Report of the Public Service Benchmarking Body June 2002

The excerpt that follows is taken from pages 212 ff of the report which profiles the jobs of all dental grades examined by the body. It places a high value on the public dental service, as it should, and draws some interesting conclusions; in particular I would draw your attention to the reporting relationship of the Principal Dental Surgeon P&E to to the Assistant Chief Executive Officer - in most boards this in effect meant the Programme Manager, Community Services. In the HSE however, given the nature of the restructuring agreement, all Principals now report to the Local Health Manager.

Generic Observations - Principal Dental Surgeon
As a minimum job holders should be qualified dentists, with either a BDS/B Dent Sc or equivalent and be registered to practice in Ireland with the Statutory Body (the Dental Council). Job Holders identified a requirement for a Post Graduate qualification in any of the following areas: Business Administration, Management, Information Technology or Public Administration. The Dental Council state that at least 5 years experience in the practice of community or hospital dentistry is required. Analysts consider that up to 10 years experience would be required. The job requires the application of expert knowledge and skills at a strategic level in order to plan, develop and evaluate the dental services at regional level. Problems are varied in nature and highly diverse ranging from strategic issues such as service planning and dental health promotion to more operational matters such as personnel issues and patient complaints.
The Principal Dental Surgeon - P&E leads a number of dental teams within their region comprising of Senior Administrative Dental Surgeons, Senior Clinical Dental Surgeons, General Dental Surgeons, Dental Hygienists, Dental Surgery Assistants and Dental Nurses.

The Principal Dental Surgeon-P&E reports to the Assistant Chief Executive Officer and is responsible for the evaluation and development of dental services within their region. This involves prioritising and targeting user groups, preparing budgetary requirements and formulating strategies and policies at both regional and national level. Communications are at a high level and extremely developed interpersonal skills are required in order to influence and negotiate with a number of bodies including the Irish Dental Council, government departments, medical insurers, individual patients, solicitors, senior management of the health board, trade unions and public representatives.

The job holder is occasionally required to practice highly intricate clinical procedures. The job holder may occasionally be exposed to a number of occupational hazards such as sharp objects, needles, exposure to blood, mercury, difficult patients and also high risk patients e.g. Hepatitis B, HIV positive.

Dental Grades - Senior Administrative Dental Surgeon
Generic Observations - Senior Administrative Dental Surgeon Job Holders require a BDS/B Dent Sc or equivalent and registration to practice in Ireland with the Statutory Body (the Dental Council).16 In practice most job holders will have a post graduate qualification in any of the following; Management, Dental Public Health, Health Care Management or Information Technology. The requirement as set out by the Dental Council is for 3 years satisfactory experience in community or hospital practice. Analysts consider that 5 years experience is required to conduct the role in a proficient manner.

The Senior Administrative Dental Surgeon is required to have excellent clinical skills in order to advise other dental and medical practitioners. The job holder is also required to have administrative and management skills and a knowledge of Personnel, Health Promotion and Public Health. Problems vary widely and are often complex for example health and safety issues (e.g. radiation), the administration of personnel issues and information queries (e.g. parliamentary questions).

The Senior Administrative Dental Surgeon manages a team of General Dental Surgeons, Dental Nurses, Dental Hygienists and auxiliary staff. The Senior Administrative Dental Surgeon is required to have highly developed communication skills to educate, motivate, influence and persuade a wide variety of bodies including; the Irish Dental Council, health board management, the Department of Health & Children, other health professionals, trade unions, the media, teaching hospitals, other staff and patients.

The Job Holder has full responsibility for the day to day management of Dental Services within a defined Community Care/Dental area and in the absence of the Principal Dental Surgeon will act as deputy. The job is physically challenging, as there is a requirement to stand or sit in an awkward position while tending to some clients. Some patients may require help getting in and out of the chair. Procedures such as tooth extractions often require physical strength. Very high levels of dexterity are required for procedures such as filings, root canal work, removing lesions on lips or tongue, extractions and giving injections. There is occasional exposure to occupational hazards such as sharp objects, needles, exposure to blood, mercury, difficult patients and high risk patients e.g. Hepatitis B, HIV positive.

