Undertaking DwSI AccreditationRuth Edwards

SDO, HMP Buckley Hall

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Undertaking DwSI Undertaking DwSI AccreditationAccreditation

Ruth EdwardsRuth Edwards

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Currently a male category C Prison

Location- Rochdale, Greater Manchester

Re-rolled from female to male in December 2005

H.M.P. Buckley HallH.M.P. Buckley Hall

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DwSI- DefinitionDwSI- Definition

““A dentist working in the primary care setting who A dentist working in the primary care setting who provides services which are in addition to their usual provides services which are in addition to their usual and important generalist role”and important generalist role”

““The DwSI may deliver a clinical service beyond that The DwSI may deliver a clinical service beyond that normally delivered by a primary dental care practitioner normally delivered by a primary dental care practitioner or may be able to deliver a particular type of treatment. or may be able to deliver a particular type of treatment. Individual DwSIs will be able to demonstrate their Individual DwSIs will be able to demonstrate their competencies in their special interest areas. Special competencies in their special interest areas. Special Interests may be demonstrated by dentists through the Interests may be demonstrated by dentists through the completion of formal training programmes and/or completion of formal training programmes and/or experience based evidence”experience based evidence”

Department of Health, FGDP (UK) 2004Department of Health, FGDP (UK) 2004

www.fgdp.org.ukwww.fgdp.org.uk

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Steele Review, June 2009Steele Review, June 2009

Commisioners should support dentists to Commisioners should support dentists to enable best use of the available dental enable best use of the available dental workforceworkforce

The guidelines produced by FGDP (UK) The guidelines produced by FGDP (UK) and DoH set out guidelines and and DoH set out guidelines and competencies for DwSI. These guidelines competencies for DwSI. These guidelines support commisioners in developing support commisioners in developing complex services.complex services.

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Why is gaining DwSI accreditation Why is gaining DwSI accreditation important?important?

Recognises a population with different dental Recognises a population with different dental needsneeds

Recognises challengesRecognises challenges Of the Of the patient grouppatient group Of the Of the environmentenvironment

Promotes good practicePromotes good practice Increases awareness of Prison DentistryIncreases awareness of Prison Dentistry

Within the professionWithin the profession Commissioners/ Primary Care Trust’sCommissioners/ Primary Care Trust’s

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GDPs

Community Dental ServicesOral Surgeons

PrisonDentists

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Caution!Caution!

The following describes my path to become The following describes my path to become contracted as a DwSI in PDcontracted as a DwSI in PD

It is not necessarily It is not necessarily thethe route to DwSI route to DwSI accreditation- it is simply the methodology accreditation- it is simply the methodology that I appliedthat I applied

All PCTs, Prison Dental Posts etc are All PCTs, Prison Dental Posts etc are different and different approaches may be different and different approaches may be requiredrequired

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Gaining DwSI accreditation-Gaining DwSI accreditation-Where to start?Where to start?

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Portfolio of Evidence- contentsPortfolio of Evidence- contents

C.V.C.V. Certificates of qualificationCertificates of qualification Domain evidenceDomain evidence TestimoniesTestimonies Sample referral lettersSample referral letters Clinical case studies and reflectionClinical case studies and reflection CPD records/ Mandatory training recordsCPD records/ Mandatory training records Teaching and TrainingTeaching and Training Clinical Governance, audit and multidisciplinary Clinical Governance, audit and multidisciplinary

workingworking

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Faculty of General Dental Practice-Faculty of General Dental Practice-“Guidelines for the appointment of Dentist’s with “Guidelines for the appointment of Dentist’s with Special Interest in Prison Dentistry” 2007Special Interest in Prison Dentistry” 2007

Four DomainsFour Domains

1)1) Environmental*Environmental*

2)2) ClinicalClinical

3)3) Leadership and Leadership and ManagementManagement

4)4) CommunicationCommunication

*this is a key domain and unique to *this is a key domain and unique to PDPD

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Table of domain evidenceTable of domain evidence

Major Competencies Supporting Competencies Evidence Provided CommentsReference

ENVIRONMENTAL DOMAIN

1a) Security Knowledge and awareness of security issues including:●personal security●security of instruments and materials●key training/protocols and procedures for accessing the surgery●prison timetables●use of escorts●need for training and security clearance, both for the dentist and members

of the dental team

■Development of security tool checks for dental department and continual redevelopment of this, working closely with the Security Department, HMP Buckley Hall.

■Initial set-up of Security Tool Check Proceedures and subsequent redevelopment of Security Procedures when Central Sterilization was introduced in November 2008

■Compliance with HMP Protocols (e.g. security procedure for entering prison with controlled items such as memory sticks, intra-oral camera)

■Knowledge of legal aspects of dental practice.■Regular attendance of Prison Staff Meetings,

Prison Open Forums■Attendance of in house prison training:-drug awareness-key and security training-ACCT training-personal protection-P-NOMIS■Attendance of National Prison Dental Meetings■Member of the National Association of Prison

Dentistry UK and attendance of conferences

■Completion of HMRPCT Mandatory training■Attendance at “HMP Buckley Hall Clinical

Services” Meetings

○See “Local instructions for the security and disposal of tools” and “Accountability return” documents

○See Tool Check Documents.○Testimony from Jane Grundy, Senior

Dental Nurse ○ Testimony from Sean McNicholas,

Security Senior Officer ○Testimony from Steven Morley,

Operational Manager for Healthcare, HMP Buckley Hall

○Testimony from Dr Wilson Ranawickrema, Prison Medical Practioner, HMP Buckley Hall

○CPD “Legal Aspects of General Dental Practice” August 2009

○HMP Open Forums ○Certificate of attendance ○Attendance Certificates 3/7/09,

6/2/09, ½/08, 12-13/2/07, 27-28/11/06, 28/2/05

○Annual conferences ½/08, 6/2/09 ○Scheduled as Speaker 5/2/10 (see e-

mail confirmation)○Summary Table of Mandatory

Training and CPD Summary ○Summary Meetings Attended

1b) Ethical issues and safe practice in prison

Understanding of health and safety issues within the prison setting

Understanding of the relationship between security and confidentiality

Understanding of health and safety issues that may arise when facilities are shared and how these can be effectively managed.

