education and training needs of prison dentists
DESCRIPTION
TRANSCRIPT
Prison Health Research NetworkPrison Health Research NetworkConference Manchester Conference Manchester
2020thth October 2006 October 2006
Education for Prison Education for Prison DentistsDentists
Helen FalconHelen FalconDirector of Postgraduate Director of Postgraduate Dental Education, Oxford Dental Education, Oxford
PGMDEPGMDEVice Chair COPDENDVice Chair COPDEND
Identified wide range of issues relating to prison dental care-• Action Plans• Focus on facilities, waiting lists and workforce• Clinical governance issues • Funding (Capital and Revenue) for SHAs and prisons
Educational Needs Educational Needs AssessmentAssessment• Focus group Focus group
– DH lead (Tony Jenner)DH lead (Tony Jenner)– Consultant in dental public health (John Beal)Consultant in dental public health (John Beal)– Prison dentistsPrison dentists– Postgraduate dental dean (Helen Falcon)Postgraduate dental dean (Helen Falcon)
• Costed proposal to DH for educational Costed proposal to DH for educational events and development of educational events and development of educational framework for prison dentistsframework for prison dentists
Prison Dentists’ Educational Needs Prison Dentists’ Educational Needs --What the Focus Group saidWhat the Focus Group said
• How the prison health system worksHow the prison health system works• Substance misuseSubstance misuse • Detoxification programmesDetoxification programmes • Blood borne virusesBlood borne viruses • Mental health – impact on dental careMental health – impact on dental care • Oral health promotionOral health promotion • Clinical governance in the prison settingClinical governance in the prison setting • Minor oral surgeryMinor oral surgery • Sharing good practiceSharing good practice
Educational Events plannedEducational Events planned
• 2 part seminar events repeated in Leeds and 2 part seminar events repeated in Leeds and London (Watford)London (Watford)
• First part November/DecemberFirst part November/December
• Follow up February 07Follow up February 07
• 24 hour residential format24 hour residential format
• Conference and accommodation costs Conference and accommodation costs fundedfunded
• GDP loss of earnings allowance fundedGDP loss of earnings allowance funded
• Travel to be claimed from PCT/PrisonTravel to be claimed from PCT/Prison
How many prison How many prison dentists?dentists?• Letter toLetter to
– all English prison governors, healthcare all English prison governors, healthcare managers, dentists (120+ prisons)managers, dentists (120+ prisons)
– UK Consultants in Dental Public Health UK Consultants in Dental Public Health
• Application form sent to all prison dentistsApplication form sent to all prison dentists– 75 applications from dentists received, 66 with 75 applications from dentists received, 66 with
questionnaire responses (not all complete)questionnaire responses (not all complete)– 16 applications from dental nurses received, 16 applications from dental nurses received,
12 with questionnaire responses12 with questionnaire responses
Dentists responsesDentists responses
• 37 GDPs37 GDPs
• 28 Salaried Dentists28 Salaried Dentists
• 1 consultant1 consultant
How the prison health How the prison health system workssystem works
Never received any training 45Never received any training 45
Received some training 17Received some training 17
None requiredNone required 3 3
No responseNo response 11
How the prison health How the prison health system workssystem works““Thrown in at the deep end 11 years ago as Thrown in at the deep end 11 years ago as
prison desperate and had to find out prison desperate and had to find out everything for myself”everything for myself”
““More training needed on legal rights of More training needed on legal rights of prisoners in relation to dental treatment and prisoners in relation to dental treatment and responsibilities of prison dental surgeon”responsibilities of prison dental surgeon”
““I learnt more from a recent TV programme I learnt more from a recent TV programme about Drake Hall than from any training”about Drake Hall than from any training”
““Have asked for induction but told this would Have asked for induction but told this would be after security clearance which has taken be after security clearance which has taken a year. Training still not available”a year. Training still not available”
Substance misuseSubstance misuse
Never received any training 44Never received any training 44
Received some training 20Received some training 20
None requiredNone required 1 1
No responseNo response 1 1
Substance misuseSubstance misuse
““Would really appreciate training on above! Would really appreciate training on above! Would v much appreciate info on types of Would v much appreciate info on types of drug abuse, effects orally and systemically-drug abuse, effects orally and systemically-feel v naïve on this topic when dealing with feel v naïve on this topic when dealing with inmates”inmates”
““Received some training- little as an Received some training- little as an undergraduate”undergraduate”
““I know a little …from reading journals”I know a little …from reading journals”““Have completed the certificate in management Have completed the certificate in management
of substance mis-users from Royal College of of substance mis-users from Royal College of General Practitioners London”General Practitioners London”
Detoxification Detoxification programmesprogrammes
Never received any training 55Never received any training 55
Received some training 9Received some training 9
None requiredNone required 0 0
No responseNo response 2 2
Detoxification Detoxification programmesprogrammes““You hear a lot about detox but not much else You hear a lot about detox but not much else
– you almost feel an annex to the whole – you almost feel an annex to the whole subject and not part of it”subject and not part of it”
““Prisoners often talk to me about the courses Prisoners often talk to me about the courses they are on”they are on”
““Know only a small amount from own study”Know only a small amount from own study”
““Worked in a drug treatment centre as dentist Worked in a drug treatment centre as dentist and part of multi disciplinary team”and part of multi disciplinary team”
Blood borne virusesBlood borne viruses
Never received any training 20Never received any training 20