Dental Grades - Senior Clinical Dental Surgeon
Generic Observations - Senior Clinical Dental Surgeon Job Holders require a BDS/B Dent Sc or equivalent and registration to practice in Ireland with the Statutory Body (the Dental Council).18 In practice most job holders will have a post graduate qualification in a specialist area In practice most job holders will have a post graduate qualification in any of the following; Management, Public Health, Health Care Management or Paediatric Dentistry. The requirement as set out by the Dental Council is for 3 years satisfactory experience in community or hospital practice. Analysts consider that 5 years experience is required to conduct the role in a proficient manner.
The Senior Clinical Dental Surgeon is required to apply specialist clinical skills and knowledge to the treatment of patients with special needs and to guide and advice others on the dental team and other multidisciplinary groups. Clinical experience and associated analytical skills are required for complex patient care and to deal with problems such as emergency trauma, patients with multiple injuries involving other disciplines or patients with rare medical conditions.

The Senior Administrative Dental Surgeon (sic) supervises the General Dental Surgeons, Dental Nurses, Dental Hygienists, Dental Surgery Assistants and Dental Students. The Senior Clinical Dental Surgeon is responsible for the planning, auditing and setting of goals within their own area such as the prioritisation of groups of patients, the development of treatment plans and also for developing strategies for targeting special needs groups. As the Senior Clinical Dental Surgeon works with children and special needs adults, highly skilled communications are required in order to influence, negotiate, reassure and relate to clients.

The Senior Clinical Dental Surgeon requires excellent communication skills in liasing with other disciplines and supervising the dental team. The job is physically challenging, as there is a requirement to stand or sit in an awkward position while tending to some clients. Some patients may require help getting in and out of the chair. Procedures such as tooth extractions require physical strength. Very high levels of dexterity are required for procedures such as filings, root canal work, removing lesions on lips or tongue, extractions and giving injections. There is frequent exposure to occupational hazards such as sharp objects, needles, exposure to blood, mercury, difficult patients and also high risk patients e.g. Hepatitis B, HIV positive.

Dental Grades - General Dental Surgeon
Generic Observations - General Dental Surgeon The basic requirements are a BDS/B Dent Sc or equivalent and registration to practice in Ireland with the Statutory Body (the Dental Council).20 The Dental Council of Ireland specify that 1 years experience is required to reach competency in the role. Analysts consider that 3 years experience would be required. General Dental Surgeons require excellent clinical skills in order to deliver best practice patient care to a user group largely made up of children and special needs clients. Clinical experience and associated analytical skills are required for patient care and to deal with problems where no precedent exists such as dealing with medically compromised patients, dealing with rare disorders or difficult patients.

The General Dental Surgeon supervises a team comprising of the following; Dental Surgery Assistants, Dental Hygienists and Dental Students. The decisions made by the General Dental Surgeon are in line with set procedures and codes of practice. These decisions impact upon the safety, comfort, health and well being of patients.

The General Dental Surgeon is required to communicate complex clinical issues directly to patients in a perceptive and sensitive manner. The General Dental Surgeon is also required to consult, advise and educate colleagues in a variety of settings. There is also a requirement to deliver and communicate oral hygiene instructions to groups within the community. The job is physically challenging as there is a requirement to stand or sit in an awkward position while tending to some clients. Some patients may require help getting in and out of the chair. Very high levels of dexterity are required for procedures such as filings, root canal work, removing lesions on lips or tongue, extractions and giving injections. There are many occupational hazards such as sharp objects, needles, exposure to blood, mercury, difficult patients and also high risk patients e.g. Hepatitis B, HIV positive.