‘Get involved, make a difference’
In a Q&A conducted in October, Professor Philip Taylor, the new Dean of The Faculty of Dental Surgery at The Royal College of Surgeons Edinburgh, reflects on his career and the future
Why dentistry, and why Newcastle?
When I was considering a career in dentistry, there was very little advice on choosing a dental school. I had heard there were plans to build a new school in Newcastle in the next few years so chose it as it was just far enough away from my home in Leigh, Lancashire, that my mum could not come to check on me but near enough I could still bring my washing home! I had considered a career in medicine but decided to pursue dentistry as I liked that it was a very hands-on profession and also the fact that the hours are fairly steady with no regular night shifts.
What have been the highlights of your career in practice?
I am lucky enough to say that there have been so many. Achieving the Diploma of Membership in General Dental Surgery (MGDS) in the North East after 12 years in general practice was something very special and spurred me on to believe I could do more.
During that time, I was the secretary for the North of England BDA and first became involved in national dental politics while working with the Local Dental Committee and the Strategic Health Authority.
Running the Master’s and, later, the Doctorate specialist course in prosthodontics at Queen Mary University of London (QMUL) was such a great honour and with that came promotion to Professor status.
In between that, I had five years in private practice in Harley Street which provided another perspective on patient care.
I have been president of two national societies, the British Society for Prosthodontics (BSSPD) and the British Association of Teachers in Conservative Dentistry. Achieving consultant status in Restorative Dentistry and being the Barts Health NHS Trust Clinical Director for Dentistry, OMFS and Ophthalmology for seven years was a major role with the opportunity to feed into the running of the largest NHS Trust in the country.
But of course, retirement and the honour of emeritus status by QMUL and becoming Dean of The Faculty of Dental Surgery at The Royal College of Surgeons Edinburgh is the very pinnacle for me.
Can you describe how practice has changed?
So much has changed since I began my career in the early 1980s. Clinically, I began at the very beginning of resin retained bridges, the start of glass ionomers and, in the year that I qualified, Branemark published his first paper in English on successful dental implants.
Even practice itself has changed. There were no gloves, no masks, one handpiece for the whole day, re-usable endodontic files (called Reamers then) and it was rare to find a practice with any sort of steriliser, even a hot air one. Most practices just had disinfectant and instruments were washed and dipped in a solution. This all changed following the HIV epidemic and practices quickly implemented new procedures. They had an autoclave, multiple sets of instruments, multiple handpieces and PPE became the norm.
On the financial front, the change from fee per item was huge, and I think it has restricted what happens in general practice. It is strange that the same system under a different name (payment by results) is accepted for hospital practice but so despised in General Practice.
How has the UK’s oral health, and its place in health and social care policy, changed?
It has absolutely changed for the better and this is evidenced in the Adult Dental Health and Child Dental Health surveys. But the budget for these has been stopped, and we do have an issue with the changing population in this country due to increased mobility, which may change the picture from the last survey. One criticism of the surveys was the relatively small sample size per area and that they were questionnaires, not all actual inspections. But that said, they gave an overall guide to our nation’s oral health. I am disappointed that water fluoridation has not been universally accepted as I saw first-hand the difference in fluoridated and non-fluoridated areas when I worked in the North East of England.
How did the connection with the RCSEd come about?
I sat the Faculty of Dental Surgery examination and the people I dealt with there were so friendly and helpful which had not always been the case with other Royal College exams I had sat previously.
Your thoughts on your time as a member of the College?
Everyone in the College has the same friendly attitude and they are all working as one to make the experience for exam candidates, affiliates, members and fellows the same high quality. I like the way the College makes a conscious effort to be inclusive and it covers all aspects of dentistry from dental nurses, to therapists and hygienists and general practice, not just specialist practice. I also like the way we engage with dental students through our skills competition, which I think demonstrates everyone can aspire to be a member or fellow of the College.
You took office on 10 March – a pivotal month in UK healthcare and policy. Can you describe your perspective on COVID-19’s impact on oral health and what the model of NHS oral healthcare should, or might, be long-term?
I think COVID-19 has had a terrible effect on dentistry, but hopefully as a profession we can use this as a learning exercise, to re-evaluate the ways in which we can improve patient safety and care for the long-term future.
Obviously, the financial impact on practices and the increased waiting times for treatments has a risk effect on levels of disease and viability of practices.
I think the pandemic has created an opportunity for practices to look at a blended approach to commissioning care, including potentially revisiting fee per item, and encouraging practitioners to achieve more in their careers through enhanced fee structures. This might be through exams like our Membership in Advanced General Dental Surgery whereby a practice can show it has achieved an exceptional level of care. I also have a few other ideas on how RCSEd can help practitioners build a career portfolio which will be unveiled over the next year.
You have published the Faculty’s Manifesto 2020-2023. What might lead to your ‘Call to Arms’ being fulfilled?
To get people involved and give them autonomy to make change happen. If everyone gets involved, then we can make change – sitting back and complaining solves nothing!
How might the promises on Education, on Assessment, and on Patient Safety be fulfilled?
Education & Assessment: We need to offer relevant, validated examinations that dentists can feel proud of succeeding in. I am keen to make more of our exams open access, so portfolio dentists can achieve without necessarily being tied to university exams. This will help move us closer towards the aim of providing high quality, educational offerings as courses, webinars and in specific online lecture content. We have already made great strides in this respect with over 4,000 people attending one of our webinars recently.
Patient Safety: We are committed through our rigorous examination processes to ensuring all of our members and fellows can be trusted to have quality assured skills in their chosen specialty. We help our teams reach those standards through carefully planned educational offerings both face-to-face and online, with well attended webinars and now through our excellent new App. Many of these educational resources are online and free to access, though of course we would welcome any of the readers to join us in a more formal manner.
I would like to think that anyone reading this would feel able to contact the College and ask about how they could be involved. I am more than happy to personally try to answer questions and if I don’t know the answer, point you to the right person who does know. Only if we work together can we make dentistry better, get involved and make a difference.