Contingency planning can be a nightmare but it is absolutely vital
NewsPosted by: Dental Design 24th April 2020
Former Chief Dental Officer, Barry Cockcroft, looks at current provisions within dentistry.
Throughout my career, contingency planning has always been a nightmare and the current media coverage around the coronavirus outbreak has reminded me of at least three times as CDO when we had to develop contingency plans to deal with a potential issue where the impact was uncertain.
As a practice owner I had always been involved in the contingency planning necessary, on a smaller scale, and required to ensure that the practice ran smoothly despite all the problems we faced. In a busy large practice this was always managed internally without the scrutiny of the media waiting in the wings to criticise, with the benefit of hindsight, when one of your working assumptions proved to be inaccurate. Contingency planning is a way of dealing with uncertainty which is probably the thing that causes most worry even if the worst never comes to pass.
I remember, not long after I joined the practice in 1980, seeing a lady who was clearly deeply worried about her health. This lady had been to see her GP who had told her it was probably nerves and prescribed anti depressants but she was certain this was not the issue. When I saw the same lady some months later she looked much better so I asked her if things had been sorted out. She told me that they had not but she now knew what was wrong and felt much better because of that – she had been diagnosed with Parkinson’s disease. A diagnosis of this condition is a life changing moment but for this lady it was better than the uncertainty she had before.
Uncertainty is one of the most difficult things to deal with and at the moment there is a lot of uncertainty around the coronavirus and the impact it will have on the country over the next few weeks and months. The government is quite rightly preparing for all eventualities but people will always be waiting to publicly criticise the authorities for either overreacting or being under prepared, whichever suits with hindsight!
During my time as CDO we had to carry out significant contingency planning on at least three occasions and much of this work never sees the light of day. Prior to the publication of HTM 01 05 we had to convince quite a considerable body of opinion that the provision of dental services, given well publicised articles about poor quality of decontamination in primary dental care was not a major source of transmission of prions, at a time when Bovine Spongiform Encephalopathy was a mega issue. Being able to demonstrate that we could set and maintain standards was key to deflecting many people from their wish that all dental instruments should be single use or that all dental instruments should go through a hospital based central sterilisation process, which would surely have made dental services, as we know, them undeliverable.
Later, we had to develop plans for maintaining the delivery of services through the likely epidemic of bird flu that was predicted and then the threat from the ebola virus.
The bird flu scare was very similar to the current situation with the coronavirus, we worked up plans to deal with all eventualities and also how we would maintain the financial viability of practices in the event that it became necessary to stop the provision of routine dental surgery and how we would provide emergency care.
In the event, the bird flu epidemic was nowhere near as serious as had been expected and it passed by without the catastrophic impact that had been predicted by some people.
Interestingly there was much comment in the media, after the threat had passed, about the amount of money spent by the Department of Health on supplies of Tamiflu, the available vaccine at the time. These criticisms were largely made in the media with the benefit of hindsight; imagine the furore there would have been if the decision had been taken not to prepare in this way and the strain of bird flu had turned out to be virulent and lethal to many.
The media has a really important role in our society but when dealing with health scare issues they need to behave responsibly.
I noted quite recently when the prevalence of measles was in the news that there was much criticism of the DH and NHS about the levels of measles vaccination. The same newspapers that were being critical then were the same newspapers that in 1998 were splashing research findings linking the MMR vaccine with autism across their front pages despite assurances and rapid repudiation of the research that the vaccine was safe and protection against these, sometimes serious, childhood diseases was essential. The research is now totally discredited but the damage was done.
Accountability and responsibility for the nation’s health is both a great burden and a great privilege; let’s support those who are doing their best in difficult circumstances.
