title: Dentists with extended skills: the challenge of innovation.
abstract: BACKGROUND
  The aim was to obtain stakeholders' views on the former London Deanery's joint educational service development initiative to train dentists with a special interest (DwSIs) in endodontics in conjunction with the National Health Services (NHS) and examine the models of care provided.
  
  
  METHODS
  A convergent parallel mixed methods design including audit of four different models of care, semi-structured interviews of a range of key stakeholders (including the DwSI trainees) and questionnaire surveys of patients and primary care dentists.
  
  
  RESULTS
  Eight dentists treated over 1,600 endodontic cases of moderate complexity over a two year training period. A retrospective audit of four schemes suggested that first molars were the most commonly treated tooth (57%; n = 341). Patients who received care in the latter stages of the initiative were 'satisfied' or 'very satisfied' with the service (89%; n = 98). Most dental practitioners agreed that having access to such services would support the care of their patients (89%; n = 215) with 88%; (n = 214) supporting the view that DwSIs should accept referrals from outside of their practice.
  
  
  CONCLUSIONS
  This initiative, developed to provide endodontic care of medium complexity in a primary care setting, received wide support from stakeholders including patients and primary care dentists. The implications for care pathways, commissioning and further research are discussed.
authors.affiliation: Queen Mary, University of London, Barts and the London School of Medicine and Dentistry, Centre for Clinical and Diagnostic Oral Sciences, Institute of Dentistry, London, E1 2AT.
authors.forename: M
authors.initials: M
authors.lastname: Al-Haboubi
authors.affiliation: Charles Clifford Dental Hospital, Sheffield Teaching Hospitals NHS Trust, Wellesley Road, Sheffield, S10 2SZ.
authors.forename: S
authors.initials: S
authors.lastname: Eliyas
authors.affiliation: Department of Restorative Dentistry, Maxillofacial Unit, St. George's Hospital, London, SW17 0QT.
authors.forename: P F A
authors.initials: PF
authors.lastname: Briggs
authors.affiliation: HEE NW London (formerly London Deanery), Stewart House, 32 Russell Square, London, WC1B 5DN.
authors.forename: E
authors.initials: E
authors.lastname: Jones
authors.affiliation: Formerly London Deanery, Stewart House, 32 Russell Square, London, WC1B 5DN.
authors.forename: R R
authors.initials: RR
authors.lastname: Rayan
authors.affiliation: King's College London Dental Institute at Guy's, King's College and St Thomas's Hospitals, Division of Population and Patient Health, Denmark Hill Campus, Bessemer Road, London, SE5 9RS.
authors.forename: J E
authors.initials: JE
authors.lastname: Gallagher
mesh_terms: D002983:Clinical Competence; D003815:Dentists; D004708:Endodontics; D006801:Humans; D009936:Organizational Innovation; D012189:Retrospective Studies; D013222:State Medicine; D011795:Surveys and Questionnaires; D006113:United Kingdom
references.citation: Community Dent Health. 2013 Dec;30(4):219-26
references.pmid: 24575524
references.citation: Br Dent J. 2010 Feb 13;208(3):103-7
references.pmid: 20147923
references.citation: BMC Health Serv Res. 2009 Sep 14;9:160
references.pmid: 19751504
references.citation: Br Dent J. 2011 Feb 12;210(3):127-36
references.pmid: 21311538
references.citation: Br Dent J. 2010 Nov 27;209(10):E17
references.pmid: 21109782
references.citation: Prim Dent Care. 2010 Apr;17(2):53-60
references.pmid: 20353653
references.citation: Cochrane Database Syst Rev. 2013 Nov 06;(11):CD009853
references.pmid: 24194456
references.citation: Br Dent J. 2009 Feb 28;206(4):195-9
references.pmid: 19247334