The role of the dental nurse
Only when NHS England pays nurses directly will you get a nurse-led clinic, Michael Watson says.
At the British Dental Association (BDA) Conference in Manchester last month, I spent a most informative session listening to Jane Delgano, president of the British Association of Dental Nurses (BADN).
Her subject was: ‘The role of the nurse in providing prevention in practice-based clinics and the wider community’.
Now, my knowledge of dental nurses is distinctly old-fashioned, based on my early experiences of being a dentist more than 50 years ago.
In those days, my dental nurse’s role was limited to handing me the instruments (including having to identify what I wanted without being told) and reassuring patients that I was not quite the ogre portrayed by the popular press.
They had no independent clinical role and often no qualifications to their names, let alone a first-class honours degree in primary dental care with the University of Kent that Jane recently achieved.
Assistants to professionals
Her talk was centred around the development of dental nurse led clinics with the Community Dental Services (CDS) to deliver prevention.
It showed that the status of dental nurses has risen from assistants to professionals.
This was recognised by the General Dental Council (GDC) some time ago, both becoming equal members along with dentists and, more recently, when their scope of practice was expanded.
One question that Jane raised was why, if the approach of delivering care and prevention through dental nurse led clinics was such a success in the CDS, could it not be the same in the general dental services?
This is a ‘live’ question as we pilot or prototype a new general dental services (GDS) contract based on prevention.
The problem, as I see it, is that the GDS contract both since 2006 and before that is there to pay dentists, and dentists only.
So, to put it crudely, every £1 you pay to a dental care professional (DCP), whether hygienist, therapist or nurse, is £1 less you pay a dentist.
Only if NHS England decides to pay DCPs directly, albeit through a GDS contract, can dental nurse led clinics become a reality in general dental practice.