GDC has rethink on direct access to hygiene treatments

The General Dental Council (GDC) is considering the viability of restrictions that force patients to see a dentist before getting treatment from a hygienist or therapist.

It recently produced a paper on re-opening discussions on direct access for DCPs – or hygienists and therapists – for hygiene treatment.

This follows dialogue last year between the GDC’s former chief executive and the Office of Fair Trading (OFT) on the suitability of the current rules.

The OFT wrote to the previous chief executive in October 2009, airing concerns about the current restriction, one of which was that it creates unnecessary cost in having a treatment plan drawn up by the dentist.

They reasoned that if a patient is able to access a DCP directly, costs may be lower.

Added to this, the GDC’s own Customer Advice and Information Team (CAIT) reveals that, on average, they receive one call every fortnight and that call is always from a patient who is aggrieved that they have to see the dentist before seeing the hygienist, rather than from a DCP who wishes to see a patient directly.

The GDC discussion paper details the results of the Scope of Practice consultation and highlights all the concerns expressed by the Office of Fair Trading and by patients.

It acknowledges that ‘the question of direct access is a contentious one in dentistry as many hygienists and therapists would like to be able to see patients direct, particularly as there is a demand for direct access to dental hygiene treatment from patients’.

One of the questions posed to respondents was ‘what skills would be needed to make direct access to DCPs safe and effective?’

There were 341 responses:
• 25 stated that direct access should not be opened up to DCPs
• 12 believed that dental hygienists and therapists already have the necessary skills
• 2 stated that technicians already had the necessary skills

The remaining 302 respondents were asked to list the skills that they felt would be needed and the most frequently occurring of those skills were:
• Examinations and screening to identify, recognise and diagnose (69)
• Writing treatment plans (22)
• Knowing when to refer (20)
• Recording, taking and maintaining medical and/or dental histories (18)
radiography (12)
• Knowledge of anatomy, conditions, drugs, pathology etc. (11)
• CPD in pharmacology (11)
• Patient management, customer care, language and communication (10)

But the GDC conceded that it was unable to ascertain the ratio of dentist/DCP respondents who believed direct access should not be opened up to DCPs.

It also could not tell which category of respondents believed that hygienists and therapists already had the necessary skills.

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