Key Points
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Provides awareness of learning from measuring training GDPs upskilled to the level of dentists with enhanced skills (DES) in endodontics in primary care dental services.
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Suggests ways in which outcomes can be measured in primary care as part of routine practice
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Suggests ways in which primary care can be engaged in research.
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References
World Health Organisation. Models and tools for health workforce planning and projections. Human Resources for Health Observer. 2010. Available at http://apps.who.int/iris/bitstream/handle/10665/44263/9789241599016_eng.pdf;jsessionid=356F941C1162C0E48C9A32018A7A01FF?sequence=1 (accessed August 2016).
House Of Commons Health Committee. Dental services – fifth report of session 2007–08. Vol. 1. London: The Stationery Office Ltd, 2008. Available: https://publications.parliament.uk/pa/cm200708/cmselect/cmhealth/289/289i.pdf (accessed May 2016).
Steele J . NHS dental services in England: An independent review led by Professor Jimmy Steele. 2009. Available at http://www.sigwales.org/wp-content/uploads/dh_101180.pdf (accessed July 2016).
Centre for Workforce Intelligence. Securing the future workforce supply: dental care professionals stocktake. 2014. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/507376/CfWI_Dental_care_professionals_stocktake.pdf (accessed July 2016).
Health And Social Care Information Centre. Dental treatment band analysis England 2007 preliminary results. April to July 2007 and comparisons with 2003–04. 2007. Available: https://digital.nhs.uk/data-and-information/publications/statistical/nhs-dental-statistics/dental-treatment-band-analysis-england-2007-preliminary-results (accessed August 2018).
House Of Commons Health Committee. Dental services – fifth report of session 2007–08 Vol 2. London: The Stationery Office Ltd, 2008. Available at http://www.publications.parliament.uk/pa/cm200708/cmselect/cmhealth/289/289ii.pdf (accessed May 2016).
McDonald R, Cheraghi-sohi S, Tickle M, Roland M, Doran T, Campbell S . The impact of incentives on the behaviour and performance of primary care professionals. Queen's Printer and Controller of HMSO, 2010. Available at http://www.netscc.ac.uk/hsdr/files/adhoc/158-final-report.pdf (accessed August 2016).
Tickle M, McDonald R, Franklin J, Aggarwal V R, Milsom K, Reeves D . Paying for the wrong kind of performance? Financial incentives and behaviour changes in NHS dentistry 1992–2009. Community Dent Oral Epidemiol 2011; 39: 465–473.
Tanalp J, Güven E P, Oktay I . Evaluation of dental students' perception and self-confidence levels regarding endodontic treatment. Eur J Dent 2013; 7: 218–224.
Davey J, Bryant S T, Dummer P M H . The confidence of undergraduate dental students when performing root canal treatment and their perception of the quality of endodontic education. Eur J Dent Educ 2015; 19: 229–234.
Al-Haboubi M, Eliyas S, Briggs P F A, Jones E, Rayan R R, Gallagher J E . Dentists with extended skills: the challenge of innovation. Br Dent J 2014; 217: E6.
Department of Health/Faculty of General Dental Practitioners United Kingdom. Implementing a Scheme for Dentists with Special Interests (DwSIs). 2004. Available: http://webarchive.nationalarchives.gov.uk/20120503230817/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4083120.pdf (accessed August 2016).
Department Of Health/FGDP UK. Guidelines for the appointment of Dentists with Special Interests (DwSIs) in Endodontics, London. 2006. Available at http://webarchive.nationalarchives.gov.uk/20130124072759/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4133752.pdf (accessed August 2018).
Department Of Health/FGDPUK. Primary Care Contracting. Dentists with Special Interests: a step by step guide to setting up a DwSI service – London. 2006. Available at https://www.pcc-cic.org.uk/sites/default/files/articles/attachments/step_by_step_guidance_dwsis.pdf (accessed June 2016).
Pawson R, Greenhalgh J, Brennan C . Chapter 5 Role change: general practitioners with a special interest – can they control and shape demand? In Demand management for planned care: a realist synthesis. No. 4.2. Southampton (UK): NIHR Journals Library, 2016. Available at http://www.ncbi.nlm.nih.gov/books/NBK338669/ (accessed August 2016).
Department of Health. Five-Year Forward View. 2014. Available at https://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf (accessed August 2016).
Rooney E . The evolution of dentists with enhanced skills. Fac Dent J 2015; 6: 66–69.
