Patient satisfaction with care by dental therapists

Sun, Ningwei; Burnside, Girvan; Harris, Rebecca

doi:10.1038/sj.bdj.2010.209

Cited by 47 publications

(43 citation statements)

References 31 publications

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“…93 Despite this, it does appear that adults are willing to receive treatment from DCPs under the NHS and there is evidence of increased patient satisfaction. 95 However, some patients expect to pay less for treatment provided by a DCP and are reticent about care provided by a DCP for young children or when anxious. 93 The NHS GDPs run their practices as businesses to offset the cost of the capital risk of the premises and the equipment that they own, while ensuring liquidity to cover their overheads.…”

Section: Organisation Of Nhs Dentistry In Primary Carementioning

confidence: 99%

“…These views concur with earlier research. [93][94][95] However, all patients who had had an experience of being treated by a DT were happy. This may indicate that patients' prior experience of treatment is key.…”

Section: Attitudes Of Patients and The Nhs Dental Team To Role Substimentioning

confidence: 99%

“…91 As a result, many DTs have been employed by the NHS as DHs in England, limiting their ability to use the full range of their skills. 92 Although the social acceptability of DTs appears to be positive, [93][94][95] public awareness of DTs as a professional group is not widespread. 93 Despite this, it does appear that adults are willing to receive treatment from DCPs under the NHS and there is evidence of increased patient satisfaction.…”

Section: Organisation Of Nhs Dentistry In Primary Carementioning

confidence: 99%

“…It may also reflect the concerns of NHS dental teams about patients' attitudes to role substitution, although the evidence in the literature is mixed. [93][94][95] Taken together, there is a need to explore the views of patients and the different members of the dental team on role substitution to examine the formal and informal aspects of organisational life.…”

Section: Introductionmentioning

confidence: 99%

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Determining the optimal model for role substitution in NHS dental services in the UK: a mixed-methods study

Brocklehurst

Birch

McDonald

et al. 2016

Health Serv Deliv Res

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BackgroundMaximising health gain for a given level and mix of resources is an ethical imperative for health-service planners. Approximately half of all patients who attend a regular NHS dental check-up do not require any further treatment, whereas many in the population do not regularly attend. Thus, the most expensive resource (the dentist) is seeing healthy patients at a time when many of those with disease do not access care. Role substitution in NHS dentistry, where other members of the dental team undertake the clinical tasks previously provided by dentists, has the potential to increase efficiency and the capacity to care and lower costs. However, no studies have empirically investigated the efficiency of NHS dental provision that makes use of role substitution.Research questionsThis programme of research sought to address three research questions: (1) what is the efficiency of NHS dental teams that make use of role substitution?; (2) what are the barriers to, and facilitators of, role substitution in NHS dental practices?; and (3) how do incentives in the remuneration systems influence the organisation of these inputs and production of outputs in the NHS?DesignData envelopment analysis was used to develop a productive efficiency frontier for participating NHS practices, which were then compared on a relative basis, after controlling for patient and practice characteristics. External validity was tested using stochastic frontier modelling, while semistructured interviews explored the views of participating dental teams and their patients to role substitution.SettingNHS ‘high-street’ general dental practices.Participants121 practices across the north of England.InterventionsNo active interventions were undertaken.Main outcome measuresRelative efficiency of participating NHS practices, alongside a detailed narrative of their views about role substitution dentistry. Social acceptability for patients.ResultsThe utilisation of non-dentist roles in NHS practices was relatively low, the most common role type being the dental hygienist. Increasing the number of non-dentist team members reduced efficiency. However, it was not possible to determine the relative efficiency of individual team members, as the NHS contracts only with dentists. Financial incentives in the NHS dental contract and the views of practice principals (i.e. senior staff members) were equally important. Bespoke payment and referral systems were required to make role substitution economically viable. Many non-dentist team members were not being used to their full scope of practice and constraints on their ability to prescribe reduced efficiency further. Many non-dentist team members experienced a precarious existence, commonly being employed at multiple practices. Patients had a low level of awareness of the different non-dentist roles in a dental team. Many exhibited an inherent trust in the professional ‘system’, but prior experience of role substitution was important for social acceptability.ConclusionsBetter alignment between the financial incentives within the NHS dental contract and the use of role substitution is required, although professional acceptability remains critical.Study limitationsOutput data collected did not reflect the quality of care provided by the dental team and the input data were self-reported.Future workFurther work is required to improve the evidence base for the use of role substitution in NHS dentistry, exploring the effects and costs of provision.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Section: Organisation Of Nhs Dentistry In Primary Carementioning

confidence: 99%

Section: Attitudes Of Patients and The Nhs Dental Team To Role Substimentioning

confidence: 99%

Section: Organisation Of Nhs Dentistry In Primary Carementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Determining the optimal model for role substitution in NHS dental services in the UK: a mixed-methods study

Brocklehurst

Birch

McDonald

et al. 2016

Health Serv Deliv Res

View full text Add to dashboard Cite

show abstract

“…12 In a 2010 UK study, Sun et al report that of 431 patients, those attending appointments with therapists were found to have a significantly higher level of overall satisfaction than those attending appointments with dentists. 13 A recent large-scale survey examined the nature of clinical work undertaken by singly and dually qualified therapists in the UK and their attitudes towards teamwork.…”

Section: British Dental Journalmentioning

confidence: 99%

Dental hygienists and therapists: how much professional autonomy do they have? How much do they want? Results from a UK survey

Turner¹,

Ross²,

Ibbetson³

2011

Br Dent J

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Evaluation of a Pilot Bridging Program to Enable Australian Dental Therapists to Treat Adult Patients

Calache

Hopcraft

2011

Journal of Dental Education

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This study evaluated a pilot educational bridging program designed to provide dental therapists in Australia with the appropriate knowledge and skills required to enable them to translate their current clinical scope of practice to adult patients. Ten dental therapists completed a bridging program consisting of forty-two hours of didactic content, fourteen hours of clinical observation, forty-two hours of clinical practicum under direct supervision, and 105 hours of clinical experience with supervision by mentoring dentists. Process and impact evaluation was undertaken at various stages of the program by participants and supervising dentists. Self-reported conidence and knowledge for dental therapists had increased at the completion of the course. Supervising dentists reported high levels of knowledge for dental therapists after completing the course and said that the course adequately prepared the dental therapists to translate their current clinical scope of practice to treat adult patients. Eight of the ten participants successfully completed the assessment at the completion of the course and were permitted by the Dental Practice Board of Victoria to extend their clinical scope of practice to adult patients aged twenty-six years of age or more. The dental therapists thought that the educational model was relevant in developing their clinical skills. The evaluation indicates that this model is an effective method of extending the scope of practice for dental therapists and has important implications in enhancing the lexibility of the dental team.

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Patient satisfaction with care by dental therapists

Cited by 47 publications

References 31 publications

Determining the optimal model for role substitution in NHS dental services in the UK: a mixed-methods study

Determining the optimal model for role substitution in NHS dental services in the UK: a mixed-methods study

Dental hygienists and therapists: how much professional autonomy do they have? How much do they want? Results from a UK survey

Evaluation of a Pilot Bridging Program to Enable Australian Dental Therapists to Treat Adult Patients

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