DOCSLIB.ORG

Education, Regulation, Representation and Remuneration in Dentistry

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Education, Regulation, Representation and Remuneration in Dentistry Education, regulation, IN BRIEF • Elucidates the principal roles of the key boards, committees, associations, GENERAL representation and remuneration societies and councils related to dentistry. • Provides a useful resource for those applying to higher specialist training, in dentistry – who does what? as well as those with an interest in the dental political arena. S. Tabiat-Pour,1 T. Pepper2 and N. L. Fisher3 • Empowers the reader to understand who does what in the business of dentistry. VERIFIABLE CPD PAPER Dentistry in the United Kingdom demands a wide range of supportive and regulative bodies, the roles of which are inter- twined, overlapping and changeable. The interaction between these bodies is not always clear, and often the present-day role of the body is far removed from its original purpose. Consequently, the system can appear daunting and opaque. Even so, a thorough understanding of this topic is requisite for those considering applying for higher specialist training, and pertinent for practitioners with an interest in the dental political arena. We hope this paper goes some way towards unravelling the tangle of boards, committees, associations, societies and councils that commonly influence dentistry, and provides a starting point for those interested in increasing their knowledge of the profession at the strategic level. INTRODUCTION landscape. In the interests of simplicity, not each of whom has areas of responsibility In the current politicofinancial climate, all all detail has been given for each country related to their appointment (for instance, public sector organisations – in particular the of the UK, but wherever possible we have the Parliamentary Under-Secretary of State NHS – are experiencing a period of unprec- outlined the distinguishing factors. for Public Health is responsible for public edented change.1 Within this turbulent and health measures such as fluoridation, while evolving environment is the organisational DEPARTMENT OF HEALTH (DH) the Parliamentary Under-Secretary of State machinery engaged with the day-to-day The Department of Health is the UK gov- for Quality is responsible for dentistry, education, regulation, representation and ernment department with overall responsi- among other things). The DH’s Permanent remuneration of dentists in the UK. However, bility for health and social care in England. Secretary is a civil servant who does not the interaction between these bodies is not The devolved governments of the United play a political role, does not change with always clear, and often the contemporary Kingdom each have their own health governments, and is responsible for the role of the body is disparate from the pur- departments, namely the Department of overall efficient running of the DH. The pose for which it was originally conceived. Health and Social Services (Welsh Assembly majority of healthcare in England is deliv- Despite these difficulties, a thorough under- Government), the Health Directorates (The ered by NHS bodies, and this close link standing of this topic is requisite for those Scottish Government), and the Department between the NHS and the DH is reflected in considering applying for higher specialist of Health, Social Services and Public Safety the fact that the NHS Chief Executive – the training and pertinent for practitioners with (Northern Ireland Executive). While every government’s principal adviser on all NHS an interest in the dental political arena. department is responsible for elements issues – also works for the DH. This paper aims to outline the prin- of its own health policy and service, the There are six chief professional officers cipal roles of the key boards, commit- DH deals with non-devolved matters and working for the Department of Health, of tees, associations, societies and councils issues common to all systems. which the Chief Dental Officer (CDO) is one related to dentistry, as well as the interplay The DH does not deliver care services (the others being Chief Medical, Nursing, between them, in order to confer a broad directly but develops policy according Health Professions, Pharmaceutical and understanding of this somewhat nebulous to decisions taken in Parliament. The Scientific Officers). The CDO is the profes- Secretary of State for Health, a Cabinet sional head of dental staff and provides the 1*Specialist Registrar in Restorative Dentistry, Guy’s appointment, is responsible for the DH and government with expert knowledge on all Dental Hospital, 2Consultant in Restorative Dentistry, Guy’s & St. Thomas’ Hospital NHS Foundation Trust, accountable to Parliament. He or she is matters relating to dentistry in England, as Guy’s Hospital, Great Maze Pond, London, SE1 9RT; appointed by the Crown after nomination well as providing leadership and dissemi- 3Medical student, King’s College London, Guy’s Campus, London, SE1 1UL by the Prime Minister. The Department nating policy to the profession through let- Correspondence to: Ms Sara Tabiat-Pour is led by the various Health