The recent disclosure of emails by the GDC under FOI concerning the Williams case shows an absolute refusal by the NHS to become involved in the litigation. The reasons for this decision have been redacted, or not even given to the GDC.
Once again the new patient charges have been announced for the NHS, and once again they have gone up far more than the amount dentists will get for their UDA’s. The third consecutive inflation-busting rise in patient charges means that an ever increasing number of dentists will find themselves as unpaid tax collectors for the government, with the added pleasure of having to continue to practice in a hostile environment where the threat of litigation and GDC involvement is ever present.
So what will it actually take for dentists to wake up and smell the coffee? Patients are paying an increasing amount for their care, and as they do so, direct their annoyance as ever to the dentists. Its unlikely that they will understand or accept the explanation given that the charges are in effect a taxation, as they are too closely linked to the provision of a service.
Why do many of the dental practices seem to forget that they are in truth independent contractors within the NHS, and as such only have to refuse to contract to the NHS in order to retake a degree of control of their own future once again? It can’t be that working within an NHS contract is too easy; we increasingly hear of the demands on the practitioner’s time to fulfil the contract requirements. This time of year is full of comments on social media about the increased flurry of activity in order to hit the UDA’s targets once again or suffer claw-back.
By raising the patient charges, the government is contributing less and less each year to the cost of dental provision. The population of the UK isn’t reducing, and the cost of providing dentistry isn’t either. But for less and less contribution the government is still dictating the terms of the contract, and dentists continue to accept it.
Will it actually take the government to raise the patient charge to £30 for an exam (whilst still paying £25 for the UDA) for dentists to realise that they would be better off just charging the patient £30 and sticking two fingers up at the government? Or is it the NHS pension that people are holding out for? Or the continued chance to pay an associate £10 per UDA when they are really getting £30?
Practice owners (and particularly the bigger practices and corporates) definitely have the whip hand here. I can remember the times when associates were few and far between. It appears that the reverse is now true in many areas of the UK (particularly in metropolitan areas), which allows the principal to reduce the unit price of a UDA paid to an associate. An increase in patient charges will likely bring a drop in the number of patients visiting practices, and in one fell stroke this will reduce the PCR, and reduce the chances of the UDA targets being met, and therefore a claw-back occurring. I know of many associates that are made liable for the gross amount of any claw-back due to their individual underperformance (rather than the net amount they have been paid per UDA). Add this to the NHS pension of the principal that is effectively enhanced by paying a smaller percentage of the UDA value, this hardly puts the principal under any immediate pressure to withdraw from the NHS system they are still aligned with. However, I suggest that it is now causing a much greater ‘Us and Them’ situation with associates than ever before.
So why is it ok to make money out of the associates and not charge the patients a decent amount for their care? Whilst a business has a duty to its shareholders and owners to keep its costs low, with the introduction of the minimum wage this means they don’t tend to be propping up their bottom line by charging their staff for the privilege. They tend to charge their customers for it with the increase in the charge for the product.
Unless you happen to be in a fixed price system…so the only way money can be made (let’s forget upselling to patients using the NHS as a way to get them in the practice for now) is by reducing the costs of the workforce and investment in the business. However the government expect more and more for less and less (look at the next round of orthodontic commissioning that is going on) and it becomes impossible to square the circle unless someone actually pays for it. That certainly isn’t going to be the government.
Given that some patients will not be able to afford the hike in charges does not mean that many others would not pay for a decent service if they had to. Surely having fewer patients (but of the sort that don’t sue and complain) that are being charged a fair amount for the service provided, with no third party dictating targets has to be better for the stress levels of both dentists and patients under their care?
Will it take associates to actually walk away from the profession and retrain? With the current environment of stress due to the GDC, threat of litigation, and the real time reduction in associate income, then this has never been more possible than it is now. And that will lead to a reverse in the associate market again, especially if the (currently unknown) effect of Brexit results in European dentists returning to their home countries – and who wouldn’t if it meant avoiding the GDC and Litigation!
So what will it take for the profession to see the light? That we need to realise the government would still wish to control us if they only contributed £1 in every £100 charged and only then will we react? Or do we need to remember that everyone who owns a practice is a private practitioner already and they should just tell the government:
‘No More’.
Image credit - Pascal under CC licence - not modified.
On Monday 22 August, Denplan welcomed Chief Dental Officer for England, Sara Hurley, and Andrew Taylor, her Dental Programme Manager, to the company’s head office in Winchester. The aim of the meeting was to explore areas of mutual interest between the private and public sectors. There was acknowledgment that engagement between the two sectors centres on common patient-centred goals – not least that of offering more patient choice, and improving the long term oral health of patients in the UK.
