Exemptions legislation: a new era in oral healthcare?

Miranda Steeples shares insight into the dental hygienist and dental therapist approval of exemptions legislation

Miranda Steeples shares insight into the dental hygienist and dental therapist approval of exemptions legislation.

In a recent stride towards enhancing the operational capacity and efficacy of oral healthcare in the UK, a pivotal legislative amendment is underway. This change pertains to the Human Medicines Regulations 2012 (HMRs), enabling dental hygienists and dental therapists to supply and administer specified medications.

This move, initiated by the BSDHT and BADT back in 2013 and developed over the past 11 years, aligns with the broader objectives of the NHS Long Term Workforce Plan, aiming to bolster direct patient care while liberating dentists to tackle more complex procedures within the NHS framework.

At the BSDHT, we wholeheartedly support the initiative to empower our professionals by expanding their capabilities, allowing them to provide the comprehensive care our patients require. This development promises to enhance the efficiency of the oral healthcare team, ensuring smoother operations and more effective use of time for everyone involved.

Legislative background

Initiated by a public consultation that was open from 18 August to 15 September 2023, this legislative amendment seeks to give dental hygienists and dental therapists the authority to supply or administer specific medicines independently.

The consultation garnered significant attention, with 2,743 responses indicating a robust engagement from the dental community and the public. The overwhelming support, with 97% agreement, underscores a collective endorsement of this initiative across England, Wales, Scotland and Northern Ireland.

It is also important to note that numerous consultation respondents highlighted direct access. They suggested that the proposed exemptions would enable dental hygienists and dental therapists to leverage direct access fully, allowing them to treat their patients comprehensively within their scope of practice and utilising their training, competence and indemnity coverage.

As it stands, dental therapists and dental hygienists can administer treatments such as local anaesthetic and high-strength fluoride, but only after obtaining a prescription from a dentist. This requirement often disrupts both the patient’s treatment flow and the dentist’s work to secure the necessary signatures.

So, this change will streamline the treatment process, enhance efficiency across practices, minimise the need for multiple patient visits and allow these professionals to fully employ their expertise.

Potential benefits of exemptions legislation

  1. Improved patient access and efficiency – by enabling dental hygienists and dental therapists to administer treatments like high-strength fluoride and local anaesthetics independently, patient waiting times are expected to decrease significantly
  2. Enhanced professional practice – this legislative change allows dental hygienists and dental therapists to practise to their full potential, reducing dependency on dentists for prescriptions and enhancing job satisfaction and professional autonomy
  3. Support for preventive care – with easier access to necessary medications, dental teams can better engage in preventive treatments, crucial for long-term oral health.

Challenges and considerations

Despite a generally positive reception, some concerns have been raised regarding the need for appropriate indemnity coverage and the potential lack of comprehensive knowledge required for assessing and prescribing medications. These issues point to the necessity of continuous professional development and potential adjustments in educational curricula to incorporate these new competencies.

With these regulatory changes, the role of dental hygienists and dental therapists is poised to expand significantly, aligning with the government’s broader healthcare strategy to optimise the use of mixed professional skills across the NHS. This legislative update not only promises improved patient care and professional satisfaction but also marks a significant shift in how dental services are delivered across the UK.

A time of change

The approval of exemptions for dental hygienists and dental therapists to administer specific medications marks a transformative period in oral care delivery. As the legislation moves towards implementation, it holds the promise of a more efficient, autonomous and comprehensive oral care system, directly benefiting patients and the dental profession alike.

After reviewing the consultation responses and considering the broad support for the proposal and its regulation, the Department of Health has pledged to advance efforts to amend the HMRs. Only then will dental hygienists and dental therapists be able to supply or administer medicines under exemptions.

We expect these changes to take effect by the end of the year. The BSDHT will offer guidance to our members as developments occur. Please check our social media pages for updates and keep an eye out for further communications from us on this significant issue.

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