Ministers*, ters and CDO Update. Separate CDOs work Email: [email protected] for the devolved governments in Scotland, Refereed Paper *Minister of State for Health, Minister of State for Care Wales, and Northern Ireland. Accepted 9 December 2010 Services, Parliamentary Under-Secretary of State for DOI: 10.1038/sj.bdj.2011.340 Quality (Lords), and the Parliamentary Under-Secretary A series of 25 National Clinical Directors ©British Dental Journal 2011; 210: 431-438 of State for Public Health (also known as tsars) work for the DH. They BRITISH DENTAL JOURNAL VOLUME 210 NO. 9 MAY 14 2011 431 © 2011 Macmillan Publishers Limited. All rights reserved. GENERAL essentially spearhead change, each over- England consists of ten regional§ Strategic independent from SHA and DH control seeing the implementation of a National Health Authorities (SHAs), which hold and represent one element of the govern- Service Framework‡ or strategy for key their local NHS Trusts – Primary Care ment’s decentralisation of public services. health issues (such as cancer or diabetes), Trusts, Acute Trusts, Ambulance Trusts, Approximately two thirds of hospitals or key patient groups (for example, chil- Care Trusts and Mental Health Trusts – to have currently achieved Foundation Trust dren). In this role they also work with the account for their performance. SHAs are status; the g overnment’s aim is for all Royal Colleges to ensure that changes in directly accountable to the DH and NHS NHS Trusts to become Foundation Trusts health and social services are reflected in Chief Executive, and are responsible for by 2013. Foundation Trusts are regulated training and education. developing plans to improve health ser- by Monitor,|| a body that reports directly The future role of the Department vices in their area as well as ensuring that to Parliament and that has been proposed of Health is proposed to feature a radi- DH directives and policy are integrated to become a full economic regulator for cal reduction in NHS functions, thereby into local health service plans. the NHS.1 allowing greater focus on improving At the time of writing, approximately public health.1 80% of the £100 billion NHS budget is NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE (NICE) directly allocated by the DH to primary NATIONAL HEALTH SERVICE (NHS) care trusts (PCTs). PCTs are responsible for The National Institute for Clinical The NHS began operating in July 1948 with assessing the needs of their local population Excellence was established in 19995 with the ambition that ‘Everybody, irrespective and ensuring that there is a comprehensive the aim of promoting clinical excellence in of means, age, sex or occupation shall array of primary care and public health England and Wales and establishing parity have equal opportunity to benefit from services available (for example, dentistry, across regions with regard to the range the best and most up-to-date medical and pharmacy and optician services). PCTs also of treatments available, thereby abolish- allied services available… services should play a large role in commissioning second- ing the so-called postcode lottery that was be comprehensive and free of charge…’.2 ary care. In 2006 their number was reduced apparent at the time. In 2005 NICE merged However, within a few years the cost of from 303 to 152 with the aim of combining with the Health Development Agency6 to providing a fully comprehensive service services and reducing costs. Six of these become the National Institute for Health had soared beyond the Government’s most PCTs are Care Trusts – agreements between and Clinical Excellence – a special pessimistic predictions. In an attempt to the NHS and local authorities resulting in health authority (SpHA, an Arm’s Length mitigate its effect, patient charges were a close relationship between health and Body – see Table 1) of the NHS in England implemented for dentistry, prescriptions, social care. While the services that PCTs only. Its future role will include develop- and spectacles. deliver are all NHS-funded, they may be ing quality standards for adult social care.7 Today the NHS is the world’s largest pub- provided by private companies (for exam- NICE publishes guidance in three areas: licly-funded healthcare service. Although ple, Independent Sector Treatment Centres). health technologies (for example, ozone funded centrally from national taxation, A health White Paper1 proposes to phase out treatment), clinical practice (for example, the devolved administrations manage their PCTs and SHAs by 2013, moving respon- dental recall intervals), and public health NHS services separately.3 Strictly speak- sibility for commissioning the majority of (for example, smoking cessation services). ing, the health service in England solely health services to consortia of GP practices The decisions it makes with regard to its carries the title ‘NHS’, with the other UK (who will likely buy in support from other guidance are intended to be apolitical, being services designated ‘NHS Wales’, ‘NHS organisations, such as local authorities, vol- based entirely on clinical efficacy and cost- Scotland’, and ‘Health and Social Care untary organisations and the independent effectiveness.