Henry Clover, Denplan’s Chief Dental Officer said: “We were delighted to welcome Sara and Andrew to our offices, where we were able to explain Denplan’s business model and the range of support services we offer to 6,500 member dentists nationwide. We see this as the start of a conversation on potential areas of collaboration and information sharing.”
One area of discussion was the Denplan Excel certification programme, developed over 15 years ago for dentists to help support clinical governance, professional regulation and excellence in patient care and communication. The Denplan Excel programme was also UKAS accredited in January this year. Denplan explained that they would be open to future discussions with the GDC regarding continuing assurance plans, and with the CQC, to discuss the potential value of clinical service accreditation and peer review schemes. These could be useful information sources to support their inspection programmes and to help continue driving up standards in dentistry.
Henry also shared some data recently published in the British Dental Journal which demonstrated that worsening oral health correlates with worsening general health. This was derived from over 37,000 patients who had received a Denplan PreViser Patient Assessment (DEPPA)1. The research provided further evidence for the association between high-risk lifestyle factors such as smoking and heavy drinking and poor oral health outcomes in an area of common interest in all sectors of primary care.
There were also discussions around the array of tailor–made practice training sessions that Denplan runs for practices and their dental teams – over 450 sessions per year. Denplan Academy training covers areas such as complaint handling, legal and ethical issues and GDC standards, preparing for CQC inspections, and caring for patients with dementia to name a few.
Henry said: “It was generally agreed that any initiatives and training that improves practice efficiency and in turn improves oral health outcomes, would serve the profession well to be explored on a wider scale.”
Sara also outlined the case for a national programme to improve dental health through better co-ordinated care and empowering communities to implement their own sustainable oral health initiatives. She will be launching the concept of “Smile 4 Life” at the Health and Care Innovation Expo next month; national support for existing community based projects, a hub for sharing best practices across Local Government Authority areas and ensuring that local oral health initiatives are complemented by innovative commissioning approaches within local NHS England Commissioning Teams and supported by the profession.
The initial focus is “Early Years/under 5’s” with the aim to provide opportunities for families and children to establish good oral health habits as a daily norm, be it nursery school or at home. With encouragement and ease of access to dental care professionals, first check-up by age 1 and opportunity to continue to visit the dental team regularly for age–appropriate preventive advice, together with help to ensure problems are identified early, the prospect of a generation of children free from decay becomes increasingly real.
Keen to expand the concept of Smile 4 Life beyond childhood, Sara also touched on an ambition for a wide-ranging programme for oral health reform – with a focus on improvements for the oral health of the over 65’s, the 16-24 age group, the homeless, the ageing well (typically aged 35-55) and those aged 85 plus – a population expected to double between 2010 and 2030. She also expressed her determination that the dental profession work together to lead and achieve the required changes.
Henry commented: “Denplan will continue to support such prevention strategies that recognise that good dental health in childhood is vital, not only for lifelong oral wellbeing, but for good overall long term general health. This is ever more so important now, given the lack of an oral health focus in the government’s recently published obesity strategy.”
[1] http://www.nature.com/bdj/
About Henry Clover
Henry Clover joined the Professional Services team of Denplan in 1998, having worked as a dentist for 17 years looking after patients’ oral health in his own practice. He now holds the position of Director of Dental Policy at Simplyhealth and is also Chief Dental Officer at Denplan. Henry playing a vital role in Simplyhealth’s Leadership Team and is at the forefront of private dentistry liaising with more than 6,500 member dentists.
About Denplan
Denplan is the UK’s leading dental payment plan specialist, with more than 6,500 member dentists nationwide caring for approximately 1.7 million registered patients. Established in 1986 by two dentists who pioneered the concept of dental payment plans, Denplan has been at the heart of dental care for nearly 30 years and today the company is owned by Simplyhealth. Denplan has a wide range of dental plans for adults and children, enabling patients to budget for their private dental care by spreading the cost through a fixed monthly fee. We support regular attendance and preventive care, reducing the need for clinical intervention and helping patients to maintain healthy teeth and gums for life.
For further information visit www.denplan.co.uk. For oral health tips and advice visit www.myteeth.co.uk. Patient enquiries telephone: 0800 401 402 Dentist enquiries telephone: 0800 328 3223
Denplan also provides a range of professional services for its member dentists and their practice teams, including the Denplan Quality Programme, Denplan Excel Accreditation Programme and Denplan Training, plus regulatory advice, business and marketing consultancy services and networking opportunities.
What’s in your GDS contract?
