Dental Education: Present and Future Nicholas H Taylor - - PowerPoint PPT Presentation

LDN Conference

Dental Education: Present and Future

Nicholas H Taylor

Postgraduate Dental Dean - HEE NW Chairman of COPDEND - UK Chairman of English Dental Deans - HEE 27th June 2017

Aim

To improve understanding of the role of Health Education England in providing the workforce for NHS service provision.

Objectives

• Need into Numbers - the need for a more holistic

strategy to meet current and future health care needs

• Understand central decision making based on local

evidence of need and national HEE workforce plan

• Demographic, geographic and requirement factors
• Signposting & support to the prospective “Tier Two”

cadre of providers

• Future NHS workforce provision

HEE Mandate

https://hee.nhs.uk/

Health Education England (HEE) exists for one reason only: to support the delivery of excellent healthcare and health improvement to the patients and public of England by ensuring that the workforce of today and tomorrow has the right numbers, skills, values and behaviours, at the right time and in the right place.

www.gov.uk

Currently delivering

• Foundation Training

– Satisfactory completion

• Dental Core Training

– Certificated years of personal training

• Specialty Training

– 13 disciplines

• Workforce Development & Transformation

– Local Professional Networks – Appraisal, mentoring – Bespoke courses

• Restoration of Efficiency of Registrants
• Dental Care Professionals

Tax payer funding

Current funding streams for training:

• Health Education England
• Joint Funding (HEE/Trust)
• National Institute for Health Research (NIHR)
• Trust Funded
• University Funded
• (Self-funded)

All Quality Managed by HEE staff

Self-funding

• Workforce Transformation & Development
• Performer List Validation of Experience (PLVE)
• Remediation and support (NHSE & GDC)
• Specialty Training (London)
• Other certificate, degrees and masters

General Dental Council

• Quality Assurance

Undergraduate Specialty Training

• Specialty curriculum review (13)

‘On pause’

Dental Disease is changing

The population is changing

Technology is changing

Current workforce

Current issues

• GDS/PDS UDA Contract
• History of dental service provision
• Vested and conflicts of interest
• Primary Care Business models
• DFT – competence and experience
• Dentistry outside main body of NHS provision
• Division between Primary & Secondary Care
• Mixed dental economy – NHS & Private
• HEE Investment plan

HEE Comprehensive Spending Review (CSR)

• HEE Programmes £4.9bn
• HEE Administration £71m

Programmes- Flat Cash till 2019/2020 Administration - 2019/20 £57.9m CUTS

Educational Support – 30% Administration – 20% (already 20%)

Comprehensive Spending Review English Dental Deans

• Regionalisation of HEE

Provision

• Foundation Review
• Non-NHS funding

Commissioning Guides

NHS Commissioning Guides Proposed clinical pathways to cover complexity of care

• Tier 1-
• Tier 2-
• Tier 3-

DCPs to Specialist/Consultant to Deliver

Workforce

GDC Scope of Practice - Team Approach to Primary Dental Care Diagnosis & treatment planning Fluoride varnish,

• ral hygiene

instruction, radiography Periodontal treatment Routine restorative, deciduous extractions Extractions, advanced restorative, MOS, Prosthetics Specialty areas

Dental Nurse Hygienist Therapist Dentist Ortho Therapist DES Specialist CDT CDT F/F

Screening

Direct Access

Tier II

Boundaries

• NHS GDS/PDS mandatory contract
• What should a generalist (Provider) be doing?
• Avoiding the NHS (tax payer) paying twice
• What is the remit of the specialist?
• Where does tier II fit?

Reducing priority for public funding

(Steele Report 2009)

Current Tier II Service Educational Element

Lancashire Model

• Selection
• Contracting
• Triage
• Delivery
• Training

Changes to the skill mix in the practice as a consequence of the pilot care pathway

• Q19. Consider changing the skill

mix?

• Q20. In what way?

85 %

PROVIDERS

• Q19. Would you consider changing the skill mix of staff at some point if the new way of working becomes permanent? Base: All providers (40).
• Q20. How might your practice change the skill mix of staff in the future to help deliver the new way of working? Base: All providers who say ‘yes’ at Q19 (34).

The pilot contract

Has been exceptional opportunity to:

• Improve the quality of dental care
• Better value for money for tax payers
• Engender patient compliance
• Re-structure the dental workforce
• Public health approach to delivery

Local Dental Networks

and their constituent

Managed Clinical Networks

What do you need?

Workforce Planning

OCDO – Dental Strategy Department of Health - Contract Reform Local Dental Networks

• Managed Clinical Networks

University Requirements – Under/post graduate Workforce planning team (HEEAG/DWAG Report)

All drive HEE Investment Plan

HEE training numbers - the HEE Investment Plan

1907

Critical Activities

Opportunities

• “Putting the mouth back in the body”
• DH Contract Reform
• Skill mix and multi professional & multi disciplinary working
• Leadership from LDN & MCN, STPs, LWABs

Challenges

• Influx of European & RoW Dentists (PLVE)
• The business of dentistry
• Have we the correct specialties?
• Complexities of change management

Clinical 1- CDT or Hygienist Outside envelope HEI, DH & DGH

Level I - core capitation contract provision Dental Team – Dentist as Leader

(Workforce Development HEE remit)

Community Responsibility contract modules

Smile4Life, Epidemiology, Fluoride progs, Out of hours, Children Centres, care/nursing homes , schools etc.

Level II contract modules E.g. OS, SCD, Endo, Perio, Pros, ortho, etc.

Inside envelope Primary Care Basic Dental Science Clinical 2 -Therapist Undergraduate Postgraduate

Primary Care ACF(CL)

Specialty Training Academia

Dental Core Training

3 Years available

*Rotations in DGH, DH, GDS and CDS

Specialty of General Dental Practice* Recognition Level III Joint Foundation Training

PLVE

Dentist 2 Dentist 1

Educational Pathways to Provide High Quality Care

Workforce Restructuring and Reform Project

• To support Contract reform
• Geographical and demographical need
• Provide equity of HEE funding
• Dental Team with the right skills
• DCPs
• Dentists
• Specialties
• Academics

Stakeholders

This is a great opportunity to do something different!

For Patients For the Profession For the NHS

Thank you for listening