The Dental Reference Service employs a team of experienced and calibrated dentists to monitor and advise on quality within the GDS and PDS through a risk based monitoring system. This quote is taken from their website in November but my first encounter with the DRS – working as the Dental Practice Board in Eastbourne - was as a newly qualified dentist in 1969. I had charted a generously drawn occlusal filling on the paper form. The final form was submitted as an occlusal-palatal filling-in error. The ensuing protracted discussion with the visiting regional dental officer engendered a healthy respect for accuracy and caused sleepless nights anticipating charges of fraudulently claiming 20p.
The next momentous occasion was the successful application for prior approval of the first multiple anterior crowns for a 15-year-old boy in 1971. He had severe tetracycline staining and wore very long hair over his face as a mask and never spoke or smiled. The RDO agreed that something had to be done but that it should be limited to upper anteriors. The six crowns were duly fitted and the resulting probity check with the RDO was a revelation in that the crowns were passed as acceptable but the transformation to the patient was awesome. Short hair and a big smile and both the RDO and I felt elated.
Over the years I have come to respect these colleagues as being fair and proportionate.Times have changed and their title is now dental reference officer and their role has been greatly altered.
I am not alone in acknowledging their contribution to the National Health Service and dentistry. DROs are now used in other aspects of dentistry. If there is a case for arbitration they are used as neutral observers and have even been used to resolve dental complaints as an unbiased view accepted by both patient and dentist alike. So here we have a service of 28 highly trained and motivated dentists whose expertise is valued – if not fully appreciated by all GDPs – supporting dentistry in its many forms.
Many years ago the banks were looking at their staffing system and, in an attempt to streamline and cut costs, adopted a policy of making all bank managers over 50 redundant.
The result was a huge knowledge gap. The younger managers had much less experience in both coping with customers and also answering their needs. Their loss has still not been made up fully and whilst no bank would ever admit to a mistake, they have paid a far greater price in retraining and correcting errors than was ever saved by redundancies.
So what has this to do with the Dental Reference Service? The DRS which employs the DROs has just issued a notice of redundancy to all existing DROs. There had been a rumour that the CQC might take them on board as practice inspectors. But no! In their wisdom the CQC under the CEO Cynthia Bowers (ex-CEO of NHS West Midlands) have decided that they have no use for this incredible pool of highly trained dentists. The reason for this is that apparently they do not want anyone to actually look at patients’ mouths. The only job required of a CQC inspector will be to tick boxes and not meet with, or inspect, the patient. Any DRO worth their salt will tell tales of perfect systems practices where there is untreated decay, suppurating abscesses and neglect. Often the good, competent dentist can fare badly in the paper work but be a star in the mouth.
Who or what will protect the NHS billions in dentistry? Who or what will ensure that what is claimed for is carried out? Or, more worryingly, what is being ignored, neglected or not even noted? Who will blow the whistle on fraud? Those at the top of NHS dentistry should be worried about the direction dentistry is going. This is certainly not to suggest that all dentists will exploit the system but there will always be a few. So who will protect the rights of the NHS and the patient? Or does it not matter?