To infinity and beyond
Andrew Lamb: BDA chief executive Scotland
Q How will the dental landscape change in 2011?
A great deal will obviously depend on the election in May. Whether – and how – the dental landscape changes as a result of our election will only become clear later this year. What is certain though is that in Scotland, as is the case elsewhere in the UK, dentistry is becoming increasingly regulated. That will impact on dental practices by increasing the time spent on bureaucracy and will inevitably impact on access.
Q What would change/improve your professional life?
I’m really keen that 2011 is the year when Scotland finally catches up with its neighbours and adopts a modern contract for our salaried dental services. England did this several years ago and the introduction of the arrangements was very popular. We’ve been arguing for Scotland to go down a similar route for a long time now and it would be good to finally get this off the ‘to do’ list in 2011.
Q What will give you sleepless nights?
The thing that would really give me sleepless nights would be any suggestion that the General Dental Practice Allowance was to be scrapped. For many NHS practices that allowance makes the difference between viability and non-viability. I talk to colleagues in other parts of the UK about the reforms to health service dentistry they have witnessed and hear of numerous problems. I don’t think anyone would argue that what we have in Scotland is perfect, but with this allowance we really have achieved something positive. Thankfully, I think whoever gets elected this year would have more sense than to meddle with it.
Q What would get you cracking the champagne open?
If it ever comes, the day when we finally agree a new contract for salaried services will have me cracking open the champagne.
Q Who’s the ‘player’ to watch this year?
In an election year we’re in the lap of the political gods. The man or woman to watch this year will be whoever has the health brief after 5 May. Naturally we’ll be watching the outcome of that day carefully and seeking to work closely with the new ministers as soon as their timetable allows.
Q What’s your New Year’s resolution?
It’s time to try grasping the issue of water fluoridation again. The benefits of this measure are well understood but it’s become a difficult issue politically. In England we’ve seen a decision to fluoridate water in Southampton go to judicial review and the ferocity with which opponents resist the measure makes it easy to understand why some politicians are anxious about pursuing the policy. But we know it is effective and must encourage the government of Scotland elected in May to think again.
Dr Stephen Jacobs, Clinical Director and Principal dentist, dental FX
Q How will the dental landscape change in 2011?
I think that the profession is in for a really tough year, especially those in the higher-end private sector. There is no doubt that patients are not committing to elective treatment in the same way, and in particular, with the big ticket items.
Speaking to friends and colleagues in the West End of London, things are getting stretched there, and while it is never quite as bad north of the border, it is a good barometer.
People who are highly geared will especially feel the pinch, with interest rates set to increase and taxation already rising, I would not like to be the one with the large mortgage and pratice loans.
Q What would change/improve your (professional) life?
We are constantly trying to enhance and further streamline our systems within the practice, both to optimise the patient journey and to improve the communication lines with our referring dentists. By this, I mean developing systems within our website where the dentist can track the stages of treatment that their patients have completed and reached. We are already working on this.
Q What will give you sleepless nights?
Hopefully nothing, in that we will have intercepted the problem before it gets to that stage. Although, with my eldest children being two teenage daughters, I guess it will be waiting for them to arrive home after parties and nights out with friends… that seriously does keep me awake!
Q What would get you cracking the champagne open?
Seeing the economy starting to improve and the country making its recovery, so that our patients will feel more confident about the future and especially giving them confidence to seek the dental treatment that they really wish for. On a personal note, seeing my eldest achieve the A-level grades that she needs in order to follow her dream of studying medicine… that would be worth a bottle of Cristal.
Q Who’s the ‘player’ to watch this year?
Based on my previous musings, I would have to say George Osborne, backed up by David Cameron and Nick Clegg.
Q What’s your New Year’s resolution?
The old cliche “I never make resolutions”, holds true with me as I do not seem to be able to keep them. But, if I was being pushed to make some, it would be to get a bit fitter, lose a little weight and make some more time to try and get my golf handicap moving in the opposite direction than it is currently going.
Gerard Boyle GDP, Glasgow
Q How will the dental landscape change in 2011?
More bad news, I reckon. There will be pension changes, withdrawal/capping of NHS allowances, all of which would push more GDPs into the private sector.
Q What would change/improve your professional life?
Please can we have less bureaucracy? The last thing the profession needs is more regulation (revalidation, Care Commission, etc.) getting in the way of our day-to-day ability to deliver care to our patients.
Q What will give you sleepless nights?
The prospect of draconian changes to the NHS pension system, (particularly the possibility that we may be working until 65) after the final instalment of the Hutton Report in March 2011.