Load more

Recommended publications
  • Three Essays on the Behavioral, Socioeconomic, and Geographic Determinants of Mortality: Evidence from the United Kingdom and International Comparisons
    University of Pennsylvania ScholarlyCommons Publicly Accessible Penn Dissertations 2016 Three Essays on the Behavioral, Socioeconomic, and Geographic Determinants of Mortality: Evidence From the United Kingdom and International Comparisons Laura Kelly University of Pennsylvania, [email protected] Follow this and additional works at: https://repository.upenn.edu/edissertations Part of the Demography, Population, and Ecology Commons, and the Epidemiology Commons Recommended Citation Kelly, Laura, "Three Essays on the Behavioral, Socioeconomic, and Geographic Determinants of Mortality: Evidence From the United Kingdom and International Comparisons" (2016). Publicly Accessible Penn Dissertations. 1806. https://repository.upenn.edu/edissertations/1806 This paper is posted at ScholarlyCommons. https://repository.upenn.edu/edissertations/1806 For more information, please contact [email protected]. Three Essays on the Behavioral, Socioeconomic, and Geographic Determinants of Mortality: Evidence From the United Kingdom and International Comparisons Abstract This dissertation contains three chapters covering the impact of behavioral, socioeconomic, and geographic determinants of health and mortality in high-income populations, with particular emphasis on the abnormally high mortality in Scotland, and the relative advantages of indirect and direct analyses in estimating national mortality. Chapter one identifies behavioral risk factors underlying mortality variation across small-areas in Great Britain, using the indirect estimation
    [Show full text]
  • The Four Health Systems of the United Kingdom: How Do They Compare?
    The four health systems of the United Kingdom: how do they compare? Gwyn Bevan, Marina Karanikolos, Jo Exley, Ellen Nolte, Sheelah Connolly and Nicholas Mays Source report April 2014 About this research This report is the fourth in a series dating back to 1999 which looks at how the publicly financed health care systems in the four countries of the UK have fared before and after devolution. The report was commissioned jointly by The Health Foundation and the Nuffield Trust. The research team was led by Nicholas Mays at the London School of Hygiene and Tropical Medicine. The research looks at how the four national health systems compare and how they have performed in terms of quality and productivity before and after devolution. The research also examines performance in North East England, which is acknowledged to be the region that is most comparable to Wales, Scotland and Northern Ireland in terms of socioeconomic and other indicators. This report, along with an accompanying summary report, data appendices, digital outputs and a short report on the history of devolution (to be published later in 2014), are available to download free of charge at www.nuffieldtrust.org.uk/compare-uk-health www.health.org.uk/compareUKhealth. Acknowledgements We are grateful: to government statisticians in the four countries for guidance on sources of data, highlighting problems of comparability and for checking the data we have used; for comments on the draft report from anonymous referees and from Vernon Bogdanor, Alec Morton and Laura Schang; and for guidance on national clinical audits from Nick Black and on nursing data from Jim Buchan.
    [Show full text]
  • Same Difference a Comparison of International Health Systems England • U.S
    SAME DIFFERENCE A COMPARISON OF INTERNATIONAL HEALTH SYSTEMS ENGLAND • U.S. • GERMANY INTRODUCTION ........................................................................................................................01 HEALTHCARE IN ENGLAND, THE U.S. AND GERMANY ....................................................02 THE CHANGING ENVIRONMENT .................................................................................. 08 COMMISSIONING RESPONSES .................................................................................. 13 CASE STUDY: UK........................................................................................................ 15 CHANGING CARE MODELS: PROVIDERS .......................................................... 16 CASE STUDY: U.S. .............................................................................................20 CHANGING CARE MODELS: PRIMARY CARE ............................................22 TECHNOLOGY ..........................................................................................24 CASE STUDY: GERMANY .....................................................................26 CONCLUSION ..................................................................................28 UNDERSTANDING THE TERMS WE USE ...................................30 REFERENCES ............................................................................ 31 PRODUCED BY THE BDO CENTRE FOR GLOBAL HEALTHCARE EXCELLENCE & INNOVATION NOVEMBER 2016 A COMPARISON OF INTERNATIONAL HEALTH SYSTEMS | SAME DIFFERENCE 01 INTRODUCTION
    [Show full text]
  • Dental-Service-Spec-Prisons-2020.Pdf
    Service specification Dental service for prisons in England 2020 NHS England and NHS Improvement 1 NHS England and NHS Improvement Publishing Approval Reference: 001181 Contents 1. How to use this document ................................................................................... 3 2. The model ............................................................................................................ 4 3. Introduction .......................................................................................................... 7 4. Guiding principles ................................................................................................ 8 5. Core service delivery ......................................................................................... 11 5.1 Service vision .................................................................................................. 11 5.2 Days and hours of operation ........................................................................... 13 5.3 Service availability ....................................................................................... 13 5.4 Inclusion criteria .......................................................................................... 14 5.5 Exclusion criteria ......................................................................................... 14 5.6 Equivalence for services in prisons ............................................................. 14 5.7 Setting ........................................................................................................
