Your NHS dentistry and oral health update

Wednesday 27 October 2021 (Issue 29)

Special focus on NHS dental clinical leadership

An update from Sara Hurley and Jason Wong 

Dear colleague,

Sound clinical leadership and advice is one of the bedrocks of the NHS. Contract and system reform are important but regardless of the system you have, clinical leadership is essential. This is not just to assist commissioners and operational officials in their decisions, but to develop the profession and to drive improvement in clinical practice for patients. 

In dentistry, we have many talented practice owners in general dental practice and clinical directors in the community services. In primary dental care, those roles shouldn't be the limit of local leadership with the next jump being the national Chief Dental Officer - our secondary care dentists have a number of roles through which to develop, from consultant to clinical director and more.

We are taking an exciting next step with a new Regional Chief Dentist in the Midlands and we are delighted to welcome Adam Morby to the role. This new role is an important step in advancing clinical leadership in the NHS.

Over the last few years, NHS England's Local Dental Network (LDN) Chairs have provided clinical advice and leadership to your regional teams. We have seen some excellent examples where clinical leaders and commissioners have worked effectively together in developing strategies and transforming services in line with the Long Term Plan. In particular the input of LDN Chairs during the pandemic and the mobilisation of urgent dental care centres was highly valued. LDN Chairs are drawn from primary, secondary and community dental care. 

However, it's not just about creating the posts. We need to grow leadership from the grass roots up, with opportunities open to all GDC registrants and start creating the leadership skills in our young people from when they first join the profession. That's why initiatives such as the Chief Dental Officer's Clinical Fellows scheme, the NHS Regional Clinical Fellows scheme and Clinical Entrepreneur Programme are so important. 

There is much more to do and some decisions can't be taken until any new legislative framework is properly settled. Over the coming months and years, we are working to develop a strong team, so our hard working NHS dental teams, the wider health service and most importantly patients are best served whatever the future brings.

We look forward to taking you with us on this exciting journey.

Best wishes,

Sara and Jason

The NHS appoints first Chief Dentist for the Midlands Region

Adam Morby, has been appointed as Regional Chief Dentist for NHS England and NHS Improvement in the Midlands. Adam will be working to deliver improved outcomes for patients and overseeing dentistry in the region. 

The Regional Chief Dentist is an employee of NHS England and NHS Improvement, accountable to the Midlands NHS Medical Director. The role includes providing clinical leadership and support not only within the NHS England regional team but also to all stakeholders within the region. Adam will work with the Chief Dental Officer England Sara Hurley to implement national work programmes such as Starting Well (children’s prevention and treatment service), Mouth Care Matters (oral health in care homes and hospitals) and Making Every Contact Count (general health prevention in dental practices and hospital settings) on a regional basis.

Adam, has been a general dental practitioner for 27 years, qualifying from Birmingham University in 1993 and practicing in Staffordshire for the last 21 years. He has spent a number of years as an Educational Supervisor for Foundation Dentists. 

He has worked with the South Staffordshire Local Dental Committee as Chair and Secretary for 20 years, along with chairing the West Midlands Association of Local Dental Committees. This also involved representing local practitioners in the area at the British Dental Association General Dental Practice Committee since its inception. 

Dr Vijay Rawal, Deputy Medical Director Commissioning (Primary Care Strategy and Public Health) at NHS England and NHS Improvement for the Midlands said: “I am really pleased to welcome Adam to this new role which is one of the first such posts in the country. Dentistry is such a key part of all-round health, Adam’s experience and strong clinical leadership will support improvement in patient outcomes and drive up the quality of care”.

Local Dental Network Chairs in the Midlands 

Under the proposed Health and Care Bill before parliament, many commissioning decisions will in the fullness of time be delegated down to new integrated care systems, with regions continuing to play an important role. So it's important we begin to look at the clinical infrastructure around those bodies at a local level. 

The Midlands region have aligned their LDN Chairs and ICSs to help support this development and we are delighted to share with you the local appointments that make up a strong team across the patch.

LDN chairs are an important innovation in the NHS. As the NHS moves towards a system led approach, we will look to ensure effective coordination of our current structures with the new. No decisions have been taken at this time, but we will keep you updated.