General dental services (GDS) contracts are lengthy, complicated and dentists are, on the whole, not fully accustomed to the plethora of legal terms that can be found in them – and why should they be? Dentists have undertaken substantial training to care for patients’ teeth and oral health, not digest convoluted legal phrasing and contractual terms.
Which is why it is vitally important for any dental practice owner who holds a GDS contract to have a comprehensive understanding of all of the terms to which they have agreed.
Thus, it is imperative to take proper legal instruction from a professional who understands the ins and outs of dental contracts – and who can offer relevant advice and ongoing support.
With this in mind, let’s discuss some of the more important points that require careful deliberation.
Firstly, clause 14 of the GDS contract concerns whether or not the Contractor has elected to be regarded as a health service body. This status determines the processes that will be followed in the event of any contractual dispute, and while this electing to do so will not affect any other aspects of the contract, there are benefits to not doing so.
For example, if a Contractor does not elect to be regarded as a health service body, they will be free to choose either the NHS dispute procedure or to proceed through the Courts should any contract disputes arise – giving a Contractor more options in the long term.
Another good example of where careful consideration must be taken is in clauses 198-200, which concern the permission of sub-contracting under the GDS contract. These may be useful if the contract is to remain in the name of the individual holder, but performed by a company – and may be considered an alternative to having the contract vested in the company on incorporation.
Notice of this must be served to NHS England in accordance to clause 199 – which states that any required information be supplied as quickly as reasonably practicable. Be aware that NHS England may seek a formal contract variation as a result.
Thirdly, clause 339 of the GDS contract states that where a partnership contract reverts to an individual contract, the NHS England has the power to terminate in the event that, in its reasonable opinion, the change is likely to have a serious adverse impact on the ability of the provider to perform its obligations. This could include the fact that there will be fewer performers (e.g. dentists carrying out the units of dental activity (UDAs) following a change from partnership to individual). This is a particularly pertinent consideration should one of your partners be approaching retirement, or if serious illness threatens the current partnership. Either way, a contingency should be arranged with your lawyer to ensure you are fully prepared for any eventuality.
There are many more points that need to be addressed before you commit your signature to the contract.
Goodman Grant Solicitors are experienced, dental-specific lawyers that fully understand the minutiae of GDS contracts. Their expert team is prepared to answer questions regarding any of the specific clauses of the contract and can provide a useful checklist to ensure that everything is in order before you sign.
Paul Harris of Goodman Grant Lawyers for Dentists – a NASDAL member
For more information call Paul Harris on 0151 707 0090 or email This email address is being protected from spambots. You need JavaScript enabled to view it.
www.goodmangrant.co.uk
A new director, Paul Harris joined Goodman Grant as a trainee solicitor in September 2010 and qualified to the Dental Team at the end of 2012. Paul works on a variety of dental matters relating predominantly to dental practice acquisitions and disposals – though he has an in depth understanding of all dental-legal issues that make him an indispensible member of the team
The preceding NHS Confidence Monitor, conducted in May and June of 2015, solicited over 300 responses from dentists across the UK. To reflect the profession’s growing interest in the NHS Confidence Monitor, this latest survey has been opened up to enable all members of the dental team to share their thoughts, providing a deeper and wider understanding of the whole profession’s perception of NHS dentistry.
As previously, the survey will monitor the profession’s confidence in:
• The future of NHS dentistry as a whole
• Future career prospects
• Remuneration levels
• Getting the balance of treatment versus prevention within the NHS right
• The ability of the team to work effectively within the NHS
• Whether patients will be happy with level of care provided.
In addition to widened access, the survey has increased in scope to explore a number of new topics. Those taking part are invited to respond to questions concerning their proposed age of retirement to gauge the possibility of a staffing crisis in the future, and whether they would feel happy encouraging a family member or friend to pursue a career in dentistry.
‘Finding out about team members’ retirement plans should offer an interesting insight into whether there might be a Provider crisis when it comes to asking dentists to sign up to a reformed NHS contract. In addition, asking whether one might encourage a family member or friend to pursue a career in dentistry really brings the overall mood of the profession into focus,’ remarked Andrew Lockhart-Mirams, a specialist in business advice and structures in healthcare and co-founder of Lockharts Solicitors.
Also commenting on the survey, Judith Husband, who sits on the BDA’s Principal Executive Committee, said: ‘I think it is very important to understand the landscape of what is going on. That is why I believe the ongoing, enhanced NHS Confidence Monitor survey is so important and I would urge team members to have their say.