NHS England, Introductory Guide for Commissioning Dental Specialties. 2015. Available: https://www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2015/09/intro-guide-comms-dent-specl.pdf (accessed May 2016).
Burke F J, McCord J F, Research in general dental practiceproblems and solutions. Br Dent J 1993; 175: 396–398.
Rajarayan R K . Dental Science – Reality of the evidence. Prim Dent Care 2000; 7: 134–139.
Wilson M A, Cowan A J, Randall R C . A practice based randomised controlled clinical trial of a new resin composite restorative: one year results. Oper Dent 2002; 27: 423–429.
Crawford F . Clinical trials in dental primary care: what research methods have been used to produce reliable evidence? Br Dent J 2005; 199: 155–160.
Koch M . On implementation of an Endodontic Programme. Swed Dent J Suppl 2013; S230: 9–97.
Dahlström L, Molander A, Reit C . The impact of a continuing education programme on the adoption of nickel–titanium rotary instrumentation and root-filling quality among a group of Swedish general dental practitioners. Eur J Dent Educ 2015; 19: 23–30.
Reit C, Bergenholtz G, Caplan D, Molander A . The effect of educational intervention on the adoption of nickel-titanium rotary instrumentation in a public dental service. Int Endod J 2007; 40: 268–274.
Molander A, Caplan D, Bergenholtz G, Reit C Improved quality of root fillings provided by general dental practitioners educated in nickel–titanium rotary instrumentation. Int Endod J 2007; 40: 254–260.
Koch M, Eriksson H G, Axelsson S, Tegelberg A . Effect of educational intervention on adoption of new endodontic technology by general dental practitioners: a questionnaire survey. Int Endod J 2009; 42: 313–321.
Koch M, Wolf E, Tegelberg A, Petersson K . Effect of education intervention on the quality and long-term outcomes of root canal treatment in general practice. Int Endod J 2015; 48: 680–689.
Dahlström L, Molander A, Reit C . Introducing nickel-titanium rotary instrumentation in a public dental service: the long-term effect on root filling quality. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011; 112: 814–819.
European Society Of Endodontology. Quality Guidelines for endodontic treatment: consensus report of the European Society of Endodontology. Int Endod J 2006; 39: 921–930.
Eliyas S, Briggs P, Gallagher J E . The experience of dentists who gained enhanced skills in endodontics within a novel pilot training programme. Br Dent J 2017; 222: 269–275.
Helminen S E, Vehkalahti M, Murtomaa H . Dentists' perception of their treatment practices versus documented evidence. Int Dent J 2002; 52: 71–74.
Eliyas S, Briggs P F A, Harris I R, Newton J T, Gallagher J E . Development of quality measurement instruments for root canal treatment. Int Endod J 2017; 50: 652–666.
Rasheed T . Outcome measure for Endodontic Treatment: PhD research at King's College London. 2012. Available at https://kclpure.kcl.ac.uk/portal/files/13552179/StudentthesisTahir_Rasheed_2012.pdf (accessed August 2016).
Farzaneh M, Abitbol S, Friedman S . Treatment outcomes in endodontics: The Toronto Study. Phases I and II: orthograde re-treatment. J Endod 2004; 30: 627–633.
Liu P, Mcgrath C, Cheung G . What are the key endodontic factors associated with oral health–related quality of life? Int Endod J 2014; 47: 238–245.
Ghotane S G, Al-Haboubi M, Kendall N, Robertson C, Gallagher J E . Dentists with enhanced skills (Special Interest) in Endodontics: gatekeepers views in London. BMC Oral Health 2015; 15: 110.
Department Of Health. NHS dental contract pilots – Early findings. 2012. Available: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/212999/NHS-dental-contract-pilots-early-findings.pdf (accessed August 2016).
Health Research Authority, Ethics Guidance: Payments and Incentives in Research. 2014. Available at http://www.hra.nhs.uk/documents/2014/05/hra-guidance-payments-incentivesresearch-v1-0-final-2014-05-21.pdf (accessed May 2016).
Grant R W, Sugarman J . Ethics in Human Subjects Research: Do Incentives Matter? J Med Phil 2004; 29: 717–738.
Singer E, Couper M P . Do Incentives Exert Undue Influence on Survey Participation? Experimental Evidence. J Empir Res Hum Res Ethics 2008; 3: 49–56.
Cheung A, Weir M, Mayhew A, Kozloff N, Brown K, Grimshaw J . Overview of systematic reviews of the effectiveness of reminders in improving healthcare professional behaviour. Syst Rev 2012; 1: 36.
