Background: The two most common models of workforce planning are the ‘stock and flow’ and the demographic approach. The former balances future losses from a system against recruitment and retention, whilst the latter simply ‘grosses up’ current provision based on changes to population demographics. However, such approaches ignore the impact of improving health and can confuse demand with population need. On the supply side, they also assume that there will be no changes to working practice in respect of service levels and service delivery, or any improvements in medical technology. This paper aims to examine the complex interactions between these factors in order to take a more considered approach to workforce planning in dentistry.
BirchS. Health human resource planning for the new millennium: Inputs in the production of health, illness and recovery in populations. Can J Nurs Res, 2002: 33: 109–114.
2.
World Health Organization (WHO). Everybody’s Business. Strengthening Health Systems to Improve Health Outcomes. WHO’s framework for action. Geneva: WHO, 2007.
3.
MasnickKMcDonnellG. A model linking clinical workforce skill mix planning to health and health care dynamics. Human Resources for Health, 2010: 8: 11.
4.
BirchSKephartGTomblin-MurphyGO’Brien-PallasAlderRMacKenzieA. Human resources planning and the production of health: a needs-based analytical framework. Canadian Public Policy, 2007: 23: S1–S16.
5.
Department of Health. Report of the Primary Care Dental Workforce Review. London: Department of Health, 2004.
6.
SteeleJ. NHS Dental Services in England. London: Department of Health, 2009.
World Health Organization (WHO). Report of the Working Group on the Concepts and Principles of Health Promotion. Copenhagen: World Health Organization Regional Office for Europe, 1984.
9.
WrightJWilliamsRWilkinsonJR. Health needs assessment – Development and importance of health needs assessment. BMJ, 1998: 316: 1310–1313.
10.
NutbeamD. Health literacy as a public health goal: A challenge for contemporary health education and communication strategies into the 21st Century. Health Promotion International, 2000: 15(3): 259–267.
11.
BirchS. The identification of supplier-inducement in a fixed price system of health care provision: The case of dentistry in the united kingdom. J Health Economics, 1988: 7: 129–150.
12.
GodsonJHWilliamsSA. Inequalities in health and oral in the UK. Dent Update, 2008: 35: 243–242.
13.
MilsomKMJonesCKearney-MitchellPTickleM. A comparative needs assessment of the dental health of adults attending dental access centres and general dental practices in Halton & St Helens and Warrington PCTs 2007. Br Dent J, 2009: 206(5): 257–261.
14.
British Dental Association. The British Dental Association Oral Health Inequalities Policy. London: BDA, 2009. Online. Available: www.bda.org/inequalities
15.
DixonALe GrandJ. Is greater patient choice consistent with equity? The case of the English NHS. J Health Serv Res & Policy, 2006: 11(3): 162–166.
16.
KotlerPArmstrongG. Principles of Marketing. London: Prentice Hall; 2005.
17.
GallagherJEPatelRWilsonNHF. The emerging dental workforce: Long-term career expectations and influences. A quantitative study of final year dental students’ views on their long-term career from one London Dental School. BMC Oral Health, 2009: 9: 35.
18.
StewartFMJDrummondJRCarsonLTheakerED. Senior dental students’ career intentions, work-life balance and retirement plans. Br Dent J, 2007: 203(5): 257–263.
19.
GallagherJEClarkeWEatonKAWilsonNH. Dentistry – a professional contained career in healthcare. A qualitative study of vocational dental practitioners’ professional expectations. BMC Oral Health, 2007: 16: 7–16.
20.
GallagherJEClarkeWEatonKAWilsonNH. A question of value: A qualitative study of vocational dental practitioners’ views on oral healthcare systems and their future careers. Prim Dent Care, 2009: 16(1): 29–37.
21.
DaviesLThomasDRSandhamSJTreasureETChestnuttIG. Factors influencing the career aspirations and preferred modes of working in recent dental graduates in Wales. Primary Dental Care, 2008: 15(4): 157–163.
22.
NewtonJTGibbonsDE. The ethnicity of dental practitioners in the United Kingdom. Int Dent J, 2001: 51: 49–51.
23.
BediRGilthorpeMS. Ethnic and gender variations in university applicants to United Kingdom medical and dental schools. Br Dent J, 2000: 189(4): 212–215.
24.
LightbodyPNicholsonSSiannGWalshD. A respectable job: Factors which influence young Asians’ choice of career. Brit J Guid Counsel, 1997: 25(1): 67–79.
25.
HarrisRBurnsideGAshcroftAGrievesonB. Job satisfaction of dental practitioners before and after a change in incentives and governance: A longitudinal study. Br Dent J, 2009: 207(2): 1–7.
26.
European Ministers of Education. The Bologna Declaration on the European Space for Higher Education: An Explanation. Bologna, European Union, 1999.
27.
KravitzASTreasureET. Utilisation of dental auxillaries – attitudinal review from six developed countries. Int Dent J, 2007: 57: 267–273.
28.