    [Show full text]
  • Accessing Healthcare in Other Countries of the European Economic Area by the S2 (E112) Route
    Accessing Healthcare in England If you are registered with a general practitioner in Scotland then you are entitled to free NHS care arranged by NHS Scotland. Generally that care will be provided as close to home as possible and within your own NHS Board area but care may be provided elsewhere in NHS Scotland if that is clinically necessary. NHS England runs a different financial system involving internal charging between “providers” (NHS Trusts) and “commissioners” (NHS Primary Care Trusts) for health care services. Residents of Scotland who are registered with a GP in Scotland will always be entitled to emergency care anywhere in the UK but are not automatically entitled to access elective (planned) NHS care in England as NHS providers will expect to invoice NHS Scotland for providing that service. Before providing elective services to patients registered within NHS Scotland, a provider Trust is therefore required to obtain advance financial consent from the relevant NHS Scotland Board. Where a patient wishes to access routine healthcare in England for social reasons such as studying or working in England or staying with relatives for a period longer than a normal holiday then we would strongly recommend that the patient registers with a local general practitioner in England which will entitle them to access their routine NHS care including community services from NHS England. Where it is necessary for clinical reasons to refer a patient to a specialist service in England because that service is not available in NHS Scotland then this is usually funded through national agreements managed by NHS National Services Division in Edinburgh.
    [Show full text]
  • Quality in the New Health System ‐ Maintaining and Improving Quality from April 2013
    Quality in the new health system ‐ Maintaining and improving quality from April 2013 A draft report from the National Quality Board Final Report, January 2013 3 Contents Foreword 1. Introduction 6 2. Our common purpose 13 – improving quality and delivering better outcomes 3. Our shared values and behaviours 21 – putting patients and service users first 4. Our distinct roles and responsibilities for quality 25 5. How we will work together to maintain quality 51 – spotting the early signs of failure – judging when there has been a quality failure – responding when things go wrong 6. Making it happen 57 4 Foreword The Health and Social Care Act 2012 is fundamentally changing the way the NHS, public health and care system in England is organised and run. Over the past two years, there has been much debate about these changes. This debate has often been emotive, polarised and technical in nature, and the focus on quality has tended to be implicit rather than explicit. Yet improving the quality of care for patients and service users is the driving force behind these changes and is what unites us around a common purpose. The NHS is organising itself around a single definition of quality: care that is effective, safe and provides as positive an experience as possible. This simple, yet powerful definition that arose out of the NHS Next Stage Review has now been enshrined in legislation. It lies at the heart of the first ever NHS Outcomes Framework and continues to help unite the ambitions and motivations of staff with the hopes of patients and the expectations of the public.
    [Show full text]
  • Investigating What the UK Can Learn from the French Model of Healthcare Funding
    Investigating what the UK can learn from the French model of healthcare funding November 2018 Thomas Mills The UK is reaching a healthcare funding crisis. The population is ageing and there is strong demand for a process of modernisation.1 But the finances to ameliorate these problems are not available. The UK funding model cannot keep up with the financial demands of quality universal healthcare.2 Yet the system remains without serious proposals for reform. This report seeks to understand the ways in which healthcare in the UK is failing and how the method of funding may be responsible. The weaknesses of the oft-referenced US model should not stand as confirmation of the pre- eminence of the government-controlled system. The shortcomings of the American structure should serve only as a warning against shifting the majority of funding responsibility to the private sector. This comparison obscures the fact that an abundance of European nations have rejected the notion that universal healthcare must be funded through taxation. A significant number of countries with universal healthcare avoid using direct, unhypothecated taxation as their core funding mechanism. This includes Germany, Switzerland, the Netherlands and France. And given its similarities to the UK in foundational principles and domestic appreciation for the respective system, as well as its relative strengths, France shall be the nation under review. After exploring the key mechanisms, analysis will turn to the merits and drawbacks of the model. This will aid in assessing whether elements of the French healthcare funding system are suitable and effective enough to implement in the UK.
