Notes for Contributors
The NZAO Newsletter welcomes original articles, personal comment and news items. Text should preferably be e-mailed to the Editor at as an attachment in rich formatted text (RFT). Illustrations and photographs should also be e-mailed as attachments in jpeg format. Illustrations and photographs may alternatively be sent on diskette provided the resolution is at least 150 dpi. The Editor reserves the right of refusal, the right to edit articles so they conform to the style of the Newsletter and the right to cut to meet space restrictions. Galley proofs will be sent by prior arrangement only. Special thanks to Karen Brook, Paul Crowther, Mark Beresford, Kirsty McDonald, Phillip Murfitt, Randal McAlister, Judith Hey, Janice Somerville and Peter Fowler for their contributions to this issue as well as to our advertisers. Next issue close off date 20 August 2004.
PRESIDENTIAL NOTESJune 2004
Registration of Orthodontic Auxiliaries
I expect by now you will have read more than you every really wanted to read on this subject. My “Letters to members” of May 12 and June 14 (previously emailed) are reproduced below. To ensure that your staff can be registered as an Orthodontic Auxiliaries under the grandparent provision the completed forms must be with the Dental Council by July 9.
Queries can be directed to me or directly to Janet Eden .
Radiography Training Programme
Those who attended the pilot Radiation Training Course organised by Peter Fowler late last year have received their exemptions from the MRTB and can legally take intra and extra oral radiographs. Judith Hey is now organising this same course in Auckland, August 26 and 27. We will be applying to the Dental Council for this course to be approved as a prescribed qualification for registration on the additional Scope of Practice for Extra Oral Radiography in Orthodontic Auxiliary Practice.
Remember, after September 19 only staff who are registered Orthodontic Auxiliaries with the additional Scope of Practice for Extra Oral Radiography in Orthodontic Auxiliary Practice will be legally able to take radiographs.
We are hoping to run another South Island course later this year.
Peter Fowler’s detailed report on the pilot course features in this issue of the Newsletter.
The Survey
Paul Crowther has worked hard to provide Part 2 of the Survey report and this is also published in this Newsletter. As you will see comments are many and varied, frequently positive, mostly very constructive with only a few that are just plain negative. The committee will be incorporating constructive suggestions into the strategic plan at its face-to-face meeting in Auckland on August 2.
Marketing
Derek Barwood is working on putting together a comprehensive pack to be given to each new graduate involved in the new-graduate program. This kit will include an invitation to join the NZAO as an Associate member, sample of NZAO brochures and posters, articles on the need for post-graduate training, case selection for orthodontics in general practice, guidance on when to refer and articles on why extractions can be necessary.
Conference and Continuing Education
Dunedin, 13 - 16 October 2004
The Conference will open with Welcome Drinks, at the Art Gallery at 5pm on Wednesday October 13.
You should all have received registration brochures by now and the online registration is running well. For general conference queries contact Pat at Dunedin Conference Management Services . Specific queries about the Staff program can be directed to Peter Fowler at and queries about the orthodontists program should go to Janice Sommerville at .
Membership of APOS
We have received notification from Dr Mitani (President APOS) that the ASO and the NZAO will be offered membership of the APOS. We look forward to receiving more details soon.
HDC Advisors
The Health and Disability Commissioner has asked for advisors from our Association. I would like to thank Drs Trevor Webster, Wayne Dalley, Richard Clarke for agreeing to have their names put to the Commissioner.
DCNZ Disciplinary Tribunal Advisors
Drs Janice Sommerville, Bob Stallworthy, Peter Dallimore have kindly agreed to nomination as advisors to the DCNZ Disciplinary Tribunal.
Oceania WFO Representative
In September 2004 Robert Max will compete his second and final term as Oceania representative on the WFO . The NZAO (and the ASO) have nominated Dr Ian Watson (Immediate Past President ASO) as Robert’s replacement. Ian has worked incredibly hard building bridges in the Asia and Pacific Region. He was largely responsible for securing the successful bid for Sydney to host the 7th WFO Congress in 2010 and has worked tirelessly to have both New Zealand and Australia accepted as members of the APOS. A decision on this position will be made by the WFO in September.
Membership
At the May NZAO Committee meeting Dr Pei Ti Lin was granted Provisional Membership. Pei Ti graduated form the Melbourne postgraduate program. She has joined Heather Keall in practice in West Harbour in Auckland and is also working at Greenlane Hospital.
Dr Andrew Marriott (Nelson) also became a Full member of the NZAO.
Communication
Feedback on my emails sent to all members to coincide firstly with the DCNZ Newsletter on Orthodontic Auxiliaries and secondly with the arrival of registration packs for registration of Orthodontic Auxiliaries was very positive and illustrated the benefits of all members being on email (and checking it regularly).
Next Meeting
The next meeting of the NZAO Committee will be a Teleconference meeting on Wednesday June 30 with an all day meeting scheduled for Monday August 2 in Auckland.