GallagherJEWilsonNHF. The future dental workforce?Br Dent J, 2009: 206(4): 195–200.
29.
LaurantMReevesDHermensR. Substitution of doctors by nurses in primary care. Cochrane Database of Systematic Reviews, 2009: 4: DOI: 10.1002/14651858.CD00127110.1002/14651858.CD001271.
30.
RichardsonGMaynardACullumNKindigD. Skill mix changes: Substitution or service development?Health Policy, 1998: 45(2): 119–132.
31.
DrinkwaterC. Local Commissioning: Opportunity or Threat?London: BDA, 2009.
32.
DyerTAHumphrisGRobinsonPG. Public awareness and social acceptability of dental therapists. Br Dent J, 2010: 208(1): E2, discussion 16–17.
33.
DyerTARobinsonPG. Exploring the social acceptability of skill-mix in dentistry. Int Dent J, 2008: 58(4): 173–180.
34.
SunNBurnsideGHarrisR. Patient satisfaction with care by dental therapists. Br Dent J, 2010: 13: 208(5): E9.
35.
NilchianFRoddHDRobinsonPG. Influences on dentists’ decisions to refer paediatrc patients to dental hygienists and therapists for fissure sealants: a qualitative approach. Br Dent J, 2009: 207: E13.
36.
GallagherJLWrightDA. General dental practitioners’ knowledge of and attitudes towards the employment of dental therapists in general practice. British Dental Journal, 2002: 193: 37–41.
37.
HayISBatchelorPA. The future role of dental therapists in the UK: A survey of district dental officers and general practitioners in England and Wales. Br Dent J, 1993: 175: 61–66.
38.
IrelandRS. Dental therapists: Their future role in the dental team. Dent Update, 1997: 24: 269.
39.
NewtonJTGibbonsDE. Vacant posts reported in dental practice: Implications for human resource planning. Br Dent J, 2002: 192: 37–39.
40.
HarrisRVHaycoxA. The role of team dentistry in improving access to dental care in the UK. Br Dent J, 2001: 190: 353–356.
41.
RossMKIbbetsonRJTurnerS. The acceptability of dually-qualified dental hygienist-therapists to general dental practitioners in South-East Scotland. Br Dent J, 2007: 202: E8.
42.
HarrisRBurnsideG. The role of dental therapists working in four personal dental service pilots: Type of patients seen, work undertaken and cost-effectiveness within the context of the dental practice. British Dental Journal, 2004: 197: 491–496.
43.
HoltRDMurrayJJ. An evaluation of the role of New Cross Auxiliaries and of their clinical contribution to the Community Dental Service. Part 2: Analysis of day books. Br Dent J, 1980: 149: 259–263.
44.
JonesDEGibbonsDEDoughtyJF. The worth of a therapist. Br Dent J, 1981: 151: 127–128.
45.
DouglassCWLipscombJ. Expanded function dental auxiliaries: Potential for the supply of dental services in a national dental program. J Dent Educ, 1979: 43: 556–567.
46.
SwallowN. School for dental therapists. Br Dent J, 1996: 180: 285.
47.
ScarrottDM. The economic case for delegation in dentistry. Br Dent J, 1973: 134: 23–24.
48.
WardP. The changing skill mix – experiences on the introduction of the dental therapist into general dental practice. British Dental Journal, 2006: 200: 193–197.
49.
JonesGEvansCHunterL. A survey of the workload of dental therapists/hygienist – therapists employed in primary care settings. British Dental Journal, 2007: 204: E5.
50.
RossMKTurnerSIbbetsonRJ. The impact of team-working on the knowledge and attitudes of final year dental students. British Dental Journal, 2009: 206(3): 163–167.
51.
JonesGEvansCHunterL. A survey of the workload of dental therapists/hygienist–therapists employed in primary care settings. British Dental Journal, 2007: 204: E5.
52.
House of Commons Health Select Committee. House of Commons Health Committee: Dental Services – Fifth Report of Session 2007–08. London: HMSO, 2008.
53.
TickleMMcDonaldRFranklinJAggarwalVMilsomKReevesD. The impact of incentives on the behaviour and performance of primary care professionals. SDO Project 08/1618/158. Online. Available: http://www.sdo.nihr.ac.uk/files/project/158-exec-summary.pdf (accessed 11 November 2010).
54.
BrocklehurstPRTickleM. Is skill mix cost effective in the NHS dental contract?Br Dent J, 2010 (accepted for publication).
55.
GodsonJHWilliamsSACsikarJIBradleySRowbothamJS. Dental therapy in the United Kingdom: Part 2. A survey of reported working practices. Dent J, 2009: 207: 417–423.
56.
Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: Institute of Medicine, 2001.
57.
LaneDCHusemannE. System dynamics mapping of acute patient flows. J Operat Res Soc, 2007: 59: 213–224.
58.
EvansRGStoddartGL. Producing health, consuming health care. Social Science & Medicine, 1990, 31: 1347–1363.
