Manar Elkhazindar on some of the challenges faced by the Hospital Dental Service in Scotland in dealing with COVID-19 and planning what comes after.
It's great to see so many of my Hospital Dental Service colleagues across Scotland contributing to the NHS COVID-19 response, but the pandemic crisis has also highlighted some areas of real concern for dentistry.
Our creaking digital infrastructure
The pandemic has led to an explosion in the use of digital technology in dentistry, with tele-dentistry, remote access, webinars and virtual meetings. Access to electronic patient record (EPR) and digital radiographs (PACs) by clinicians in primary/ secondary care has never been more critical, but remains a challenge. Urgent dental care centres (UDCs) could increase their efficiency if EPR, particularly medical history and medication list, and PACs were accessible.
"Time spent overseeing a creaking IT systems is time taken away from delivering patient care."
We all know that time spent overseeing a creaking IT infrastructure, is time taken away from delivering patient care. That's why, we have
campaigned for a national integrated electronic record system covering both primary and secondary care. We haven't been alone in this call; GPs, dentists, optometrists, nurses and pharmacists have all made the same case.
The COVID-19 outbreak has highlighted the urgent need for our IT systems that talk to each other. I believe this should be a priority when considering what post-COVID-19 dentistry looks like. A single system that's upgraded and maintained throughout the whole of the NHS could transform delivery. But it needs to be government-led. If we leave it to the individual NHS Boards, we will be stuck with systems which are not able to communicate with each other. We now have the opportunity to do better.
Dental education and training impacted
It's also important to note, that the suspension of routine dentistry may have a serious impact on dental education and training for the foreseeable future. We have contacted NHS Education for Scotland (NES) to highlight a number of concerns about the potential impact on dental education and training and how the current schedule dental training could be maintained.
I'm pleased to see that NES has set up a working group which includes representatives from the all three Dental Schools in Scotland, Vocational Training (VT) organisers and DCP School Leads to look at continuity from undergraduate to VT, both this year and beyond. Discussions also included intercalated BScs/Leadership courses to fill in time until clinical activity could be restored. However, at present it is still unclear what impact the pandemic will have on dental education and training.
Your mental wellbeing matters
The COVID-19 outbreak isn't only endangering our physical health, it's also putting our mental wellbeing under strain. I encourage you to take stress seriously at this time and to reach out for support when you need it.
During this difficult time, you may also have to make clinical decisions that prioritise scarce resources. For guidance on the ethics of this, please see Section 27 under our
FAQ to see the guidance we have produced along with the BMA. This won't answer every question you have, but we hope that it will support and guide you in making the decisions asked of you.
"No matter what situation you find yourself in, I encourage you to take some time to consider what steps you can take to support your wellbeing."
For staff who are working from home or self-isolating, it is vitally important to stay connected with colleagues during the current crisis. Working alone can lead to feelings of isolation and stress. No matter what situation you find yourself in, I encourage you to take some time to consider what
steps you can take to support your wellbeing.
BDA members have access to our
24/7 counselling service. Or if you are looking for advice on a work-related issue, members working under hospital terms and conditions can contact the BMA for employment relations support: 0300 123 1233 (please quote your BDA membership number).
Redeployment in action
I've found it very heartening, how many hospital dentists have been proactive in offering themselves to be redeployed across the NHS to help the fight against COVID-19. As the pandemic escalated in late March,we joined with the BMA to offer ethical guidance to those opting for redeployment.
We've argued that as highly trained professionals with a wide range of skills, hospital dentists should be redeployed in roles that reflect their expertise and experience where possible, and be remunerated at the appropriate rate. I'm pleased to see many examples of this in action in Scotland.
If you are in the process of being redeployed and being asked to undertake other duties, you should have received an interim job plan and have been provided with training to enable them to carry out any new role with confidence and competency. To help you, the BDA has prepared an
8-step plan (see section 24) on how to prepare for redeployment and to help make sure you are safe.
At present, it's very difficult to know what will happen next week, not to mind in a few months' time. The Hospital Dental Service in Scotland faced challenges even before the outbreak, and the effects of the pandemic are likely to be felt for a long time yet. As we look towards the future post-COVID-19, it's clear to me that we're stronger together. In this crisis we have shown that we can overcome the challenges that we face by working together.
Consultant in Restorative Dentistry, NHS Highland
Lead, Scottish Hospital Dentists Reference Group