NEWS DIGEST


GDC gives green light for direct access DENTAL hygienists and therapists will now be able to offer


treatment without a prescription or patients having to see a dentist first under new GDC rules. The decision to remove the barrier to direct access for some dental care professionals was made following a GDC consultation and full discussion of the evidence at a Council meeting in March. Under the changes, dental hygienists and therapists can now carry out their full scope of practice without prescription and without the patient having to see a dentist first, but the guidance makes clear that they must be confident that they have the skills and competences required to treat patients direct. The GDC believes that a “period of practice working to a dentist’s prescription is a good way for registrants to assess this”. Also under the new rules, dental nurses will be allowed to participate in preventative programmes, and orthodontic therapists will be able to carry out index of orthodontic treatment need (IOTN)


Weekend surgery more risky MORTALITY rates assessed in a


review of elective surgery were 82 per cent higher in procedures performed over the weekend rather than on a Monday. These are the findings of a new study published by the BMJ. Researchers at Imperial College London


looked at over four million elective procedures conducted in NHS hospitals in England between 2008 and 2011 and found that the mortality rate was lowest for patients having operations on Monday and increased for each subsequent day of the week. The odds of death were 44 per cent


higher for operations on a Friday rather than a Monday and rose to 82 per cent for those performed over the weekend – though the relative number of weekend operations was small and may represent a different mix of patients. The authors of the study suggest the findings could reflect differences in the quality of care at the weekend. Lead reseacher Dr Paul Aylin of the School of Public Health at Imperial said: “The first 48 hours after an operation are often the most critical period of care for surgery


● FEVER IN CHILDREN Febrile children with tachycardia should be considered to be at “intermediate risk” at least for serious illness, according to updated NICE guidance, which also provides greater clarity on the use of paracetamol and ibuprofen


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screening without the patient having to see a dentist first. Clinical dental technicians will continue to see patients direct


for the provision and maintenance of full dentures only and will otherwise carry out their other work on the prescription of a dentist, but this decision could be reviewed in future given the potential for further training for CDTs. The work of dental technicians (other than repairs) will continue to be carried out on the prescription of a dentist. GDC chair Kevin O’Brien said: “Registrants treating patients direct


must only do so if appropriately trained, competent and indemnified. They should also ensure that there are adequate onward referral arrangements in place and they must make clear to the patient the extent of their scope of practice and not work beyond it.” The move has been condemned by the BDA’s General Dental


Practice Committee who said the decision “fails to promote the concept and value of the dental team, which we believe is integral to the delivery of safe, high-quality care for patients.”


differences in mortality rates are due to poorer quality of care at the weekend, perhaps because of less availability of staff, resources and diagnostic services.”


Nearly half of GPs risk burnout A RECENT survey carried out by


patients. So if the quality of care is lower at the weekend as some previous studies have suggested, we would expect to see higher mortality rates not just for patients operated on at the weekend, but also those who have operations towards the end of the week, whose postoperative care overlaps with the weekend. That is what we found. “Unlike previous studies, we included


both deaths in hospital and deaths after discharge, so this eliminates a potential bias of counting only in-hospital deaths. We tried to account for the possibility that different types of patients might have operations at the end of the week, but our adjustment made little difference. This leaves us with the possibility that the


in children with high temperatures. The updated guidelines retain most of the original recommendations, including use of the traffic light system to predict the risk of serious illness in febrile children. Access at http://guidance.nice. org.uk/CG160


Pulse has revealed that 43 per cent of GPs are at a high risk of suffering burn out. Over 1,700 GPs were assessed using the Maslach Burnout Inventory tool which was adapted with input from the Royal College of General Practitioners. It contained questions assessing three key areas signalling a high risk of burnout – emotional exhaustion, depersonalisation and a low level of personal accomplishment. The survey found that 43 per cent of


GPs showed a high risk in all three areas and 99 per cent in at least one. Of particular concern was the finding that 97 per cent of GPs do not believe they are “positively influencing other people’s lives or accomplishing much in their role”. Doctors who suffer from burnout should seek help before patient safety is compromised, says MDDUS medical adviser Dr Barry Parker. “While doctors are caring for patients,


● UK ORGAN DONATION RISE Organ donations in the UK have increased by nearly 50 per cent in the last five years according to statistics released by NHS Blood and Transplant (NHSBT). The number of deceased organ donors increased from 809 in 2007/8 to


1,212 in 2011/12 while total organ transplants from deceased donors increased 30.5 per cent from 2,385 in 2007/8 to 3,122 in 2011/12. The findings mean that the target of a 50 per cent rise in organ donors set by the Department of Health’s Organ Donation Taskforce


SUMMONS


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