Your NHS dentistry and oral health update 

7 March 2025 

An update on patient safety

On the topic of sharing best practice, I encourage you contribute to the Change NHS conversation. Since the launch, over 100,000 contributions have been made to change.nhs.uk. As dentists, you provide care for people throughout the course of their life and we need your views on the emerging ideas from the engagement so far. Please visit priorities for change to have your say by Monday 14 April and help shape immediate steps and the 10-Year Health Plan for the NHS.

We also look forward to engaging with members of our profession in person at the upcoming British Dental Industry Association (BDIA) Dental Showcase, 14-15 March at the Excel, London. I’m grateful to be able to present an array of accomplished dental leaders at the Chief Dental Officer (CDO) Zone covering a range of contemporary oral healthcare topics. Further information on the BDIA CDO programme can be found below.

Kind regards,
Jason Wong

NHS Patient Safety Strategy

Patient safety remains a key priority within the field of dentistry and oral health. As defined in the NHS Patient Safety Strategy published in July 2019, patient safety is about maximising the things that go right and minimising the things that go wrong for people experiencing healthcare. Patient safety is integral to the NHS’s definition of quality in healthcare, in conjunction with effectiveness and patient experience.

Since the publication of the Patient Safety Strategy, applicable to all sectors, figures released in June 2023 show the strategy is halfway towards achieving its initial aims of saving an additional 1,000 lives and £100 million per year. Progress so far has demonstrated:

• Disability due to severe harm incidents has been reduced by around 480 cases per year, via the mitigation of risk through national recording and learning systems.
• The use of systems and acquired data has helped National Patient Safety teams to identify safety risks which may be new or under-recognised, aiding in the development of corresponding advice and guidance to keep patients safe.  
• Early adopters of the Patient Safety Incident Response Framework (PSIRF), replacing the previous Serious Incident Framework, have reported improved safety cultures, early signs of harm reduction and identification of more effective risk reduction strategies. Healthcare providers are advised to work towards implementing PSIRF principles into their organisations, to help develop and maintain effective systems and processes to respond to patient safety incidents, for learning and improvement purposes.   
• Organisations have also been encouraged by regulators such as the CQC to use incident reporting systems, an example being the Learn from Patient Safety Events (LFPSE) service. Through increased incident reporting, opportunities for patient safety to be improved both locally and nationally can be highlighted and shared, via timely, tailored mechanisms.  

NHS Primary Care Patient Safety Strategy

90% of NHS interactions are delivered through primary care, either in person or remotely. The vast majority of these interactions are safe, however there are still many instances of avoidable significant harm occurring across primary care services in England, costing £100 million per year.

The NHS Primary Care Patient Safety Strategy builds on the wider NHS Patient Safety Strategy. It describes the specific national and local commitments to improve safety in primary care, using real examples and case studies. The strategy is co-designed with NHS frontline staff and lay patient safety partners. It supports staff to better involve patients in safety improvement work, access available training and utilise modernised incident reporting and response systems. 

The OCDO and the Primary Care Patient Safety Strategy recognise decreased uptake in recording incidents within primary care, which could hinder our understanding and prevention of such events. Patient safety research within dentistry has demonstrated a lack of knowledge of how to record incidents, as well as a fear of repercussions arising from incident reporting, representing significant barriers to the recording of patient safety events. Work by the OCDO has sought to address this through its Project Sphere working group (detailed below). This group advocates for culture changes to help foster learning from patient safety events, whilst encouraging prevention and open, non-judgemental reviews of patient safety incidents amongst dental teams, through the publication of the patient safety huddle sheets.

Project Sphere spotlight

Project Sphere, a working group led by the OCDO continues to make strides in initiating a culture change amongst the profession from a perceived blame culture, to a just and learning culture, reflecting the principles underpinning the national patient safety strategy and PSIRF.  The Office of the Chief Dental Officer (OCDO) England is also pleased to have Project Sphere referenced within the Primary Care Patient Safety Strategy. The Primary Care Patient Safety Strategy highlights the groups’ work in collaborating with indemnity providers to publish the indemnity consensus statement and advocating for the transition to a learning from events culture, rather than a blame culture. Further recognition of Project Sphere’s work can be found within the Health Service Journal as part of its Patient Safety Watch newsletter.

Project Sphere relies upon the union of a safe culture and safe systems to deliver safe oral healthcare.

