Direct Access for Dental Therapists and Hygienists – When do We Refer?

Wake, Charlotte

doi:10.1308/205016814812144085

Cited by 3 publications

(3 citation statements)

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“…This favours the recent developments in the scope of practice of DTs implemented by the GDC, 2 as well as the policy for patients to have direct access to them for care. 20,53 In addition, a national survey of DHs and DTs in 2011 indicated a similar inclination towards working in primary dental care within a mixed system; however, dually qualified DTs reported treating almost twice the volume of patients (40%) under the NHS contract, compared with singly qualified DHs (15.5%). 54,55,56 Given their aspirations and relatively low numbers, the NHS in England possibly may find it difficult to attract DTs to makeup the workforce shortfall and deliver frontline care.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, given that research suggests that considerable levels of primary dental care could be delegated to dental therapists (43% to 46% respectively) and therefore help reduce dentists' workload, 15,60 it becomes all the more important to utilise the full potential of dually qualified DTs 61 and minimise their frustrations regarding under-utilisation of their skills. 21,22,61 Whilst enabling 'direct access' for patients nationally has been advocated and facilitated in the private sector, 20,53 this is now becoming a reality within NHS England. 62 In addition, Health Education England's (HEE) Advancing Dental Care (ADC) Review supports widening access to dental careers and producing a skilled multi-professional oral healthcare workforce to respond to the needs of patients.…”

Section: Discussionmentioning

confidence: 99%

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Career aspirations of dually trained dental therapy and dental hygiene students from one London dental institute

Belsi,

Ghotane,

Asimakopoulou

et al. 2024

BDJ Team

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Career aspirations of dually trained dental therapy and dental hygiene students from one London dental institute

Belsi,

Ghotane,

Asimakopoulou

et al. 2024

BDJ Team

View full text Add to dashboard Cite

“…Wake in 2014 [ 57 ] rightly suggests that the direct access plans only facilitate better working within general practice and do not signify opportunities to setup rival practices against dentists, as several other elements of patient care are still regulated under dental leadership, such as the prescribing of drugs. It is, however, a challenge for general practitioners, many of whom are practice leads and “providers” holding NHS contracts and performer numbers, to envisage the benefit of including DCPs in care.…”

Section: Discussionmentioning

confidence: 99%

Alternative scenarios: harnessing mid-level providers and evidence-based practice in primary dental care in England through operational research

et al. 2015

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BackgroundIn primary care dentistry, strategies to reconfigure the traditional boundaries of various dental professional groups by task sharing and role substitution have been encouraged in order to meet changing oral health needs.AimThe aim of this research was to investigate the potential for skill mix use in primary dental care in England based on the undergraduate training experience in a primary care team training centre for dentists and mid-level dental providers.MethodsAn operational research model and four alternative scenarios to test the potential for skill mix use in primary care in England were developed, informed by the model of care at a primary dental care training centre in the south of England, professional policy including scope of practice and contemporary evidence-based preventative practice. The model was developed in Excel and drew on published national timings and salary costs. The scenarios included the following: “No Skill Mix”, “Minimal Direct Access”, “More Prevention” and “Maximum Delegation”. The scenario outputs comprised clinical time, workforce numbers and salary costs required for state-funded primary dental care in England.ResultsThe operational research model suggested that 73% of clinical time in England’s state-funded primary dental care in 2011/12 was spent on tasks that may be delegated to dental care professionals (DCPs), and 45- to 54-year-old patients received the most clinical time overall. Using estimated National Health Service (NHS) clinical working patterns, the model suggested alternative NHS workforce numbers and salary costs to meet the dental demand based on each developed scenario. For scenario 1:“No Skill Mix”, the dentist-only scenario, 81% of the dentists currently registered in England would be required to participate. In scenario 2: “Minimal Direct Access”, where 70% of examinations were delegated and the primary care training centre delegation patterns for other treatments were practised, 40% of registered dentists and eight times the number of dental therapists currently registered would be required; this would save 38% of current salary costs cf. “No Skill Mix”. Scenario 3: “More Prevention”, that is, the current model with no direct access and increasing fluoride varnish from 13.1% to 50% and maintaining the same model of delegation as scenario 2 for other care, would require 57% of registered dentists and 4.7 times the number of dental therapists. It would achieve a 1% salary cost saving cf. “No Skill Mix”. Scenario 4 “Maximum Delegation” where all care within dental therapists’ jurisdiction is delegated at 100%, together with 50% of restorations and radiographs, suggested that only 30% of registered dentists would be required and 10 times the number of dental therapists registered; this scenario would achieve a 52% salary cost saving cf. “No Skill Mix”.ConclusionAlternative scenarios based on wider expressed treatment need in national primary dental care in England, changing regulations on the scope of practice and increased evidence-based preventive ...

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Interprofessional enhanced skills training in periodontology: a qualitative study of one London pilot

et al. 2017

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OBJECTIVES/AIMS:Health Education England (HEE) London developed an innovative 2-year pilot educational and training initiative for enhancing skills in periodontology for dentists and dental hygienists/therapists in 2011. This study explores the perceptions and experiences of those involved in initiating, designing, delivering and participating in this interprofessional approach to training.MATERIALS AND METHODS:Semi-structured qualitative interviews were conducted with a purposive sample of key stakeholders including course participants (dentists and dental hygienists and/or therapists), education and training commissioners, and providers towards the end of the 2-year programme. Interviews, based on a topic guide informed by health services and policy literature, were audio-recorded and transcribed verbatim. Data were analysed based on framework methodology, using QSR NVivo 9 software to manage the data.RESULTS:Twenty-two people were interviewed. Although certain challenges were identified in designing, and teaching, a course bringing together different professional backgrounds and level of skills, the experiences of all key stakeholders were overwhelmingly positive relating to the concept. There was evidence of ‘creative interprofessional learning’, which led to ‘enhancing team working’, ‘enabling role recognition’ and ‘equipping participants for delivery of new models of care’. Recommendations emerged with regard to future training and wider health policy, and systems that will enable participants on future enhanced skills courses in periodontology to apply these skills in clinical practice.CONCLUSION:The interprofessional approach to enhanced skills training in periodontology represents an important creative innovation to build capacity within the oral health workforce. This qualitative study has provided a useful insight into the benefits and tensions of an interprofessional model of training from the perspectives of different groups of key stakeholders and suggests its application to other areas of dentistry.

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Direct Access for Dental Therapists and Hygienists – When do We Refer?

Cited by 3 publications

References 0 publications

Career aspirations of dually trained dental therapy and dental hygiene students from one London dental institute

Career aspirations of dually trained dental therapy and dental hygiene students from one London dental institute

Alternative scenarios: harnessing mid-level providers and evidence-based practice in primary dental care in England through operational research

Interprofessional enhanced skills training in periodontology: a qualitative study of one London pilot

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