Dentists' preparedness to provide Level 2 services in the North East of England: a mixed methods study

Abstract

Background Dentists capable of delivering Level 2 complexity treatments may benefit patient access to dental care and increase workforce morale. However, little is known about attitudes, capability and training needs relating to Level 2 dental services. Aims To examine attitudes to, and perceived readiness for delivery of Level 2 dental services by NHS dentists in the North East of England and North Cumbria. Method A sequential mixed methods study with an online survey and semi-structured interviews. Participants were general, community, and hospital-based dental practitioners. Descriptive statistics of survey and thematic analysis of qualitative data were undertaken. Results Overall, 56% of 124 respondents had a limited understanding of the Level 2 performer role. A minority felt they were already providing Level 2 care across all speciality areas; 9% (n = 11) had a professional portfolio suitable for Level 2 accreditation. Confidence to undertake Level 2 competencies varied by speciality area, being highest in paediatric dentistry, and lowest in endodontics and orthodontics. Qualitative data identified motivations, and personal, organisational and system factors that were seen as barriers or enablers to upskilling. Conclusion The regional NHS workforce is unprepared to provide Level 2 dental services. Successful introduction will require review of necessary infrastructure and transparency of accreditation and contracting processes.