Q What would get you cracking the champagne open?
A 20 per cent rise in the NHS fees. I also believe in Santa Claus.
Q Who’s the ‘player’ to watch this year?
Richard Simpson MSP, part of Scottish Labour’s public health team, who could well replace his SNP counterpart Shona Robison in Government after the election in May. He is a qualified medical practitioner and should therefore be expected to be familiar with his brief.
Q What’s your New Year’s resolution?
More work, less ranting.
Margie Taylor, Scotland’s Chief Dental Officer
Q What are the major challenges you face in 2011?
We need to address inequalities in oral care. It is unacceptable that in modern Scotland the poorest in our society and those in remote and rural areas still suffer from unacceptable inequalities in health.
We also want to ensure that those who suffer from a physical or mental condition that affects their dental treatment are receiving the care that they need.
The Healthcare Quality Strategy sets out the overall direction and focus for the NHS over the coming years. The aim is for the NHS to provide the highest quality healthcare to the people of Scotland.
The Quality Strategy has helped focus our attention on what makes a ‘quality dental practice’ and we are going to be engaging with the profession in 2011 to ensure they get an opportunity to help define this clearly.
Q How will you meet these challenges and how will they be prioritised?
Improving oral health is
obviously a top priority for the Scottish Government.
Work to address inequalities is already well underway and paying dividends. Heath boards have been developing programmes for priority groups and have started to implement these.
Targeting children in the most deprived areas, the Childsmile School programme will deliver a range of preventative care interventions for children in primary one and two to reduce the risk of dental decay.
The most recent National Dental Inspection Programme reports have shown that children’s oral health has never been better. Now 64 per cent of P7s and 62 per cent of P1s have no sign of tooth decay – a huge improvement on recent years.
It is fantastic to be able to say that our primary school children now have the best oral health since our records began. Thanks to work already underway to ensure that children know the importance of dental care at the earliest age, Scotland’s children are now primed to have a lifetime of good oral health.
Our latest figures show there are record numbers of dentists working in NHS Scotland and this has resulted in more people being able to access an NHS dentist. Between 1995 and 2009 the stock of dentists has increased by almost 41 per cent.
We now have outreach training centres in place throughout Scotland including Aberdeen, Inverness and Dumfries and Galloway. We are continuing to increasing the number of dental students in training – the dental school in Aberdeen is training 20 dentists every year.
With increased access to dentists we will expect to see improvements in oral health.
I want to see all of this good work continue in 2011.
Q How will you be looking to the profession to meet your objectives?
I am pleased to say that the profession have been engaging in the Childsmile Practice programme and have contributed to the improvement in oral health.
The Childsmile Practice programme is designed to improve the oral health of children in Scotland from birth by working closely with dental practices. It is being developed to provide a universally accessible child-centred NHS dental service.
It is carried out through a network of primary care dental service providers involving both independent contractors and salaried services. All of the Childsmile strands – including Practice – are due to be rolled out in every heath board area in 2011, so I would like to see the profession continue to be involved.
As well as this, the community dental service has traditionally provided a service to priority groups complementing that provided by the general dental practitioners’ service.
The academic dentists are responsible for training the new dentists and the dental hospitals see patients needing specialist care on referral. We now have many more dental care professionals (dental nurses, therapists, technicians, clinical technicians) who, as important members of the dental team, can help ensure access is maintained.
Q What are you looking forward to in 2011 and beyond?
Quite simply, I want to see improvements in oral health and to continue to have a dedicated workforce providing a quality service.
Irene Black, GDP and assistant director, NHS education
Q How will the dental landscape change in 2011?
Over the next few years more dentists will be competing for the same pool of regular dental attenders.
The result will be more choice for patients, more discontented NHS dentists and possibly more dissatisfied patients.
Q What would change/improve your professional life?
My life would be easier if NHS dentists were properly rewarded for providing quality care and a quality service. I would want direct funding for NHS practices for all governance requirements. This could enable them to employ enough staff to make ‘quality’ a realistic possibility.
Q What will give you sleepless nights?
That would have to be more regulation of NHS dental services. The prospect of reducing numbers of health boards and special health boards with possible amalgamation, meaning they would become larger and even more out of control.
Q What would get you cracking the champagne open?
My son graduating and getting him off my payrole.
Q Who’s the ‘player’ to watch this year?
Andy Murray – again. This will be the year. In dentistry, still the CDO.
Q What’s your New Year’s resolution?
Take up a hobby and prepare to retire. Not to mention decontamination ever again. (I’ve never been very good at resolutions!)