‘No one wants to stop positive progress – but, from the Government’s perspective, this should be in the context of open and honest debate and a willingness to listen to what we, as a profession, have to say. This is a great opportunity to help facilitate that dialogue.’
To take part in the latest NHS Confidence Monitor and share your thoughts, please visit https://www.surveymonkey.com/r/PracticePlanNHSConfidencemonitor3 before the closing date of 31st January 2016. The survey should take approximately three minutes of your time.
Once the results of the latest survey have been independently verified, they will be presented to an ‘Insights Panel’ made up of key opinion leaders and experts from the dental profession who will explore and debate their significance and their implications for the future of NHS Dentistry. The panel’s findings will then be shared with dental professionals throughout the UK.
For detailed results from the last two surveys, as well as to gain access to the discussions from our previous Insights Panel meetings and interviews with our panel members, visit www.nhsdentistryinsights.co.uk.
So the Government is trying to implement a new contract whilst retaining this same level of control. However, it is very difficult to envisage a system that will allow them to do that and satisfy the dental profession.
For the last few years, everything seems to have been focused on reducing spending on NHS dentistry. This can be seen with both GDS and PDS contracts. As the PDS contracts come up for renewal the LATs are taking a much harder stance and reducing values wherever they can.
There was a time, a number of years ago, when over 50% of practices had not achieved their UDA target on a regular basis and yet no action had been taken by PCTs to recoup any monies. This was certainly the case for the first five years of the current contract; however, one of the changes we have seen recently is a significantly stronger focus on performance. So that now if a practice does not hit targets, not only will the LAT recoup the money but they will seize every opportunity to reduce the contract value, either by decreasing the number of UDAs or lessening the UDA value.
Under any new contract, if there is one, underperformance and failure to achieve KPIs is going to lead to a similar situation. Whilst the latest prototype proposed contains remuneration based on capitation, the number of patients that you have registered, the work performed and some for achieving KPIs, the potential risk for missing these targets is a massive 10%. Nevertheless, a lot of the essential details here remain unknown.
In some ways the most concerning part about the change in contract is the notion it might be time limited. This completely fails to recognise the investment that dentists have to put into practices, not only in terms of equipment, but also regarding the time spent building a good dental business. To fit out a dental practice is a very significant cost, and nobody is going to do that if there is a contract that only lasts for five years – over that period one is not going to get back that which one has paid out, never mind actually make any money!
It seems, whether stated or unstated, that it is the Government’s clear intention to reduce spending on NHS dentistry. To achieve this, perhaps all they would have to do is introduce time limited contracts and there would be a very large shift away from NHS ownership towards private.
And this, in my opinion, is what the Government wants. They need to save money and whilst they talk about the NHS in hallowed terms, I’m not so sure that NHS dentistry is quite so hallowed as the rest of it.
John Grant of Goodman Grant Lawyers for Dentists
For more information call John Grant on 0113 834 3705 or email This email address is being protected from spambots. You need JavaScript enabled to view it.
ASPD MEMBER
Over 300 NHS dental professionals completed the second NHS Confidence Monitor, a comprehensive industry survey conducted on behalf of Practice Plan, sharing their views about the future of NHS dentistry. The aim of this on-going survey, which will take place every six months, is to gain insight into the profession’s confidence levels in NHS dentistry over the coming months and provide a snapshot of the mood of the profession going forward.
The NHS Confidence Monitor also revealed that dentists are very worried about their own future, with 90% of respondents saying they are less confident about their career prospects within NHS dentistry going forward than they were a year ago.
Confidence levels are also at a shocking low in terms of dentists’ ability to offer their patients the right balance of treatment versus prevention in times to come under the NHS, with 85% of respondents expressing fears that the balance won't be right.
94% of respondents said they had lost confidence that practising dentistry within the NHS will offer an appropriate level of remuneration in the future, serving as a worrying statistic for the Government since this is suggestive of staffing shortages in times ahead if dental professionals choose to leave NHS practice.
It also seems that there is little confidence that dental teams will be able to work effectively within the NHS framework as time progresses, with 89% feeling less confident on this matter than they did in the previous 12 months.
Perception of patient satisfaction is also at a worrying low, with over three-quarters (77%) of respondents lacking confidence that patients will be happy with the outcome of attending an NHS dental practice in the future, when compared to 12 months ago.
Commenting on the results, Eddie Crouch, Vice Chair of the Birmingham Local Dental Committee, stated: ‘I think it’s worrying that so many people have become markedly more despondent since the last survey. I think it’s partly anticipatory and partly because the issue appears to be so low down the Government’s list.
