Gallagher J E, Wilson N H F
Oral Health Services Research & Dental Public Health, King's College London Dental Institute at Guy's, King's College and St Thomas' Hospitals, Oral Health Services Research & Dental Public Health, London.
Br Dent J. 2009 Feb 28;206(4):195-9. doi: 10.1038/sj.bdj.2009.114.
The Editor-in-Chief of the BDJ has previously raised important questions about dental workforce planning and the implications for dental graduates of recent changes and pressures. It is now time to revisit this issue. Much has changed since the last workforce review in England and Wales, and the rate of change is in all probability set to increase. First, at the time of writing this paper the momentous step of including dental care professionals (DCPs) on General Dental Council (GDC) registers in the United Kingdom has recently been completed. Second, the Scope of Practice of all dental professionals has been under consultation by the General Dental Council, and research evidence suggests that greater use should be made of skill-mix in the dental team. Third, within England, Lord Darzi has just published the 'Final Report of the NHS Next Stage Review', which emphasises 'quality care' and 'team-working' as key features of healthcare; this report was accompanied by an important document entitled 'A High Quality Workforce', in which plans for local workforce planning within the NHS are outlined, placing responsibilities at national, local and regional levels. Fourth, policy makers across the UK are wrestling with addressing oral health needs, promoting health and facilitating access to dental care, all of which have implications for the nature and shape of the dental workforce. Fifth, with the impact of globalisation and European policies we are net gainers of dentists as well as having more in training. Sixth, although there have been reviews and policy initiatives by regulatory, professional and other bodies in support of shaping the dental workforce, there has been little serious consideration of skill-mix and funding mechanisms to encourage team-working. Together, these events demand that we enter a fresh debate on the future dental workforce which should extend beyond professional and national boundaries and inform workforce planning. This debate is of great importance to future generations of dental healthcare professionals, funders, commissioners and providers of both dental services and dental education and training, and most importantly our patients and the public whom we serve. Furthermore, workforce planning must be linked to a philosophy of care which promotes promotion of health and embraces quality care, rather than merely treatment of disease, and addresses oral health needs and demands.
《英国牙科杂志》主编此前曾就牙科劳动力规划以及近期变化和压力对牙科毕业生的影响提出过重要问题。现在是时候重新审视这个问题了。自上次对英格兰和威尔士的劳动力情况进行审查以来，情况已经发生了很大变化，而且变化速度很可能还会加快。首先，在撰写本文时，英国已迈出重大一步，将牙科护理专业人员（DCPs）纳入了英国牙科总会（GDC）的注册名单。其次，英国牙科总会正在就所有牙科专业人员的执业范围进行磋商，研究证据表明，牙科团队应更多地采用技能组合模式。第三，在英格兰，达兹勋爵刚刚发布了《国民保健服务下一阶段审查最终报告》，该报告强调“优质护理”和“团队合作”是医疗保健的关键特征；这份报告还附带了一份重要文件，题为《高素质劳动力》，其中概述了国民保健服务体系内地方劳动力规划的计划，明确了国家、地方和区域各级的职责。第四，英国各地的政策制定者都在努力应对口腔健康需求、促进健康以及便利获得牙科护理等问题，所有这些都对牙科劳动力队伍产生了影响，并决定了其性质和构成。第五，全球化和欧洲政策的影响使我们成为牙医的净输入国，而且正在接受培训的牙医也更多。第六，尽管监管机构、专业团体和其他机构已进行了审查并出台了政策举措，以支持塑造牙科劳动力队伍，但对于鼓励团队合作的技能组合和资金机制，却很少进行认真考虑。这些事件共同要求我们就未来的牙科劳动力队伍展开一场新的辩论，这场辩论应超越专业和国家界限，并为劳动力规划提供参考。这场辩论对于牙科医疗保健专业人员、资助者、服务提供者、牙科服务和牙科教育与培训的委托方的后代，以及最重要的是我们所服务的患者和公众来说都至关重要。此外，劳动力规划必须与一种护理理念相联系，这种理念促进健康、接受优质护理，而不仅仅是治疗疾病，并满足口腔健康需求和要求。