Safe culture: Human factors are a critical component of patient safety management. To help build effective teams, due regard for aspects, such as the below, will collectively help to foster environments where patient safety can be maintained and prioritised:

• psychological safety of the dental team by addressing the impact of litigation on staff wellbeing
• moving away from blame cultures
• eliminating barriers to incident reporting
• upholding duty of candour and ensuring practitioner support
• promotion of diversity and inclusivity in the workplace
• effective communication between the workforce, regulators and indemnity providers
• tackling of misconceptions within the profession

Safe systems: Safer systems are achieved through guidance and education, across multiple domains. In addition to effective incident reporting mechanisms outlined above to facilitate learning from patient safety events, it also involves ensuring safe digital processes are in place, such as when accessing patient records and as part of electronic prescribing. Frameworks such as Freedom to Speak Up within working environments, will also help to improve the quality of safe care delivery. Furthermore, there has been increased drive to embed patient safety principles into undergraduate curriculums, as well encouraging all teams and recently qualified colleagues to review important resources such as the Patient Safety Syllabus highlighted below and the GDC Safe Practitioner framework.

Patient safety cannot exist without team safety​. Therefore, as one of Project Sphere’s objectives for 2025, we hope to improve incident reporting cultures. This includes challenging current negative cultures surrounding litigation fear, the misuse of referrals to regulators within the profession and improving culture change processes. This may be through local and national staff surveys, including input from undergraduate trainees, to evaluate views towards patient safety. We also intend to:

• advocate for the creation of a national wellbeing support network, detailed further below
• address the issue of double/triple jeopardy by working with dental regulators
• encourage safer record keeping practices
• maintain a right-touch regulation approach towards managing incidents
• seek patient safety event stories to share key experiences and learning amongst the profession

If you would like to join the Project Sphere mailing list, please contact us via england.ocdo-patient-safety@nhs.net

Patient safety syllabus

Dental teams are encouraged to complete the NHS Patient Safety Syllabus Training, particularly Levels 1 and 2. This free online training is available to all NHS employees and will contribute to NHS employees receiving enhanced patient safety training. 

This training includes information on safety culture, human factors and ergonomics, just culture and incidents. It can be accessed by those without an nhs.net email address and takes around 1 hour to complete.

Dental record keeping evaluation

Colleagues within NHS England have started work on exploring what should be the appropriate threshold for a professional standards concern in relation to record keeping. A cohort of NHS England Dental Clinical Advisers working with OCDO England are evaluating the approach taken towards clinicians where minor record keeping concerns are identified, looking at how this can be modified to become supportive of continuous improvement and how it could be managed outside of a professional standards process.

Oral Health Regulatory Strategic Leadership Forum

The OCDO England and regulators of dental services across England are working in partnership and collaboration on the Oral Health Regulatory Strategic Leadership Forum (OHRSLF), which aims to establish a strategic shared view of safety and quality in oral health across England.

Previously known as the Regulation of Dental Services Programme Board (RDSPB), this group has now transitioned to become a strategic leadership forum, across oral health and dental care in England.  

The OHRSLF provides one of the only forums for strategic debate, discussion, and communication. It is an opportunity for members to form a shared view and understanding regarding matters affecting and influencing dental services across England. This is within the policy context, at a local system and place-based level, as well as with individual providers of dental care. There is a positive culture of working together and it is important to continue this for the benefit of both patients and professionals. Primary aims of OHRSLF includes:

• Focusing on topics, issues, and workstreams where working together could influence quality improvement, safety improvement, service integration, and system-level change across England, for both patients and professionals.  
• Evaluating how commissioning, delivery and regulation supports and influences the integrated care systems (ICSs) and integrated care boards (ICBs) formed as a result of the Health and Care Social Act 2022.  
• Supporting proportionate regulatory responses and reducing bureaucracy and double jeopardy, where dental professionals may be undergoing investigations by multiple regulatory bodies simultaneously.  

The forum meets three times a year and its members include the General Dental Council (GDC), Care Quality Commission (CQC), Department of Health and Social Care (DHSC), Healthwatch England, NHS England Primary Care Commissioning, NHS England Professional Standards and NHS England Workforce, Training and Education (WTE) directorate.

Dental treatment abroad information for patients

The General Dental Council (GDC) has published information for patients intending to travel abroad for dental treatment. As dental regulation is likely to vary according to country, the GDC advises patients to undertake initial research prior to confirming any dental procedures. This also applies to interacting with dental providers who come to the UK to promote their services and encourage patients to travel overseas for treatment.

All dental professionals must be registered with the GDC to work in the UK, and the GDC sets the professional standards they must adhere to. They cannot guarantee however that similar regulatory organisations exist in other countries, or even that the standards will be the same as they are here.

Consequently, such avenues of seeking care may represent a significant risk to patient safety and all patients should undertake the necessary thorough research prior to committing to any dental treatments abroad.

Patient safety and Ramadan

The month of Ramadan began at the start of March 2025. It is a time where Muslims around the world observe the act of fasting, refraining from consuming any food or drink daily from sunrise to sunset. This could present some important considerations for dental teams, to help maximise safe outcomes in the workplace.