Euan Thomson GDP, Rothesay
Q How will the dental landscape change in 2011?
With the countdown to LDU compliance running, there will be a lot of practices struggling to comply and a sensitive approach will be needed by the health boards.
Q What would change/ improve your professional life?
Implementation of ‘new’ combined health board and VT inspections will be put on hold for a year! Oral health Assessments will be introduced as an item of service in the SDR after much discussion over a ‘realistic’ fee! Less patients, more time!
Q What will give you sleepless nights?
Mrs McClumpha on her second remake of full/full dentures, and the taxman!
Q What would get you cracking the champagne open?
Joined-up thinking in terms of budget allocation for NHS dentistry especially in relation to decontamination.
QWho’s the ‘player’ to watch this year?
CDO, of course!
Q What’s your New Year’s resolution?
That people vote for a party at Holyrood with a different philosophy from the party at Westminster if we want to avoid the disastrous reforms which were introduced into dentistry in England.
Liz Hutchison, NES Scotland Lead DCP Tutor – South East
Q How will the dental landscape change in 2011?
Introduction of the GDC’s Scope of Practice documentation means that DCPs may be even more involved in direct patient care with additional skills training for these groups being even more in demand.
Q What would change/improve your professional life?
As a practising DCP (oral health educator), a greater emphasis should be put on the importance of home care to patients. Educating patients to look after what they have had done to them is paramount. Ensuring that they value the treatment. In my role as a lead DCP tutor, I’d like to see DCPs embracing the concept of their newly raised professional status; taking ownership for their own continuing professional development.
Q What will give you sleepless nights?
DCPs who seek employment without being registered.
Q What would get you cracking the champagne open?
GDC putting a timescale on students ‘in training’.
Q Who’s the player to watch this year?
Lee Westwood. He needs a couple of nice veneers on his upper laterals!
Q What’s your New Year’s resolution?
Lose a stone, play lots of golf and read Scottish Dental mag!
Q What would change/improve your professional life?
My life would be easier if NHS dentists were properly rewarded for providing quality care and a quality service. I would want direct funding for NHS practices for all governance requirements. This could enable them to employ enough staff to make ‘quality’ a realistic possibility.
Q What will give you sleepless nights?
That would have to be more regulation of NHS dental services. The prospect of reducing numbers of health boards and special health boards with possible amalgamation, meaning they would become larger and even more out of control.
Q What would get you cracking the champagne open?
My son graduating and getting him off my payrole.
Q Who’s the ‘player’ to watch this year?
Andy Murray – again. This will be the year. In dentistry, still the CDO.
Q What’s your New Year’s resolution?
Take up a hobby and prepare to retire. Not to mention decontamination ever again. (I’ve never been very good at resolutions!)
Craig Thorn DF2, Inverurie
Q How will the dental landscape change in 2011?
The Childsmile programme looks set to be adopted across the salaried and community services in Grampian where I am currently working. The aim is to improve oral health in children by increasing the numbers registered with a dentist and by concentrating on effective prevention. Hopefully 2011 will see improved oral health in children.
Q What would change/improve your professional life?
My dental foundation training has already improved my skills and confidence in working with special needs patients and stroppy teenagers. I’m about to start a six-month rotation in the ARI which I hope will do the same for my oral surgery.
Q What will give you sleepless nights?
Probably something involving paperwork or red tape.
Q What would get you cracking the champagne open?
Signing off on a long, complicated prior approval case always earns me an extra biscuit.
Q Who’s the player to watch this year?
Mike Gow – the Derren Brown of Dentistry.
Q What’s your New Year’s resolution?
To get back in the swimming pool.
Mike Brown, Laurencekirk Dental Practice
Q How will the dental landscape change in 2011?
I think that the current financial climate will make things very difficult. Patients will have less money to spare, perhaps leading to a shift away from private dentistry and a corresponding increased demand for (already difficult to find) NHS dentistry. This, in itself, is becoming more and more difficult to provide, with costs increasing markedly more than fees so who knows where things will end up!
Q What would change/improve your professional life?
Water fluoridation.
Q What will give you sleepless nights?
I’m lucky (in some ways) to work within the SDS so things are perhaps more stable than they would be within an independent practice scenario. With this in mind, other than the fact that a tank of diesel will soon be more valuable than my house, I’m hoping my slumber will be relatively peaceful!
Q What would get you cracking the champagne open?
If our new contract were to be as generous as the new GMP contract was.
Q Who’s the player to watch this year?
Tiger Woods – he’s definitely due a comeback!
Q What’s your New Year resolution?
My usual – live more healthily. One year it will happen!
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