How do current Senior Registrar job profiles relate to proposed Specialist Registrar FTTA posts? Fixed-term training appointments.
The proposed United Kingdom training pathway for Orthodontic Specialist Registrars is now accepted to be of 3 years duration. In the final year, Specialist Registrars will take the Membership in Orthodontics, with the end point of training marked by the award of the Certificate of Completion on Specialist Training (CCST). There will be a predetermined number of fixed-term training appointments (FTTAs), available through competitive entry, which will provide 2 years of additional training and lead to eligibility to apply for a Consultant appointment. The end point of the Specialist Registrar (FTTA) will be marked by the Intercollegiate Specialty Examination (ISE). The current 3-year Senior Registrar orthodontic training will be reduced to 2 years as the transition to the Specialist Registrar FTTA grade occurs. In the light of these changes, a survey of full time NHS Senior Registrar posts was carried out to examine current job profiles with particular reference to their suitability for assimilation into the Specialist Registrar (FTTA) grade and preparation for the ISE. (+info)
New contracts for specialist orthodontic practitioners?
This paper discusses the possibility of new forms of contacting or commissioning emerging between UK Health Authorities (or other parties such as Primary Care Groups and Primary Care Trusts) and established providers of specialist orthodontic services. (+info)
Action on smoking--opportunities for the dental team.
In 1998, the UK government published a White Paper outlining a comprehensive range of measures to reduce smoking rates across the population. In the same year a detailed overview of the evidence base for smoking cessation activities within the NHS was published. Both these documents provide useful information for health professionals interested in developing their roles in smoking cessation and prevention. An increased risk for the development of oral malignancies and a susceptibility for the breakdown of periodontal tissues are the most significant effects of smoking on the mouth. This paper aims to highlight how dentists and their team members can become actively involved in efforts to reduce smoking. Opportunities at both a clinical and public health level are considered. (+info)
The privatisation of NHS dentistry? A national snapshot of general dental practitioners.
There is a prevalent perception that NHS dental treatment is increasingly difficult to access. In order to access the validity of this perception data on the percentage of private and NHS patients treated by general dental practitioners (GDPs) were analysed. These data were derived from a national survey. The findings showed that GDPs can be divided into three broad groups on the basis of the proportion of patients treated privately or through the National Health Service (NHS). Approximately 50% of GDPs nationally concentrate on NHS dentistry (85% or more of their patients are treated under the NHS); 25% treat more than 70% of their patients privately; the remaining minority of practitioners fall between these two positions treating moderate proportions of both private and NHS patients. Regional differences also exist in the payment systems chosen by GDPs. The median percentage of private patients per dentist varies widely by area being around 50% in the South East and South West, 30% in London, 20% in the West Midlands and Eastern counties and less than 10% elsewhere. In a multivariate regression GDP characteristics were also significant in explaining the median percentage of private patients per GDP The findings add to widely held concerns about access to NHS dentistry, though suggest that problems may be limited to certain areas of the United Kingdom. (+info)
Capitation registration and social deprivation in England. An inverse 'dental' care law?
OBJECTIVE: To examine associations between NHS child dental registration data and area deprivation scores of English Health Authorities (N= 100) in 1996/97 and 1997/98. METHOD: The Department of the Environment index of local conditions and the Jarman Underpriviledge Area Score from the 1991 census were used to measure deprivation. Prior to September 1997, children got free dental treatment under a capitation scheme with an NHS dentist. If they did not attend within 24 months their registration lapsed on the last day of December of the second registration year and they were deleted from the capitation list. After September 1997 the registration period was reduced to 15 months. OUTCOME: Curve-linear regression of the Health Authority (HA) percentage of children registered, lapses in capitation registrations and deprivation scores. RESULTS: In England 68% of children were registered in December 1996. The percentage registered in each Health Authority was associated with deprivation (DoE, r2=0.33, Jarman, r2=0.27 p<0.01). In January 1997, 17.8% (1,345,142) of children registered lapsed (HA range 12.8% to 30.3%) and this was also significantly associated with deprivation (DoE r2=0.66, Jarman, r2=0.51 p<0.01). Similar results were found in 1997/98. CONCLUSIONS: Registration and lapse rates were significantly associated with social deprivation confirming that there is an inverse 'dental' care law for children in England. NHS capitation may widen dental health inequalities. (+info)
The role of team dentistry in improving access to dental care in the UK.
The role of professionals complementary to dentistry (PCDs) in improving access to NHS primary dental care is discussed. The pattern of under-supply of dentists in poor socio-economic areas is highlighted and identified, in drawing a parallel to the workings of primary medical teams, as a possible area where PCDs could be used. (+info)
Inequalities in availability of National Health Service general dental practitioners in England and Wales.
AIM: To model the inequalities in availability of National Health Service general dental practitioners in England and Wales in relation to key socio-demographic factors. METHODS: Current estimates of the numbers of NHS general dental practitioners for each health authority were related to data from the 1991 census using Poisson regression models, and generalised estimating equations to allow for correlation between results for neighbouring health authorities. RESULTS: An 'average' health authority, without a dental school, would be expected to have 2,138 residents for every NHS dentist. Controlling for relevant factors, health authorities with higher proportions of the following are associated with lower (better) population to dentist ratios by the amounts shown: each 1% higher female population (-11.8%; 95%CI -19.1%, -3.9% P = 0.004); each 1% greater South Asian population (-1.4%; 95%CI -2.1%, -0.7% P <0.001). A health authority with a dental school is associated with a more favourable ratio compared with one without such a facility (-9.2%; 95%CI -16.2%, -1.6% P = 0.019). Each additional 1% of the following are associated with a worse ratio by the amounts shown: children aged 0 to 14 years old (+5.2%; 95% CI +2.4%, +8.1% P < 0.001); adults aged over 65 years old (+2.8%, 95%CI +1.0%, +4.7% P =0.002); households without a car (+0.8%; 95%CI 0.0%, +1.6% P =0.042). CONCLUSIONS: Ensuring access to dental care may be a more complex issue than simply providing adequate numbers of dentists at a national level. Any manpower planning exercise should additionally consider local factors that may act as incentives or disincentives to those professionals who provide care. (+info)
'What do our patients really want from us?': Investigating patients perceptions of the validity of the Chartermark criteria.
BACKGROUND: The 'restructuring' of the NHS over the last decade has demanded a 'market oriented' service more receptive to the needs and priorities of 'clients'receiving health care. These changes have been important to the provision of dental health care in which there has been a similar need to provide increasingly patient and market oriented services. One of the ways in which quality care has been assessed within NHS Trusts is through the national 'Chartermark' award, which identifies national centres of excellence in health care and research. AIM: The aim of this paper is to assess whether patients themselves considered the criteria identified by the Chartermark award important in the provision of good quality dental services METHOD: This is a pilot study consisting of a structured questionnaire conducted face-to-face with a 'convenience' sample of 46 patients. ANALYSIS: Data were inputted into SPSS and thematic analysis was conducted on the data. RESULTS: The Chartermark criteria relevant to patient involvement were divided into four main themes.The findings from this small pilot study suggest that in relation to dental care, although patients are interested in information on standards, performance and complaints, there is considerable disinterest in organisational and financial dimensions. (+info)