APEX Solutions


More Movember

Posted by Robert Pilcher

Only 9 days to go. The facial hair is starting to irritate a bit, but the fact that we have now hit £300 makes it worth it.

We don't have a photo of Steve today - he has been in hiding in his surgery. He didn't even make it for afternoon coffee!

We do have one of my ugly mug to compare with last week


Posted by Robert Pilcher

Well the Blog is back. It was removed from the website for a few months as it was just generating spam.

About a month ago, I mentioned in passing that I was considering doing Movember (It's all Chris Evans fault on Radio 2. He mentioned it on his morning show as I was driving in from Cambridge). This was latched upon by the girls at Bury and suddenly it was set in stone and Mr Little and I were signed up. None of the girls wanted to join us!

So now we are a week in and it is itching like, well, ltchiness itself. Especially under a mask. Mr Little has gone for moustache, but my wife insisted I went for full set after a few days of moustache only. I wish I hadn't listened, as my beard is coming through white. My wife thinks she is growing her own Santa.

 One week in we have raised over £100, so thank you all the patients who have donated. It is a bit like being an old fashioned exhibit at a travelling show - £1 entry to see the bearded man!

Mr Pilcher


Mr Little's Moustache


Woolpit Moustaches



Rebuild complete

Posted by Robert Pilcher

The rebuild of Mr Pilcher's Surgery is now completed as the photos below show. Mr Pilcher has bought a Castellini Skema 8 operating unit - Their top of the range unit - and cabinetry by Tavom. Both these are Italian, as shows in their fantastic design. These were supplied and fitted by RPA Dental based in Wigan - a specialist Dental Surgery design and fitting company. Building work was carried out AM Building Ltd who have ben working with RPA for 25 years. Mr Pilcher is 'over the moon' with the new surgery.








Mon 22nd April Surgery Build

Posted by Robert Pilcher

There have been big noticeable changes today as the cabinets went in today and the templates for the work surfaces and desk areas were made. The corian work surfaces will be installed next monday.


Templates for work surfaces



Refurbishment continues

Posted by Robert Pilcher

Here are the latest photos from the rebuild of Mr Pilcher's surgery. There has been a lot of work carried out by the building team today, although most of it is unseen being first fit of all the electricals and plumbing. A top skim of plaster went on today, and the final fitting of the air conditioning.

Neat fitting of Air Con.

Hard at work


Refurbishment continues

Posted by Robert Pilcher

Another very busy day in the surgery. The services have all been laid under the floorboards, air conditioning fitted, walls had their first coat of bonded plaster.






Surgery Refurbishment starts

Posted by Robert Pilcher

The refurbishment of Mr Pilcher's surgery sarted today. I will chart the progress of the rebuild as it goes along.

Surgery before the start of day one.



Starting to dismantle the surgery


















Infection Control Training

Posted by Robert Pilcher

On the 6th, I highlighted the fact that the Department of Health had published a new Guideline on Infection Control in Primary Care Dental Practices. This came completely out of the blue, as it had not been anounced in advance. Abbey Dental Practice, decided that we would take the opportunity to implement the new guidelines as soon as possible and arranged to have a practice training afternoon from 2 - 5pm today. The practice covered all aspects of infection control, including the sources of infection, personal protection, environmental cleaning, cleaning, sterilisation and storage of instruments and auditing infection control - to ensure we are doing it correctly.

All clinical staff from both sites attended the training - nearly 30 staff.

Changes in Infection Control Regulations

Posted by Robert Pilcher

Four years ago, The Department of Health decided that it would publish a new Health Technical Memorandum on Infection Control in Dental Practices - HTM01-05 - Decontamination in primary care dental practices. Up until this point, the accepted document on decontamination was produced by the British Dental Association - Advice booklet A12. This had been produced in consultation with the Department, and had been the document I had used since the 1980s (It was reviewed and republished every couple of years).

At one swift stroke, the Department cast aside the A12, which had been produced and adapted as more evidence based advice became available, and produced it's own HTM. There was consternation within the profession at the time, as there were massive sweeping changes, and massive inconsistencies compared to the standards for other healthcare environments, and no published evidence to back-up the changes. One example was the storage of bagged sterilised instruments. In hospitals this has been set at 1 year - instruments must be used within 1 year of being sterilised, but in dental practice it was 21 days - yes hospitals have 365 days to use a bagged sterilised instrument, and we got 21 days. After 21 days, the bag has to be opened and the instrument re-sterilised and re-bagged in a new bag.

 The HTM was so suspiciously non-evidence based, the BDA and other dental organisations put pressure on them to release the evidence that had been used to make the sweeping changes. After many months, the Department finally, reluctantly, released the list of evidence they had used. Funny old thing. Hardly any published, refereed research; mostly opinions, committee decisions, and other department documents. This evidence would not have been taken seriously by anyone with an enquiring mind. The evidence was flimsy at best.

It was promised by the Chief Dental Officer that it would be reviewed after 2 years, but we would be stuck with these changes for at least 2 years, and the changes have been extensive requiring expensive changes to surgeries and procedures with no evidence it would improve patient safety.

In the meantime, research was conducted by the Scottish Department of Health (Yes there are different standards for different parts of the UK!), and others. They soon found that the assumptions made by HTM01-05 were just that - the evidence showed they were wrong, and the HTM needed re-writing.  Well 2 years came and went; Then 3 years: then 4 years; and nothing; Then very quietly, with no fanfare, no press release, NO NOTIFICATION TO DENTISTS, NO APOLOGY, they quietly published the 2013 version of the HTM on 3rd April (3 days ago). In fact the majority of Dentists will still be unaware there have been changes, as there has been no notification by the Department of Health, and it was only a partial review, but a number of important changes had been made. A full reveiw will now not happen until the end of 2014 - 6 years after to original 'living' document - if it is a living document, it must be a walking dead zombie.

So we made all these expensive changes (£1000s), with no evidence, and now it has changed again, and lots were conpletely unnecessary in the first place - and from the DH - NO APOLOGY.