Dental Quality Improvement

The Scottish Government has issued new guidance on the Quality Improvement activity in the 2022 – 25 contract cycle. Given that the information was sent in April 2024, less than a year from the end of the three year cycle, this is – late.

You can see the instructions at this link. The new requirements include:

• Submitting a team-based reflective report
• Completing an online equality and diversity training module
• Taking part in a workforce census

There are supporting materials on TURAS, the on-line learning system used by NHS Scotland.

The team-based reflection only needs to be submitted once for each practice. The expectation is that the practice will conduct a meeting, using a provided template for guidance, and then submit a summary. A wide range of potential topics for the team to consider are provided.

Having a good understanding of the Scottish dental workforce is sensible, given the well known recruitment problems being experienced by practices. Training new professionals is a long road, but better information at least makes the problems, and the needs of dental practices, clear.

A good understanding of the numbers, working patterns and career stages of dentists, dental nurses, dental hygienists and dental therapists is essential. The slew of retirements after the COVID pandemic coming on top of pre-existing problems; the ‘missing’ year of Vocational Trainees in Scotland; dissatisfaction with working patterns; litigations and strain in dentistry; limits on clinical autonomy, and the impact of financial strains on practices has had a huge impact. Inevitably, workforce shortages are felt even more keenly in rural and coastal areas far from dental schools, and this should be considered in the Scottish Government survey.

From a Quality Improvement perspective, it is important that a workforce survey goes beyond the immediate practice team. A General Dental Practice feels like a standalone entity, but it is part of a wider system. Even with the advent of 3-D printers, practices depend on laboratories, and laboratories, in turn, depend on dental technicians.

It is easy for people outside dentistry to interpret the ‘technician’ term as suggesting a mundane role that covers work that would otherwise be carried out by dentists. Dental teams know otherwise, and understand technicians’ skills, the training required, and the impact of delays when their numbers are limited. To understand the flow of materials and supplies to and from dental practices, a comprehensive survey must take account of the laboratories that support Scottish practices. The results of the Scotland-wide survey will be vital for service planning, and should be published in full.

A further post considers where equality and diversity fit into the Quality Improvement firmament (spoiler alert: the Institute for Healthcare Improvement has put equality at the heart of its mission).

Image by Michal Jarmoluk from Pixabay