SCOPE
Research type
Research Study
Full title
Study of the utilisation of Clinical skills Of dental nurses/hygienists/therapists working in dental Primary care: a realist Evaluation
IRAS ID
349165
Contact name
Susan Bissett
Contact email
Sponsor organisation
Newcastle University
Duration of Study in the UK
2 years, 11 months, 30 days
Research summary
This study is looking at how dental nurses, hygienists, and therapists are used in high-street dental practices and their impact on patient care and costs.
Background
The NHS dental system is struggling. Nearly six million people have been unable to get an NHS dentist appointment in the past two years. To improve access, the NHS plans to increase the number of dentists, hygienists, and therapists trained by 40% by 2031/32. However, keeping trained staff in the NHS is a challenge.
One issue is that many dental professionals—especially nurses, hygienists, and therapists—aren’t fully using their skills. In 2022, a new rule called Direct Access (DA) allowed hygienists and therapists to see patients for check-ups and if a patient needs treatment beyond their skills, they are referred to a dentist.
The NHS aims to free up 2.5 million appointments in 2024 by expanding DA, with a goal of hygienists and therapists providing 15% of dental care. Research shows this approach is effective, but uptake varies. Some patients also worry that seeing a hygienist or therapist instead of a dentist might mean lower-quality care.
Aim
We want to understand:
• How DA is being used in dental practices.
• What influences practices to adopt or avoid DA.
• Whether DA is cost-effective for dental practices.
What We Will Do
1. Study different dental practices – We will look at NHS data to find practices with high and low DA use. Then, we will interview staff, commissioners and patients, and hold focus groups to understand their experiences.
2. Analyse incentives, costs and benefits – Using the data, we will create surveys using economic theory to see what influences practices to adopt DA; how cost-effective DA is; and whether if improves access to NHS appointments.
3. Inform policy – Our findings will help shape future NHS policies to improve access to NHS services.REC name
South Central - Oxford B Research Ethics Committee
REC reference
25/SC/0311
Date of REC Opinion
7 Oct 2025
REC opinion
Further Information Favourable Opinion