‘It seems a sad state of affairs and we can only hope that results such as these will persuade the powers that be to look at the situation anew in consultation with representatives of the profession.’
Each NHS Confidence Monitor survey will be followed up with a forum of key opinion leaders, dentists and dental professionals to explore the results in greater depth and place them in context. The next forum is scheduled for October 2015, after which the group’s opinions on the survey results will be made available to the dental profession in the UK.
In the meantime, to see the full results or for further information on the NHS Confidence Monitor, please visit www.NHSDentistryInsights.co.uk.
Over 300 NHS dental professionals completed the second NHS Confidence Monitor, a comprehensive industry survey conducted on behalf of Practice Plan, sharing their views about the future of NHS dentistry. The aim of this on-going survey, which will take place every six months, is to gain insight into the profession’s confidence levels in NHS dentistry over the coming months and provide a snapshot of the mood of the profession going forward.
The NHS Confidence Monitor also revealed that dentists are very worried about their own future, with 90% of respondents saying they are less confident about their career prospects within NHS dentistry going forward than they were a year ago.
Confidence levels are also at a shocking low in terms of dentists’ ability to offer their patients the right balance of treatment versus prevention in times to come under the NHS, with 85% of respondents expressing fears that the balance won't be right.
94% of respondents said they had lost confidence that practising dentistry within the NHS will offer an appropriate level of remuneration in the future, serving as a worrying statistic for the Government since this is suggestive of staffing shortages in times ahead if dental professionals choose to leave NHS practice.
It also seems that there is little confidence that dental teams will be able to work effectively within the NHS framework as time progresses, with 89% feeling less confident on this matter than they did in the previous 12 months.
Perception of patient satisfaction is also at a worrying low, with over three-quarters (77%) of respondents lacking confidence that patients will be happy with the outcome of attending an NHS dental practice in the future, when compared to 12 months ago.
Commenting on the results, Eddie Crouch, Vice Chair of the Birmingham Local Dental Committee, stated: ‘I think it’s worrying that so many people have become markedly more despondent since the last survey. I think it’s partly anticipatory and partly because the issue appears to be so low down the Government’s list.
‘It seems a sad state of affairs and we can only hope that results such as these will persuade the powers that be to look at the situation anew in consultation with representatives of the profession.’
Each NHS Confidence Monitor survey will be followed up with a forum of key opinion leaders, dentists and dental professionals to explore the results in greater depth and place them in context. The next forum is scheduled for October 2015, after which the group’s opinions on the survey results will be made available to the dental profession in the UK.
In the meantime, to see the full results or for further information on the NHS Confidence Monitor, please visit www.NHSDentistryInsights.co.uk.
In 2006, the NHS and Primary Care Trusts (PCTs) introduced the current funding system to NHS dental practices based on the amount of Units of Dental Activity (UDAs) completed in one year. Since NHS England took over the responsibility from PCTs in 2013 operating this system, a total of 27 Area Teams replaced the 150 PCTs nationwide.
There is no sign the pressure on practices to reach their UDA targets will ease. In fact, underperforming practices today could be finding the targets even harder to meet; any shortfalls in one financial year are carried over to the next, meaning a ‘rolling’ deficit is a real concern for year-on-year figures. During this financial year, NHS England is also required to reduce running costs by between 10-15%, so if anything a tightening rather than a slackening of the rules on meeting targets is inevitable[i].
In the quarter of the financial year ending December 31st 2014, the NHS published data showing that in England, 88.8 million UDAs had been commissioned. This presented a 0.8% decrease from the same quarter in 2013, equating to 696,000 fewer contracts and also 90,000 fewer contracts than were commissioned in the previous quarter of 2014[ii]. This situation has had a knock on effect that determines the prospect of selling those NHS practices struggling to make the quotas they’ve been allocated.
The sale of practices with NHS contracts in some areas of the UK has been detrimentally affected where NHS England has over-commissioned dental services. Simply having enough people in a locality to justify a contract hasn’t proven to be reason enough to award one. It doesn’t automatically follow that the community wants more NHS dentistry; they may instead prefer long-standing local private practices, or worse still, not be seeking dental services at all.
Failing to be within 4% of the fixed year-on-year target can be catastrophic, in the most extreme cases practice contracts can be terminated. In examples such as underperformance or closing during contractual hours, NHS England initially serves a breach notice but if the practice then makes any kind of future breach of contract (which may be for an entirely different reason) the contract can be immediately revoked. NHS England will then negotiate a new contract, with less funding. Also, the degree of leniency previously afforded to NHS dentists will diminish with Area Teams having to enforce a harsher approach and breaches of contract are far more likely to be issued this financial year than ever before. In cases of underperformance alone, NHS England may deem that a practice was over-funded for the services being provided and will effectively ask for a refund from the practice (a claw back).