Derbyshire: Rami Khatib

As Chair of the Derbyshire County LDC he takes a leading role in organising free CPD events and peer reviews for in the region.

 Northamptonshire, Leicestershire and Rutland: Steve Claydon

Steve’s previous clinical adviser work for NHS England included Northamptonshire and Leicestershire. He is very much looking forward to working with colleagues and other key stakeholders to help improve oral health service delivery for the local population.

 Lincolnshire: Kenny Hume

 Nottinghamshire: Dr Pavni Lakhani

Promoting good oral health is a key component of her daily practice alongside providing treatment under local anaesthetic and inhalation sedation as well as domiciliary visits. 

She has a passion for improving dental health and reducing health inequalities and is currently involved in the BASCD survey of children aged 5 years old in school settings. Pavni is a clinical tutor for dental hygiene and therapy students and has completed a certificate in coaching and mentoring. She is currently enjoying the challenge of completing her 2nd year MA in Dental Law and Ethics.

Birmingham and Solihull: Peter Thornley

Peter has been involved with the managed clinical networks for a long time as an LDC member, and before that worked as a part-time dental adviser for the old Heart of Birmingham Primary Care Trust.

Birmingham, Black Country and West Birmingham: Afy Ilyas

Coventry and Warwickshire: Alison Lee

Alison developed the highly effective Urgent Care System for the Coventry and Warwickshire Community Dental Service, coping with the pandemic restrictions affecting primary care provision.

Shropshire and Staffordshire: Tony Ahmed

The post of Herefordshire and Worcestershire LDN Chair is out for recruitment.

Clinical Entrepreneur Programme 2021: training the clinical leaders of the future

Are you an innovator in the NHS? Do you have an idea you wish to develop and scale for patient benefit? The NHS Clinical Entrepreneur Programme might be for you.

Budding entrepreneurs can now apply for this ground-breaking programme that is helping bring innovations into the NHS to improve patient care.

The NHS Clinical Entrepreneur Programme, delivered by Anglia Ruskin University, is the biggest entrepreneurial workforce development programme of its kind. Open to all NHS staff, the programme aims to provide the commercial skills, knowledge and experience needed to successfully develop and spread innovative solutions to the challenges facing the NHS.

The curriculum covers all aspects of setting up and running a small business, including attracting investors, applying for funding, and ensuring appropriate corporate governance. A dedicated programme in how to build a start-up – and how to operate in this highly-charged environment – is delivered as a series of educational events attended by industry mentors.

The programme aims to allow entrepreneurs to pursue their innovation without having to leave the health service, providing a wider benefit to economic growth through inward investment in the health, social care and life science sectors. As such, the programme currently offers bespoke commercial education, customer matching, resources and development tools. We are encouraging innovators with greats ideas from a diverse range of backgrounds to apply for this exceptional opportunity- could this be you or someone you know?
 
For more information and to apply visit www.nhscep.com 

Closing date is Tuesday 2nd November 2021

Chief Dental Officer's Clinical Fellows Scheme

The Chief Dental Officer's Clinical Fellow Scheme was established in 2017 by Sara Hurley, Chief Dental Officer and is managed by the Faculty of Medical Leadership and Management. It provides dentists who have had limited dental leadership opportunities and have not held a senior leadership role in dentistry, with a unique opportunity to spend 12 months in a national healthcare-affiliated organisation outside of dentistry practice. The aim of the year is to develop skills in leadership, management, strategy, project management, and health policy.

Successful applicants will gain the unique opportunity to spend one year working in a leading, national healthcare-affiliated organisation with the most senior leaders in healthcare. Clinical fellows have the opportunity to further their leadership skills and experience in a diverse range of organisations, including Health Education England, NHS England and NHS Improvement, and the General Dental Council. Clinical fellows lead and collaborate in meaningful projects at a national level. The fellowship is fully immersive and is an intensive experience designed to gain unique insight, skills and experience outside of the clinical setting.

"We can rise to emerging challenges of the 21st century by fostering talent and prepare a cadre of capable and motivated dental leaders who can confidently take their seat alongside their healthcare peers in the key national and regional forums."