    [Show full text]
  • Imagine, a World Without DIS-EASE Is It Possible?
    Imagine, A World Without DIS-EASE – Is It Possible? Mark S. Grenon Imagine, A World Without DIS-EASE Is It Possible? Mark S. Grenon Volume One Copyright © 2018 Mark S. Grenon All rights reserved. ISBN-13: 978-1727749144 ISBN-10:1727749146 Imagine, A World Without DIS-EASE – Is It Possible? Mark S. Grenon In LOVING Memory of Bishop David “Maverick” Glover for his help and dedication to creating “a world without dis-ease”! Imagine, A World Without DIS-EASE – Is It Possible? Mark S. Grenon 100% of the proceeds from this book will be donated to the Genesis II Church of Health and Healing to support its workers and support official G2 Projects around the world to help create, “a world without dis-ease.” REAL SCIENCE: We at the Genesis II Church of Health and Healing have been involved in one of the most comprehensive, worldwide, cross cultural, broad spectrum, voluntary, human health studies of this world for the past 8 years. If you include Jim Humble and his studies in Africa, it has been almost 20 years. 95% of the world's diseases have been CURED with the Genesis II Church Protocols! No monies were received from any pharmaceutical/medical companies wanting a certain result. The people of this world who have followed the G2C protocols have not been paid in any way, but they have “self-dosed” themselves voluntarily. “Self-Care” is what is being taught and encouraged by the Genesis II Church worldwide and it is working incredibly well. Every person on this earth has the God-given right to control their own health and not rely on the pharmaceutical/medical industry.
    [Show full text]
  • NHS Long Term Plan (Pdf)
    Long-Term Plan Long-Term Plan Long-Term The NHS Long Term Plan Plan Long-Term Plan #NHSLongTermPlan www.longtermplan.nhs.uk [email protected] www.longtermplan.nhs.uk #NHSLongTermPlan January 2019 The NHS Long Term Plan 3 Contents THE NHS LONG TERM PLAN – OVERVIEW AND SUMMARY 6 CHAPTER 1: A NEW SERVICE MODEL FOR THE 21ST CENTURY 11 1. We will boost ‘out-of-hospital’ care, and finally dissolve the historic divide 13 between primary and community health services A new NHS offer of urgent community response and recovery support 14 Primary care networks of local GP practices and community teams 14 Guaranteed NHS support to people living in care homes 15 Supporting people to age well 16 2. The NHS will reduce pressure on emergency hospital services 18 Pre-hospital urgent care 19 Reforms to hospital emergency care – Same Day Emergency Care 21 Cutting delays in patients being able to go home 23 3. People will get more control over their own health and more personalised 24 care when they need it 4. Digitally-enabled primary and outpatient care will go mainstream 25 across the NHS 5. Local NHS organisations will increasingly focus on population health – 29 moving to Integrated Care Systems everywhere CHAPTER 2: MORE NHS ACTION ON PREVENTION AND HEALTH INEQUALITIES 33 Smoking 34 Obesity 36 Alcohol 38 Air pollution 38 Antimicrobial resistance 39 Stronger NHS action on health inequalities 39 CHAPTER 3: FURTHER PROGRESS ON CARE QUALITY AND OUTCOMES 44 A strong start in life for children and young people 45 Maternity and neonatal services 46 Children
    [Show full text]
  • 70 NHS Years: a Celebration of 70 Influential Nurses and Midwives
    0 A celebration of 7 influential nurses NHS YEARS20 and midwives from 1948 to 18 In partnership with Seventy of the most influential nurses and midwives: 1948-2018 nursingstandard.com July 2018 / 3 0 7 years of nursing in the NHS Inspirational nurses and midwives who helped to shape the NHS Jane Cummings reflects on the lives of 70 remarkable As chief nursing officer for England, I am delighted figures whose contributions to nursing and to have contributed to this publication on behalf of midwifery are summarised in the following profiles, the CNOs in Northern Ireland, Scotland and Wales, and on the inspiration they provide as the profession identifying some of the most influential nurses and Jane Cummings meets today’s challenges midwives who have made a significant impact across chief nursing officer the UK and beyond. for England I would like to give special thanks to the RCNi As a nurse, when I visit front-line services and and Nursing Standard, who we have worked in meet with staff and colleagues across the country partnership with to produce this important reflection I regularly reflect on a powerful quote from the of our history over the past 70 years, and to its American author and management expert Ken sponsor Impelsys. Blanchard: ‘The key to successful leadership today is influence, not authority.’ Tireless work to shape a profession I am a firm believer that everyone in our Here you will find profiles of 70 extraordinary profession, whatever their role, wherever they work, nursing and midwifery leaders. Many of them have has the ability to influence and be influenced by the helped shape our NHS.