Nowadays, competition is fierce between NHS practices to entice patients through the door so that they have a fighting chance of meeting their UDA targets. This fact contributes towards complicated agreement negotiations when valuing a dental practice for sale. Purchasers (and their financial backers) involved in buying NHS practices must thoroughly research and become assured that the UDA contracts can be maintained and that they have the finances for any necessary improvements to facilitate this. Sellers on the other hand, will want to ensure that the post-completion obligations and liability are kept to a minimum. In short, a shrewd perspective and business plan are two essential ingredients for all involved in the sale of NHS practices. The predicted outcome of patient recruitment plans and any expense involved in them needs to be assessed and built into the valuation of the dental practice for sale.
A claw back of 500 UDA’s is equivalent to a £11,000 reduction in funding (based on average treatment costs) which can seriously undermine profit, so a potential buyer will need these kinds of figures incorporated in the practice value. Essentially, you are on your own in terms of building a patient base, NHS Clinical Commissioning Groups play no part in filling appointment slots. This means examining the practice’s current performance to see if there is room for improvement on reputation and profit.
Action plans cover anything from a complete re-fit of the surgery and reception areas, to designing a trendy website, prioritising SEO and right down to the skill of your receptionist in welcoming patients and putting them at ease. The team at Dental Elite can help you identify key areas to note during the sale of NHS dental practices whilst retaining a realistic view of the changes that actually need to be made to the business; often the simplest aspects such as chairside manner and the comfort of the patient waiting room are the cheaper and most effective alterations needed.
For more information and to find out how Dental Elite can value
and assist your practice sale visit www.dentalelite.co.uk, email This email address is being protected from spambots. You need JavaScript enabled to view it. or call 01788 545 900
[i] Local Government Chronicle – NHS England to cut hundreds of posts in restructure by Dave West 30 July, 2014. http://www.lgcplus.com/opinion/health/more-on-health-and-social-care/nhs-england-to-cut-hundreds-of-posts-in-restructure/5073456.article (accessed 28/5/2015).
[ii] NHS UK – Dental Commissioning Statistics, England – December 2014. https://www.england.nhs.uk/statistics/2015/02/05/dental-commissioning-statistics-england-31-december-2014/ (accessed 2/6/2015)
Available to download free of charge at nhs.practiceplan.co.uk/guidetoleavingtheNHS, ‘Your guide to leaving the NHS’ contains valuable insights and advice to help you evaluate your options if you are contemplating making the move from NHS to private practice.
Highlighting the key areas that need to be considered before making any decision, as well as presenting the answers to many of the frequently asked questions that might be weighing on your mind when contemplating a move to private practice, this is an indispensable guide.
Nigel Jones, Practice Plan’s Sales Director, commented: ‘A recent independent survey commissioned by Practice Plan indicated that many dentist are feeling less confident about the future of NHS dentistry, so we’re delighted to offer a new avenue for investigation, to help crystallise what is best for dentists, their teams and patients going forward.
‘This simple guide covers the important considerations – such as how your patient numbers and financials will stack up, what will happen to your NHS pension, how to prepare your team and how you can communicate the change to your patients – and can therefore help to build a picture of what’s possible.’
‘Your guide to leaving the NHS’ is part of the specialist and expert support and guidance available from Practice Plan’s NHS Change Support Team.
To download your free copy of this invaluable guide, simply visit nhs.practiceplan.co.uk/guidetoleavingtheNHS or to contact a member of the Practice Plan Team please call 01691 684165.
Adding some fun to election day on 7th May, but asking some serious questions about dentistry and the future of the NHS, the poll also reveals that the majority of dentists (66%) do not think that, going forward, NHS dentistry will be able to provide the right balance of treatment versus prevention. Furthermore, while a third (33%) of dentists thought the Conservatives could be trusted with NHS dentistry, a similar number (29%) felt that none of the political parties could be depended upon with this aspect of state-funded healthcare.
With 62% of respondents working in a practice offering either predominantly NHS or mixed treatment, these figures offer significant insight into dentists’ views on the NHS. The poll also revealed that if they were in David Cameron’s shoes, the majority would support NHS dentistry through increased spending, closely followed by wanting to change the current contract. These feelings were further reinforced by respondents’ finding a lack of time and the potential financial repercussions of the UDA banding system the greatest challenges they face in the present climate.
In addition, with cosmetic treatment considered by dentists to the biggest influence in dentistry at the moment, expanding beyond NHS care seems a distinct possibility for those who have not already done so.
