LDC Conference Manages Expectations for NHS Dentistry
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- Published: Wednesday, 21 June 2023 19:37
- Written by Peter Ingle
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The Annual Conference of Local Dental Committees has at its centre a series of motions proposed by the various LDC’s. Once proposed there is an opportunity to debate them, and then a vote is taken. Members of the General Dental Practice Committee, the professions negotiating team, attend, and it is expected that they will take note of conference decisions.
Scottish LDC’s had their conference in April and inevitably the majority of the 35 motions came from English LDC’s. However before any were debated, there were three brief presentations providing an update on the situation in Northern Ireland, Wales and Scotland.
Ciara Gallagher, Chair Northern Ireland Dental Practice Committee, wasted no time in summarising the challenges facing dentists there. “Our issues are the same as everyone else’s,” she said, though she did add that they also enjoyed a bonus misfortune, the lack of a functioning government. The system there is of registration plus fee per item, the example of a fee of £17.07 for an extraction being provided. In May 2023 dentists were hitting just 72% of pre-Covid production, and the figure was falling. There would be no fee uplift in 2023/2024.
Outlining the situation in Wales, Russell Gidney, Chair, Welsh General Dental Practice Committee, explained that practices there had not closed during Covid, but that UDAs had been suspended. In 2021/22 there were just new patient targets, and then there had been a choice offered to contractors. Option one was UDAs plus the time consuming ACORN (Assessment of Clinical Oral Risks and Needs) assessment, this was in effect a 110% workload. The “reformed” option two had specific sub targets as a partial substitute for some UDA’s. There had been “winners and losers” with this. As a result, some dentists including Russell, had reverted from option two to option one.
Charlotte Waite, Director, BDA Scotland described the situation there as an “exodus in motion” The post pandemic emergency multiplier of 1.1 on UDAs remained and there was a deadline of October 31st for reformed arrangements. It was hoped to be a blended version of fee per Item with the current plethora of fee codes reduced. Costings though, had yet to be negotiated. When Charlotte mentioned the hope for a “move to high trust” working, there was a weary laugh from many of those listening. She conclude by stating that NHS Dentistry is at a tipping point.
Summarising, Chair Mark Green, said that he had asked for these presentations to demonstrate that all the nations were in a similar predicament. This is despite the devolved nations all having different political parties in power, and may have been unnerving for those English delegates hoping for significant changes post-election.
With 35 motions considered and voted on, and many passed with very substantial majorities, there were some that stood out.
The first two followed on from the GDC v Williams case. One asserted that this was another demonstration of the unsatisfactory nature of the contract, and that it should be subject to “immediate and wholesale reform.” The other demanded that NHS England pay the legal fees associated with the failed appeals, rather than dental professionals funding them through their GDC registration fees. Both motions passed with strong majorities. In the debate one speaker pointed out that the GDC standards now needed revision to reflect the judgement.
Other motions that were well supported, included a request that sessional payments be offered in a new contract, that clawback money be used to improve below average UDA rates, that whole time equivalents be used when discussing the workforce, and that all members of the team delivering NHS dentistry should have access to benefits such as pensions.
When it came to regulation, a motion that chairs of FTP panels should have experience of healthcare was well supported. Another motion described the GDC as unfit for purpose and asked that dental regulation revert to the GMC. While there was a broad consensus in the debate agreeing with the description of the GDC, the motion was lost. This followed comments that the GMC were no better, including from a GP observer, and that dentistry might well be lost in a new multi-purpose healthcare regulator with opticians, pharmacist and others.
A motion calling for an evidence based review of HTM 01-05 with a particular consideration of sustainability, was passed with a large majority.
The perennial core motion, fell. Those speaking against it argued that it would be accompanied by core funding, and also said that the profession, ‘should not be the doing dirty work for government.’ It was generally agreed that such a decision was one for the government to make, and wholly own.
One motion called for a national CPD day to demonstrate the effect of there being no NHS dentists, whilst trying to avoid being criticised as ‘striking’ by ministers and NHS England. This was passed by a narrow margin.
Ways of committing new dental graduates to the NHS were debated in two motions. Both failed, even after making it clear that any such arrangement would not be compulsory. One motion called for a voluntary protected arrangement to support post FD dentists to “help develop their skills.” Some of those speaking against it made the point that working in the NHS as it now functioned, was hardly the best way of developing skills.
Image Credit: Russell Gidney
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