As from April 1 (why do they always choose that date? – even the tax year manages to avoid it by a few days) the world (well the English bit at least) has undergone significant change.
Let’s start with the Department of Health website, which now rather has the Gov before the DH in its URL – maybe that’s a message for the future. It also has a new mission statement - it “helps people to live better for longer”. Given the weather and the recent budget announcements, maybe it just seems like we are living longer. And after the recent Francis Report on Mid Staffs, someone has thought to add “compassion respect and dignity” onto the end of its very worthy intentions.
There’s no more chief dental officer page of course, he’s gone off to the...no sorry wrong again, it’s NHS England now, and as everyone knows, they’re based – where? We all thought it was Quarry Hill, the well-known mid-Soviet style edifice in Leeds. But it turns out that if you wish to contact them, either to make a complaint or a freedom of information request, you should address it to PO Box 16738 in Redditch, Worcestershire. So now you know.
Meanwhile, the deputy CDO will have moved to a role at Public Health England, an executive agency of the Department of Health and located at fashionable Wellington House, a converted department store just down the road from Waterloo. Sadly a search for the words ‘dental’ or ‘dentist’ on their publications website returned no results.
Because there is no end to change, the ‘steady state’ transfer of all primary dental care NHS contracts has moved to NHS England, whose 27 local area teams will ensure a close local connection with the needs and demands on the ground which was formerly occupied by 152 primary care trusts. They are: “Not independent organisations, but an integral part of the NHS commissioning board” (sorry, NHS England) according to the Health and Social Care Information Centre. Oh, that used to be the NHS Information Centre.
Talking of local areas, it’s good to see the return of good old-fashioned English regions such as Wessex, Thames Valley and Arden, none of which currently figure in any known legislative atlas. One characteristic of this change to a single commissioner will be ‘more consistency’ of contract management, but can anyone say what that actually means?
Back at www.gov.dh we also have a revised edition of HTM 01-05. More change. Suddenly, bacteria that were once capable of invading sealed packages within 21 days have been re-bred so that it now takes them a full year to burrow in. Whilst those two-bowl sinks that CQC inspectors were demanding to be installed just a couple of weeks ago can now become a single bowl again with a removable bowl inside.... sorry about that plumbing bill, all part of the learning curve.
Even unwrapped instruments now benefit from additional anti-microbial qualities, especially if stored away from clinical areas. And handwashing now has one level of guidance replacing the former social, hygienic and surgical levels. Clinical waste has run away and stars in its own dedicated HTM. More change.
Finally, and much heralded, the Care Quality Commission is to announce a new statement of purpose and the potential to recognise that dentistry may no longer be considered to pose the risks that might arise from, say, the social care of vulnerable individuals or an accident and emergency unit of an acute hospital.
In future, it is possible – some would say inevitable – that dental practices will be regulated in a way which is more proportionate to the risks posed to their patients, and for that at least we must be truly thankful.