Annual Report Of The Chief Dental Officer 2012

6. Dental Workforce

6.1 Introduction

NHS Education for Scotland and NHS National Services Scotland published a comprehensive Dental Workforce Report in 2012 (http://nes.scot.nhs.uk/education-and-training/by-discipline/dentistry/resources/puboications/dental-workforce-report-september-2012.aspx).

The dental workforce of Scotland continues to evolve, with more dental undergraduates undergoing training in Dundee and Glasgow and on Aberdeen's 4-year graduate course, which saw the first cohort of students graduate in summer 2012.

Services are provided by dentists and a number of dental care professionals in a variety of general, community and hospital dental service settings.

6.2 The Supply of Dentists

Since the publication of the Dental Action Plan in March 2005, there has been a significant increase in the number of NHS general dental practitioners (GDPs) (both non-salaried and salaried). The Dental Action Plan set out a range of targets to increase the number of dentists, dental graduates and vocational trainees.

The age and sex distribution of the dental workforce has changed over time and this has implications for workforce planning. In 1995, fewer than one third of NHS GDPs were female, while in 2011 almost 45% were female. Information from Scottish dental schools shows that well over half of dental students are female, and the percentage of female NHS GDPs is likely to increase.

Key highlights from the Workforce Report include (30th September 2011 compared to 30th September 1995):

• The average age of GDPs had decreased.
• The percentage of female GDPs had increased.
• The percentage of dentists who qualified outside Scotland had increased.

6.3 The Supply of Dental Care Professionals

The Dental Action Plan also acknowledged the important role of dental care professionals (DCPs) and their contribution to improving oral health and the provision of oral health care in Scotland; it proposed an increase in the number of dental therapists in training to 45 per year and dental nurses in training to 250 per year. These proposals were based on the shift in demand on dental services, with a greater number of people keeping their teeth into old age, and changes in the patterns of work, with dentists retiring earlier or working reduced hours and some practitioners choosing to work more for the private sector.

Since 2008, dental care professionals have had to register with the General Dental Council and adhere to the Standards for the Dental Team (http://www.gdc-uk.org/Dentalprofessionals/Standards/Pages/default.aspx) to protect patients and staff and maintain the appropriate level of knowledge, skills and competence. The Office of Fair Trading (OFT) report published in May 2012 (www.oft.gov.uk/OFTwork/markets-work/dentistry/#.UqbtOScgGK0) raised concerns over the "continued restrictions preventing patients from directly accessing DCPs". The OFT felt the restrictions were unjustified and were likely to reduce patient choice and dampen competition. The report recommended that the GDC "change regulations and remove restrictions preventing patients from making appointments to see DCPs directly". In March 2013, the GDC, following a detailed review, agreed to direct access, permitting dental hygienists and therapists to treat patients within their full scope of practice without prescription from a dentist.

6.4 Education and Training

NHS Education for Scotland commissions and delivers a wide range of dental education and training in Scotland for all members of the dental team to ensure patients receive high-quality care.

6.5 The Dental Workforce of the Future

The workforce of today needs to be designed for tomorrow, to ensure it has the necessary competencies, skills, knowledge and experience to enable "the right person to do the right job at the right time".

Forecasting dental workforce requirements is challenging, as it is based on the supply of dentists and DCPs, population projections and their needs and demands on dental services. It is currently forecast that there may even be an excess supply of NHS GDPs, considering the potential contribution of dental therapists.