NHS Confirms Clawback: ‘Too Little, Too Late?’

NHS Confirms Clawback: ‘Too Little, Too Late?’

Amidst all the speculation surrounding how the NHS might respond to mounting concern about the consequences of clawback on practices, a letter (dated 19th June) from Ali Sparke, ‘Director for Pharmacy, Optometry, Dentistry and the NHS Standard Contract NHS England’ removed all doubt. 

Sparke announced that “to support practices during the ongoing recovery of dental services and maximise access for patients we are waiving our rights to financial recovery at the usual tolerance level of 96% and have set a revised lower performance tolerance of 90% for contractors delivering mandatory services.”

Quite how this generous move, which comes on the back of a decade of underfunding, will help practices ‘help dentistry recover and manage access’ the missive did not say.

The letter also emphasised that this generous gesture was for 2023-24 only and was driven by a recognition that dental services had endured a post-pandemic hangover dating back to the early months of the 2022-23 financial year.

For the avoidance of doubt, the letter continued “any un-delivered activity between 90 to 100% of that contracted will be carried forward into 2023-24 contract year. Where 90% of the total annual contract activity has not been delivered, financial recovery will apply as normal.”

Under-delivery is, therefore, not being ‘written-off’.

In an era of an unprecedented exodus from the NHS by dentists and practice owners alike and coming on the heels of a once-in-a-century pandemic , many hoped for more generous terms in a last ditch attempt to make NHS work more enticing.

One dentist we spoke to, who wished to remain anonymous, told us he believed that “exceptional times call for exceptional measures and surely the NHS should be focused on keeping the dwindling number of practices it still works with on board by waiving or reducing to 80% any clawback for 2022-23.”

To help practices navigate their way through the 2022/23 reconciliation process, NHS England has sent every contract holder a 23 page document containing a bewildering collection of illustrative numeric tables dissecting various operating scenarios.

Shawn Charlwood, Chair of the British Dental Association’s General Dental Practice Committee was criitical of the news.  “With record breaking sums set to be lost from the frontline, the government has moved the goalposts.

It will come too late for the dentists that have already called time on NHS work. And it won’t be enough for the hundreds about to be pushed to the brink.  Ultimately this will only delay the inevitable for countless struggling practices.”


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