Meeting 15th May 2024
THE HUNTINGDON MARRIOTT HOTEL
DIRECTOR’S BOARDROOM
WEDNESDAY 15th MAY 2024
7.30 START
MINUTES
Attendees:
Patrik Zachrisson LDC Chairman & Treasurer
Mariana De Villiers LDC Administrator
Chokshi LDC Secretary
Elinor Japp
Peter Mullins
Marlise De Vos
Jessica Wyatt
Abigail Bridson
Kaushal Patel
Prashant Patel
Bharpur Sanghera
2. Guest:
Ricky Worraker
3. Apologies:
Claire Jackman
Francis Scriven
Julia Hallam-Seagrave
Deepak Kumar
4. Chairman’s/Treasurer’s Report: Patrik Zachrisson:
Treasurer’s report:
The Cambridgeshire and Peterborough LDC continues to be financially stable and secure.
The LDC continues funding towards Hepatits B vaccinations, Needlestick injuries and Disclosure & Barring Service (DBS) checks, following the incurred costs of such procedures, to support the Dental Team. Funding will be available for the year 1st Jan 2024 to 31st December 2024 to all NHS dental practices in Cambridgeshire and Peterborough who are providing NHS dental services.
LDC has agreed to further support the dental teams by contributing towards the cost of the Dental Nurse’s Courses. Nurses currently on the dental nurse’s course as well as those aspiring to become a dental nurse can also apply. As funds are limited, only a limited number of applications will be successful on a first come first basis.
The LDC has donated to The British Dental Guild and further supported BDA talks.
Chairman’s Report:
No changes or significant developments have been reported.
Lack of recruitment across the full dental team has escalated even more and is at a all time high. Recruitment through agencies is expensive and fees seem to be going up constantly. It was reported that some agencies charged £5 000.00 per associate. Recruitment outside of agencies is difficult. It was noted that following Covid-19 pandemic it appears that dentists do not apply for full time positions and that the norm is to apply for 4 day work week.
NHS dental access for remains difficult and with the cost of living rapidly increasing more patients opt for NHS treatment. However, with a shortage of dental team members across the board this is not likely to ease up soon.
There is a notion that Dental therapists should be utilised in a wider scope of treatment as to free up time with the dentist. It might be beneficial to alternate check-up appointments between dentist and therapist.
Previously dentists from abroad were allowed to work as dental therapists. This has now stopped.
5. Secretary’s Report: Amiras Chokshi:
The Area Team (AT) has changed from AT to Integrated Care Board (ICB) in April 2022. In other areas of England new members were introduced to the team whereas in the Cambridgeshire and Peterborough the same members of the Area Team have transferred over to the ICB. Although the ICB has more control over the budget for dentistry, no changes over the year have been noted.
It is reported that the management consultancy company IQVIA has been approached to investigate NHS dentistry and how to improve the service. IQVIA has supported NHS hospitals with tariffs by utilising extensive ranges of data. However, to apply this model to NHS Dentistry would be very difficult due to so many variables. NHS dentistry in England is funded by a combination of payments from NHS England and revenue from patient charges and some services as an example: would be referred to a hygienist which would be a private service, therefore not a full picture.
Access to NHS Dentistry:
Patient premium:
From March 2024 to March 2025, practices will be offered a “new patient premium” - extra payments for seeing new NHS patients. The new patient premium will mean that participating NHS practices can benefit from payments of either £50 or £15, depending on care, for each new patient treated. This will apply for any patient who has not seen an NHS dentist over the past 2 years. The level of the payment will depend on the complexity of the treatment required and would be on top of existing funding the practice receives for treating patients. The scheme is particularly designed to improve the oral health of those who do not have an existing relationship with a dental practice. The payments will be accommodated within the current contract values. This means dentists will receive more Units of Dental Activity (UDAs) for seeing a new patient, but the total number of UDAs commissioned will remain the same.
Dentists delivering core NHS services, including examination, diagnosis and treatment, will be eligible for the new patient premium. The premium will be paid to dental practices automatically after treating a patient who has not been seen within the past 2 years.
