Skill sharing is the ultimate test for volunteers who join the CCDS according to the 2018 shift leaders - or should that be tea-makers?

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Millie, Balraj and Sukh, foundation dentists, whose job it was to go out on the streets and find people who needed dental treatment.

Imagine going into work one day and finding that you are doing someone else's job. You might be triaging patients while the dentist you normally work with is carrying out the cross infection control. Or your receptionist might be giving out oral hygiene advice while you make a cup of tea for a patient. Welcome to the Crisis at Christmas Dental Service (CCDS).

In the dental profession, we regularly hear the terms skill-mix and team-working used to describe the successful engagement of all members of the dental team. Team working is equally essential for the dental teams that give their time and skills to delivering a yearly Crisis at Christmas Dental Service (CCDS) for people experiencing homelessness.

Each year, volunteer shift leaders are tasked with delivering a high-quality dental service to over 400 homeless or marginalised people. The volunteers arrive as strangers and leave as friends and team mates. The key role of the shift leader is to ensure that a fine balance is met between delivering the service efficiently and ensuring that volunteers have a purposeful, fulfilling experience. Volunteers come from across the country with a range of past clinical experience, skill sets and, of course, varying levels of apprehension.

Crisis gives its volunteers the opportunity to work with new dentists, nurses, technicians and team members to truly test and enhance our team working skills. When was the last time you nursed for a colleague? Sat on reception and triaged patients? Helped in the decontamination room? Our amazing volunteers embrace these challenges and accept their new roles.

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Kev Chavda, an associate from Nottingham, mucking in with cleaning up.

Shift leaders and Clinical Dental Supervisors encourage those who are reticent about participating in an unfamiliar environment to try something new, with support and a non-judgmental attitude; this may include supporting highly competent dentists who can extract a complicated third molar without a second thought, yet have never operated an autoclave before, or dental students who have never received patients on reception. By creating a safe environment in which to learn new skills dental colleagues come away from Crisis at Christmas with more fulfilling experiences and a new perspective on their own practice.

In 2018 we had some amazing dental students assisting on reception and giving oral hygiene instruction to all the patients who had completed their treatment. We tried to rotate roles throughout the day so everyone understands the Crisis dental team. A willingness to do the job of others helps build a cohesive team. We try and cultivate opportunities for skill-mix, skill-swap and skill-share to happen.

Skill-mix

All members of the dental team are represented at CCDS, including oral health promoters, dental hygienists, laboratory staff and clinical dental technicians. We encourage dentists to triage patients and support hygienists to deliver care that falls within their scope of practice. Dental laboratory staff are often called into the clinical environment and where we have clinical dental technicians on site every effort is made to engage them in the clinical processes of denture production. Oral health promotion nurses are encouraged to deliver oral hygiene advice and supported to apply fluoride varnish, especially on outreach triage. Exploiting all the skills of the dental team enables the whole dental team to get involved and contribute to holistic patient care.

Every role is crucial to the functioning of the service; from making a cup of tea for a guest and sitting down to chat about their life story right through to supervising less senior colleagues in the mobile vans.

Skill-share

Examples include long-standing volunteers learning skills of leadership and management from shift leaders by observing them prior to shift leading. One volunteer learns a skill from another in order to ensure their development; meanwhile, experienced volunteers and dental nurse colleagues teach other members of the team how to use the decontamination suite.

Skill-swap

Skill swapping can have benefits for all involved and can lead to bidirectional learning. Dental volunteers are able to go behind the scenes in the denture laboratory and learn more about the processes of creating a denture. Meanwhile, the laboratory team gain valuable insight into work in the field with the clinical team and observe first-hand the challenges and successes experienced front of house. Clinical Dental Supervisors support and provide clinical insight for all members of the team and in turn gain valuable experience in delivering supervision and chair-side professional feedback. We aim to ensure all volunteers are comfortable and able to achieve their role.

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A laboratory selfie with (l-r) Delroy Reeves, Desmond Solomon, Ashton Sheerkhan, David Hinkley, Andrea Johnson.

Conclusion

Every role is crucial to the functioning of the service; from making a cup of tea for a guest and sitting down to chat about their life story right through to supervising less senior colleagues in the mobile vans. It is a true testament to our volunteers that they are all happy to undertake any job. We hope that many of you will join us next year as we continue to expand and provide this exceptional service.

Quotes from volunteers:

'Volunteering with Crisis Dental Team was an amazing experience. Every single member of the team had a buzz about them and pitched in from admin duties to decon, clinical treatment to set up and close down, sharing stories and enthusiasm. It gave me a real appreciation of the work our amazing DCPs and reception teams have to do on a daily basis, and I would definitely recommend anyone thinking about it to join in - whether you are a student, clinician, technician or DCP it's a fantastic opportunity to see the meaning of good will in action.'

'Usually I work in a general dental practice, at Crisis at Christmas I get the opportunity to support younger dentists with treatment planning and co-ordinating the flow of patients on the van. It's great to feel that the skills developed from being a practice principal are helpful in supporting Crisis, but also great for me to have the opportunity to develop my own mentorship and teaching skills in an informal way.'

This article was compiled by the Crisis at Christmas Dental Service shift leaders and service organisers: Doughty J, Leigh C, Bradley N, Davies S, Fletcher A, Patel S, Shah N and Tatari A.