Practice Plan’s Nigel Jones and the British Dental Association’s (BDA) Eddie Crouch delved into a range of topics within the NHS dental landscape in a recent webinar.
Throughout the webinar, many dentists submitted questions to Eddie on a range of subjects , some of which, along with Eddie’s answers, are detailed in this blog…
Q: What can principal dentists expect from associate delivery? If we have a reduced workforce, can we expect 100% delivery of associates contracts? We have two surgeries back-to-back (no fallow time required) for the associates.
BDA have provided side agreements for the arrangements for associate contracts; the delivery expected from contracts is detailed in Letter 8 and will need negotiation at practice level.
So, this delivery is shared across the practice. However, it is clear than 100% of delivery is unachievable with the current guidance and SOPs. The SDCEP guidance on fallow time has no indication that, with any mitigation, no fallow time is appropriate.
Q: What is the minimum time recommended for a routine dental examination including taking medical history, radiographs and writing records? Our employer is demanding more productivity, but this seems at the expense of quality of care.
A: I think the issue to address is that associates in the main are not “employed” but self-employed; At a recent GDC meeting I raised the issue on safe levels of targets, and certainly the GDC would expect an individual registrant to be responsible. Certainly, if you feel this is being compromised it would need a discussion at a local practice level. As for time, that will be very much an individual decision backed up by what additional support you may have either via DCP or electronic gathering of information.
Q: Will practices who do the right thing and continue seeing patients after achieving the 60% target be penalised? Last quarter, they had a calculation which made it difficult to go beyond 2% carry forward.
A: There has been an expectation that 60% is the minimum that practices deliver in UDAs and that contracts have been paid 100% (obviously minus the abatement). Initially, when the 45% was set for January to March, there was uncertainty on this being a maximum and there was messaging over carry forward.
This was clarified that the only benefit from passing the 45% was that the abatement would be reduced pro rata on undelivered activity. So technically carry forward will only apply for anything over 100%. It is hoped that the six-month agreement will allow some ability to take some time off and schedule your delivery.
Q: Can you give an opinion/insight to the likely impact to NHS services in Northern Ireland?
This is a wide-ranging question and probably best to refer you to the blogs written by the BDA team in Belfast with this as an example:
Q: What do you think will change with our SOP after 21st June when the rest of the country is supposedly going back to normal with restrictions lifted?
A: I have sought a meeting with Anna Ireland, who is the new Dental Public Health lead at PHE following the retirement of Sandra White who previously advised NHS England and DHSC. There is little indication in the short term that the SOP will alter dramatically, and SDCEP continue to review the issues on AGPs. There is still widespread expectation of a further spike in cases as detailed by CMO Chris Whitty.
Q: We have a severe lack of dentists wanting to do NHS Dentistry yet there seems no action to overcome this?
A: There are sufficient dentists just an insufficient number willing to take on work in the current NHS contract, hence our continued efforts to change the contract to one that encourages dentists to work in the profession. Local NHS England initiatives to recruit have been mainly unsuccessful, and the BDA have highlighted the dreadful access issues in many parts of the country pre-pandemic and did so again this week when a practice closed in Scarborough based on recruitment issues.
Q: Can you clarify, if the practice has reached the 45% requirement, then you will not have abatement on your practice UDA value?
Abatement will be applied at 16.75% of activity not delivered. So, if you hit 45%, the 16.75% will be applied to the remaining 55%; any delivery above 45% will have abatement removed pro rata. Anyone delivering under 36% will have no abatement but only receive UDAs as 1 for 1.
Q: What do you think the landscape will look like for dental laboratories post-pandemic?
A: I think the support for dental laboratories during the pandemic was very poor and the report on support produced by Jason Wong, sadly not taken up by the Treasury, may have started to address that. However, I am hearing that labs are now seeing a higher level of work and that the demand for private work is higher than ever. I hope all those that have managed to survive will continue to thrive, and of course the altered activity levels expected in the NHS will have resulted in some return to pre-pandemic levels.