What does it mean to be an NHS practice? Well, that’s a good question …

09 April, 2021 / editorial
 Will Peakin  

The headline here last edition was Lockdown: an opportunity taken? It was a nod to the notion that the past year had been an opportunity for people to make the kind of long-term changes that normal daily life does not allow. Take up yoga. Learn how to podcast. Subscribe to MasterClass and sing like Christina Aguilera1. Undertake a fundamental reform of the oral healthcare system in Scotland. That kind of thing.

If the evidence of ‘The Summit’, the Scottish Dental Association’s impressively run webinar held last month, is anything to go by then we are all as guilty of watching a year drift by our living room window, while simply trying to stay well and stay employed.

The webinar featured Cynthia Pine, Professor of Dental Public Health at the Institute of Dentistry, Queen Mary University of London, Professor Philip Taylor, Dean of Dental Surgery at the Royal College of Surgeons in Edinburgh, and Tom Ferris, Scotland’s Chief Dental Officer (CDO).

This is not to malign Professors Pine or Taylor, who respectively gave thoughtful and thought-provoking presentations. Nor the CDO. It can’t have been easy for him to watch the chat function scroll by – peppered with calls for Prof Taylor to be made CDO – and maintain a cheery disposition.

What was slightly deflating, however, was the frequent use by the CDO (Mr Ferris, that is, not Prof Taylor – hereafter known as ‘The People’s CDO’) of: “It’s a conversation we need to have.” More than a year ago, a good deal of work had already been done by him, his team and others in the profession on the so-called New Model of Care that would herald an end to 50 years of ‘drill and fill’, and usher in a new era of disease prevention. We would all benefit from an ‘oral health risk assessment’, a personal ‘care pathway’ would be agreed, with a ‘treatment toolbox’ to hand, and – fundamentally, for the profession – the Statement of Dental Remuneration would be replaced with a more appropriate financial model. Working groups had been established, a colourful flow-chart drawn, and a timetable more or less agreed.

But then, as the CDO (Mr Ferris, not …), told the webinar, there was a pandemic. He conceded that, a few months in, he did not conceive that the temporary financial support measures put in place at the time would still be operational a year later. But, as he added – and you can’t really argue with him on this point – “We are where we are.” Indeed. I never did take up yoga, or learn to podcast, and my MasterClass subscription runs out this month.

As I remember the timetable, the detail of the New Model of Care would have been agreed by now; in time for a presumably convinced SNP-led Government to go into an election on its promise (among other pledges). Early adopter practices might have gone live towards the end of the year. There would have been a period of evaluation, and then possibly the beginnings of a full roll-out by the end of 2022. Now, as we report, it’s just about finding “a more sustainable interim financial support process for practices and dentists”.

After that, the CDO told the webinar, there can be “a conversation”. Lots of them, in fact. I counted 16 mentions of “a conversation” in his presentation, but have pared them down to three for our report. What does it mean to be an NHS practice? That is one of the conversations to be had. Fairly fundamental. A good place to start.

As well as lots of conversations to look forward to, there were also a few straws in the wind from other speakers. Here’s one from The People’s CDO: “Should we be training as many dentists as we do?” That is, might it be better to train more dental hygienists and therapists? Another straw; fluoridation of the water supply. Actually, not so much a straw in the wind, but more a bale of hay rolling across the field in a storm; such is the evidence to support its implementation.

We cover all these issues, and more, in this edition. I wonder where we will be by next spring?


Tags: new model of care

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