In any healthcare system there will be an element of expected variation and an element of unexpected variation. The variation may arise from treatment provided by different healthcare professionals or it could be in relation to the way in which services are commissioned. There may also be variation in the way in which health systems function for different professional groups. As well as variation from the health system, there may be variation in the way that regulators operate. If all dental professionals used different titles and different nomenclature, the variation may become unmanageable within the profession but more importantly patients would soon lose track of whom or what they are accessing for care.
In March 2012, the General Dental Council published guidance on ethical advertising. This guidance was aimed at dental professionals to help define parameters on how and when to advertise as well as informing those within the dental profession whether or not they can use the title specialist. The main driver for this has been to help patients make informed choices about their dental care. You may wonder whether this was necessary and perhaps as dental professionals it may not always have been so obvious, however from a patient’s perspective this was a very helpful move. Patients are now faced with the option of directly accessing a range of dental care professionals as well as a range of dental surgeons who may or may not be specialists. Patients that have visited me have often not understood the difference between clinical dental technician and prosthodontist and therefore any guidance that helps patients is certainly useful.
In recent years, the GDC appears to have taken a more robust approach to handling variation in professional titles. When notified of potentially inappropriate use of professional title, the GDC’s current approach seems to involve writing to a dental professional and reminding them of the GDC’s Principles of Ethical Advertising. In fact the GDC gazette last year highlighted examples of which groups could use which title. This seemed to set out professional boundaries which appeared to offer much needed clarity. Therefore it is surprising that some organisations within the NHS still advertise jobs which seem to contradict the GDC’s guidance. A recent advert from a central London hospital advertised the position of specialist dental nurse. It may be that the GDC needs to carry out some further work with NHS employers. It is possible that general nurses, who often manage dental nurses in these large trusts, may not be aware of the strict guidance that is provided by the GDC. In fact a quick search on the internet would reveal that there are still a number of UK dental websites that refer to a plethora of specialist titles in relation to dental nurses. It is probable that these are unintentional oversights on the part of the web developers, who may also be unfamiliar with GDC guidance.
In order to reduce the variation in the way in which dental professionals are managed by the GDC and also so that patients and the public are protected in a consistent manner, the GDC may need to proactively engage with the healthcare community to help reduce the unintended use of the term specialist. It is important that dentists and dental care professionals are treated in a consistent manner and that one group of registrants is not treated any differently to the other group.
In my view, reducing such variation will help the public get the best out of the health system, reducing variation and achieving consistent processes and outcomes is good in any health system.