NHS. National Institute for Health Research Clinical Research Network Portfolio. Available at https://www.nihr.ac.uk/research-and-impact/nihr-clinical-research-network-portfolio/ (accessed March 2018).
Mjör IA . Review Article: Practice-based dental research. J Oral Rehab 2007; 34: 913–920.
Draper H, Wilson S, Flanagan S, Ives J . Offering payments, reimbursement and incentives to patients and family doctors to encourage participation in research. Fam Pract 2009; 26: 231–238.
Newington L, Metcalfe A . Factors influencing recruitment to research: qualitative study of the experiences and perceptions of research teams. BMC Med Res Methodol 2014; 14: 10.
Moorcraft S Y, Marriott C, Peckitt C et al. Patients' willingness to participate in clinical trials and their views on aspects of cancer research: results of a prospective patient survey. Trials 2016; 17: 17.
Department Of Health. NHS dental contract pilots – Learning after first two years of piloting. 2014. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/282760/Dental_contract_pilots_evidence_and_learning_report.pdf (accessed August 2016).
General Dental Council. Maintaining Standards – Guidance to Dentists on Professional and Personal Conduct. Revised May 1999.
General Dental Council, Standards for Dental Professionals. 2005. Available at https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=2ahUKEwiI49DRz-DcAhXJx4UKHQTRDpoQFjAAegQIAxAC&url=https%3A%2F%2Fwww.gdc-uk.org%2Fapi%2Ffiles%2FOLD%2520Standards%2520for%2520Dental%2520Professionals.pdf&usg=AOvVaw2bsgWd7gdHGfxxI2kjscfh (accessed August 2018).
National Health Service Commissioning Board. Securing Excellence in Commissioning NHS Dental Services. 2013. Available at https://www.england.nhs.uk/wp-content/uploads/2013/02/commissioning-dental.pdf (accessed August 2016).
Eckerbom M, Magnusson T . Evaluation of technical quality of endodontic treatment-reliability of intraoral radiographs. Endod Dent Traumatol 1997; 13: 259–264.
Van Der Sluis L W M, Wu MK, Wesselink R P . An evaluation of the quality of root fillings in mandibular incisors and maxillary and mandibular canines using different methodologies. J Dent 2005; 33: 683–688.
Aquilino S A, Caplan D J . Relationship between crown placement and the survival of endodontically treated teeth. J Prosthet Dent 2002; 87: 256–263.
Salehrabi R, Rotstein I . Endodontic treatment outcomes in a large patient population in the USA: an epidemiological study. J Endod 2004; 30: 846–850.
Ng YL, Mann V, Gulabivala K . Outcome of primary root canal treatment: a systematic review of the literature – part 2. Influence of clinical factors. Int Endod J 2008; 41: 6–31.
Ng YL, Mann V, Gulabivala K . Outcome of secondary root canal treatment: a systematic review of the literature. Int Endod J 2008; 41: 1026–1046.
Tickle M, Milsom K, Qualtrough A, Blinkhorn F, Aggarwal V R . The failure rate of HNS funded molar endodontic treatment delivered in general dental practice. Br Dent J 2008; 204: E8.
Ng YL, Mann V, Gulabivala K . A prospective study of the factors affecting outcomes of non-surgical root canal treatment: part 1: periapical health. Int Endod J 2011; 44: 583–609.
Tickle M, Campbell S . How do we measure quality in primary dental care? Br Dent J 2013; 215: 183–187.
Ericsson K A, Krampe R T, Tesch-Romer C . The Role of Deliberate Practice in the Acquisition of Expert Performance. Psychol Rev 1993; 100: 363–406.
Hambrick D Z, Altmann E M, Oswald F L, Meinz E J, Gobet F, Campitelli G . Accounting for expert performance: The devil is in the details. Intelligence 2014; 45: 112–114.
Skipper M . Managed Clinical Networks. Br Dent J 2010; 209: 241–242.
Guthrie B, Davies H, Greig G . SDO Project (08/1518/103). Delivering health care through managed clinical networks (MCNs): lessons from the North. 2010. Available at http://www.netscc.ac.uk/hsdr/files/project/SDO_FR_08-1518-103_V01.pdf (accessed August 2016).
Renton T, Balmer C . Primary care training for oral surgery: challenges and possibilities. Fac Dent J 2013; 4: 65–73.
