Why can’t dental health professionals supply and administer specified medicines under ‘exemptions’, Michael Watson questions.

At a study day in Manchester this weekend, dental hygienists and therapists were discussing direct access and changes to the regulations to allow them to prescribe certain medicines, so called ‘exemptions’ for these two professionals, giving them an opportunity to improve patient care.

Currently, it is not possible for a dental hygienist or a dental therapist in the UK to sell, supply or administer local anaesthetics, topical anaesthetic and/or fluoride varnishes to a patient without having to first get a prescription (a patient specific direction) from a dentist, or under a so-called patient group direction.

Other health professionals such as midwives, paramedics, orthoptists and podiatrists can sell, supply and administer specified medicines without need for a doctor’s prescription, a mechanism known as exemptions.

So why not our health professionals?

Full potential

The first hygienists were being trained before I was born.

When I was a dental student, a few miles down the road in New Cross, therapists were being trained albeit not with that title.

Throughout my professional life, there was a refusal amongst the ‘old and bold’ to recognise that anyone without the initials BDS or LDS after their name could make a valuable contribution to the care of patients.

I hope that those days are over and that nowadays dentists accept hygienists and therapists as equals.

But some of the comments I see on social media give me cause for concern.

Dental hygienists and dental therapists are an important part of the workforce and they already play a valuable role in the care of patients and in supporting them with maintaining their good oral health.

But their full potential has been somewhat hampered.

Were they allowed to supply and administer some POM (prescription only medicines) items, dental hygienists and therapists would no longer need to interrupt the dentist during surgery and take up their valuable time.

Also, they would be able to perform the required treatment, even if the prescribing dentist was not available at all, meaning the patient would not be asked to return on another day in order to complete it.

Catch Michael Watson’s previous blogs:

Time for reform

Hopefully this reform will progress through the bureaucratic machine.

But it must not be the end.

The profession and the NHS must recognise that, although dentists will continue to agree a care plan with a patient, they do not need to be involved in every single course of treatment.

In the future patients will see different members of the dental team and perhaps only see a dentist when more complex treatment is needed or problems arise.

That is using the workforce efficiently and to good effect, but it is not allowed under current NHS rules.

The granting of exemptions is only the first step towards a system that involves the whole profession, not just dentists.