Exemptions for dental hygienists and dental therapists will provide an opportunity to improve patient care

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  Posted by: Dental Design      6th February 2018

Dental hygienists and dental therapists are an important part of the workforce and they already play a valuable role in the care of patients and in supporting them with maintaining their good oral health. However, their full potential has been somewhat hampered. Fortunately, a change has been proposed to improve the situation, which could benefit not just this group but also the entire profession and the people they treat in a number of key ways.

The problem

Currently, it is not possible for a dental hygienist or a dental therapist in the UK to sell, supply or administer local anaesthetics, topical anaesthetic and/or fluoride varnishes to a patient without having to first get a prescription from a dentist, or under a Patient Group Directive (PGD). This limitation is in accordance with the Human Medicines Regulations (2012) that governs the manufacture and supply of medicines for human use, including the control of prescription-only medicines (POMs). Only an appropriate practitioner, such as a general practitioner or dentist, can prescribe POMs.

However, certain regulated health professionals such as midwives, paramedics, orthoptists and podiatrists can sell, supply and administer specified medicines without need for a prescription or PGD. This mechanism is known as exemptions.

The list of exemptions is a limited one, but if dental hygienists and dental therapists were able to supply and administer some medicines this would bring positive benefits to both them and the dentist and also the patients they treat. For example, the dental hygienists and dental therapists would no longer need to interrupt the dentist during surgery and take up their valuable time. Also, the dental hygienists and dental therapists would be able to perform the required treatment even if the prescribing dentist was not available at all, meaning the patient would not be asked to return on another day, or even week in order to complete it. This would encourage compliance and improve the patients’ all-round experience and ultimately benefit their oral health.

The solution

The British Society of Dental Hygiene & Therapy (BSDHT) and British Association of Dental Therapists (BADT) are both working closely with NHS England who is leading a programme that aims to extend supply and administration responsibilities to a number of professional groups. This includes the use of exemptions by dental therapists and dental hygienists.

Exemptions mean that a list of POMs would be specified in legislation for dental therapists and dental hygienists to sell, administer or supply. Following the necessary training in the safe use of the exemptions, it would enable them to sell, supply or administer local anaesthetic and fluoride toothpaste in their practice, for example, without a prescription or PGD.

The story so far

The BSDHT and BADT are both members of an NHS England-led project working group, which is part of the Chief Professions Officers’ Medicines Mechanisms Programme. The initial work includes writing a ‘case of need’ document that sets out the case for change and also the need for the sale, supply and administration of specified medicines listed in legislation.

Michaela ONeill, immediate past president of the BSDHT, and Fiona Sandom, immediate past president of the BADT, have stated, “We truly believe dental hygienists and dental therapists being able to use exemptions would be a positive step for patients and dentistry, although we are still at the beginning of a long and arduous process. At present, the case of need has been submitted for approval and we await feedback before moving to the next stage.”

The next steps

Once NHS England and the Department of Health Non-Medical Prescribing Board approve the case of need, the Department of Health will make a submission to ministers to alert them to NHS England’s plans to hold an eight-week statutory public consultation. Following this, which is likely to take place over the summer, NHS England will present the proposal for the use of exemptions by Dental Therapists and Dental Hygienists to the Commission on Human Medicines.

Great for patients… and good for the practice

This work is vitally important because, if exemptions for dental hygienists and dental therapists are achieved, patient care will be improved. Being able to maximise time in the practice means better patient access and better choice. Of course, the whole dental team will benefit from a practice that runs smoothly and uses its time more effectively, too! Exemptions really would be a huge and progressive step towards raising standards of oral health across the UK. The delegation of a dentist’s responsibility in this context will allow dental hygienists and dental therapists to support them more effectively in providing a high quality, efficient and patient-focused preventive service.

For more information about the BSDHT, please visit www.bsdht.uk,

call 01788 575050 or email enquiries@bsdht.org.uk




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