Dental hygienist and dental therapist approval of exemptions legislation

Our clinical Board member, Fiona Sandom, shares her thoughts on the dental hygienist and dental therapist approval of exemptions legislation.

In May 2013, dental hygienists and dental therapists were allowed by the GDC to see patients directly without the need to see a dentist. This was a massive step forward for our profession, and we celebrated. However, this joy was short lived as we discovered that the GDC may allow permitted duties, there are other rules and regulations that govern dentistry.

In our case, it was the NHS Rules and Regulations regarding the opening and closing of NHS courses of treatment, the Human Medicines Regulations regarding prescription-only medicines and IRMER regarding reporting on films. So, the task of addressing these issues began!

As President of British Association of Dental Therapist (BADT) at the time, I began looking at the barriers to Direct Access, looking at the potential solutions and speaking to a verity of people who may hold some of the resolutions. Education and training were delivered, and the profession began to understand that we had been given a length of rope that could potential strangle us in regulation unless we quickly learned to work within the parameters.

In January 2014, the Chief Profession Officer invited several stakeholders to the initial Medical Mechanisms Project meeting. Here all the invited professions made their case as to why they should be included in the project to apply for a suitable mechanism to supply and administer medicines. In attendance was Michaela O’Neill, the President of the British Society of Dental Hygiene and Therapy (BSDHT), who like me had been working on the barrier to direct access for dental hygienists and dental therapists. It was at this meeting we realised that we had very similar goals and were working in comparable ways and decided that working together and pooling our resources and knowledge would be more efficient and productive.

Following this meeting Dental Hygienists and Dental Therapists were placed in the first cohort of professionals to apply to have additional mechanisms for supplying and administering prescription only medicines.

The work began in earnest to develop a proposal for the administration and supply of medicines under exemptions within schedule 17 of the Human Medicines Regulations (2012) by dental therapists across the United Kingdom and a proposal for the administration and supply of medicines under exemptions within schedule 17 of the Human Medicines Regulations (2012) by dental hygienists across the United Kingdom.

Fast forward 10 years, several policy documents, case studies, impact assessments, meetings, consultations, Brexit, several changes within Government and a Global Pandemic all provided barriers to the project reaching completion. However, due to the current dental crisis in the UK and the drive by the Department of Health and Social Care and NHS England to open access to NHS dental care to patients by increasing the use of skill mix, there has been a sudden turnaround to address the issues of opening and closing NHS courses of treatment, by allowing dental hygienists and dental therapists “Personal Identifying Numbers” in England and Wales. The final piece of the direct access puzzle: the ability to supply and administer certain prescription-only medicines, so that we can treat our patients in a pain free manner they require as well as apply preventive medicaments to reduce their burden of disease.

So, now all that is required for dental hygienists and dental therapists to use the exemption mechanism is education and training around the use of the mechanism, not the ability to administer these medicines as this has been in the scope of dental therapists since 1963 and dental hygienists since 1992. Once this is available, then we will truly be able to see patients, via direct access.

Notice to dental therapists and dental hygienists (gdc-uk.org)

Posted by Gemma