NHS Force Closure of Practice in High Needs Area
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- Published: Friday, 21 June 2024 05:10
- Written by Peter Ingle
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Thousands of NHS patients face ’disaster’ after a dental practice was ordered to close by the NHS. Sefton Dental Centre, a practice in Bootle, estimated that it cared for 7,000 patients under the NHS. Located in one of the most deprived areas in the country, it saw many vulnerable patients with complex needs. It has now been ordered to close.
According to the Liverpool Echo, residents have expressed fears for the future about their health and said the loss of dental services in Bootle will have a detrimental impact on the area. Some accused the NHS of abandoning vulnerable people.
Smart Dental Care is the managing organisation for Sefton Dental Centre and its problems began in May last year. An NHS commissioning team conducting a ‘spot check’ concluded that the practice did not employ enough clinicians to deliver its contracted services. This was defined by Cheshire and Merseyside Integrated Care Board who are responsible for managing NHS dentists in the area, as ’non-compliance’ and they issued a remedial notice.
The next stage involved the practice being told it had ’failed to take the required action by the stated deadline.’ It was informed the ICB would be seeking to terminate its contract. Smart Dental Care dispute this claim.
Managing Director of Smart Dental Care, Suken Shah, said the firm took over the Bootle practice during early 2020, just as the pandemic was starting to hit the country. He also says that the fallout from Brexit has added an extra layer of difficulty as practices struggle to recruit dentists from abroad, to fill the workforce shortfall.
Mr Shah said that in the past, qualified dentists from the EU were able to register in three weeks to enable them to work in the UK. Now the timeframe had increased to 18 months. Brexit and the pandemic had created a ’perfect storm’ which meant dental practices were finding it impossible to recruit dentists, with matters made worse by levels of disease at the end of the Covid lockdown.
He said: "In 2022 after Covid, Sefton Dental Care like almost all NHS practices struggled with the national dental recruitment crisis. 157 out of 318 NHS dental contracts across Cheshire and Merseyside could not deliver their NHS commitment as a result."
Nevertheless, Smart Dental Care believed the NHS was acting in good faith when it issued the termination notice and vowed to put its case forward during mediation. This entailed an explanation of why the practice was one dentist short and how it had now recruited the extra dentist to meet full compliance with the contracted NHS services.
However, at a meeting with the NHS, Mr Shah claims he was informed the ICB was ’not interested’ in mediation and doubled down on its commitment to terminating the contract with Smart Dental Care.
A response to a Freedom of Information (FOI) request submitted by Mr Shah to the NHS Cheshire and Merseyside ICB showed the ICB manages 318 NHS dental contracts of which 157 were deemed to have ’underperformed’ during the financial year 2022/23. Discounting Smart Dental Care, none of the other ’underperforming’ 150+ dental providers were issued with a termination notice.
Furthermore, the response to the FOI also reveals NHS Cheshire and Merseyside ICB ’clawed back’ over £27m worth of Units of Dental Activity (UDA) during 2022/23 and recommissioned zero new UDAs for 2023/24.
Mr Shah echoed the frustration felt by many clinicians when he described the situation: "You have parents of disabled children who see this as a safe haven and elderly patients who have no other possibility of getting to a dentist outside the area. The bureaucrats never get to see patients and they do not understand the impact on people who do not have access to a dentist."
A spokesperson for NHS Cheshire and Merseyside said: “During 2022 it became clear that five practices managed by Smart Dental group were not delivering the contracted level of NHS care. In response, a nationally agreed process was followed but, as the situation remained unresolved, a decision was taken to issue termination notices in August 2023.
No alternative service has yet been presented in regard to patients of Smart Dental Care.
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