    [Show full text]
  • The Four UK Health Systems: Learning from Each Other
    The four UK health systems Learning from each other Author Nicholas Timmins The King’s Fund is an Published by independent charity working to The King’s Fund improve health and health care in 11–13 Cavendish Square England. We help to shape policy London W1G 0AN and practice through research and analysis; develop individuals, Tel: 020 7307 2591 teams and organisations; promote Fax: 020 7307 2801 understanding of the health and www.kingsfund.org.uk social care system; and bring people together to learn, share © The King’s Fund 2013 knowledge and debate. Our vision is that the best possible care is First published 2013 by The King’s Fund available to all. Charity registration number: 1126980 All rights reserved, including the right of reproduction in whole or in part in any form ISBN: 978 1 909029 09 5 A catalogue record for this publication is available from the British Library Available from: The King’s Fund 11–13 Cavendish Square London W1G 0AN Tel: 020 7307 2591 Fax: 020 7307 2801 Email: [email protected] www.kingsfund.org.uk/publications Edited by Anna Brown Typeset by Grasshopper Design Company Printed in the UK by The King’s Fund Contents About the author iv Preface v Introduction 1 Changes since devolution 3 Finance 7 Politics 9 Lessons and opportunities 13 Markets and personal care 13 Targets and public service agreements 13 Data and transparency 14 Health technology assessment 15 Inspection and regulation 15 Public health 16 Workforce and size 16 Integrated care 17 Prescription and car park charges 18 Hospital reconfiguration 19 Management and bureaucracy 20 Conclusion 22 References 24 © The King’s Fund 2013 About the author Nicholas Timmins is a senior fellow at The King’s Fund.
    [Show full text]
  • High Quality Care for All, Now and for Future Generations Welcome by Malcolm Grant, Chair
    OUR 2014-15 ANNUAL REVIEW HIGH QUALITY CARE FOR ALL, NOW AND FOR FUTURE GENERATIONS WELCOME BY MALCOLM GRANT, CHAIR 2 ANNUAL REVIEW 2014-15 NHS England is responsible for the stewardship of £99 billion of public funds to provide comprehensive health and care services available to all, where there is clinical need and regardless of an individual’s ability to pay. We are custodians of the values of the NHS Constitution, committed to putting patients at the heart of everything we do, promoting transparency and accountability of our work to citizens, and ensuring the most efficient, fair and inclusive use of finite taxpayer resources. It is our responsibility to bring about continually improving health outcomes for individuals, communities and society as a whole, by investing the NHS budget strategically to ensure real value for money. Central to our role is the commissioning of health services. We commission some services directly (mainly specialised and primary care services), but allocate the majority of the resources we receive to clinical commissioning groups, who commission services at local level. This annual report describes our second full year of operation. 2014-15 has been a very busy and successful year for us. We have matured as an organisation and begun to deliver real improvements for patients. This report outlines some of our most significant achievements. Of course, we have faced challenges too. Demand for services has continued to increase and we have faced intense pressure on services over the winter. It is in great measure thanks to the dedication and hard work of people across the service that the NHS has continued to maintain such high quality services and care for our patients.
    [Show full text]