Employment in the UK

Clinical Practice in the UK

Before you start working as a dentist in the UK, it is your responsibility to prepare yourself as you must fully understand the regulations regarding working as a healthcare professional.

Ethical Guidelines and Principles

The General Dental Council (GDC) has issued ethical guidelines which are applicable to all dentists in the UK. It is your responsibility to ensure that you are familiar with this new ethical framework. This guidance applies to all members of the dental team under the following headings.

The 9 Principles of the GDC

While the GDC's "Standards for the Dental Team" and its 9 principles are not lefally binding in the traditional sense, they are essential for maniraining registrtaion and practicing as a dental professional in the UK, and non-compliance can lead to removal from the GDC regsiter.

Standards for the dental team 

Guidance on Scope of Practice 

Guidance on Indemnity and Insurance 

Patients

Patients in the UK are generally well informed about their rights both within the NHS and private sector. You must understand your responsibilities as a healthcare professional. This includes legislation regarding all aspects of health and safety and work including for example: cross infection control, ionising radiation regulations, mandatory immunisation of all dental workers against Hepatitis B, disposal of clinical and hazardous waste, single use equipment and CPD for all dental workers.

In the UK there is considerable legislation regarding the treatment of patients. It is important that you take time to fully explain to your patients any procedures that you may be planning to undertake.

It is your responsibility to know and follow the GDC’s patient consent guidelines.  Please note that there are other patient consent guidelines in addition to these under which you will be expected to work.   

Teamwork

There is a strong emphasis on teamwork in the NHS and you will encounter other professionals, for example nurses, technicians, therapists and hygienists who are involved in the management of patients. All these groups of Dental Care Professionals (DCPs) are regulated by the GDC. It is your responsibility to know what can be provided by each group and what supervision, or requirement for your presence or your written treatment plan is required. All members of the dental team are required to undertake continuing professional development. There is a mandatory requirement for CPD on an annual basis which is regulated and monitored by the GDC.

Whether you are an employee or employer at your dental surgery / office you are subject to UK employment law where all are treated equally and there is no place for discrimination.

Employment

Primary Care

Primary Care can be offered in the private of NHS sectors or through dental insurance schemes.  It is the first level of health care and includes many medical and dental practices.  In England General Dental Practitioners also have contracts with Integrated Care Boards.

Private practice: You can provide dental treatment as a private practitioner both in primary care and as a specialist.

You could be employed by one of the dental corporate bodies offering general dental services.

Secondary / Tertiary Care

More specialised care is provided by NHS hospital / foundation or acute trusts. Patients are referred from primary care to hospitals for specialist treatment that is more appropriately provided in a hospital setting. NHS hospitals / foundation or acute trusts employ consultants, associate specialists, specialty doctors, nurses etc.

The specialties recognised by the GDC include: oral surgery, endodontics, orthodontics, periodontics, restorative dentistry, prosthodontics, dental public health, oral medicine, paediatrics, oral microbiology, oral pathology, oral and maxillofacial radiology and special care dentistry. Some of these specialties are practiced in hospitals and some also in a specialist practice.

In the UK maxillofacial surgery is a specialty of medicine and not dentistry.

University

Universities in the UK employ dentists to teach undergraduate and postgraduate students. Supervising dentists are experienced dental practitioners who have worked in primary care in the UK for several years and may have been trainers in primary care. Senior clinical academics have extensive experience in research or teaching and are employed by a university but also hold honorary consultant contracts. Training for this type of senior clinical academic posts can be very lengthy as there is a necessity to have honorary specialist registrar training in addition to acquiring a higher research degree.

The Armed Forces

Dentists are employed by the armed forces to treat service personnel. The dental officer is responsible for the maintenance of dental health which is an important part of the overall medical fitness required for all servicemen and women. More information can be found on the Defence Medical Services’ website.

Salaried Dentists

Some dentists are employed by hospitals, community dental services, or dental corporates. 

Payment in NHS primary care dentistry

General dental practices are contracted to provide dental services for the NHS. The dental activities provided by a dental practice are collectively called, Units of Dental Activity (UDA) or Units of Orthodontic Activity (UOA). Each year, NHS dental practices will contract for a pre-determined number of UDAs and UOAs. Payment is made up of the value of each activity and the patient’s contribution. Some patients are exempt from paying NHS charges for dentistry. For patients who are not exempt the NHS dental charges are divided into three bands. The bands are based on the type of treatment each patient requires. For example: Band 1 course of treatment. For example:

BAnn 1 course of treatment
Applies to a dental examination, diagnosis (including radiographs), prevention advice, a scale and polish if needed, and application of fluoride varnish or fissure sealant.

Band 2 course of treatment
This covers everything listed in Band 1 above, plus any further treatment such as fillings, endodontics or removal of teeth.

Band 3 course of treatment
This includes everything listed in Bands 1 and 2 above, plus crowns and fixed and removable appliances.