Written evidence submitted by Association of Dental Hospitals (RTR0068)

What are the main steps that must be taken to recruit the extra staff that are needed across the health and social care sectors in the short, medium and long-term?

In order to recruit more staff in the sector, there need to be a wider range of affordable entry routes made available. Currently, many skilled individuals are prevented from training for key roles due to the expensive costs of university tuition fees. The use of apprenticeships and other similar modes of training and qualification could mitigate this.

What is the best way to ensure that current plans for recruitment, training and retention are able to adapt as models for providing future care change?

Clear career pathways should be created to allow for experienced professionals in the sector to retrain for more senior positions without having to return to university for long and costly degrees (e.g. clear pathways in place for senior nurses to become doctors or dentists).

What is the correct balance between domestic and international recruitment of health and social care workers in the short, medium and long term?

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What can the Government do to make it easier for staff to be recruited from countries from which it is ethically acceptable to recruit, with trusted training programmes?

Clear and affordable pathways to convert international qualifications to UK qualifications should be in place.

What changes could be made to the initial and ongoing training of staff in the health and social care sectors in order to help increase the number of staff working in these sectors? In particular:

-To what extent is there an adequate system for determining how many doctors, nurses and allied health professionals should be trained to meet long-term need?

To determine how many dentists are need, the changing population demographic needs to be thoroughly examined in order to see where the highest need will be. Tom Clayton at HEE has already undertaken detailed analysis of trends in the UK population that will affect the provision of and the demands on the dentistry sector. This work should be consulted when assessing future need.

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It should be noted that the aging population will have a particular impact on dentistry. If patients live longer and to an older age, the demand to train dentists to manage teeth in the elderly and those with complex medical histories will increase.

DCT/early-career posts should match the needs of the aging population. This will mean realigning to promote restorative posts rather than the present focus on oral surgery. 

The changing requirements of staff (e.g. need for part-time work) must also be considered when making any determination of how many dental staff should be trained.

-Do the curriculums for training doctors, nurses, and allied health professionals need updating to ensure that staff have the right mix of skills?

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-Could the training period for doctors be reduced?

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-Should the cap on the number of medical places offered to international and domestic students be removed?

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What are the principal factors driving staff to leave the health and social care sectors and what could be done to address them?

The desire of staff to retire early to move into other sectors is a key issue. Increased use of flexible working patterns may alleviate this to an extent.

Are there specific roles, and/or geographical locations, where recruitment and retention are a particular problem and what could be done to address this?

Some district dental hospitals struggle to get consultants in specific specialties. This is a greater issue outside of London. As mentioned above, HEE are currently undertaking a mapping exercise to determine which geographical locations currently have the greatest need for more staff.

What should be in the next iteration of the NHS People Plan, and a people plan for the social care sector, to address the recruitment, training and retention of staff?

Clear and affordable career and training pathways should be laid out. Allowance for more flexible ways of working (e.g. part-time opportunities) should be included in order to allow for a wider range of people to work within service and also to increase retention of older colleagues.

To what extent are the contractual and employment models used in the health and social care sectors fit for the purpose of attracting, training, and retaining the right numbers of staff with the right skills?

In dentistry, there are currently some issues with pay which may be causing issues with attracting and retaining dental hygienists and therapists. Staff in these roles are currently recruited at as band 6 and 7, whilst some nursing positions are on higher bands. This discrepancy should be rectified in order to recruit and retain staff into these viral positions. Therapists and hygienists are band 6 and 7 and should be banded higher, in line with senior nursing roles.

What is the role of integrated care systems in ensuring that local health and care organisations attract and retain staff with the right mix of skills?

ICS’ can ensure that the right person is seeing the right patient at the right place to allow for staff to work at the top of their skillset on appropriate cases.

Jan 2022