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Human Medicines (Amendments relating to Registered Dental Hygienists, Registered Dental Therapists and Registered Pharmacy Technicians) Regulations 2024

Volume 838: debated on Friday 24 May 2024

Motion to Approve

Moved by

My Lords, the Government are proposing changes that would improve patient access to medicines from dental practices and pharmacies. The draft statutory instrument before the House today covers two distinct professions: dental therapists or hygienists and pharmacy technicians. It will enable them both to use the full range of their skills to supply patients with the medicines they need, in a timely manner.

Our proposed changes will put exemptions in place for dental therapists and dental hygienists to supply or administer a range of medicines to patients which are part of their day-to-day job without having to refer to a dentist, so that they can deliver care without the need to organise additional appointments, or interrupt colleagues who are busy with other patients.

These are sensible, common-sense measures, freeing up precious time for clinicians and patients alike. Healthcare professionals have a responsibility to carry out care only where it is safe and they are competent to do so. Many of these professionals will already have extensive experience of using these medicines, but of course we will not compromise on safety.

Dental practices will be responsible for making sure that the clinicians undertaking the procedures have the knowledge, qualifications and skills to carry them out safely; and training will be made available for those who want to make use of the exemptions.

I turn to pharmacy technicians. Our proposals will allow them to supply or administer medicines to patients using mechanisms called patient group directions. A patient group direction—PGD—is a written instruction that allows some healthcare professionals to supply or administer specified medicines to patients with a certain condition, without the need for a prescription. They are developed by experts from a range of fields who thoroughly quality-assure every PGD before signing it off. Pharmacy technicians will be responsible for assessing whether patients fit the criteria.

Pharmacy technicians are qualified and regulated healthcare professionals, and noble Lords might have come across pharmacy technicians without realising who they are and what they do. You can find them in community and hospital pharmacies, GP practices, care homes, prisons, our Armed Forces and the pharmaceutical industry.

In conclusion, these regulations provide patients with access to a wider range of clinical services delivered by healthcare professionals with the right skills, at the right time, and support this Government’s ambition to improve outcomes for patients, while reducing demand on other parts of the service. I beg to move.

My Lords, from these Benches, we support the overall terms of these draft regulations, particularly the measures on pharmacy technicians and dental hygienists, who have great value in providing timely and quality care to patients where it is safe and suitable for them to do so.

I know that the dental profession is very supportive of the intention to enable dental hygienists and dental therapists to supply and administer the majority of the medicines listed in the regulations. The Minister described the regulations as “common-sense”, and I certainly share that assessment.

However, I just draw the Minister’s attention to the inclusion of two medicines on the list: minocycline and nystatin. These were not supported by the BDA or the College of General Dentistry—I am sure the Minister is aware of this—for a number of reasons, including antimicrobial resistance. In the case of minocycline efficacy, it is not recommended in any national clinical guidelines and its use in dentistry is no longer accepted practice. Perhaps the Minister can therefore say whether the concerns of the key dental stakeholders were taken into account when the decision was made to retain these two drugs on the list. Can he also assure the House that there has been full and proper consultation with both the British Dental Association and College of General Dentistry on ensuring that the regulations are compliant with both national practice and existing clinical guidelines?

Efforts to increase the skill mix in our NHS dentistry workforce and across pharmacy more generally are welcome, but I am sure that the Minister will forgive me for thinking that we perhaps need to go rather further than technical tweaks if we are to reverse the crisis in which NHS dentistry finds itself. However, as I said at the outset, we support these regulations, and I hope that the Minister will be able to reassure us about the medicines that are included in the list.

As this is the last day that the House is sitting in this Parliament, I, like my colleagues before me and, I am sure, after me, would like to take the opportunity to say to the Minister, the noble Lord, Lord Markham, what a pleasure it has been to work with him while he has been in his role. He has always carried out that role with the greatest courtesy, but also with care and determination to improve things, no matter what obstacles he perhaps found in his way. I thank him for his dedication to his role. As he is standing in for the noble Lord, Lord Evans—who was due to be standing in for the noble Lord, Lord Markham—I also thank the noble Lord, Lord Evans, similarly, for the manner in which he has conducted himself in this House. He too has always been most helpful and a real pleasure to work with and has always tried his best to make progress, as I know we all wish to do.

I thank the noble Baroness for her kind words. Likewise, if the right words are “thoroughly enjoyed” then I have thoroughly enjoyed working with both the noble Baronesses on the Front Bench on that side, the noble Lord, Lord Allan—he is not here—and many other colleagues, including the noble Baroness, Lady Hayter. There are a number of common-sense things that we have managed to work through together.

I too take this opportunity to thank all noble Lords. It was a baptism of fire when I started two years ago, but I have come to really respect the function of the House and how well it holds our feet to the fire. We are all, in British society and in the Government, much the better for it.

On the questions raised, particularly regarding minocycline 2%, there were concerns raised, as the noble Baroness said, including by the British Society of Periodontology. However, when it was looked at, it was felt overall that it was best to keep it on the list because the concerns are quite low. On balance, it was worth keeping it on the list, but keeping it under watch—for want of a better word. Concerns were also raised around nystatin oral suspension but, again, it was felt that there were certain health benefits for certain groups of patients. But there will be training associated with these medicines, to ensure patient safety.

I will happily write in more detail on these—as is my wont; that is my “get out of jail free” card, in many cases—to make sure those questions are properly answered. I welcome the comments from the other Front Bench that these are sensible arrangements. With that, I beg to move.

Motion agreed.