Sara Hurley, Chief Dental Officer England

Perspectives on clinical leadership by Deborah Manger

Whatever pathway we take to leadership in dentistry it is important that we look outwards. To reflect what Sara has said many times we must ‘put the mouth back in the body’. This is not a hashtag or strapline,  it means we have to be present and contributing to the development of holistic health and social care with all providers.

I have always viewed myself as a healthcare leader first and a dental leader secondly. This has enabled me to have different and, in  my opinion, more effective conversations with colleagues. I was participating in serious conversations about water fluoridation pre-pandemic, before they were even mentioned nationally or in a government bill. My medical colleagues really supported the conversations with the Director of Public Health.

As a healthcare leader I contributed to the development of community nursing, palliative care service development, management of patients in mental health inpatient settings and the development of diabetes outpatients services, to name just a few. This always enabled me to raise oral health where it was appropriate to do so. Where oral health was not part of the picture I was the critical friend, challenging strategies, operational models and above all always advocating for the best patient outcomes.
 
As a profession we must be prepared to listen and support if we want people to understand and support our professional agenda. As a Deputy Dental Dean I am working with colleagues who have accepted leadership roles to develop their skills so they can influence the health and social care agenda in their regions. The support cannot be a didactic process. It will rely on mentoring, coaching and above all compassionate support.

Deborah Manger is a specialist in special care dentistry and currently the Regional Deputy Dean, Early Years for Health Education England Midlands and the East of England. Deborah has served as a Managed Clinical Network Chair as well as interim and deputy LDN Chair in the Midlands region. Deborah was also the deputy medical director for Northamptonshire healthcare NHS foundation trust.

Have you read ...?

Leadership - so what is it anyway?: Blog for the Faculty of Medical Leadership and Management by Judith Tweedie

Leadership in dentistry: Article for the British Dental Journal by Ryan Grocock

Understanding leadership within a dental context: In Dentistry magazine, Jamie Morley discusses the importance of leadership within dental teams.

The importance and challenge of clinical leadership: In this interview, Don Berwick talks to the King's Fund about the rationale for an increased role for clinicians of all levels in leadership, and what it takes to prepare clinicians for, and engage them in leadership roles.

Clinical leadership – a framework for action: NHS England's framework looks at how existing structures and expectations may stand in the way of allied health professionals, doctors, midwives, nurses, pharmacists, psychologists, healthcare scientists and social workers contributing to strategic leadership.

By Word of Mouth ... the colleagues we're all talking about!

Amarantha Fennell-Wells is the Chief Dental Officer's Clinical Fellow 2021/22, one of eight clinical fellows in dentistry this year.

Amarantha joins the Office of the Chief Dental Officer looking to understand policy governing dentistry, and learn from the phenomenal team helping the profession to navigate the uncharted waters of a 21st century pandemic.  

Amarantha values clinical leadership because, ultimately, patients receive better care. The opportunity to work with strategic leaders in Dentistry in England who work in partnership with other organisations is one she is relishing greatly. She is building upon her previous experience as the first Welsh Clinical Leadership Fellow in Sustainable Healthcare, working on international efforts concerning nitrous oxide mitigation, as well as engaging and embedding sustainability within quality improvement training. Amarantha is an author for the upcoming BDA Springer book on Sustainable Dentistry. 

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Previous NHS dentistry and oral health bulletins 

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

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. 

COVID-19 advice, guidance and resources

Communications resources for NHS dental practices

Click on the links below to view and download useful communication resources:

• Click here for social media image cards and patient leaflets
• Click here for social media assets and posters explaining IPC requirements
• Click here to download website/social media copy and scripts for answer machine message, text message and emails.

NHS updates to the profession 

Key letters from the Chief Dental Officer and the NHS dentistry and oral health team are online here. 

Transition to Recovery: Dentistry's standard operating procedure

The latest version was published on Friday 16 July 2021. Changes to the previous SOP are in yellow. You can read the SOP online here. 

COVID-19: infection prevention and control dental guidance

The guidance is an appendix to and should be read in conjunction with the national guidance on infection prevention and control for COVID-19 . You can read the general guidance and the specialist dental appendix online here.

Avoidance of doubt note: provision of phased treatments

This document is to support dental professionals, and to clarify where it might be appropriate to provide phased treatment spanning over several courses of treatment (CoT). You can read it online here.

Health and wellbeing support