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Winning the argument on recall intervals for dental patients

Blog Author Robert Donald

Blog Date 06/12/2018

Since the Oral Health Improvement Plan (OHIP) was published in January 2018 – there is one issue which has caused considerable concern among the profession - the proposal to extend the dental recall interval for 'low-risk' patients, and citing NICE guidelines that stated that it may be extended over time up to an interval of 24 months.


So, we have therefore greeted the latest assurances that 24-month dental recall intervals will not be introduced - and that 'high-risk' patients will be seen more frequently than those in good oral health.


The Chief Dental Officer has been explicit that it will be for the dentist and patient to jointly decide on the appropriate recall interval.


This will come as welcome news for patients and practitioners. 


Our members were clear as we gathered the evidence for our Oral Cancer Action Plan.


Telling 'lower risk' patients to come back in 24 months would jeopardise efforts to meet a growing threat, while putting further pressure on NHS cancer services.


In a recent survey, 97% of dentists told us they had concerns this would undermine detection of oral cancers. And 77% defined it as a major or severe risk.


And the Scottish Government has now acknowledged publicly that we are right to raise our concerns on this issue.


We believe that patients should be seen as often as we feel clinically appropriate, and that "high-risk" patients might need to be seen more frequently. 


We remain convinced the many worthy ambitions in OHIP will not be achieved by scraping a steady state budget too thinly.


It is now more than 10 months from OHIP's launch – and, apart from the introduction of occupational health services for dentists and their teams - which we have campaigned for and welcomed - none of the 41 actions in the OHIP have been completed.


Yes, OHIP is a long-term plan but the Scottish Government needs to provide greater clarity around priorities, budgets and timescales for all its key proposals. And we'll be keeping the pressure up. 


But as we sit down with minsters recall is just one issue where we can make a difference:


1. Guaranteeing a sustainable future for NHS services 

We've welcomed the Scottish Government's announcement that Public Dental Service dentists earning less than £80K would receive the same 3% increase as Agenda for Change staff, and that all pay rises for dentists would be backdated to April 2018.


However, we remain convinced that handing lower uplifts to independent general dental practitioners (2.55% overall), and below inflation uplifts to Senior Consultants, will leave the future of the service in doubt. 


Real-terms pay has fallen by 30% in recent years, and this downward trend is matched by declining morale among the profession, with increasing numbers of principals and associates considering leaving the profession. 


The message for government is simple, we cannot go on as we are.


2. Fighting to improve children's oral health outcomes

We've discovered that in some NHS Boards, young patients face waiting times of six months from referral to treatment for extractions under general anaesthetic.

It's unacceptable that children with pain and infection should wait for this length of time, and we've made the argument direct to ministers. 

We've told the Scottish Government it needs to work with NHS Boards to ensure there are sufficient local resources to alleviate immediate problems, and consider establishing a dedicated, coordinated national service in a single location to tackle this issue.


It's why we continue to press the case for expansion of Childsmile to older children. And why we are making the argument for targeted water fluoridation directly to Ministers.


Prevention and tackling oral health inequalities are both stated priorities for the Scottish Government. And as evidence from England shows every £1 spent on water fluoridation can yield nearly £22 in savings over 10 years. 


3. Delivering jabs for the boys

We have greeted the Scottish Government's announcement to introduce an HPV vaccination programme for boys. BDA Scotland has been part of the HPV Action Coalition for over four years. 


At the outset we were told progress would be impossible, so we can take some pride the Scottish Government was the first UK administration to pledge to extend the programme.


But we are still pressing hard for details on rollout, with the whole coalition behind us. And there are more battles to fight. 


Specifically 140,000 boys still in school who deserve to benefit from a catch-up programme.

Robert Donald, Chair

BDA Scottish Council

BDA Scotland

BDA Scotland supports, represents and promotes, the interests of all dentists working in Scotland. Working with elected committee members, we negotiate on behalf of the profession on terms and conditions, and pay and contracts.


With each new member, our voice and our influence grows. Add your voice, join today.