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27th June 2013

Direct Access

I am sure you will all have heard of `Direct Access` by now.  However, just to recap if you haven`t, this is the GDC decision to allow patients to see certain Dental Care Professionals without having to see a dentist first and without a prescription.  It had been talked about for years but it was the damning Office of Fair Trading report of 2012, which eventually forced the issue.  The report said that current restrictions are unjustified and reduce patient choice.

From 1st May 2013, patients can now see a Hygienist or Therapist directly in certain circumstances.  However, as there still seems to be some confusion around the details, here are a few practical suggestions.

Clear and definite information needs to be available within your practice to inform patients and visitors about your policies and what exactly is available.   Lack of information and unclear policies breed dissatisfaction and are more likely to lead to a complaint.  There should be posters and leaflets with useful information, this may include –

  • What treatments are available
  • How to book treatments
  • What will happen if a DCP feels a patient wants treatment that they cannot provide
  • Fees

No-one appears to be obliged to provide this type of service, although demand will have an effect on availability.  If you aren`t going to do it, someone else will, and that`s bad business.  However, you and your team may not feel ready to provide direct access yet.  You might make a policy that all new patients need an examination before gaining access to a hygienist in your practice.  A deep and meaningful team meeting around the subject will help everyone express their feelings and wishes.

Currently, Direct Access is in conflict with the Councils own advice on `Team Working` and `Scope of Practice`, but the word is that new standards are in the pipeline for publication in September and this will put right any contradictions.  In the meantime, conflicting references in these publications are no longer applicable.  It is really important to have solid procedures in place for internal referrals within the practice.  This is so that DCPs have a means of finding support if there are conditions or procedures which they do not feel competent to provide.

Personally, I see a downside and an upside.  I feel there is a conflict with the desire to reduce the death rates from oral cancer, as fewer patients are likely to attend for routine examinations and fewer early diagnoses will be achieved.  On the other hand, there are golden opportunities for practices to develop a business plan with much wider scope.

*All information is correct at the time of publishing

Topics: Dentists

John Shapter

Dental Specialist

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