Karen Brook
May 12, 2004
To all NZAO Members:
In the next day or two you will all receive the DCNZ Newsletter. It is vital that you READ IT CAREFULLY. It will contain all the information you need to decide whether you will need to register any or all of your staff as Orthodontic Auxiliaries and information on providing names and address of staff you will want to register. The NZAO Committee has been working closely with the Dental Council to achieve the best possible outcome for Section 11 Workers in Orthodontics, under the HPCA Act.
REGISTRATION OF ORTHODONTIC AUXILIARIES
Section 11 workers in Orthodontics will now be known as Orthodontic Auxiliaries. Only those who carry out tasks on the Restricted List will need to be registered. Unbelievable as it may seem the MOH has not yet released the Restricted List and has recently called for submissions on a discussion document (available from the secretary (). The DCNZ Newsletter gives a broad outline of the proposed restricted list. The taking of radiographs will most certainly be on the final Restricted List.
Registration prior to September 17 ,2004.
Orthodontic Auxiliaries will be registered under the Dental Hygiene Board, which will also register Hygienists and Dental Auxiliaries. It is expected that any Section 11 worker in Orthodontics who applies for registration as an Orthodontic Auxiliary prior to September 17, 2004 will be granted registration so long as their employer will vouch for their competency and experience. AFTER September 18 anyone wanting to register as an Orthodontic Auxiliary will need to have completed an approved Orthodontic Auxiliary Training Course irrespective of their previous training or experience.
Fees
The fees incurred in registering an Orthodontic Auxiliary are significant. There will be a one off Registration Fee of $150 - $300 and the initial fee for an Annual Practicing Certificate (APC) will be $1150. It is hoped that this fee will come down in the future as the initial high cost reflects the significant costs involved in establishing a totally new Board.
CPD/Competency
Under the HPCA Act all registered health practitioners (and this includes orthodontic auxiliaries) will need to demonstrate competency to qualify for an APC. The NZAO has been asked to develop a course for training orthodontic auxiliaries and a CPD/Competency program as required under the Act. Andrew Marriot has had a keen interest in Auxiliary training and has joined Mark Beresford (Chair), Tony Lund and Winifred on that Sub-Committee. Their proposed Orthodontic Auxiliary Training Program will be presented to DCNZ for ratification on June 2.
Should you wish to discuss any aspects of Orthodontic Auxiliary registration please contact either Mark Beresford ( ) or myself If you wish to find out more about the proposed training program please contact Andrew Marriott at .
Radiography Training Program
Registration as an Orthodontic Auxiliary will not automatically make it legal for an auxiliary to take radiographs. It appears they will need to have completed a recognized course and taking radiographs will then be added to their Scope of Practice. One pilot course has been completed and we are waiting for final approval of this course from the MRTB. A course is planned for Auckland once this approval is received. Only 15 can attend each course as it involves significant one- on one instruction and we realise the demand for the course will be considerable. If you wish to discus this further please contact Peter Fowler .
Other Issues Relating to HPCA Implementation
With September 18 looming there has been a flurry of discussion documents arriving from the DCNZ with tight deadlines for return submissions. Whilst the HPCA legislation itself defines the broad skeleton of how we will practice under the Act is the individual professions that have to “put skin on the bones” and make the requirements of the Act workable – and a workable system has to be in place by September 18.
Scopes of Practice (SOP)
The HPCA Sub-Committee (Wayne Dalley(Chair), Judith Hey, Mike Courtney) has been working on this. They provided a submission defining specialist orthodontists scopes of practice. However after requesting and receiving numerous submissions the DCNZ have decided to gazette the specialist definitions decided in 2001/2 with a review in 12 – 18 months.
Just this week the DCNZ have provided a second discussion document requesting detailed SOP’s despite the fact that at the it was stated clearly at the Select Committee stage that SOP were not to be a “laundry list” of tasks!!
Wayne, Judith and Mike will now work on detailed SOP with a deadline of August 6th and please contact Wayne Dalley if you would like to discuss this area further.
Registration under Specialist SOP
We received a discussion document in late March requesting a pathway for registration of overseas trained specialists in NZ. The Equivalence and Mentoring Sub-Committee of Phil Sanford (Chair), Andrew Quick and Mark Savage produced excellent submission document which is available from the Secretary or from Phil Sanford .
Competency/CPD
Dexter Bambery, Chair of the DCNZ’s HPCA Act Implementation Working Party, has invited the NZAO to develop a Competency/CPD program to fulfill the HPCA requirements in this area.