Renton T . Workforce in oral surgery: current and potential challenges and opportunities. Fac Dent J 2013; 4: 80–87.
Renton T . Level 3 service delivery: implementation of the oral surgery review. Fac Dent J 2013; 4: 88–93.
Heasman P A, Macpherson L E, Haining S A, Breckons M . Clinical research in primary dental care. Br Dent J 2015; 219: 159–163.
Grol R, Wensing M . What drives change? Barriers to and incentives for achieving evidence-based practice. Med J Aust 2004; 180: S57–S60.
Porcheret M, Main C, Croft P, Mckinley R, Hassell A, Dziedzic K . Development of a behaviour change intervention: a case study on the practical application of theory. Implement Sci 2014; 9: 42.
Michie S, Johnston M, Abraham C, Lawton R, Parker D, Walker D on behalf of the 'Psychological Theory' Group. Making psychological theory useful for implementing evidence based practice: a consensus approach. Qual Saf Health Care 2005; 14: 26–33.
Baker R, Camosso-Stefinovic J, Gillies C et al. Tailored interventions to address determinants of practice. Cochrane Database Syst Rev 2015; 10.1002/14651858.CD005470.pub3.
Chaix-Couturier C, Durand-Zaleski I, Jolly D, DurIeux P . Effects of financial incentives on medical practice: results from a systematic review of the literature and methodological issues. Int J Qual Health Care 2000; 12: 133–142.
Briggs T . A national review of adult elective orthopaedic services in England. Getting It Right First Time. 2015. Available at https://www.boa.ac.uk/wp-content/uploads/2015/03/GIRFT-National-Report-Mar15..pdf (accessed August 2018).
Campbell S, Tickle M . What is quality primary dental care? Br Dent J 2013; 215: 135–139.
Campbell S, Tickle M . How do we improve quality in primary dental care? Br Dent J 2013; 215: 239–243.
Donabedian A . The definition of quality and approaches to its management, Vol 1: Explorations in quality assessment and monitoring. Ann Arbor, Mich, Health Administration Press, 1980.
Donabedian A . Evaluating the quality of medical care. Milbank Q 1966; 44: 166–203.
Donabedian A . The Quality of Care – How can it be assessed? JAMA 1988; 260: 1743–1748.
Health Education England. Workforce planning guidance 2014/15. Available at https://hee.nhs.uk/sites/default/files/documents/Workforce-planning-guidance-2014-15.pdf (accessed August 2018).
Health Education England Framework 15. Health Education England Strategic Framework 2014–2029. Available at https://hee.nhs.uk/sites/default/files/documents/HEE%20strategic%20framework%202017_1.pdf (accessed July 2016).
Department Of Health. NHS Outcomes Framework 2015/16 at a glance. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/417894/At_a_glance_acc.pdf (accessed June 2016).
Department Of Health. Improving outcomes and supporting transparency Part 1A: A public health outcomes framework for England, 2013–2016. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/263658/2901502_PHOF_Improving_Outcomes_PT1A_v1_1.pdf (accessed August 2018).
Department Of Health. NHS Constitution: Guide to the Healthcare System in England Including the Statement of NHS Accountability. 2013. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/194002/9421-2900878-TSO-NHS_Guide_to_Healthcare_WEB.PDF (accessed July 2016).
Norman G, Monteiro S, Salama S . Sample size calculations: should the emperor's clothes be off the peg or made to measure? Br Med J 2012; 345: e5278.
Masood M, Masood Y, Newton J T . Accounting for the clustering effects of surfaces within the tooth and teeth within individuals. J Dent Res 2015; 94: 281–288.
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Professor Nora Donaldson and Mr Manoharan Andiappan for statistical help and advice.
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S. Eliyas taught on the DES course described above. P. Briggs was the educational lead for the London DES in Endodontics Programme, taught on the DES course and was responsible for patient triage for three of the DES participants. J.E. Gallagher was part of the Senior Dental Leadership Team in the Department of Health and a Dental Public Health representative in the working group for setting up DES in endodontics and reports grants from London Deanery (now Health Education England) during the conduct of the study. The other authors have stated explicitly that there are no conflicts of interest in connection with this article.
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Eliyas, S., Briggs, P., Newton, J. et al. Feasibility of assessing training of primary care dental practitioners in endodontics of moderate complexity: mapping process and learning. Br Dent J 225, 325–334 (2018). https://doi.org/10.1038/sj.bdj.2018.644
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DOI: https://doi.org/10.1038/sj.bdj.2018.644
