2011 and all that

When the year 2011 is mentioned in dental circles, the main topic of conversation is the proposed ending of the ring fencing protection of PCT funding for dentistry after March. Inevitably, there is much speculation about what will happen, with a further extension a possibility, as is allowing the PCT’s freedom to vire monies away from dental care and into more “mainstream” healthcare services, especially against a background of significant cutbacks in all areas of public sector spending.

Undoubtedly, this is an important area of focus and will impact upon many people’s lives and possible livelihoods, but it does tend to dominate and even crowd out other important planned changes occurring.

First, there is the area of cross infection control. From my perspective many practices are yet to appreciate the full impact, both operational as well as financial, of compliance with the recently issued guidance by the Department of Health in circular HTM 01-05. Apart from the additional capital expenditure on items such as washer disinfectors, vacuum autoclaves and extra instruments, there may well be the need for increased staffing levels and there will be more maintenance contracts, so practice overheads will rise as well. However, some practices may just lack the space required to accommodate such items and the associated protocols that accompany them, so decommissioning a surgery room, or in some cases relocation of the practice, may be the only options. Certainly the impact of this change will be significant.

Next, there is the matter of revalidation which is a professional’s obligation to prove to their regulatory body that they are fit to stay on a register, which is far more wide-reaching than CPD. Here, the onus is on the professional to show that they have not only undertaken some postgraduate courses, but that they comply with the standards set by the GDC throughout their professional life. The GDC is currently consulting on proposals for dental revalidation that will cover four domains: clinical, professionalism, management or leadership and communication.

Dentists will be the first professionals within the dental arena to have to go through the revalidation procedure and, again, this will take time and involve additional administration and cost. This again is scheduled to be introduced in 2011.

Finally, in 2011 it is proposed that all dental practices will have to register with the Care Quality Commission. It is interesting that the approach of the CQC seems to have focused on what makes a quality experience for service users, rather than just the policies, processes and systems deployed to deliver care. Also, apparently, the guidance has also been designed to be accessed by a range of “stakeholders” including, providers, commissioners, service users and those monitoring ongoing compliance. This additional level of regulation will almost certainly incur additional costs.

So, whilst 2011 is a pivotal year for NHS dentistry, it is going to be a very busy and challenging year for all dental practices because big changes are happening on numerous fronts, so, at the very least, it is best to start thinking about them now.

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