BLOG January 2015 Paul Coulthard This year will see the further development of the relatively new UK specialty of Oral Surgery as a separate specialty from Oral and Maxillofacial Surgery. The NHS has always undergone change but the current changes are being described as the biggest since its inception. You have to enjoy change to have a happy career or at least be robust enough to tolerate it if you are to survive. Change brings opportunity! One of the drivers of the current changes is the concern about inequality with not all communities sharing the benefits of good health and also the need to be more successful in disease prevention. As of 2013, the NHS commissioning system has changed. Groups of general medical practices have come together to take on responsibility for commissioning the best medical services for their patients. Dentistry is different and the ‘NHS Commissioning Board’ has taken commissioning responsibility for all NHS dental services: primary care including high street dental practices, community dental services, and secondary care, dental services at general hospitals and dental hospitals, and including dental out-of-hours and urgent care. This offers a huge opportunity to make a real step change in the development oral surgery services to the benefit of patients. A guide is being written to help the commissioning of specialist Oral Surgery services and I am chairing the working group doing this work. We started work last April and will complete our work by the end of March 2015. The specialties of Dental & Maxillofacial Radiology, Oral & Maxillofacial Pathology and Oral Microbiology have representation on the working group but it has become clear that they need a separate guide as their services are significantly different in the way they work. Oral Medicine on the other hand is very much a patient facing service like Oral Surgery and so the published commissioning guide will include Oral Medicine. The guide will provide a description of Oral Surgery services, including the current national picture for England, an illustrative patient journey and refer to local needs assessment information. It describes service transformation and its implications for training and the workforce. A minimum standard specification for service procurement is included and also outcome measures to assess clinical outcomes, patient safety and patient reported outcomes. It is a comprehensive read! The advantage of future services for patients will be the consistency of standards across the whole of England. Other parts of the UK are watching with interest so the benefits may ultimately be wider. The guide does not describe Oral and Maxillofacial Surgery as this is a medical specialty but obviously there is overlap with many oral and maxillofacial surgeons providing oral surgery services. Maxillofacial Surgery as a medical specialty exists in some European countries but not in the UK. As we have OMFS and OS in the UK then there is overlap but there will be implications for workforce development. Apart from additional clinical skills, consultants in OS in the UK possess management and research competences that differentiate them from a specialist and so are well placed to lead local professional networks of specialists and general dental practitioner with enhanced oral surgery skills to deliver excellent services across settings. I think this year will start to see clarity about oral surgery service development. It’s going to be an exciting year
Posted on: Mon, 19 Jan 2015 09:49:50 +0000