Round table
Access points O
How has Direct Access affected dentists, DCPs and patients in Scotland? Seven dental professionals joined Bruce Oxley to debate progress so far… and what the future holds
n ı May 20ı3, Direct Access was introduced by the General Dental Council as a direct result of a report by the Office of Fair Trading
and following support for the proposals from the Westminster Government. The decision, which effectively removed
the restriction for some DCPs to treat patients without the prescription of a dentist, was met with equal parts enthu- siasm and scepticism within the profession. Proponents saw it as recognition of DCPs’ ability and training, while others expressed concerns, not least the British Dental Association (BDA), which said the GDC’s decision was “misguided and undermines best practice in patient care”. Nearly ı8 months after the restrictions
were removed, how has Direct Access affected dentists, DCPs and patients in Scotland? Scottish Dental brought seven dental professionals together to discuss their experiences of Direct Access in practice, as well as what they see as the potential stumbling blocks to wider acceptance.
28 Scottish Dental magazine As a dual-qualified hygienist/therapist,
Lorraine Keith nailed her colours to the pro camp early on, pointing out that her students follow the same intended learning outcomes as BDS students. She said: “I know that, through these intended learning outcomes, we are meeting the criteria that will more than adequately provide the education and enough experience for a hygienist/therapist to undertake Direct Access within their scope of practice.” Carol Clark, who has two Direct Access
clinics within dental practices in Tayside, indicated that although she has relished the challenge of setting up on her own, her years of experience have been invaluable. “If I was newly qualified, I think I might
have thought that I have bitten off more than I could chew,” she said. “I think my experience has definitely
helped and it has opened up new doors for the dentists I’m working with as well. If a patient doesn’t have a dentist, I can strike up that conversation with them.” Carol explained that of ı30 patients currently on her books, only ı0 weren’t
registered with a dental practice when they came to see her. She has managed to encourage eight of those to register with a practice and the two remaining are severely dental phobic, but she has hopes of convincing them in the future. And, while many dentists have started
referring to her, she is still encountering some resistance from practices. She said: “I’m not trying to take business away from the dentists with hygienists – that’s not my remit. I just want to give an option, another service for the patient.” However, the lack of referrals is not
the only stumbling block. “Even buying emergency drugs is an issue,” said Carol. “Because I am not a dentist, I can’t buy
emergency drugs. I also tried to refer a patient to Dundee Dental Hospital and I was told that they didn’t think that I could do that.” Margaret Ross, senior lecturer for
dental care professionals at the University of Edinburgh, replied that she certainly should be able to. “So there are all these things that have to
be ironed out,” said Carol. “Because it is a bit unfair. The patient had to write a report out and then his dentist referred him to Dundee Dental Hospital. “There just has to be a lot more clarity
of what we can and cannot do and how we put the patients first.” Edinburgh dentist Stuart Lutton said that, while he can see the positives in
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