The chair of the Scottish PDS Committee tells us how the PDS have led the way in setting up urgent care in Scotland and reflects on years of underfunding.
The Public Dental Service (PDS) in Scotland has done a great job setting up urgent dental care centres (UDCs) across the country to deal with the COVID-19 outbreak. Following the Chief Dental Officer's announcement on 23 March that all routine dental care should stop immediately, PDS colleagues moved quickly to set up UDCs in their local areas.
"75% of patient-facing dentists in UDCs in Scotland are from the PDS"
Things are changing all the time, but at present approximately 75% of patient-facing dentists in UDCs in Scotland are from the PDS, and 25% are General Dental Practitioners (GDPs). The 'hot' UDCs, which are operating with full FFP3 PPE and performing aerosol-generating procedures (AGPs) and seeing COVID-symptomatic patients, are all currently staffed by PDS. The 'cold' UDCs meanwhile, which are not performing AGPs, are being staffed by a mix of GDPs and PDS dentists.
I'm fiercely proud of the fact that these clinics have been organised so quickly and efficiently by our PDS, despite the years of chronic underfunding the service has faced.
New roles and new colleagues
Plans and patient pathways for the emergency centres are broadly similar across Scotland, but each NHS Board reflects local circumstances. In my local area, Highland, there is a network of four UDCs covering East, West, North and South Highland. There's also a designated 'hot' centre for those requiring AGPs or for symptomatic COVID cases.
"The day-to-day work in these centres requires us to adopt new habits and ways of working"
The day-to-day work in these centres requires us to adopt new habits and ways of working. Having access to sufficient PPE is also essential for
infection control and the safe treatment of patients. There have been shortages in certain areas, but we continue to lobby on behalf of dentists and their patients to ensure the opinions of dentists on the front line are listened to.
Alongside the PDS, GDPs are playing a vital role both at a practice level, providing AAA (Advice, Analgesia, Anti-microbial) care and telephone triage, and also serving in UDCs providing direct patient-facing care.
It's great to see the profession coming together to ensure patients requiring urgent care receive appropriate treatment from dedicated clinicians.
Some of our PDS colleagues have meanwhile been redeployed and are currently serving in COVID testing centres in Highland. I know this story has been replicated in other Boards, and colleagues have been telling me of similar efforts in Ayrshire and Arran, Orkney, Lanarkshire and Fife.
Chronic underfunding
"I continue to be concerned about the future of the PDS in Scotland"
The great work done by the PDS is all the more impressive when you consider the chronic underfunding of the service in recent years. Indeed, I continue to be
concerned about the future of the Public Dental Service (PDS) in Scotland, including on-going funding cuts. There was a further 3.6% reduction in funding in 2018/19. We've seen a 15% drop in the number of PDS posts in the past five years. Continued reductions in PDS capacity and the departure of experienced staff may jeopardise the long-term viability of the service, and is certainly impacting patient care. There are also concerns about the non-clinical management structures of the PDS in some NHS Boards.
During the current crisis, the PDS has shown how essential it is. I would hate to imagine what patients with a dental emergency in Scotland would be doing now if the reductions in PDS capacity and the departure of experienced staff had continued much longer.
Now more than ever, I'm very proud to represent you as Chair of the Scottish PDS Committee. Alongside the rest of the BDA, we're working for you. Together we will continue to make the case for the Public Dental Service in Scotland, the essential role it plays and the need for sustainable funding.
Graham Smith
Chair, Scottish Public Dental Service Committee
