Abstract
BackgroundTo help promote a flexible and sustainable workforce in dentistry, it is necessary to access accurate and timely data about the structure and nature of the evolving dental team. This paper considers the results and learning from a region-wide dental workforce survey conducted in one area of Health Education England and how the team has changed since the last survey a decade earlier.MethodsA mixed-methods approach comprised two phases. In Phase 1 a customised workforce questionnaire was sent to all dental practices registered with the Care Quality Commission in the North East of England and North Cumbria in March 2016. Findings then informed Phase 2, a regional symposium held in October 2016, where interactive workshops generated qualitative data that elaborated on factors influencing workforce development.ResultsOf 431 primary dental care practices identified, 228 questionnaires were returned - a 53% response rate. The largest professional groups were dental nurses (n = 1269, 53% by headcount; 50% of fte) and dentists (34% by headcount; 42% by fte), though there had been increases in numbers of all staff groups over the decade, which was most marked for dental therapists (from 1 per 39 dentists to 1 per 8 dentists). The dental team predominantly fell into ‘younger’ age groups (< 46 years age), with evidence of a significant increase in the number of dentists reporting part-time working in a practice since the last survey. Around one third of dental practices reported employing dental nurses with additional skills (n = 74, 32.5%) or dental therapists (n = 73, 32%), and nearly half employed a dental hygienist (n = 104, 46%). However, there was considerable variability in whether these staff actually carried out the range of skills within their scope of practice. Factors shaping workforce development were identified as, the national context, loss of expertise, patients’ health needs and expectations, surgery premises and financial constraints.ConclusionsThe composition and work patterns of the primary care dental workforce have changed markedly over the last decade, though utilisation of skill-mix continues to be constrained. Consideration of factors determining career progression of dentists and dental care professionals is needed to optimise a sustainable future workforce.
Highlights
Dental services across the UK are operating in a changing clinical, social and political climate [1, 2]
Analysis of patient records in practices in Wales identified that at least one third of routine dentistry in primary care could be provided by hygienists and therapists [10] (though at that time they had a more limited scope of practice which has since been revised and expanded by the UK’s General Dental Council (GDC))
This paper reports findings from a regional dental workforce survey (DWS) and workshop event in 2016, commissioned by Health Education England working across the North East and North Cumbria (HEE-NENC)
Summary
Dental services across the UK are operating in a changing clinical, social and political climate [1, 2]. There are recognised geographical inequities of oral health in the UK, and of patients’ access to dental care [2, 5, 6]. This national context supports a case for reform of the dental workforce, with greater use of an integrated multidisciplinary team, shaped to address the relevant needs of the population [7]. The concept of ‘skill-mix’, or broadly, ‘people with the right skills doing the right jobs’, is long established It is over 25 years since the Nuffield Foundation advocated use of dental auxiliaries to support and rationalise the work of dentists [8]. This paper considers the results and learning from a region-wide dental workforce survey conducted in one area of Health Education England and how the team has changed since the last survey a decade earlier
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