Speaking about the poll, Nairn Wilson, President of the BDA, said: ‘It was great to see dentists being given the opportunity on the 7th May not only to vote in the general election but also to indicate how they feel about dentistry and the NHS.’
Nigel Jones, Practice Plan’s Sales Director, commented: ‘Since the election, we have struggled to gain any concrete understanding of what the future holds for NHS dentistry since, it is sad to say, David Cameron overlooked its significance in his first post-election speech, which was all about the NHS.
‘Dentists have been promised much in the past in terms of providing the very best care for patients and fair remuneration within the NHS, and the Conservative party needs to let them know where they now stand with it. Otherwise, who is to say how many more dentists would be concerned that NHS dentistry won’t be fit for purpose – if Practice Plan were to ask the same questions in 12 months’ time?’
Over 130 people completed Practice Plan’s poll at BDA. The aim of the poll was to provide a snapshot of perceptions about the future of dentistry alongside the general election.
The first survey was conducted at the end of 2014 and is being repeated to monitor how confidence levels ebb and flow as new information about the contract reforms emerges and the selected prototype practices reveal their thoughts and findings on the potential new systems. The results will then help to provide a snapshot of how the profession perceives the future of NHS dentistry.
The survey explores the profession’s thoughts on the future of:
• Career prospects
• Remuneration levels
• Getting the balance of treatment versus prevention within the NHS right
• The ability of the team to work effectively within the NHS.
Among other findings, the first survey revealed that 39% of the respondents asked were less confident about their career prospects within NHS dentistry over the next 12 months than they were a year ago.
Commenting on the opportunities the survey presents, Eddie Crouch, Vice Chair of the British Dental Association Principal Executive Committee, said:
‘It will be very interesting to see how confidence levels in NHS dentistry have changed, particularly in light of the General Election, and I look forward to the results. I hope to see even more NHS dentists taking part in this survey so the profession has a greater insight into the possible future effect of NHS dentistry.’
As an NHS dentist, how do you feel about the future of dentistry? To have your say and help to inform your colleagues, please visit https://www.surveymonkey.com/s/NHSConfidenceMonitor
It will take just two minutes of your time to take part in this unique opportunity, while the results may inform the long-term future of many.
If you would like to see the results from the first survey, please visit www.practiceplan.co.uk/NHSDentistryInsights
The NHS Confidence Monitor is an independent survey commissioned by Practice Plan.
Practice Plan is the UK’s number one provider of practice-branded dental plans. They have been supporting dentists with NHS conversions for over 20 years, helping them to evaluate their options and, for those who decide to make the change, guide them through a safe and successful transition to private practice.
So, the GDC has responded to the BDA’s challenge at the 12th hour with the response we probably all expected. Basically it’s a legalese version of a ‘la la la we’re not listening, and my dad’s bigger than your dad ‘cos he’s going to take all your money when you lose’.
The problem we have with that is that the BDA needs funds to take the GDC to Judicial review which comes from its members, us, which the GDC will fight using the money it gets from its registrants, also us.
Great. We get to pay for both sides slugging it out in court. That’s like getting the kids to pay for both sides in a divorce out of their own pocket money.
One could argue there will be no winners in this case other than the legal bigwigs who, should the BDA carry out its threat to start the Judicial Review process, will start to cost considerable amounts of our money on both sides. If the BDA wins, then this will only be one of the issues with the GDC dealt with, as the JR will only deal with the Consultation process, and not the greater failings of the GDC we are pointing out left right and centre. Given that the arrogance of the GDC throughout the whole process so far has been astounding, it wouldn’t be beyond the realms of possibility for the GDC to lose the JR, and STILL continue in the same manner as before, asking for even more money to replace that spent on the legal profession, and leave us with merely a pyrrhic victory, and an even bigger ARF increase. They even comment today that they are pleased to have received 4000 responses to the consultation. It shows they probably haven’t read them as I’m sure the vast majority of them wont be supportive ones.
If the BDA lose, and then have to pay the costs and losses of the GDC then this could spell the end of our professional association financially, and with it probably the last real chance of taking on a bullying and out of touch regulator. That’s why it needs as many members to support it financially by joining up in a show of solidarity.
We have this chance to take a stand as a profession, and I’m sure the legal team at the BDA have considered the implications of not winning the Judicial Review. But if the BDA backs down now, what message does that send to the GDC? I’d wager things would then get even worse from a whole load of other angles, not least from the DoH regarding the new contract. The BDA press release this evening in response to the GDC is possibly quite telling in that Mick Armstrong promises to put the interests of dentists first, and not just those of its members and the association.
