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Table 5 All scenarios cost minimization and workforce numbers outputs

From: Alternative scenarios: harnessing mid-level providers and evidence-based practice in primary dental care in England through operational research

  Dental professional DENTASSim clinical time in hours DENTASSim WTE Estimated NHS number of personnel required to meet total demand Ratio of NHS personnel dentist to hygiene therapist Minimum salary cost Average salary cost Maximum salary cost % salary cost saving between no skill mix and other scenarios
Scenario 1: “No Skill Mix” (dentists only) Dentists only 19,294,238 12,685 24,736   £478,410,847 £750,889,634 £1,023,368, 422 0%
Scenario 2: “Minimal Direct Access” 70% exams delegated +UPDA delegation rate Dentists 9,633,574 6,334 12,351 1:1.3 £238,869,572 £374,917,681 £510 965,790  
Dental therapists 9,660,664 6,606 16,513   £140,038,342 £185,616,859 £231,195,376  
Total     28,864   £378,907,914 £560,534,540 £742,161, 167 38%
Scenario 3: “More Prevention” 50% of children receive fluoride varnish +UPDA delegation rate Dentists 13,623,505 8,967 17,466 1.8:1 £338,185,478 £530,798,939 £723,412,400  
Dental therapists 5,815,934 4,084 9,941   £86,572,892 £114,749,918 £142,926,945 18%
Total     27,407   £424,758,370 £645,548,858 £866,339, 345  
Scenario 4: “Maximum Delegation” (delegation of 100%: examinations prevention, 50% of radiographs, tooth restoration and children’s extractions = 62.8% of total clinical time) Dentists 7,290,502 4,801 9,346 1:2 £181,073,278 £284,203,521 £387,333,764  
Dental therapists 11,913,515 8,199 20,365   £173,826,662 £230,402,321 £286,977,980 52%
Total     29,711   £354,899,939 £514,605,842 £674,311, 744  
  1. Salary source is the National Careers Service: https://nationalcareersservice.direct.gov.uk/Pages/Home.aspx [33].
  2. Number of personnel is calculated based on working hours described by Robinson et al. [30], that is, WTE for clinical time (dental therapist 0.3 WTE; dentist 0.4 WTE).