1c) The prison environment Knowledge of the varying roles and categories of prisons

Understanding the judicial system and sentencing (linked to treatment planning)

Awareness of prison regimes and the impact they have on the provision of care; managing time accordingly

1d) Prison dentistry in the wider context

Ability to understand and implement guidelines, policies and procedures implemented by PCTs including awareness of any potential for conflict of interests

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Testimonies-1Testimonies-1

Request testimonials from a wide Request testimonials from a wide range of professionals with whom you range of professionals with whom you work regularly or accept referrals fromwork regularly or accept referrals from

Include a copy of your CV and sample Include a copy of your CV and sample testimonial testimonial

Write request letters early- our Write request letters early- our colleagues are busy! colleagues are busy!

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Testimonies- 2Testimonies- 2

Prison DoctorPrison Doctor Healthcare ManagerHealthcare Manager IDTSIDTS CPN’sCPN’s CARATsCARATs Nursing staff (Medical and Dental)Nursing staff (Medical and Dental) Oral Health Promotion staffOral Health Promotion staff GovernorGovernor Security DepartmentSecurity Department Pharmacy staffPharmacy staff Dental Laboratory StaffDental Laboratory Staff

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Referral LettersReferral Letters

Include a wide ranging Include a wide ranging sample of anonymous sample of anonymous referrals referrals

--medically compromisedmedically compromised

- learning disabilities- learning disabilities

- substance mis-users- substance mis-users

- mental health problems- mental health problems

Can include patient Can include patient applications (self-applications (self-referral)referral)

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Clinical Case StudiesClinical Case Studies

Include:Include: Patient group (e.g. medically compromised, methadone etc)Patient group (e.g. medically compromised, methadone etc) Referral source (self or other)Referral source (self or other) Treatment modalityTreatment modality Age and sexAge and sex Date treatment startedDate treatment started Current OH statusCurrent OH status Effect of condition on delivery of careEffect of condition on delivery of care Treatment carried outTreatment carried out

Include radiographs/ clinical photographs if possibleInclude radiographs/ clinical photographs if possible OutcomeOutcome Reflection of management of caseReflection of management of case

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CPD RecordsCPD Records

Include a simple table of total hours Include a simple table of total hours completedcompleted

I included attendance certificates for events I included attendance certificates for events of particular relevance to Prison Dentistryof particular relevance to Prison Dentistry

e.g. e.g. NAPD(UK) certificatesNAPD(UK) certificatesSCD of relevance to PDSCD of relevance to PD

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Mandatory TrainingMandatory Training

HMP TrainingHMP Training E.g. C&R E.g. C&R key trainingkey training ACCTACCT

PCT Trust trainingPCT Trust training E.g. Vulnerable adultsE.g. Vulnerable adults Health and SafetyHealth and Safety Complaints handlingComplaints handling

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Other Information to IncludeOther Information to Include

Examples of Training and TeachingExamples of Training and Teaching Policies/systems developedPolicies/systems developed Risk/COSHH assessmentsRisk/COSHH assessments Thank-you cardsThank-you cards Dental Reference Officer ReportDental Reference Officer Report Summaries of multi-disciplinary workingSummaries of multi-disciplinary working

E.g. meetings attendedE.g. meetings attended Liaison with PALSLiaison with PALS

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Once the Portfolio is completed!Once the Portfolio is completed!

Make copiesMake copies Get copies authenticated as genuine Get copies authenticated as genuine Ask for willing reviewersAsk for willing reviewers

Other PDs (ideally DwSI)Other PDs (ideally DwSI) Oral surgeonOral surgeon

Send copies toSend copies to ReviewersReviewers PCTPCT Head of HealthcareHead of Healthcare

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Local Accreditation PanelLocal Accreditation Panel

Ideally includeIdeally include Prison Healthcare ManagerPrison Healthcare Manager Representative from PCT CommissioningRepresentative from PCT Commissioning Dental Public Health ConsultantDental Public Health Consultant Dental Practice AdvisorDental Practice Advisor A Prison Dentist (ideally contracted as DwSI in A Prison Dentist (ideally contracted as DwSI in

PD)PD)

Source: Section 5.3, p19Source: Section 5.3, p19

““Guidelines for the appointment of Dentists with Special Interests (DwSI) in Prison Dentistry”, Guidelines for the appointment of Dentists with Special Interests (DwSI) in Prison Dentistry”,

Faculty of General Dental Practice (UK), Royal College of Surgeons of EnglandFaculty of General Dental Practice (UK), Royal College of Surgeons of England

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Thank youThank you

Alan CantyAlan CantySpecialist in Oral SurgerySpecialist in Oral Surgery

NAPD(UK)NAPD(UK)

Rebecca Craven Rebecca Craven Consultant in Dental Public HealthConsultant in Dental Public Health

Douglas GunnDouglas Gunn

Director of Clinical Dental Services, Heywood, Director of Clinical Dental Services, Heywood,

Middleton and Rochdale PCTMiddleton and Rochdale PCT