The future dental workforce?

Abstract

The Editor-in-Chief of the BDJ has previously raised important questions about dental workforce planning and the implications for dental graduates of recent changes and pressures. It is now time to revisit this issue. Much has changed since the last workforce review in England and Wales, and the rate of change is in all probability set to increase. First, at the time of writing this paper the momentous step of including dental care professionals (DCPs) on General Dental Council (GDC) registers in the United Kingdom has recently been completed. Second, the Scope of Practice of all dental professionals has been under consultation by the General Dental Council, and research evidence suggests that greater use should be made of skill-mix in the dental team. Third, within England, Lord Darzi has just published the 'Final Report of the NHS Next Stage Review', which emphasises 'quality care' and 'team-working' as key features of healthcare; this report was accompanied by an important document entitled 'A High Quality Workforce', in which plans for local workforce planning within the NHS are outlined, placing responsibilities at national, local and regional levels. Fourth, policy makers across the UK are wrestling with addressing oral health needs, promoting health and facilitating access to dental care, all of which have implications for the nature and shape of the dental workforce. Fifth, with the impact of globalisation and European policies we are net gainers of dentists as well as having more in training. Sixth, although there have been reviews and policy initiatives by regulatory, professional and other bodies in support of shaping the dental workforce, there has been little serious consideration of skill-mix and funding mechanisms to encourage team-working. Together, these events demand that we enter a fresh debate on the future dental workforce which should extend beyond professional and national boundaries and inform workforce planning. This debate is of great importance to future generations of dental healthcare professionals, funders, commissioners and providers of both dental services and dental education and training, and most importantly our patients and the public whom we serve. Furthermore, workforce planning must be linked to a philosophy of care which promotes promotion of health and embraces quality care, rather than merely treatment of disease, and addresses oral health needs and demands.

Preparing for the future: challenges and opportunities for management and leadership skills

“…[14][15] One noticeable emphasis was that leadership was placed in a team context and this is particularly significant given the current stress from both the dental service and dental education perspectives on skill-mix and teamwork. 1,11,[20][21] The notion that the profession should move towards shared leadership (consulting, involving the team in decision-making, trusting and empowering team members to act) and, it may be inferred, away from vertical leadership (where the leader is in charge and tells his team what to do) would seem to be appropriate in this context. The relevance of such an approach is further supported by research evidence indicating that poor performing teams are associated with vertical leadership and high performers with a shared leadership style.…”

“…11, 20 The data suggest that professionals view leadership programmes as a way of improving and shaping dentistry at all levels. Indeed, a lack of training for the leadership role dentists have to take on at all levels and throughout the profession, was identified as a key factor in dentists leaving the profession.…”

“…,11, 14, 17-18 As a consequence it has been regarded as imperative that dental professionals take ownership of their future development to radically rethink the role of dental leadership and to find a new vision and mission. [17][18][19][20] Furthermore, current expectations that the future dental workforce will involve a changing skill mix, demands that dental leadership should embrace the entire dental team. 18,[20][21] Effective leaders are seen to be essential in moving the dental profession forward.…”

“…[17][18][19][20] Furthermore, current expectations that the future dental workforce will involve a changing skill mix, demands that dental leadership should embrace the entire dental team. 18,[20][21] Effective leaders are seen to be essential in moving the dental profession forward. 14,17,24 The leadership role in the dental profession is complex and multifaceted not least in its requirement to combine business practice with patient care -a relationship with inherently conflicting tensions.…”

“…Dental academics have also identified the need for the dental profession, UK Health Departments and educators to begin to raise the profile of leadership in a teamwork culture. 11, 20 The study described below examines perceptions of dental leaders concerning some of these issues.…”