Dental Tribune Untited Kingdom Edition

April 16-22, 20128 Interview United Kingdom Edition N K: I wanted to ask about dental nurses. Nurses are amongst the lowest paid of the dental team and they’ve suffered a huge rise in costs – registra- tion fees, compliance with CPD and other rules and regu- lations. Have they seen good value for money and are these costs fair? SS: This is one of those cir- cular issues. We know from our research that a significant proportion of practices pay their dental nurses’ regula- tion costs, and by that I mean not just the GDC fees but also the CPD fees. Now that’s fine, but of course it just gets recycled into the expenses of the practice so the wages bill looks bigger or the edu- cation bill looks bigger, prof- its are smaller and so their wages are then suppressed for longer. So it is a circular prob- lem – without a doubt it is a cost. Pay freeze The Department of Health has been told by the Treas- ury and by the Secretary of State that there’s a pay freeze on public sector workers so dentistry gets an amount of money which the Department of Health think that they can contribute to the expenses of running dental practices, plus an efficiency saving, which at the moment is currently expressed by improving pre- vention through fluoride var- nishing. So in real terms, in order to achieve the efficien- cy saving, dentists are doing more for the same money, and their expenses are not being fully met. In effect, a pay cut. Step too far? So you’re absolutely right, it’s potentially a real expense to the dental nurses ultimate- ly; however you badge it, it could end up with them. So I think that’s rather sad and in my personal view - and it’s not BDA policy at the moment - I think it was a step too far to require GDC regulation of all dental nurses. That doesn’t apply to the extended duty dental nurses – the dental nurses who have additional qualifications so that they can be more involved directly in patient care. I think the regulation in that situation is justified – not only justified from a patient safety point of view, but I think justified loosely from a career progres- sion point of view as well and for the ability to demonstrate responsibility and be a sig- nificant part of the whole dental team. Fifteen years ago, dentistry was a very paternalistic pro- fession: the dentist decided what they were going to do, issued instructions, people ran round them, made them coffee, put their metaphori- cal slippers on for them and kept quiet in the surgery. I think we can take some credit in the BDA for developing the team role through BDA Good Practice, which I think was probably, along with Denplan, one of the first programmes which suggested that dental nurses had a role in the suc- cess, the sustainability, the morale, the improvement in patient care in a practice and had a significant part to play. Now the minute that hap- pened, the whole dental team became worth something; it had a value, self-worth, self- esteem, responsibility and the enjoyment of that responsi- bility. And actually when you talk to dental nurses (perhaps not the youngsters, but cer- tainly nurses who have been around for longer), they actu- ally quite like the requirement to do CPD and they find it em- powering. So while I suspect there’s probably a compromise in my own mind – and again it’s not BDA policy, because BDA policy is that the whole team should be regulated as it stands at the moment – but perhaps there should be a mandatory regulation for anyone who has an extended duty qualification and does anything to and with patients directly, rather than just standing and being under instruction all the time, and perhaps there should be a vol- untary regulation for dental nurses as well. Empowering One of the knock-ons is that, when you look at the GDC now, the majority of the registrants with the GDC are dental nurses. So that has been hugely empowering, not just on a practice basis, but politically as well. You will not find many central com- mittees, either advisory com- mittees or committees that are influencing changes in dentistry, regulation, all sorts of other things, that don’t have the full spread of DCPs on it. So being regulated and be- ing part of the GDC has im- mediately led to full repre- sentation of the dental team, and it’s not just token repre- sentation, but this is really ac- tive representation. Now, that I think has been really good for the profession, because it’s challenged the dentists’ per- ception of paternalism. So to sum up I suspect it probably is value for money, in terms of the empower- ment of the profession of den- tal nurses – although it may not be appreciated as such. And just saying my last sen- tence highlights something new: profession of dental nurses? So it has established professional behaviour and it has established a voice and a role politically, representa- tionally and also parochially as well. NK: It seems that if you’re a full time nurse, that’s great, but it seems that there are large numbers of people who are concerned about the cost. For instance, I can pick out three nurses from my own ex- perience who have come back from maternity and have said, can I afford to go back into the profession? SS: Yes, and it isn’t just den- tal nurses either who strug- gle with it. Part time dentists still have to pay the full an- nual registration fee. They also pay a significant propor- tion of the full BDA member- ship at the moment. When we first starting having on call rotas, and it was a 1990 con- tract that brought out of hours responsibilities in, huge rows erupted about ‘well I only do one day a week, why should I do the same amount of on call cover on the rota as my friend who works seven days a week and works all night?’ It was a similar problem. DT • In the final part, Susie Sanderson answers questions on the amalgam issue and her thoughts on the future of dentistry. In the third part of this four-part interview, Neel Kothari talks to Susie Sanderson about dental nurses Discussing dental nurses Are nurses getting the best deal when it comes to cost? ‘And actually when you talk to dental nurses (perhaps not the youngsters, but certainly nurses who have been around for longer), they actually quite like the requirement to do CPD and they find it empowering’ About the author Neel Kothari qualified as a den- tist from Bristol University Dental School in 2005, and currently works in Sawston, Cam- bridge as a princi- pal dentist at High Street Dental Prac- tice. He has completed a year-long postgraduate certificate in implantol- ogy and is currently undertaking the Diploma in Implantology at UCL’s Eastman Dental Institute.