Practice Plan’s Sales and Marketing Director, Nigel Jones, discusses the dental landscape with Eddie Crouch, Chair of the BDA’s PEC.
Many dentists were left struggling to deliver 45% of their UDA contract in the first quarter of the year, and the most recent announcement regarding targets increasing to 60% left even more dentists concerned about how they would achieve the required levels of delivery, while still working within Covid-19 restrictions.
I caught up with Eddie as part of a recent Dental Update webinar, to talk about his concerns over the targets, what positives came out of the negotiations with NHS England and what he thinks the dental landscape will look like in October…
NJ: Can you tell us how the negotiations with NHS England unfolded and your views on the immediate impact of the 60% target?
EC: We’d negotiated the 45% target at the end of last year, however, just days before it was due to come into force, dentists hadn’t been informed by NHS England. So, we decided to break ranks and announce the news ourselves.
Ahead of this 60% announcement, we were promised more notice, but unfortunately the same thing happened again. We considered breaking ranks for a second time but decided against it as not to jeopardise other elements of the contract we’d negotiated – which in my view were positive changes for the profession.
One of the main things we pushed for was having a longer time frame for delivery, not the three-month sprints we’ve seen so far. So, we secured an agreement for the 60% to be delivered over a six-month period, which will allow for dentists to have time off.
So now, rather than having to sprint towards their target in just three months, like they had to do in the first quarter, dentists can work towards delivering their target while also being able to factor in down time for themselves and their staff.
There were other positives which came from the negotiations, and we noted that the Chief Dental Officer for NHS England was supportive of not setting a completely unachievable and unsafe target.
I do have real worries about whether the 60% is achievable. Practices have worked incredibly hard this year and figures have shown that many have achieved their targets. However, I’m concerned about whether practices will reach a plateau in terms of safe delivery.
NJ: What is the BDA’s view on how many practices may face clawback?
EC: When the 45% target was announced, we were really concerned that many practices would fail to reach that mark and a significant number would be financially disadvantaged.
We were relieved to learn that only 11% failed to hit that target, so our worries haven’t materialised. However, 11% is still an awful lot of practices that will be facing a potentially significant clawback at the end of the year.
It will be hard to predict how many practices are likely to achieve the new target because it is unclear how NHS England will penalise those who call below the 60% level.
With the previous target, NHS England said it would be listening to the mitigating circumstances of those facing clawbacks. However, this time, it’s unclear whether that will be the case, and that means it is difficult to make a prediction.
NJ: With dentists working hard to clear backlogs and treat more patients, could they be in danger of creating evidence that targets are achievable in the short term?
Eddie: Yes, absolutely. NHS statistics show that a significant number of dentists achieved their 45% target, however, I don’t think this is sustainable over a long period of time. Many colleagues tell me that working in PPE to the level that they are is completely exhausting. And, I guess, until we get to the point where we’re not wearing that level of PPE, and we’re not having to work to the standard operating procedures that we are, practices are in danger of overdelivering, in a sense, and making it look like the targets are achievable.
However, the six-month delivery period we’ve negotiated with NHS England is designed to give professionals a chance to take a well-earned break, which they haven’t previously been able to, while still achieving the minimum target of 60%.
NJ: And finally, how do you think the NHS landscape will look in six months’ time?
Eddie: The problem is, it’s only at the end of the year that dental practices face financial reconciliation, and it’s not clear what NHS England is planning to do with practices that don’t hit their targets by the end of this six-month period.
Are they going to allow for elements to be carried forward, so you can catch up? That’s unclear, and we don’t even know what the second half of the year will look like. The Chief Medical Officer has said that there might be a further spike in Covid-19 cases in the autumn. If that happens, presumably we will be into the realms of having to renegotiate any targets going forward.
Nigel: Thanks for your time Eddie, it’s much appreciated.
Eddie is a Dentist based in Birmingham and the current Chair of the British Dental Association’s Principal Executive Committee.
Nigel is Sales and Marketing Director at Practice Plan, the UK’s leading provider of practice-branded dental plans. He has supported the development of successful private practices throughout the majority of his 30-year career.