Dental Vans:
From later in 2024, dental vans will offer appointments for examinations and straightforward treatments in targeted rural and coastal communities. It is estimated that 15 to 18 mobile dental vans serving remote areas or areas where there is less access to transport issues will be available.
However, NHS England is “aware of the limited availability of vans and workforce to deliver mobile dental services” and therefore, alongside the provision of vans, it is also exploring other options including “non-van solutions, including the use of local facilities for pop-up services. A recent survey reported that only 1% of dentists felt that this would make a difference.
‘Golden hello’ payments:
Up to 240 dentists recruited in areas facing recruitment challenges will receive ‘golden hello’ payments of £20,000 (phased over three years) in return for a commitment to deliver NHS work in the area for at least three years. Subject to review, the scheme could be extended in future. The ‘golden hellos’ will be funded through the existing dentistry budget.
Raising the minimum UDA value:
The minimum UDA rate will be raised from £23 to £28 in 2024. This follows the previous increase to £23 in July 2022. The BDA suggested that all UDA values should be at least £35 or above and that the extra money be taken from clawback. In 2023, NHS England informed the ICBs that dental funding for 2023/24 should be ringfenced which meant that any underspend should be reinvested into dentistry services. However, in November 2023, NHS England advised that where ICBs had not spent all their allocation on dentistry, they could use the funding in other areas of the NHS to ease pressure.
Overseas Dentists:
There is an initiative to introduce legislation creating provisional registration status for overseas dentist. This would allow overseas-qualified dentists whose qualifications are not automatically recognised by the GDC to practise under the supervision of a fully registered dentist whilst working to demonstrate that they meet the standards for full registration. However, there is uncertainty regarding the skill levels of such individuals which may result in too much responsibility.
ICB and Procurement:
The Provider Selection Regime (PSR) will be a new set of rules for the procurement of health care services by relevant authorities, which have been co-developed with colleagues across the NHS and local government by NHS England and the Department of Health and Social Care (DHSC).
Relevant authorities can follow three different provider selection processes to award contracts for health care services under the PSR:
1. The direct award processes: These involve awarding contracts to providers when there is limited or no reason to seek to change from the existing provider; or to assess providers against one another, because:
· the existing provider is the only provider that can deliver the health care services (direct award process A)
· patients have a choice of providers and the number of providers is not restricted by the relevant authority (direct award process B)
· the existing provider is satisfying its existing contract, will likely satisfy the new contract to a sufficient standard, and the proposed contracting arrangements are not changing considerably (direct award process C).
2. The most suitable provider process: This involves awarding a contract to providers without running a competitive process, because the relevant authority can identify the most suitable provider. The most suitable provider process must not be used to conclude a framework agreement. This provider selection process may be used when all of the following apply:
· the relevant authority is not required to follow direct award processes A or B
· the relevant authority cannot or does not wish to follow direct award process C
· the relevant authority is of the view, taking into account likely providers and all relevant information available to the relevant authority at the time, that it is likely to be able to identify the most suitable provider (without running a competitive process).
3. The competitive process: This involves running a competitive process to award a contract. The competitive process must be used if the relevant authority wishes to conclude a framework agreement. This provider selection process must be used when all of the following apply:
· the relevant authority is not required to follow direct award processes A or B
· the relevant authority cannot or does not wish to follow direct award process C, and cannot or does not wish to follow the most suitable provider process.
Regarding orthodontic contracts: if currently a Provider with an Orthodontic contract and is performing well, a full tender would not be required and the contract may continue. If underperforming then a full tender process must be followed. More orthodontic contracts are currently available.
Amalgam:
The European Parliament has voted to ban dental amalgam from 1st January 2025. The UK will probably follow this.
The Press:
Dentistry was covered quite extensively by the Daily Mirror and BDA as a UK dental crisis in order to increase the profile of dentistry. The Mirror’s campaign to save NHS Dentistry will now be debated in the House of Commons on 13th of June. The focus is now on the government to change and improve NHS Dentistry.
6. Next LDC Meeting
11th September 2024
