum-seekers and refugees (n = 3); people living in socioeconomically deprived areas (n = 3); people with severe mental health conditions (n = 2); vulnerable children (n = 2); dependent older people (n = 1); Gypsy, Roma or Traveller groups (n = 1); and people with drug dependency (n = 1). Many facilitators involved organisational reform and more integration of health, social and other services. Other facilitators included: modification of premises; team development and skill-mix use; and awareness of needs and flexible services to meet them. Few studies evaluated effectiveness.Conclusion Although facilitators for access for vulnerable groups have been proposed, there is little evidence to support or refute their effectiveness. Efforts are needed to promote access for vulnerable groups in the UK with evaluation plans embedded. Equitable access to oral healthcare based on need is a key principle of the NHS, yet barriers to vulnerable groups accessing oral healthcare exist.Facilitators for access have been proposed. Many require reform to enable coordination of services that support vulnerable groups and include addressing physical and structural factors, dental team development and skill-mix use, increased awareness of vulnerable groups' needs, and flexible services.There is a lack of evidence about the effectiveness of these measures for increasing dental attendance. Research is needed to inform policymakers and dental professionals and educators about the best ways to increase access to oral healthcare services for vulnerable populations within the UK.