NHS Dental Services
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Describe the concept of skill mix
• Patient needs may vary in complexity • Delivering health care can be more efficient by using a mix of staff trained to different levels • Allows more highly trained staff to delegate more simple tasks
Describe the changing dental needs with regards to age
• Young adults tend to have low disease burden - Older adults have more complex needs
Describe how older adults may have complex needs
• More heavily restored teeth • Crowns / bridges / implants • Many are managing medical conditions with polypharmacy
Name 3 types of dental professionals which could contribute to a skill mix other than a dentist
• Dental nurses • Dental hygienists • Dental therapists
Describe 3 ways a dental nurse can contribute to a skill mix
• Taking radiographs • Support sedation • Apply fluoride varnish to children’s teeth
What is the underlying principle for the Scope of Practice: General Dental Council document?
All registrants work in areas for which they are trained, competent and indemnified
Name 4 types of treatments included in the Scope of Practice of Dental Therapists (post 2013 extension)
• Diagnose and develop treatment plan • Prescribe and take radiographs • Extract primary teeth • Place simple fillings in primary and adult teeth
According to Brocklehurst and Macey in 2015, what is necessary due to changing patterns of population need?
Dentistry shifts from a cure to a care culture, with the bulk of management of patients being based on prevention
If there is low variability in population need and low complexity of treatment, describe how care should be provided
• H-Ts diagnose - H-Ts provide care
If there is high variability in population need and low complexity of treatment, describe how care should be provided
• Dentists diagnose - H-Ts provide care
If there is low variability in population need and high complexity of treatment, describe how care should be provided
• Dentists diagnose • Dentists provide care • Prevention provided by H-Ts
If there is high variability in population need and high complexity of treatment, describe how care should be provided
• Dentists diagnose - Dentists / specialists provide care
Describe 2 ways H-Ts may work
• Integrated - within dental team in a practice 2. Independent - have own patients on separate premises to dentists
Name 3 other areas of the worl dwhich allow H-Ts to work independently
• Scandinavia • North America • New Zealand
Why may changing practice be challenging?
• It can reduce practice viability - May require payment incentivisation systems
Name 5 functions of the GDC
• Maintain the Dental Register • Investigate concerns and complaints about dental health professionals • Set and maintain educational standards • CPD • Provision of information to patients
What body is the independent regulator of health and social care in England?
Care Quality Commision
What body is the independent regulator of health and social care in Wales?
Health Inspectorate Wales
What body is the independent regulator of health and social care in Scotland?
Healthcare Improvement Scotland
What body is the independent regulator of health and social care in Northern Ireland?
Quality Improvement Authority
How is the CQC funded?
Dental practices pay an annual fee to remain registered
What is the CQC charged with?
Ensuring services are safe, effective, compassionate and high quality
What are 6 dimensions of healthcare equality according to Maxwell et al, 1984?
• Access to services • Relevance to need • Effectiveness • Equity • Social acceptability • Efficiency
What is clinical governance?
Framework through which healthcare organisations (NHS) are accountable for continuously improving the quality of their services and safeguarding high standard of care