NHS AND PRINICPLES Flashcards
WHAT IS THE CQC
the care quality comission
- provide safe services and encourage care services to improve
- ensure compliance to ensure public has quality care
- helps mantain trust and reputation of the dental profession
AGP’S
- aerosol generating procedure
- can be produced from scalars and polishers when in air harmful
- PPE to prevent this
- extraction
- PATIENT FIRST - gdc
WHAT IS THE NICE
- national institute for health and care excellence
- provides treatment guidelines, sets quality standards for dental care and gives public guidance
GDC
general dental council
- protect patient safety and maintain public confidence in the profession
-9 principles
NHS vs private
nhs
- Affordable treatment – NHS charges are banded, making it much cheaper than private care.
- Access to essential care – Covers necessary treatments like fillings, root canals, and extractions.
- Regulated standards – Ensures a consistent level of care across all NHS practices.
- Support for vulnerable groups – Some patients (e.g., under 18s, pregnant women, low-income individuals) qualify for free treatment.
cons
- Long waiting times – Many NHS dental practices have waiting lists, especially for new patients.
- Limited treatment options and tech– Cosmetic procedures like whitening and white fillings on back teeth are not covered.
- Strict guidelines – NHS dentists must follow regulations, sometimes limiting treatment choices.
- Appointment availability – Shorter appointment slots and limited flexibility compared to private care.
NHS BANDS
band 1 (£26.80) (x-rays, examinations, scaling and polishing)
band 2 (£73.50) (fillings, root canal treatment, extractions)
Band 3 (£319) (all of the above, dentures, crowns, bridges)
pros to free band 1:
- preventative care - oral cancer checkups, prevention of further complications detecting plaque build up or stage 1 gum disease (gingivitis)
- removes financial barrier to health
- allows access for all (NHS MORAL) - elderly, financially struggling
dental hygenist
- maintaining good oral care
- how to keep teeth and gums clean and healthy
- scaling polishing
- fluoride treatments
dental therapist
- oral health
- carry out some work like baby tooth extractions, fillings)
traffic light system
- aimed to focus on preventative care
RED = requires intervention and more care
AMBER = benefit from treatment so encouraged to enquire
GREEN = health is good and to continue what they’ve been doing
NHS Values
1) working together for patients
2) respect and dignity
3) commitment to quality care
4) compassion
5) improving lives
6) everyone counts (no discrimination in the team or to patients)
current Challenges in dentistry
1) limited funding and budget cuts - reduced staff, limited resources - so longer waiting lists = lower patient satisfaction and patient experience - nhs staff aiming to meet their units of dental activity - so more stress
2) hard to find an NHS dentist - LESS access those from less wealthy backgrounds - widening the gap and health for those in different socioeconomic backgrounds
3) diet issues - increased dental caries so more emergency appointments - pressure on resources
4) social media - expect whiter straighter perfect teeth - creates standards for nhs care which may not be possible
sugar tax
- intro’d in 2018 to reduce obesity levels
8g/100ml = 24p
- reduce obesity, reduce caries and no. sugar related diseases
pros: counteracts obesity, proven to work in other countries such as mexico, encourages reduction of sugar in food to avoid charges
cons: lack of autonomy to chose, nanny state, healthy food is more spenny
introduce: portion control or better education
What do you think about patient’s access to care within the NHS system?
- long waiting lists
- no nhs dentist nearby
- not taking on new clients due to COVID backlog
- nhs dentists get a 15-50 pound new patient bonus
- dental vans
- opening up practices in poor access to nhs care areas = £20,000 bonus
What are the most common dental conditions treated under the NHS ?
cavities - use fillings
gum disease - scaling and root planning
braces - dental alignment
early detection of oral cancer
Why are nhs dentists and patients leaving to go private?
