Title: 0124 - Training Opportunities to Support Skill-Mix Development in General Dental Practice?


Jonathan Cowpe (Presenter)
cardiff university

Alison Bullock, Cardiff University
Emma Barnes, Cardiff University
Ivor Chestnutt, Cardiff University
Kirstie Moons, Dental Postgraduate Section, Wales Deanery
Wendy Warren, Aneurin Bevan University Health Board
David Hannington, Dental Postgraduate Section, Wales Deanery
Michael Allen, Aneurin Bevan University Health Board
Ceri Negrotti, Dental Postgraduate Section, Wales Deanery
Susan Bale, Aneurin Bevan University Health Board


Objectives: Despite recent policy changes regarding the role of Dental Therapists (DTs) (including extension of duties, direct access) and increasing acceptance of their role, skill-mix development in general dental practice (GDP) has progressed slowly. This study explored real-world use of skill-mix to better understand what helps or hinders teamwork in practices both with and without a DT.

Methods: We undertook six case studies of NHS GDPs in South Wales, UK. Three employed a DT (with-DT), three did not (without-DT). We conducted semi-structured interviews with members of the dental teams, either individually or in small groups. Data were transcribed and analysed thematically.

Results: Thirty-eight dental team members were interviewed across the six sites (12 dentists/1 trainee dentist/4 DTs/13 dental nurses/5 practice managers/1 dental hygienist/2 receptionists). The six case studies operated diverse models of skill-mix. Reasons for not including a DT in the skill-mix in without-DT practices included funding, concern over initial disruption in routine, and lack of knowledge of how the role would work in their practice: “If we did have a therapist, how would it work?” Factors that influenced teamwork in with-DT practices included knowledge of each other’s role, attitudes toward DTs’ contribution and value, financial and regulatory issues, and patient opinion. Optimised skill-mix was said to lead enhanced job satisfaction and improvement in patient access, and patient satisfaction with their care.

Conclusions: Restrictions around remuneration and scope of practice regulations mean that flexibility, innovation and commitment to a prevention-focussed model of care are essential to make teamwork, and specifically employment of DTs work in practice. Through training and support, dental teams can enhance their understanding of DTs’ role and develop practical processes to facilitate their contribution to patient care in general dental practice. Particularly valuable is educational input on making a business case and setting up referral systems.

This abstract is based on research that was funded entirely or partially by an outside source:
Health and Care Research Wales, project no. 1101

Disclosure Statement:
The submitter must disclose the names of the organizations with which any author have a relationship, the nature of the relationship, and the clinical or research area involved. The following is submitted: NONE