The College has published its full response to the government’s Dental Recovery Plan, adding further detail to the interim response from its President, Dr Abhi Pal FCGDent, which was issued earlier this week.
Announcing the plan, Health Secretary Victoria Atkins MP quoted the College on the importance of making use of the full range of skills of all dental team members
The updated statement from the College includes responses to the proposal to speed up entry to the NHS Performers List; to the idea of commissioning private-only dentists to deliver NHS care; to the intention to press the GDC in relation to the recognition of additional qualifications as being equivalent to the UK BDS; to the intended expansion of the LDS, and to the plan to provide preparatory support for LDS candidates. It also includes additional considerations in relation to the proposed ‘golden hello’; to the creation of a provisional registration scheme; and to the increase in the number of dental school places.
The new commentary is as follows:
“While we support in principle the NHS making use of available local capacity to provide much-needed dental care, the proposal to use private-only dentists to do this would either fail or be completely iniquitous to those practitioners who have remained committed to NHS delivery. The correct solutions are to take measures to support the recruitment and retention of dental professionals in the NHS, and to support the financial viability of practices through adequate funding of contracts.
“We are already looking forward to an increase in the number of sittings and places for the Overseas Registration Examination, and we welcome the proposed expansion of the LDS examination. We also welcome proposals to support candidates in preparing for the LDS, and would advocate for similar support to be made available to candidates preparing for the ORE.
“We support the intention to speed up entry to the NHS Performers List, and the possibility of provisional registration, but public safety must not be compromised in our haste to fill gaps in the workforce. There must be proper structure in the training and assessment of provisional registrants, and a robust Quality Assurance process must be developed to ensure that the end product is a Safe Practitioner. Additional training and support may also be required for supervising dentists, as this role may well be more challenging than that of Educational Supervisor of Foundation Dentists.
“Similarly, we support the intention to identify non-EEA qualifications which meet the standard required for registration as a dentist in the UK, but due care and rigour must take priority in order to ensure patient safety. In time, this may prove a useful additional means of ameliorating the labour shortage experienced by dental practices, and the consequent lack of access to NHS dental care experienced by so many patients.”
The sections of the response which have been expanded are as follows:
“The planned ‘golden hello’ scheme also brings implicit recognition of the difficulties experienced by dental practices in the recruitment and retention of clinical staff to deliver NHS dental care. However, we are concerned that the proposed short-term offer, which is in any case limited to dentists, may fail to overcome many practitioners’ long-term concerns about embarking on a career in NHS care delivery, among which are burnout, lack of career progression and insufficient recognition for enhanced skills. We would emphasise that these factors apply not only to dentists but to other members of the dental team, especially dental nurses, and consideration should be given to exploring alternative models of incentivisation to support their recruitment and retention.”
“We are already looking forward to the increase in the number of dental school places available for dentistry, dental hygiene and dental therapy students. The planned expansion of student numbers must be accompanied by an appropriate increase in academic teaching capacity and resources so that the quality of undergraduate training is maintained.”
The College response in full is below.
The College’s response to the ‘Dental Recovery Plan’ in full
Responding to the government’s Dental Recovery Plan, Dr Abhi Pal FCGDent, President of the College, said:
“The government has set out a range of initiatives intended to help tackle some of the many longstanding problems facing NHS dental provision in England. These include some potentially positive new initiatives, which we welcome, alongside previously made announcements. However, while some further positive changes to the dental contract are anticipated later this year, the Dental Recovery Plan does not represent the more fundamental contract reform which is required, nor will the additional £210m in funding behind the plan, welcome as it is, restore universal access to NHS dental care.
“We welcome the proposed Smile For Life programme, with its focus on intervening early to prevent oral diseases in children. Tooth decay remains the leading cause of hospital admission for 6–10-year-olds in England, and a preventative approach has the potential to reduce the need for restorative treatment. However, we wait to see whether sufficient resources will be invested for the programme to be a success.
“The additional temporary funding aimed at those who have been unable to access dental care for two years or more is much needed. However, we would like to see consideration of the ongoing care of individuals benefitting from this initiative.
“The intention to bring NHS dentistry back to some of the many communities who have lost access to it is also very welcome. While mobile units may help in the short term, bricks-and-mortar dental surgeries should remain the backbone of routine ongoing care delivery, and appropriate funding should be put in place to support the re-establishment of NHS practices to address lack of access and meet the volume of need.
“While we support in principle the NHS making use of available local capacity to provide much-needed dental care, the proposal to use private-only practices to do this would either fail or be completely iniquitous to those practices which have remained committed to NHS delivery. The correct solutions are to take measures to support the recruitment and retention of dental professionals in the NHS, and to support the financial viability of practices through adequate funding of contracts.
“The planned ‘golden hello’ scheme also brings implicit recognition of the difficulties experienced by dental practices in the recruitment and retention of clinical staff to deliver NHS dental care. However, we are concerned that the proposed short-term offer, which is in any case limited to dentists, may fail to overcome many practitioners’ long-term concerns about embarking on a career in NHS care delivery, among which are burnout, lack of career progression and insufficient recognition for enhanced skills. We would emphasise that these factors apply not only to dentists but to other members of the dental team, especially dental nurses, and consideration should be given to exploring alternative models of incentivisation to support their recruitment and retention.
“We are already looking forward to the increase in the number of dental school places available for dentistry, dental hygiene and dental therapy students. The planned expansion of student numbers must be accompanied by an appropriate increase in academic teaching capacity and resources so that the quality of undergraduate training is maintained.
“We also look forward to the implementation of medicines exemptions for dental hygienists and therapists. Greater recognition and use of the full range of skills of all team members will enable the delivery of more care and make NHS dentistry more attractive to dental professionals. We also look forward to further proposals which empower the wider dental team when the next set of contractual changes are consulted upon.
“We also recognise that an increase in the minimum UDA value will support a minority of practices to continue delivering NHS dental care. And we support the intent to introduce community water fluoridation in areas of high need as this has the potential to reduce the prevalence of oral diseases and the need for invasive interventions.
“Finally, while dental practices struggle to recruit and many patients struggle to access care, there are many dental professionals who have qualified and practised overseas and who could be providing care here in the UK, but are unable to do so due to the waiting lists for registration exams.
“We are already looking forward to an increase in the number of sittings and places for the Overseas Registration Examination, and we welcome the proposed expansion of the LDS examination. We also welcome proposals to support candidates in preparing for the LDS, and would advocate for similar support to be made available to candidates preparing for the ORE.
“We support the intention to speed up entry to the NHS Performers List, and the possibility of provisional registration, but public safety must not be compromised in our haste to fill gaps in the workforce. There must be proper structure in the training and assessment of provisional registrants, and a robust Quality Assurance process must be developed to ensure that the end product is a Safe Practitioner. Additional training and support may also be required for supervising dentists, as this role may well be more challenging than that of Educational Supervisor of Foundation Dentists.
“Similarly, we support the intention to identify non-EEA qualifications which meet the standard required for registration as a dentist in the UK, but due care and rigour must take priority in order to ensure patient safety. In time, this may prove a useful additional means of ameliorating the labour shortage experienced by dental practices, and the consequent lack of access to NHS dental care experienced by so many patients.”