Ian Pocock

Registrar
FGDP(UK)
 COPDEUK 24 May 2012

Training and Education for the new NHS Care Pathways Oral
Surgery

The level 2 conundrum:

what defines a DwSI; and

who provides the QA
 Guidance
Dentists with Special Interests
A step by step guide to setting up a DwSI
service NHS Primary Care Contracting 2006

Guidelines for the appointment of Dentists

with Special Interests in Minor Oral
Surgery Department of Health/Faculty of General Dental Practice (UK) 2006
 Definitions
A dentist working in the primary care setting who provides services
which are in addition to their usual and important generalist role. The
DwSI provides a service which is complementary to the secondary
services and but does not replace that provided by a dentist who has
undergone the training required for entry to a specialist list. The DwSI is
an independent practitioner who works within the limits of their
competency in providing a special interest service and who refers on
where necessary.
 Definitions
The DWSI may deliver a clinical service beyond that normally provided
by a primary dental care practitioner or may deliver a particular type of
treatment. Individual DwSIs will be able to demonstrate their
competencies in the special interest areas. Special interest may
be demonstrated by dentists through completion of formal training
programmes and/or evidence based experience
 Competency Frameworks

Orthodontics
Minor Oral Surgery
Periodontics
Endodontics
Special Care Dentistry
Prison Dentistry
Leadership and Management
 National Guidelines and Clinical Competency Frameworks

If a PCT wishes to appoint a DwSI, they will need

to use these guidelines and competency
frameworks together with professional advice, to
assess the competency of potential local
candidates prior to a contract being agreed.
 Contract specification

The specification should:

Specify core activities and competencies
required
The types of suitable patients, including
inclusion and exclusion criteria
The clinical governance, accountability and
monitoring arrangements, including links with
relevant surgical disciplines (Oral and Max Fax
and Oral Surgery)
 Appointments Process

The appointments process involves accreditation of the DwSIs

competencies through:

Appraisal of a portfolio of evidence involving local appraisers

including consultants/specialists in clinical area, primary care
representative, LDC and PCT representatives
The value of training programmes recognised but, the emphasis
should be around the competencies and the role
If the appointment is experience based, the candidate must be
working under the direct supervision of a consultant or specialist for
one session per week
 Clinical Governance, Audit and Evaluation

Each DwSI should have a consultant/specialist mentor

Regular training and CPD in the relevant area

Annual appraisal of both generalist and DwSI role

Monitoring of quantity, nature, duration, and quality of

services of services against the specification
 Recommended Procedures

1. Routine extraction of single and multi-rooted erupted teeth.

2. Removal of buried roots and fractured or residual root fragments.
3. Removal of simple impacted/ectopic/supernumerary teeth.
4. Exposure of teeth.
5. Minor soft tissue surgery:
5.1 Removal of simple fibro-epithelial polyps.
5.2 Removal of simple mucocoele.
5.3 Removal of uncomplicated denture induced mucosal hyperplasia.
6. Management of minor dental trauma including the re-implantation of
avulsed teeth.
7. Surgical endodontics on single rooted anterior teeth.
8. Management of cranio-facial pain.
 Conclusions

The way forward?

Heavy onus on the commissioning organisation?

The Faculties can play their part