Firm foundations for NHS dentistry
 

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Firm foundations for NHS dentistry

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Firm foundations for NHS dentistry

 

Firm foundations for NHS dentistry

John Milne, by his own admission, is one of life's fighters – as anyone who has heard the tales of his rugby-playing days will attest.

It's just as well, considering that he's head of the General Dental Practice Committee (GDPC) at a time when the profession, arguably more than ever, needs someone who can roll with the punches.

He's well-equipped to battle for the profession, having spent many years working at the sharp end of NHS dentistry. Fully acquainted with the difficulties of providing quality care against the backdrop of a troubled NHS, he is a vocal advocate of the need for positive reform.

But he's in a diplomatic mood when we sit down to talk about the state of play with primary care trusts (PCTs) and the dental profession.

‘I think there are scenarios where the relationships... aren't good,' he says, when pressed on some of the more emotionally charged responses that have already come out of Dentistry's PCT survey. ‘Of course, we do tend to hear about more negative things than positive at the BDA, but that doesn't mean that more positive stuff isn't taking place either.'

John has acted as a dental adviser for his local PCT for several years and, while his still relatively new role at the GDPC has impacted on the amount of time he can afford that role, it hasn't stopped him coming to a clear conclusion on the way things should be.

‘I'm absolutely certain that the profession and PCTs need to build constructive relationships,' he says.

‘But you must be able to disagree, and the profession needs to be quite clear on that. Dentists know their patients very well, they know how services need to be constructed and delivered for the benefit of their population and, sometimes, there will be some disagreement with PCTs. The relationship needs to be a mature one in which proper discussion can take place – and carry on despite any disagreement.'

He adds, with a wry nod to the problem cases to which I'm referring: ‘I think ideally, that local dental committees and PCTs need to be seeking a win-win situation – rather than one party trying to batter the other into submission.'

It's good to talk
He firmly believes that communication is one of the chief problems where things aren't working well, pointing out: ‘Dental practices may not always be aware of what the priorities of the PCT are in terms of oral health and within its population. Where the communication is poor, it's very easy for all parties to draw the wrong conclusion about the motivation of one another. '

So, is it that simple? Does good communication automatically equate to a productive relationship? As with many things in dentistry, perhaps not quite – but it's a solid foundation from which to start, argues John.

He says: ‘I think openness and honesty are good starting points. I think a good PCT will talk to local practices, will make a personal relationship between the dental lead for the PCT – or maybe even some board members or non-executive members of the PCT.'

Building up that relationship can involve many things, he says, but it doesn't have to be an arduous task. It might take a bit of time – making the effort to visit practices and meet with the local dental committees – but finding out practitioners' concerns and potential suggestions could be invaluable.

‘A wise PCT would ask its practitioners how they feel they can address the issues in a given area,' he says. ‘Perhaps slightly more difficult is asking how they address those issues within the constraints of the current dental contract, but a wise PCT will nevertheless have those sorts of discussions.'

The road to progress
He is hopeful that these discussions will become more common in future. ‘I'm an optimist by nature,' says John. ‘From the GDPC's point of view, I know we're willing to work with the DoH to develop the Steele pilots. We would encourage them to reciprocate and, I think if that happens, we can have a degree of optimism as we go forward.'

For all that, it's still very clear that things are a long way from perfect. So, what can dentists do to improve things with their PCT here and now?

‘Well, there's a chain of things that probably need to happen,' he says. ‘I think it's really important that individual dentists and dental practices have good communications with their own representative organisation. There's a responsibility for local dental committees and local practices to communicate well with one another.

‘If the PCT aren't doing it well enough from their end, the dentist perhaps needs to be proactive. My advice is: don't be afraid to pick up the phone!'

The British Dental Association (BDA) itself is also coming round to the idea that it needs to be more proactive when it comes to dealing with PCTs, he says. The report published just last week by the Local Commissioning Working Group (see the front page for more details) is a case in point.

He says: ‘Rather than wait for things to happen, we want to make it easier for PCTs to get local commissioning right, so that it works for the benefit of the patients and dentists – because those two things come together.

‘We recognise that, because services are being developed with a much greater emphasis on local needs and local provision, it's mutually advantageous for PCTs, dental practices and LDCs (as the local representatives) if there's a constructive relationship between the parties. The GDPC, under the umbrella of the BDA, is keen to promote that.'

He is certainly hopeful that things can get better – although he's not getting carried away just yet. ‘It's certainly not good for either party if there's no discussion,' he says. ‘But, of course, it does take two to tango!'



If you haven't already, please take a minute to complete our PCT survey – either by sending in this form or completing it online.

Simply click here to have your say in our online survey.

The response so far has been phenomenal – and emotive, with staggering tales of good and bad experiences coming to light. But we still need more if we are to provide the chief dental officer with compelling evidence. Your opinion matters – even if you think your PCT is ‘just OK', we want to know. Every single response is crucial to the cause. So please, take a minute, and have your say.


 Posted on : Mon 19th - Oct - 2009

 

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