The rather abrupt departure of Barry Cockcroft as chief dental officer (CDO) for England and the delay in announcing his successor raises questions in my mind.
Add to this the strong rumour that his successor is not one of the obvious candidates and has no direct experience of working in the NHS and I am bound to ask what NHS England is up to.
There may be a simple explanation in that we are in a pre-election period when ministers (who may be out of office in a few weeks) and the civil service (which includes NHS England) are precluded from making policy decisions or announcing key appointments.
A change of thinking
However, having a devious mind, I am bound to ask whether this appointment, whenever announced, signals a change of thinking at NHS England, in regards to NHS dentistry.
I am prompted to do this by the publication last week of an NHS England paper, describing its approach in 2015/16 to deliver on its plan for the NHS, published last year in the Five Year Forward View.
It is difficult to summarise a long and complex paper, but the essence is to make the NHS cope with a growing and ageing population with complex needs, all within a fixed budget.
Prevention must have a pivotal role in the NHS of the future and care must be integrated across all parts of the system.
NHS dentistry is going to have to prove that it can deliver a prevention based service, working with other parts of the health system and delivering improved oral health.
Dentists, not the Government, will be held responsible for the high level of hospital admissions for the extraction of children’s teeth.
Improved oral health
It will no longer be good enough to say: ‘We have done all the UDAs required; we have done our job.’
Units of Dental Activity (UDAs) mean nothing, they are a measure of activity not of delivering improved oral health.
Dentists will have to work with the rest of primary care, especially GPs, who through their clinical commissioning groups will want a say in how dentistry is commissioned.
Under the Five Year Forward View dentistry can no longer remain in a backwater, churning out UDAs and discussing the best structure of a new contract.
That is why, I believe, NHS England has accepted Barry Cockcroft’s resignation and is appointing a new pair of hands with a fresh view of how NHS dentistry should be delivered.
That does not mean that all dentists will be happy with this.