DENTISTS
pay is low compared to work being done
- uda system is putting dentists under stress
- greater clinical freedom
- spend more time w patients and build stronger relationships
PATIENTS
- better tech - less invasive more comfy
- working hours - weekends late hours - convenient
- cosmetic dentistry
- assumed better quality treatment - more specialists - better equipmeny
How has brexit affected uk dentistry?
- workforce from areas such as norway and iceland
- delays in dental equipment & material imports
- treatment prices higher due to increasd operational costs
strains the NHS - longer waiting times
more dentists shifting to private
Do you think that all dentists should be obliged to work in the NHS?
PROS
- taxpayers invest in training dentists
- gain good experience whilst benefitting patients
- address the shortage of NHS appointments
CONS
- reduces professional freedom
- reduces earning potential
- discourage those from entering the profession
- burnout
solutions:
- increasing nhs funding for dentistry
- incentives for nhs work ( student loan forgiveness, bonuses or tax breaks)
- split time between NHS and Private
How has Covid 19 impacted dentistry?
- increased waiting lists
- overall health decline affecting the oral cavity ie diabetes, untreated issues (tooth decay, broken tooth, toothache and overall moth pain)
- worried about catching covid
- some practices not accepting new patients due to covid backlogs
- financial impacts on dental procedures (had to close or increase to stay afloat)
- fallow time - increased waiting lists
What are some barriers to oral health?
language:
- can’t build rapport
- anxiety
- miscommunication
- hard to gain consent
- risk of litigation
access:
- LOCATION and opening hours
- bariatric chairs restrict certain weights and heights
- lift access
-waitlist times
cultural:
- beliefs in homeopathic medicine
- gender of dentist
- lack of cultural sensitivity
cost:
- cant afford treatments
- UDA bands
anxiety
- phobias (previous dental trauma)
- longer appointments
- missed appointments
Do you think all NHS dental appointments should be free?
PROS:
- fairness for all socioeconomic background
- more willing to visit for general checkups if free - improve the nations dental health
- reduces health inequality which is already a prevalent problem
- good oral health =related to other co-morbidities - can reflect on overall health - save general costs
- GP appointments are free why not dental check ups?
CONS
- expensive to upkeep free funding
- prevents people from booking unnecessarily
- was initially free - racked up high costs - compromise formed
solutions:
- charging for missed appointments
- virtual appointments for smaller issues
- Expanding NHS-Private Partnerships
- health campaigns for schools and workplaces
How Is A Child Deemed Gillick Competent?
whether a child U16 can consent to their own medical treatment
- How old are they? How mature are they?
- What’s their mental capacity?
- Does the child understand what the treatment entails?
-Has the child understood the advice and information they’ve been given? - Is the child aware of alternative options, if available?
Frasers guidelines
advice can be given to an under 16 about contraception and sexual health without parental consent
- Is the child mature and intelligent enough to understand the nature and implications of the treatment proposed?
- Is it impossible to persuade the child to tell their parents, or let the Doctor tell them?
- Are they likely to begin or continue having sexual intercourse with or without contraception?
- Are their physical or mental health likely to suffer unless they get the advice or treatment?
- Is the advice or treatment in their best interest?
UDAS
dentists are compensated based on Units of Dental Activity (UDAs)
- how dentists are compensated
pros:
- allows access for all, reducing health disparity due to financial concerns
- increased availability for appointments
- reform leads to higher payments for dentists
cons:
- no mention or focus on preventative care (diet and lifestyle)
- shorter appointment times - less comprehensive evaluation - not able to build a patient rapport - impacts on overall patient care - missing through diagnosis
- increased stress on dentists - leaving to go private - increased strain on NHS - longer waiting lists - fewer staff
how would you reform the NHS?
- increased funding for education - in school, at work, advertisments - oral hygeine - prevents dental caries, gum disease and other issues - saves money on expensive dental emergency appointments
- increased workforce
more staff - dental vans - opening practices in areas with low access to oral health - prevent emergency appointments - oral cancer screening - increased tech
disparity between NHS & Priv - long term investment cad & cam
