Spring Newsletter 2017

Hello Lancashire: as the days lengthen and the weather starts to get warmer everything seems that much better. That is of course apart from the fact there is little money in the NHS and we all continue to struggle to meet targets whilst maintaining standards. On the other hand all my bulbs have come through and the villainous Cyril the Squirrel (bless him ) has not dug any up this year – Happy Days! Memory Lane: for our trip down Memory Lane in this issue we are to consider General Anaesthesia in Dentistry. Up until the late 90’s we regularly used GA as an excellent means of achieving the relief of pain and sepsis. In those early days most practices offered a GA service with the GDP giving the anaesthetic. Consequently in the 80’s we all charged down to London to get on the SAAD courses and undertook Post Grad courses in our local hospitals in order to upskill ourselves in both GA and Sedation. GA was not just used for extractions though, one of the most useful tools to manage nervous patients needing restorative work was “Intermittent Brietal” whereby we had an indwelling butterfly and infused increments of the IV anaesthetic at intervals in order to maintain adequate anaesthesia. It made life so easy when you could just get on with the surgery without the inevitable concerns of managing a nervous patient. Needless to say the patients loved it! As governance became more formalised we started to use hospital anaesthetists and GA services became more restricted and specialised. In the heyday in the 90’s in our practice we took referrals from other dentists and got through around 30+ GAs per week. With the network of practices across the Fylde Coast no child or nervous adult had to suffer with toothache for more than 24 hours. The service was also absurdly cheap when compared to the cost of a hospital GA. It was unusual for dentists of my generation not to have experienced some of this activity but after “A Conscious Decision” in the late 90’s all GDP based GA ceased to be! CQC: please be aware that as part of practice governance process it is necessary to keep photographic records of all staff as part of the regulations. The CQC are asking for this as part of their inspections. There is more detailed information on the LDC website courtesy of Dave Bradley. If you are not registered with the website already it would be useful to do so to take advantage of the free resource. DPASS: following some changes in GDC procedure we decided a couple of months ago as an LDC Exec in conjunction with the Area Team to work up and resurrect our old Lancashire DPASS scheme. Some of you will remember how successful the scheme was. DPASS stands for Dental Practitioner Advice and Support Scheme and worked very well some 15 years ago where practitioners needing some Peer Support could be offered it. In those days initially the LDCs owned the scheme but latterly it became part of the old PCT Performer Management Process before disappearing in favour of Appraisal. In those days also the GDC were very interested in the idea as a means of assisting practitioners in keeping out of trouble. Participation in the scheme is voluntary and completely supportive. Just to show how we are ahead of the game in Lancs it was mentioned at a regional LDC event attended by David Geddes that dusting off DPASS was to be recommended – guess what – we had already done it! More to follow over the next few months but if you are in a position where you would appreciate some peer support from an experienced practitioner just let me know and we will arrange it for you. The DPASS representative can be either within or outside your area depending on the circumstances and your choice. SHARPS: and so it rolls on! We have had some mixed responses from our Acute Trusts around the provision of end point care in the case of Sharps Injury. The LDC Exec Protocol is acknowledged as best practice (see the website for more details) but in some cases the end point delivery has been found lacking. An incident last year in East Lancs triggered off discussions at the Local Dental Network where we were all concerned that our Dental Practitioners and Staff were not getting the best case management from our Acute Trusts. It was decided that we should put in an official complaint to the Nursing Directorate at the Area Team to flag concerns. I put a letter together and it has now gone off for comment. I will keep you updated as to progress. AMR PUBLICITY: the current drive around antimicrobial resistance and the reduction of the use of antibiotics in all areas of healthcare is appropriate and very laudable. Work has been ongoing through the RCN in support of this. One of our GDPs, Wendy Thompson, from Lancaster is currently undertaking a PhD on this very subject and has given us great support. The profession across the county are also grasping the nettle and only providing an antibiotic prescription in the appropriate cases. Great we all say – well done guys! However there have been some cases where this stance has backfired on practitioners and criticism has been brought around the non-prescription of antibiotics and in some cases this has been from fellow healthcare providers. As the Exec we decided we needed to get some support in place for the troops on the ground. Criticism such as been received has been borne out of ignorance and we do need to educate healthcare providers and patients alike. I have been working with the LMC and the Area Team around the concept of getting information out to GP practices and Acute Trusts. It is early days yet and we do need to take a joint approach with our Area Team and Dental Public Health around this whole issue. We are looking at suitable literature for distribution rather than daft songs on the radio! More information to follow as it emerges. CONTRIBUTIONS TO THE NEWSLETTER: I am looking for contributions to include in the newsletter from any of you out there with an interesting story or information. If anybody has anything please forward it to me and we will include it in future editions. Contact email is JUST ONE MORE THING:

RECYCLING: OK so in the past I have had a go at the excessive Cumbrian approach to recycling but have now “got the bug”; I have invested in a range of containers to recycle with and have noticed how keen the bin men are to gather up as much recyclable stuff as possible – might have something to do with the fact they get paid for it! Mrs A thinks I am ill and need to go and see somebody about it but hey it is addictive and to be recommended CLOSING CREDIT CARDS: I recently closed a credit card I had not used for ages. I rang the company and informed the chap that I no longer needed their services – Hasta la Vista etc – he did all the necessary and then said I would receive a letter in a few days formally closing the account. I thanked him and then he said – is there anything else I can do for you! How the heck could he do anything else for me when I have closed the account! FRACKING: political hot potato this one! There is a Fracking site not too far away from us and it has sparked off some discontent from the locals. As you drive past there is usually a few “senior citizens” peacefully stood there with placards saying “No to Fracking in Lancashire” I only recently found out that Boys in Blue were deploying around 60 officers a day to the site! Is this not excessive under the circumstances? I mean nothing ever happens round our way in Fleetwood. The most serious offences are someone nicking a pork pie from the Shell Garage or dropping some litter, both of which normally merit the Police Helicopter incidentally! I thought the police, like everyone else had to save money – maybe not! ONWARDS AND UPWARDS Bernard Bernard Alston Sec Lancs LDC Executive

#ccc #DPASS #sharps #AMR