Received some training 41Received some training 41
None requiredNone required 3 3
No responseNo response 2 2
Blood borne virusesBlood borne viruses
““Refresher would be useful, also relevant for Refresher would be useful, also relevant for my nurse”my nurse”
““Very relevant topic which I would appreciate Very relevant topic which I would appreciate learning from prison perspective”learning from prison perspective”
““Very important……..never taught or informed Very important……..never taught or informed about it in the prison setting”about it in the prison setting”
““Medical personnel other than dental Medical personnel other than dental surgeons need educating as to how these surgeons need educating as to how these viruses can affect the surgeons themselves”viruses can affect the surgeons themselves”
Mental health – impact on Mental health – impact on dental caredental care
Never received any training 52Never received any training 52
Received some training 13Received some training 13
None requiredNone required 0 0
No responseNo response 1 1
Mental health – impact on Mental health – impact on dental caredental care
““Pharmacology regime review helpful”Pharmacology regime review helpful”““I feel this is a vital part of providing care for I feel this is a vital part of providing care for
people in prison and am finding it very people in prison and am finding it very difficult to get any relevant and practical difficult to get any relevant and practical training in mental health”training in mental health”
““Mental health unit is adjacent to the surgery Mental health unit is adjacent to the surgery – what goes on in there is a mystery”– what goes on in there is a mystery”
““Feel v naïve and clueless when dealing with Feel v naïve and clueless when dealing with mental health- no background learning on mental health- no background learning on the subject”the subject”
Oral health promotionOral health promotion
Never received any training 29Never received any training 29
Received some training 31Received some training 31
None requiredNone required 4 4
No responseNo response 2 2
Oral health promotionOral health promotion
““I already undertake this, would be useful I already undertake this, would be useful for my nurse”for my nurse”
““Have had training though not prison relatedHave had training though not prison related““Not specific to prisons”Not specific to prisons”“…“…but have great difficulty implementing it”but have great difficulty implementing it”““Dental surgeons understand their Dental surgeons understand their
importance in oral health promotion, the importance in oral health promotion, the rest of the medical team need educating rest of the medical team need educating to understand our potential”to understand our potential”
Clinical governance in the Clinical governance in the prison settingprison setting
Never received any training 40Never received any training 40
Received some training 23Received some training 23
None requiredNone required 2 2
No responseNo response 1 1
Clinical governance in the Clinical governance in the prison settingprison setting
• Attended several lectures but too Attended several lectures but too busy with clinical work on patients to busy with clinical work on patients to find much time for this subjectfind much time for this subject
• From PCT as part of requirements of From PCT as part of requirements of GDC registration. Not specifically for GDC registration. Not specifically for prisonprison
• Keen to implementKeen to implement
• Belong to a peer review groupBelong to a peer review group
Minor oral surgeryMinor oral surgery
Never received any training 11Never received any training 11
Received some training 45Received some training 45
None requiredNone required 8 8
No responseNo response 2 2
Minor oral surgeryMinor oral surgery
““This is what I do all day”This is what I do all day”““Would welcome info on surgical policies Would welcome info on surgical policies
and referrals- nobody seems to know”and referrals- nobody seems to know”““Oral Surgery SHO in past- biopsy Oral Surgery SHO in past- biopsy
refresher (would be) helpful”refresher (would be) helpful”““Stronger links need to be forged between Stronger links need to be forged between
prison dental surgeries and OMFS Depts”prison dental surgeries and OMFS Depts”““A good practical training would be usefulA good practical training would be useful1 (clinical) attachment 25 years ago!”1 (clinical) attachment 25 years ago!”
Improving care by Improving care by sharing good practicesharing good practice
Never received any training 42Never received any training 42
Received some training 21Received some training 21
None requiredNone required 1 1
No responseNo response 2 2
Improving care by Improving care by sharing good practicesharing good practice
““Really no time for this under present Really no time for this under present conditions in the prison I work in. I conditions in the prison I work in. I have a clinical waiting list of over 4 have a clinical waiting list of over 4 months”months”
““Minor appraisals – verbally met by Minor appraisals – verbally met by manager, personal development manager, personal development plans independent of prison setting”plans independent of prison setting”
““Received some training within PCT”Received some training within PCT”
SustainabilitySustainability
• Working with Faculty of General Dental Working with Faculty of General Dental Practitioners to establish a framework for Practitioners to establish a framework for prison dentistryprison dentistry
• Using “Dentists with a Special interest” Using “Dentists with a Special interest” model, building on existing frameworks model, building on existing frameworks and others in preparationand others in preparation
• Representative working groupRepresentative working group• Potential uses? Portfolio approach to work Potential uses? Portfolio approach to work
based learning, DwSI contracts, induction based learning, DwSI contracts, induction programmes, training and education programmes, training and education leading to accreditationleading to accreditation
SustainabilitySustainability
Role of Prison Health Research Network?Role of Prison Health Research Network?
AcknowledgementsAcknowledgementsDepartment of HealthDepartment of HealthAnnette RushmereAnnette RushmereFaculty of General Dental Practitioners, RCS Faculty of General Dental Practitioners, RCS EnglandEngland