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Dental access comes under spotlight

21st Jun 2011

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Mike Warburton Mike Warburton

Key figures in dentistry put dental access under the spotlight recently.

An international panel of speakers addressed the issue of access to dental services at a symposium organised by the Faculty of General Dental Practice (UK).

More than 60 key figures in dentistry listened to a range of definitions of ‘access' – and so too the challenges that arise.

Benedict Rumbold, of the Nuffield Trust, argued that ‘equal access is about equal opportunity, not equal utilisation', while Maria Goddard, director of the Centre for Health Economics at York University contended that “utilisation is usually the proxy for access, but does it capture quality?

More access does not necessarily result in better access'.Paul Batchelor, honorary senior lecturer in dental public health at UCL and course director of the FGDP(UK)'s Diploma in Dental Health Services Leadership and Management, defined access as ‘the opportunity to use a service if the individual feels it appropriate'.

Evidence was presented of the progress made towards improving access to dentistry.
Mike Warburton, formerly the national director for GP access at the Department of Health (DH), argued that work by the DH had greatly improved access.

However, he stated concerns around the effective management of dental contracts by primary care trusts in the past and described a number of DH initiatives to support PCTs in delivering dental access more effectively.

He heralded achievements in improving access over the last year or so and quoted results from a recent GP survey showing that 96% of patients who tried to get an NHS dental appointment in the last six months were able to do so.

Paul Batchelor asserted that no single measure will ensure access and that the biggest barrier is cost, stating that “if you want to increase attendance, offer access as a free entitlement through lifelong registration”.

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In other presentations, Rick Curro, from the PEARL Dental Network in New York presented the access challenges faced within the US health system, while Jon Crail of the Phrisk Digital Agency presented on the impact of socio-economic factors on the demand for dental services.

Finally, Mike Smith of the Patients Association presented the patients' perspective on access, making a plea for greater levels of preventive care to be provided.

The evcent was staged at the Royal College of Surgeons of England.

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The question is :
Did they get access to good quality dental care? With this "Nectar point" system , Hardly !
Posted by Expat 22/6/11 at 21:35
Oooh, Expat! You are naughty! Maybe they are getting 'access' to rubbish!? Nobody here would suggest that. Would they!?

--This post was last edited on 23/6/11 at 05:53--
Posted by docholliday 22/6/11 at 23:35
certainly not doc we all believe nhs work is exactly the same as private-can't understand why anyone would want to pay 5 times more. "if you want to increase attendance,offer access as a free entitlement through lifelong registration" What a crock-income support had /have it free but still don't attend. Very few patients register for life. " cost " is perceived-pts are continually told private is "expensive"-so its a mental thing. They are used to the joke prices of the nhs so perceive private as expensive. Dentistry will never move on while dentists are prepared to offer their services for nhs fees.It doesn't work any where else-why should the uk be different
Posted by gordie 23/6/11 at 09:20
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No Doc they wouldn't.
I just remember the look on referred "NHS patients" back in the UK when they saw a rotary NiTi or (System B and Obtura) or even a rubber dam for the first time. They thought it was "from another planet". Gordie is right. It won't work.
My mates who work for IDH and ADP are telling me that a 30 something "manager/ Dental nurse" is deciding how much clinical time they should allocate for their fillings and RCT's !!!
Posted by Expat 23/6/11 at 12:00
Expat - 'managers' have to do something to justify the laptop and the BMW!
Posted by docholliday 23/6/11 at 13:23
ha ha brilliant expat/doc
Posted by gordie 23/6/11 at 15:07
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I work in a private practice north of the border and the NHS access initiative resulted in 3 new nhs practices being opened in the last year .Many patients have decided to try the NHS in the last six months but we have found almost all of them return to us after one or two nhs appointments .They all repeat the same story of not getting the same attention or time that they recieved privately and that they better understand the fee differences.They also appreciate someone who can answer a question in English without having to reply via the nurse .IDH managers ? How wrong is it to allow a fellow Dentist who has studied and worked for years to be interviewed by two ex [often older] nurses and no fellow dentist being present .Why do we now belittle our colleagues this way at interviews .I refuse to attend interviews if no Dentist is present .I advise all dentists to do the same and stop allowing these BMW driving laptop carriers to have as much influence on our younger colleagues .My old profs would be horrified !!
Posted by poker12 23/6/11 at 15:27
poker12 - quite. I have to say that a few weeks ago one of my least-favourite patients 'walked', with a set of snide remarks to reception about our 'profiteering' by abandoning the NHS. The Denplan monthly report came back 'leaving for NHS - already registered'. Apparently, our hygienist literally danced for joy on learning that this character would be taking his plaque-riddled mouth elsewhere. Then, a week ago, he turned up on the doorstep!!! Can he come back? A loose post crown at the front - no pain, but he had a meeting to go to, and.....He phoned his NHS practice many times, but they wouldn't see him for several weeks. I believe the phrase I overheard our Practice Manager use was 'you've made your bed and now you can lie upon it!'.
Posted by docholliday 23/6/11 at 20:46
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Well done by your practice manager doc !
He probably was lucky he did not get an appointment at the NHS practice right away. They probably would have suggested extraction and a 1 tooth acrylic to get 12 "Nectar points" !
On the "profiteering" front , all data (even for recent years) show that larger NHS practices in England are more profitable than the private ones. I think patients should be informed about that every time they say something like this.
Poker 12
Agree with you , but life as a newly qualified dentist is probably not that easy with this "Nectar point" system.
Posted by Expat 23/6/11 at 21:32
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Life for the newly qualified dentist will be very difficult indeed when the new Care Pathway NHS contract comes in in 2014....many clinical positions held by therapists and hygienists, leaving inexperienced young dentists jobless for the first time. Especially with all these new dental schools churning out new graduates......
Posted by Gunglik 24/6/11 at 06:31
I think there is a small possiblity that a critical mass of pissed of dentists will say no to these govt inspired cock up contracts-at least I hope so.There must be a point at which even the die hard nhs dentists can't take any more of govt. interference in running their lives/practices .I have a feeling the university fees will kill off demand to do a career in med/dentistry so there will be a shortage again in 5-7 years. By that time most of the foreign influx will have realised the nhs is not for them and hopefully the bda will have grown some gonads again and represent dentists again-must cut down on the friday wine.

--This post was last edited on 24/6/11 at 16:07--
Posted by gordie 24/6/11 at 15:51
expat-part of me agrees with your receptionist but the other part thinks -probable implant missed-difficult call as I don't know the ...patient.However I would have loved to have relieved him of a couple of grand and emphasised the benefits of private dentistry ha ha
Posted by gordie 24/6/11 at 16:08
Ha - gordie! This guy deserves the Nectar point treatment, I know it's defeatist, but my general health ie hypertension is more important.....this guy has an ancient post-it placed about 15 years ago annotated 'MOB'. I.e miserable old......... Note: post-its fall off, especially if record cards are leaving the practice. Strangely, his daughter-in-law is a lovely patient who fully appreciates our efforts. But she is American. I fear the locals have a steep 'learning curve'.......
Posted by docholliday 24/6/11 at 21:05
your right prices can't go down from nhs
Posted by gordie 25/6/11 at 14:52
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