The complexity of this task resulted in combining the membership of two sub-committees into a new, very broad based sub-committee. Phil Sanford is chairing this committee supported by Andrew Quick, Mark Savage, Wayne Dalley, Judith Hey and Mike Courtney
Dental Therapists
You all received this discussion document from the DCNZ and Winifred emailed all NZAO members urging you to put in your own individual submission. The Committee has also drafted an NZAO submission (available from )
On behalf of all NZAO members I would like to thank to all those who have worked so hard at such short notice to provide submission documents which we can only hope may be taken into account in the implementation of this complex piece of legislation. Please feel free to contact any NZAO Committee or sub-committee members to discuss issues relating to the HPCA implementation.
Regards
Karen Brook
President
REGISTRATION OF ORTHODONTIC AUXILIARIES – Update 14 June, 2004, from Karen Brook
Registration packs, for registration of staff as Orthodontic Auxiliaries, were sent out last week by the Dental Council. If you have not received a registration packs for your staff, please contact Janet Eden at DCNZ as soon as possible.
To ensure that your staff can be registered as an Orthodontic Auxiliary under the grandparent provision the completed forms must be with the Dental Council by July 9 (only 4 weeks away).
The registration pack contains 5 documents:
- Appendix 1. The Scope of Practice for Dental Hygiene Practice, Dental Auxiliary Practice and Orthodontic Auxiliary Practice.
- A general guide to the registration process – please read this VERY carefully.
- A guide specifically for Employers
- The Application Form (6 pages)
- Information and application form for Professional Indemnity Cover.
It is a lot to read!!! To follow is a summary of various salient features of each document to help you and your staff complete the required documentation quickly and correctly.
1.APPENDIX 1. THE SCOPE OF PRACTICE FOR DENTAL HYGIENE PRACTICE, DENTAL AUXILIARY PRACTICE AND ORTHODONTIC AUXILIARY PRACTICE.
Confusion has arisen between concept of a Scope of Practice and the issue of the Restricted List.
- The restricted List:
The HPCA legislation provided for the Minister of Health to create a list of activities which could only be carried out by registered practitioners (the Restricted List). If a task is not on this list then anyone can do it – no evidence of any training or any need to maintain any competency is required.
Unfortunately and almost unbelievably the Ministry of Health still has not provided the definitive Restricted List although the Minister of Health Annette King has reiterated many times that there will be one.
The problem for us is that our auxiliary staff WILL ONLY NEED TO BE REGISTERED IF THE TASKS THEY PERFORM ARE ON THIS LIST.
So where does that leave us?
There is a “provisional list” and it seems that this will become part of the definitive list. Two items on that list that effect us are:
“Carrying out any invasive activity ie where there MAY be bleeding”
“Taking radiographs”
The best advice I can give is that any staff who takes radiographs or carries out any activity on a patient WHERE BLEEDING MAY OCCUR will need to be registered as an Orthodontic Auxiliary.
There is of course an understandable disquiet that the need for registration of a staff member is determined only on the say so of a “provisional restricted list” – I agree that this is far from satisfactory but there seems no way around the impasse.
Individual orthodontists may choose make a stand and not apply for registration of staff until the restricted list is finalised. However the Dental Hygiene Board has given notice that it cannot guarantee that applications received after July 9 will be processed in time to grant registration before September 18. If you delay sending in your staff registrations until the final restricted list is gazetted then it is unlikely that the registration will be processed by September 18 and your staff will loose the opportunity for automatic registration as an Orthodontic Auxiliary under the “grandparent “ provision.
After September 19, 2004 the prescribed qualification for registration as an orthodontic auxiliary will be an accredited qualification in orthodontic auxiliary practice. So regardless of previous experience any staff wishing to register as an orthodontic auxiliary after September 19 will have to go back and complete an approved course in orthodontic auxiliary practice before they can be registered (NZAO is developing such a course but the first of the training modules will not be available until early 2005.)
B. Scopes of Practice
All registered Health Practitioners will be registered in a Scope of Practice – this is basically a description of the tasks they have been trained to do and the tasks that they will be required to maintain competency.
By definition a Scope of Practice will include all tasks that are on the restricted list but also many other tasks that are not. Hence the Orthodontic Auxiliary Scope of Practice includes restricted activities such as placing separators, taking impressions, fitting bands (which could all cause bleeding in some patients but also activities such as providing oral hygiene instruction and taking clinical photos which are not restricted activities.
i. Clinical Staff who take extra-oral radiographs
Staff who take radiographs will need to register under an additional separate scope of practice . At this time only an registered Orthodontic Auxiliary can apply for the additional Scope of Practice for Extra Oral Radiography in Orthodontic Auxiliary Practice and only these staff will be legally able to take radiographs after September 18.
To gain registration with this SOP your staff must provide a MRTB Exemption Certificate in Extra-Oral Radiography and they must provide the name and address of the person who holds the x-ray licence for the machine they will be using. Exemption certificates have been granted to those who completed the pilot radiation-training course in Christchurch last year. A second Radiation Training course will run in Auckland on August 26 and 27. In the next day or two you will be receiving details about this course from Judith Hay.