John Makin analyses the challenges and opportunities posed by recently announced changes to dental regulation and policy as a result of the dental recovery plan.
We are in an election year and access to an NHS dentist is undoubtedly something that politicians of all parties will want to promise to their constituents. However, policies to improve access need to be well thought through, clearly communicated and carefully implemented in the interests of dental professionals and patients alike.
What changes have been announced in dentistry recently?
A key plank of the government’s dental recovery plan in England is to make better use of the skills of the whole dental team. It was recently announced that dental hygienists and therapists will soon be able to administer certain types of medicines – including pain relief and fluoride – without a prescription from a dentist.
And in January 2023 NHS England stated that dental care professionals (DCPs) could open and close courses of NHS treatment, explaining there had been a ‘widespread misunderstanding’ of the regulations governing NHS dental treatment in force since 2006. Since April 2024, DCPs can submit claims without the need for a dentist’s performer number.
The regulations, in my view, clearly state that any banded course of treatment must contain at its outset a comprehensive examination by a dental practitioner. There have been no changes to the regulations themselves and I have yet to see an explanation of the legal basis for this interpretation of the rules.
One can only imagine how dentists previously subjected to financial, regulatory and even criminal sanctions on the basis of the previous interpretation must now be feeling.
Another proposal by the Department of Health and Social Care is provisional registration for overseas-qualified dentists, meaning these colleagues could treat patients under the supervision of a dentist, while awaiting full registration.
What are the potential challenges of the changes?
We all want to see access to NHS dentistry improve. The DDU’s view is that the rush to achieve this should not put colleagues in a vulnerable position due to unintended consequences. For example, DCPs being asked to work outside their scope of practice or competence level, or colleagues being compelled to accept responsibility for the supervision of provisional registrants.
Changes also need to be properly communicated to patients. This will help to avoid a situation where patients expecting to be treated by a dentist only find out on arrival at the practice, or worse after something has gone wrong, that the treatment was provided by another member of the dental team. Patients may attribute a perceived poor outcome to the type of practitioner carrying out the treatment, whether this is the case or not.
The challenges ahead are significant and wide-ranging. At the DDU, our role is to ensure dental professionals are aware of best practice and latest guidance so they can practice safely and ethically, while supporting them with any complaints that arise.
For further advice on direct access and scope of practice, visit the DDU website.
