GDC gives green light to direct access

DENTAL hygienists and therapists will now be able to offer treatment without a prescription or patients having to see a dentist first under new GDC rules.

The decision to remove the barrier to direct access for some dental care professionals was made following a GDC consultation and full discussion of the evidence at a Council meeting in March. Guidance for registrants will be published before the changes come into effect on 1 May 2013.

From that date dental hygienists and therapists will be allowed to carry out their full scope of practice without prescription and without the patient having to see a dentist first, but the guidance will make clear that they must be confident that they have the skills and competences required to treat patients direct. The GDC believes that a "period of practice working to a dentist’s prescription is a good way for registrants to assess this".

The GDC further states in regard to dental hygienists and therapists: "Registrants who qualified since 2002 covered the full scope of practice in their training, while those who trained before 2002 may not have covered everything. However, many of these registrants will have addressed this via top-up training, CPD and experience. Those who qualified before 2002, or those who have not applied their skills recently, must review their training and experience to ensure they are competent to undertake all the duties within their scope of practice."

Also under the new rules, dental nurses will be allowed to participate in preventative programmes, and orthodontic therapists will be able to carry out index of orthodontic treatment need (IOTN) screening without the patient having to see a dentist first.

Clinical dental technicians will continue to see patients direct for the provision and maintenance of full dentures only and will otherwise carry out their other work on the prescription of a dentist, but this decision could be reviewed in future given the potential for further training for CDTs. The work of dental technicians (other than repairs) will continue to be carried out on the prescription of a dentist.

Dental professionals are encouraged to get in touch with the GDC if they have any questions.

Chair of the GDC Kevin O’Brien said: "This decision has been made with patient safety as an upmost priority. Registrants treating patients direct must only do so if appropriately trained, competent and indemnified. They should also ensure that there are adequate onward referral arrangements in place and they must make clear to the patient the extent of their scope of practice and not work beyond it."

The British Dental Association (BDA) is not happy with the GDC decision on direct access believing it will undermine best practice in patient care.

Dr Judith Husband, Chair of the BDA’s Education, Ethics and the Dental Team Committee, said: "This is a misguided decision that fails to consider best practice in essential continuity of care, patient choice and cost-effectiveness, and weakens teamworking in dentistry which is demonstrated to be in patients’ best interests.

"Dental hygienists and therapists are highly-valued and competent members of the dental team, but they do not undertake the full training that dentists do and on their own are not able to provide the holistic, comprehensive care that patients need and expect. Our fear is that this could lead to health problems being missed in patients who choose to access hygiene and therapy appointments directly."

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