So are the BDA going to play Chicken with the GDC?
I think they should.
Playing Chicken with the BDA?
A survey on NHS Dentistry which was hosted by GDPUK was featured this morning on the ITV Daybreak breakfast programme.
This morning (16th January 2014) a survey that was run on the GDPUK forum for the ITV Daybreak Programme was featured as headline news. Link to the ITV news story can be found here and the GDPUK News story here.
Daybreak contacted GDPUK a few days ago and we were able to get the survey posted to the forum within a number of hours. The survey was run in response to the letter posted by Dr Tony Kilcoyne BDS in the Daily Telegraph a couple of weeks ago, on the “Big Lie”. Only NHS Dentists were able to complete the survey and 340 NHS Dentists, who are all GDPUK members, responded to the survey. This was an amazing response from the GDPUK community and shows firstly this topic is an area many dentists care deeply about and secondly how an online community make things happen on a short time span. Thirdly it also shows the large audience that GDPUK attracts, the thread announcing the survey has had nearly 900 views and 58 replies within a few days!
The debate and discussion of the state of NHS Dentistry still has a long way to go but we feel proud that we have been involved in the formation of the “Big Lie” letter and also running the survey that was then featured on National TV news this morning. Thanks to Dr Tony Kilcoyne BDS and also the whole GDPUK community who continue to contribute to the forum on a daily basis. We feel it is a great example of a small social media platform, utilising the power of the digital world.
The GDPUK forum is free to join for all dentists and members of the dental profession. Please register here
If you would like to find out how you can engage with this dental community further, please get in touch with This email address is being protected from spambots. You need JavaScript enabled to view it.
Video coverage of Tony Kilcoyne on the Daybreak couch can now be viewed here
When Andrew Lansley drafted his Health and Social Care Bill, being married to a Doctor obviously drew his focus away from other healthcare providers. The structures were all there for GP commissioning and the formation of Clinical Commissioning Groups, even the removal of PCTs and transfer to NHS England and Area Teams. We can argue if any of this amounted to "no more top down reorganisation of the NHS" as promised in the manifesto, or the most challenging time anyone working within NHS management had ever faced.
It is hard to remember when someone at NHS England twigged or tapped Sir David on the shoulder and said what are we doing with dentists? Are they supposed to be part of this clinically lead new NHS? Someone somewhere found the fag packet, and I think it was John Milne's sister Helen Hirst that wrote the first plan for Local Professional Networks on the back of it. Helen had hardly got the ink dry before she passed the empty fag box to Sam Illingworth; before the final details were released both had jumped ship to the CCGs leaving others at NHS England to finalise.
Of course by this stage pilots had been invited to test the model, this too lacked direction with a "get on and see what you can do" mantra. Even the regular teleconferences to see what was happening and share experiences fell apart amongst the maelstrom of the de structuring of PCTs and the reapplying for posts.
By February and with the impending changes just a few weeks away, the NHS Commissioning Board (remember them?) released Securing Excellence in Commissioning in NHS dentistry was published. Within its pages contained the framework for LDNs and some examples of what the pilots had achieved. Some like in Manchester under the stewardship of Colette Bridgman clearly had an effect, albeit she struggled to fund her projects. Others exampled in the document like the reorganisation of Oral Medicine services in Birmingham perhaps needed placing in the fictional section of any library, but highlighted how little many of the pilots achieved in their lifespan.
Well six months in, we have recruitment processes in all the Area Teams and in others they have appointed a Chair. Many of these posts have been taken by LDC people, some have continued to wear both hats, and for me I am not convinced that's possible. As far as I am aware many of these newly appointed Chairs are yet to be paid for their new job, apparently due to a HR issue at NHS England, it seems like LDNs have taken them by surprise!
Of course the challenges for the LDN Chairs is to assist depleted commissioning teams in delivering national strategy and developing structural changes in service delivery locally, all within perhaps one afternoon a week. Not only is that the challenge but the budget given to them is somewhere in the region of £40,000, a share of a pot of £120,000 secured for Local Professional Networks for dentistry, pharmacy and opticians. The CDO describes this as "seed money" to allow the LDN to grow and show its usefulness, perhaps he is providing the fertiliser?
It really shows the importance of dentistry within the NHS when it's funding is pennies per patient population for an LDN compared to the £25 per patient that CCGs get for management costs. Clearly if members of the dental team are to be involved in LDNs, they are to be expected to do this with benevolence and with no remuneration; it's clinical leadership on the cheap.
Leadership on the Cheap