Here’s a plan…

I’ve written it down and you can read it. Unlike those in power, who have never communicated anything reasonable in advance of public announcements

14 February, 2022 / insider

Looking forward to the coming year, I thought I’d look at what new things in dentistry interest me. Boringly enough, I still can’t get over the COVID thing. I know we’re all dreadfully fed up with it. However, it has dominated our thoughts and lives for the last (nearly) two years. More importantly, it will define the next several years as we all struggle to come out of this troubled time and get back on top of our patients’ dental problems.

So, what can I do to help? I’m trying to be positive here. Speaking to several dentists recently, the biggest problem is the ongoing uncertainty. I’ve harped on about this before but, in dentistry, business and life in general, having some kind of plan and something to look forward to is essential. A way to control, direct and have a positive, forward-looking outlook is good for us all. 

Here’s a plan. This is my plan. It may mirror what has been discussed. It may be something that might happen and what the Chief Dental Officer (CDO) and the Scottish Government are going to do. But more than anything, I’ve written it down and you can read it. Unlike those in power, who have never communicated anything reasonable in advance of public announcements.

Treat this as folly or fantasy. However, if it’s written down, then maybe we can start to talk about it. Plan things out. Create some momentum of what to do. I’m pushing the first domino. Let’s see if they fall in a pretty, world record-breaking pattern or it’s just another fanciful false start.

Current guidance: let’s use it as it’s meant to be.  Standard PPE for all procedures unless you have respiratory symptoms. If you have respiratory symptoms, put on an FFP3. Simple, practical, almost normal. Keep the PPE coming till 2023.

There’s going to be a lot of treatment required. We need to support the workforce to do this.

Stop the support. Not immediately, but gradually with targets increased month-by-month, over the next six months or so. We need to change the way we are being paid to re-incentivise hard work and long hours. If we don’t, we are never going to get through the work needed.  Use the SDR with small amendments, use something we know. A whole new model at this point is crazy. Get on with the massive ****storm of work that needs done.  Now.

Stop paying dentists to vaccinate. We need dentists to be carrying out dentistry. If you want a vaccination programme to include COVID boosters, fund it and staff it properly. It’s a massive waste of skilled resource to have dentists vaccinating.

If the support (direct and indirect) for dentists changes, it will drive the inevitable NHS exodus. We need this to happen and soon. The Scottish Government 

must own this. If they want NHS dentistry in Scotland, they need to fund it and train enough staff to run it. We will need a lot more DCPs. Train more hygienists in two 

years, not therapists in three. Unless you change how the payment system works, therapists won’t get places to work. We need staff and now. Not in three years, when it’s too late and the hole is massive. Dentists too. Young dentists are neither inclined nor able to do volume NHS work; the kind that will dig us out of said hole. We need more of them too.

Let the Public Dental Service and dental hospitals get on with specialist care. They have been shackled terribly and redeployed throughout this. There is a mass of referrals coming over the hill for them too. Incentivise basic care in practice to ensure referrals are kept to a minimum. Have a quality review of these referrals and a ceiling for referral numbers based on the practice size and profile. If practices organise in-house care and reduce the burden on secondary care, give them a bonus.  If practices are willing to take cases on referral from other GDPs, introduce some enhanced fees. Utilise the specialist knowledge and skills which some practitioners have and reduce the waiting lists. Having some sort of certification and affiliation to the local referral centres could help this. A little work done now to set this up will reduce the increasing burden in the next year.

We need a range of ideas about how to transform the methods of care. However, that needs to happen at the same time as increased patient need is met, free dentistry is rolled out to other age groups and DCPs and dentists leave the profession, or at least the NHS side of it. We need to help ourselves and be proactive. The suppression of normal working patterns and delay of care has gone on too long. It can only lead to more harm, to patients and dental professionals alike.

The inevitable boom in need, and subsequent advanced care, is a huge opportunity for dentistry. Let’s grasp the nettle and get on with it. It will be tough, but let’s use our collective will and brain power to change things. Think smart, work smart. Do the best for our patients. 

This is a plea to dentists to develop our profession.  More importantly, it’s a plea to the Scottish Government and CDO to use a little free thinking and advance the care of the Scottish people. Don’t be reticent. Use this time to make changes. Listen to people in the profession. We may not be at the point for normality yet but waiting until it is without a plan is unprofessional. Not involving the profession or telling them in advance to help businesses organise is criminal. If even one of the ideas above sparks something, then this will be worthwhile. The challenge is huge, but we are clever and adaptable people. We need to rise to it to do justice to our patients and protect ourselves against the coming onslaught.

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