How will exemptions transform patient care?

Exemptions in focus: Rhiannon Jones explores how exemptions will transform patient care, enhance professional autonomy and support the delivery of preventive oral health.

The introduction of exemptions for dental hygienists and dental therapists marks a pivotal moment for the profession. Until now, providing care to the full scope of practice has often been challenging. Dental hygienists and dental therapists have required a Patient Specific Directive (PSD) or a Patient Group Directive (PGD) to administer certain prescription-only medicines (POMs), such as local anaesthetics.

The new legislation removes these barriers for those who complete the appropriate training, enabling independent administration of listed medicines and streamlining care delivery. This change therefore empowers dental hygienists and dental therapists, recognising their expertise and reinforcing their vital role in oral health promotion and disease prevention.

Enhancing care and autonomy

Exemptions allow dental hygienists and dental therapists to address patient needs in real time, reducing delays and improving the overall patient experience.

For example, treatments like fluoride varnishes or local anaesthetics can now be administered in a single appointment. This capability is especially impactful in underserved communities, where timely access to care can significantly affect outcomes.

The ability to work independently not only enhances the efficiency of care but also highlights the expertise of dental hygienists and dental therapists. As patients experience faster and more comprehensive treatment, these professionals will gain greater recognition as integral members of the primary healthcare team.

For practices, exemptions present an opportunity to redefine workflows, reducing reliance on dentists for routine prescribing and enabling smoother, more efficient care pathways. This shift not only enhances patient satisfaction but also supports the profession’s overarching goals of promoting health and preventing disease.

Practical considerations

Practitioners who regularly use the listed medicines and wish to utilise exemptions are encouraged to undertake training. However, for those who opt out, a PSD will still be required to administer these medicines.

This flexibility ensures that practitioners can make decisions based on their confidence, experience and practice setting. Open discussions within practices can help ensure that team members feel supported in their decisions, whether or not they choose to complete the training.

For those undertaking the training, it does not teach administration techniques. These should already be in place from undergraduate education or postgraduate skills courses. Clinicians who feel their practical skills need refreshing are advised to address this first. Administering medicines carries inherent risks, and patients deserve care from practitioners with the appropriate skills and confidence.

Additionally, clinicians intending to utilise exemptions must notify their indemnity providers to ensure they are appropriately covered. Taking this step ensures practitioners are not only adhering to professional requirements but are also safeguarding themselves and their patients.

Open communication within practices can help identify any overlooked details, such as indemnity coverage, while fostering mutual understanding and supporting decision-making among the team.

Addressing challenges

While the potential benefits of exemptions are clear, challenges remain. Issues around product labelling and sale regulations persist, although professional organisations are working to resolve them to ensure compliance with legal standards and avoid disruptions in care delivery.

Additionally, exemptions cannot be delegated. For example, a practitioner with exemptions cannot ask a dental nurse to apply fluoride varnish on their behalf, even under their supervision. This limitation reinforces the importance of each practitioner’s individual scope and responsibilities.

For those teaching dental hygienists and dental therapists or working in secondary care settings, these limitations may require careful planning to ensure compliance without compromising care quality. Clear guidance and collaboration are essential for overcoming these practical hurdles.

The wider profession must also support practitioners by providing clear explanations of how exemptions work in practice. Open discussions at the practice level can help ensure a shared understanding of roles and responsibilities, promoting respect and alignment across teams. This mutual understanding is crucial for delivering high-quality patient care.

Moving forward

The introduction of exemptions represents a transformative opportunity for dental hygienists and dental therapists. By enabling independent practice, the profession takes a significant step toward greater efficiency, improved patient outcomes and enhanced professional autonomy.

While challenges remain, the benefits are undeniable. Exemptions allow the profession to address care gaps, improve access to treatment, and provide safer, more efficient care pathways. With the right support, dental hygienists and dental therapists can confidently embrace these changes and continue to deliver exceptional care.

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