Regarding patient care, dental teams may benefit from an increased understanding of how fasting may impact a patient’s overall wellbeing, their preferences in respect to attending appointments at particular times and patients electing to delay treatment altogether, providing it is clinically safe to do so.

For our dental colleagues, staff wellbeing can be nurtured further amongst teams through constructive conversations on the spiritual significance of Ramadan and potentially supporting those who are fasting with additional adjustments in the workplace. Such considerations may help to maintain clinical performance and facilitate safe and effective treatment delivery. Further information on healthy Ramadan practices for both patients and colleagues, including advice for those living with systemic conditions, can be found in the links above and on the British Islamic Medical Association (BIMA) website.

British Dental Industry Association Dental Showcase 2025

The OCDO England will once again have a zone and theatre at the British Dental Industry Association (BDIA) Dental Showcase on 14-15 March. In order to meet the challenges of modern-day healthcare our profession must be dynamic, and the Showcase is the ideal setting in which to engage with colleagues and discuss key oral health matters. The OCDO programme will feature a lineup of respected colleagues covering a diverse range of topics that are relevant to the entire profession.  We look forward to providing essential insights applicable to all members of the dental team, students, and leaders of industry.  

BREATHE dental wellness platform

BREATHE Dental Wellness is a platform being developed to nationally support the health and wellbeing of the entire dental team, not just those on the register. 

By prioritising the wellbeing of dental professionals, BREATHE aims to enhance patient care and safety, as a well-supported dental team is better equipped to provide high-quality care to patients. Further information will be shared in upcoming Dentistry and Oral Health Bulletin issues.

Nitrous Oxide Waste Mitigation: A toolkit for NHS trusts

NHS England has worked with UCLPartners to create a comprehensive toolkit to support NHS Trusts to identify and address waste from piped nitrous oxide. Nitrous oxide waste mitigation can lead to measurable cost savings and substantial carbon emission reductions, while improving patient care, choice and staff experience. The toolkit, which builds on existing NHS England guidance, is accessible, clear and offers step-by-step guidance to address the practical barriers to reducing waste from piped nitrous oxide.

Survey: Primary care cyber security readiness

The Joint Cyber Unit within the Department for Health and Social Care (DHCS) and NHS England are seeking to understand the cyber security readiness and capabilities of the primary care sector, focusing on general practice, community pharmacy, optometry, and dentistry. Through a wide-ranging survey, they would like to investigate the following areas:

• Exploring cyber security readiness and preparedness
• Understanding the areas of greatest cyber security risk
• Understanding behaviours and attitudes related to cyber security
• Sharing good practice in cyber security

If you would like to take part, please complete the survey by 6 April 2025. The findings from these interviews will allow NHS England and DHSC to better understand cyber security in primary care, and how they can support the sector.

You can support primary care cyber security readiness by:

• promoting this survey to colleagues within newsletters, bulletins, and networks
• helping identify key stakeholders to undertake surveys, particularly those:
  • working in or supporting practices with IT/cyber/data security and protection toolkit/E-Dec compliance
  • representing practice groups, clinical or practice manager forums etc.

For further information or to take part in the interviews, please contact chan.maher@nhs.net, Head of Cyber Security Primary Care, Joint Cyber Unit.

Chief Dental Officer England Clinical Fellowship Scheme

Applications are now open for the 2025/26 Clinical Fellowship scheme sponsored by the CDO and managed by the Faculty of Medical Leadership and Management (FMLM). The scheme provides a unique opportunity to spend 12 months from September 2025 within a national healthcare organisation to develop non-clinical skills in leadership, strategy, policy development and project management. There is also dedicated time for interprofessional shared learning with those from other medical disciplines.

Open to all members of the dental team, the aim of the fellowship is to develop those who show promise as future leaders but have not yet had had a significant leadership role. For full information, please visit the FMLM website. The deadline to apply is 9pm Sunday 6 April, good luck!

Sign up to the NHS Primary Care bulletin 

The NHS primary care bulletin provides resources on health policy and practice and we encourage you to sign up for this, too. It is aimed at teams across general practice, dentistry, community pharmacy and optometry. 

Signing up to this bulletin

Have you been sent this bulletin by someone else? 

This bulletin is a round up of all the latest news and important resources for anyone working in NHS dental services. We'll send it out as and when important news needs to come your way. If you've already signed up but didn't receive the update, then check your junk folder for the confirmation email and make sure you've followed the instructions to complete sign up.

Recent dentistry and oral health bulletins 

Previous bulletins can be accessed by clicking on the links below:

Special focus bulletins 

The Office of the Chief Dental Officer and the NHS England team regularly produce 'special focus bulletins' on clinical priorities and key aspects of patient care. These bulletins summarise the key information dental teams need to know and act as a refresher, combining best practice, expert opinion and useful resources. If you would like to suggest a topic for a future special focus bulletin please email the CDO's team at England.CDOExecutive@nhs.net