| 5.1
Provision of Services |
| 5.1.1 Health
boards are responsible for ensuring the overall provision
and availability of NHS dental services to meet the needs
of the population. Most dental care and treatment is
given in the General Dental Service (GDS) by independent
dentists who are contractors to the NHS. The Community
Dental Service (CDS), made up of dentists employed
directly by the NHS, carries out screening of the oral
health of children, monitors local oral health,
undertakes oral health promotion, and gives treatment to
patients who cannot get access to the GDS. The Hospital
Dental Service (HDS) sees patients referred by dental or
medical practitioners and provides advice and specialist
care. Hospital and community dental services are usuallly
provided by Trusts through contracts with health boards.
Health boards may also employ salaried dentists if this
is necessary to ensure adequate access to GDS services in
an area. |
| 5.1.2 The
Government has confirmed its intention, set out in the
recent consultation paper "Improving NHS
Dentistry"(10), to introduce in the longer term a
purchaser/provider approach into the general dental
service, in order to enable health boards to make
decisions locally about provision of services. Under this
approach the various arms of the dental service will be
developed to complement each other and to interact more
closely with other services to provide comprehensive oral
health care services. Health boards should be able to
make local decisions about where services should be
provided and how to allocate resources for oral health
care within their area. |
| 5.1.3 The
dental profession plays a vital role in achieving oral
health by diagnosing and treating the needs of their
patients. As the oral health of large numbers of people
improves, dental services will be targeted increasingly
towards those whose oral health is still poor or is at
most risk. General dental practitioners should be
encouraged to give priority particularly to the oral
health of children by registering them early, encouraging
regular attendance and providing appropriate preventive
care and treatment. The arrangements under which dentists
provide dental services will be developed to ensure that
they encourage dentists to give their patients all
necessary care and treatment. |
| |
| 5.2
Manpower |
| 5.2.1 At 30
September 1994 there were 1,757 general dental
practitioners (including 28 employed by health boards as
salaried dentists) on health board dental lists in
Scotland. This amounted to 36 general dental
practitioners for every 100,000 people - the ratio varies
between health boards from 20 to 41. The equivalent of
around 230 full time dentists were employed within the
CDS, and over 190 full time equivalent dentists within
the HDS. There were also around 600 full time equivalent
dental auxiliaries employed within the community and
hospital dental services. General dental practitioners
may also employ auxiliaries, but these are direct
employees of the dentist and no information is held
centrally on the numbers. |
| 5.2.2 The
recently published Nuffield Report on auxiliary dental
staff makes wide-ranging recommendations about the
training and role in the future of auxiliary staff in
dentistry. The Report concludes that changes in the
present mix of skills within dentistry and a greater use
of suitably qualified auxiliary staff would deliver oral
health care more effectively and with better value for
money. The implications of these recommendations are
currently being discussed within the profession. |
