Implementing the therapy-led model

This month, Cat Edney discusses how a therapy-led approach can turn a one-man band into a cohesive well-oiled machine.

This month, Cat Edney discusses how a therapy-led approach can turn a one-man band into a cohesive well-oiled machine.

2023 has been a year of exploration for dental practices. I have been inundated with calls to help implement a dental therapy-led model – explaining how it works and crucially, why it works.

This shift has been a long time coming and something I have been talking about for a number of years. More recently, I have toured the UK with Chris Barrow’s Extreme 100 coaching group to discuss the features of a therapy-led model.

In September 2022, the NHS made changes to the guidance on how courses of treatment can be opened and closed (and also by whom), and now we are seeing the idea of therapy-led filter into all types of dental settings, with even Prime Minister Rishi Sunak using the much-misunderstood professional title in a recent debate.

Why does therapy-led work?

My memories of dentistry before I worked in the industry are of the standard 1980s style dentist. It was a lovely man, using the bottom floor of his house as a dental surgery. He had one nurse who was also his receptionist. Instruments were hung up along the wall, the X-rays were tiny films stuck to a light under the wall cabinet, and they had a fish tank in the waiting room – the highlight of my visits.

This dentist did it all – from paediatrics to surgical extractions, hygiene and dentures. If you needed it, it happened in that one room with that one dentist and his one nurse. That one dentist was playing every instrument in his solo – a one-man band.

In contrast, modern dental surgeries have multiple rooms, multiple chairs and multiple support staff. There are often practice managers, social media managers, treatment coordinators, head dental nurses, decon nurses, hygienists and GDP associates.

However, these GDPs are still working to the ‘one-man band’ model. They have their own list of patients, often their own room they work in, and we all know a GDP who likes to have their own dental nurse.

Why change?

The one-man band model works, and has worked for years. So, why change?

What I have noticed from working in multiple teams like this is that every individual clinician has their strengths. There is usually a direction they want to take their own personal development or a passion they have in dentistry – be it oral surgery, orthodontics, endodontics or smile makeover work.

The therapy-led model supports these GDPs to play to their strengths. It turns a dental surgery from multiple rooms of one-man bands to a well-tuned and cohesive orchestra, with the dental therapist as a conductor.

It’s a familiar set-up that our medical colleagues have led the way in. They have followed their passions by choosing a profession within medicine, so now it seems ridiculous to expect your GP to also be your surgeon and your physiotherapist.

The therapist does the check-ups

Traditionally, dentists have referred to dental hygienists and dental therapists. This puts some pressure on the dentist to know what the individual they are referring to is confident to undertake, while also potentially walking a fine line of keeping their own diary busy, but not too busy with low profit treatments.

When we implement a therapist-led model with a multi-dentist team, we flip this concern. The therapist does the check-ups and is able to treatment plan and undertake the treatment they are confident with. They can then refer the out-of-scope treatment to the right clinician for the patient’s needs, often referring to multiple GDPs if need be.

The therapist is able to triage patients to ensure that when they have a missing tooth and are interested in replacing it, they get in with the implant dentist who is passionate, knowledgeable and confident in discussing all things implants.

As a result, this fills each dentist’s diary with treatments they enjoy and are passionate about, reducing the time the dentist spends on check ups – which can easily take up half of their diary time.

How does a team make therapy-led work?

The move to a therapy-led model can throw up some concerns and questions along the way. Understandably, the team may need guidance and support when navigating the transition.

How this model works in your own practice will often vary from team to team and also may vary depending on the team members you have at the time. This is why developing protocols within the team has always been my focus when supporting dental practices through their structure changes.

Key areas that we explore include the patient journey, the booking process, the referral criteria for each clinician, and detailed swim lane protocols. This is to ensure clinicians are confident that there is a level of standardisation between them all.

This takes some time and a number of conversations, and it also depends on a level of understanding between clinicians and support staff.

In short, it works by taking a ‘team’ from a group of people who work in the same building on different projects to a cohesive well-oiled machine that jointly looks after every patient under its care.

To learn more about implementing dental therapy in practice, visit

Catch up with Cat’s previous columns:

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