More Disruption to Contract Reform Process and the Office of the Chief Dental Officer

More Disruption to Contract Reform Process and the Office of the Chief Dental Officer

“It is very vulgar to talk like a dentist when one isn’t a dentist. It produces a false impression.” This may not be the best known line from “The importance of being Earnest.” 

That honour probably belongs to: “To lose one parent, Mr. Worthing, may be regarded as a misfortune; to lose both looks like carelessness.” Recent events have made that too, take on a dental significance, with OCDO now appearing to lose a second senior officer, in the space of a month.

In December 2020, Rebecca Harris, Professor of Dental Public Health at Liverpool University was appointed Deputy Chief Dental Officer (England). This was as part of a job share with the other Deputy CDO Jason Wong. Professor Harris qualified in Dentistry from Bristol University, and then moved between clinical roles (including Clinical Director of Salaried Services in South Glamorgan) and academia (Kings College London), before joining the University of Liverpool as Professor and Honorary Consultant in Dental Public Health. She bought with her a research background focussed on oral health inequalities and health systems, especially in relation to real world settings of primary dental care and vulnerable communities.

Importantly Professor Harris provided the clinical leadership on the Dental Strategy Reform Group, which was tasked with dealing with contract reform. Last June as the final speaker at a Westminster House Forum on dentistry, she gave a presentation entitled, “Next steps for dentistry and oral health in England.” The visual metaphors were strong with multiple images of staircases to underline the incremental nature of any changes to the dental contract. A number of key elements were clear, however. Two in particular, were to be crucial to those remaining in NHS practice and hoping for significant improvements.

Firstly there had to be an acceptance that contractual change can only go “so far”. And then, there was a fundamental assumption that funding will not change. Whatever the new scope or ambition of NHS dentistry may be, one thing was clear, it would not be getting any more money. A year later, both predictions have held true.

The Professor’s exact status remains unclear. On twitter, Simon Hearnshaw, Dental Training Programme Director in Yorkshire and a key figure in the genesis of Urgent Dental Care Centres during the pandemic, began a comment with: “I’m hearing we may be losing Rebecca Harris as the lead for DSR.” To which Professor Harris replied thanking him and saying that it had been a “very interesting time to be involved”. While Professor Harris still has her OCDO post shown on her Linkedin, she does not appear on the NHS England website for the OCDO. This does however, still show Sara Hurley as CDO and Jason Wong as Deputy. It may be that like NHS find-a-dentist, the OCDO website is only required to be updated every 90 days.

If Professor Harris is indeed leaving her CDO position this leaves, as part time interim CDO, Jason Wong, with no deputy CDO. Potentially, two whole time posts have now reduced to a single part time one. It also leaves the Dental Strategy Reform Group without clinical input, just as the influential Commons Select Committee report into NHS dentistry is expected to land. NHS National Medical Director, Professor Stephen Powis, has yet to provide the promised update on the arrangements for recruiting the next Chief Dental Officer England, so the current situation is likely to remain for some time.

Last June, Professor Harris finished her presentation with a slide showing a quote by President Obama, asking, “Do we proceed in a politics of cynicism or a politics of hope?” Recently she provided a presentation at the GDC’s Dental Leadership Network, on the structure and component parts of the system behind dentistry.

From dental contract to system reform: why an incremental approach is needed - PubMed (nih.gov)


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