Meeting 6th October 2021

THE HUNTINGDON MARRIOTT HOTEL

BOARDROOM

WEDNESDAY 6^TH OCTOBER 2021

 7.30 START

MINUTES

1. Attendees:

 Patrik Zachrisson - LDC Chairman & Treasurer

 Mariana De Villiers - LDC Administrator

 Amiras Chokshi - Secretary

Peter Mullins

Claire Jackman

Avtar Pardesi

Francis Scriven

Gawain King   

Jaco Craig              

 Marlise De Vos

Julia Hallam-Seagrave

Francis Scriven

2. Apologies:

Bharpur Sanghera

Deepak Kumar

Meeraj Patel

3. Chairman’s/Treasurer’s Report: Patrik Zachrisson:

Chairman’s Report:

Contractual arrangements for Coronavirus Recovery in England:

From 1^st April 2020 to 7^th June 2020:

National lockdown to combat the spread of coronavirus resulted in the suspension of routine NHS dental treatment and restricted face-to-face urgent care. Instead, dentists offered urgent advice and remotely prescribed antibiotics as required. In addition, patients were able to receive care through urgent dental centres, with patients triaged into these through NHS 111 or by their own dentist.

Due to lower activity contracts were subject to a 16.75% abatement.  This did not apply to Urgent Dental Care Centres.

From 8^th June 2020 to 1^st January 2021:

On 8^th June 2020 all practices were able to resume routine care.

Practices had to followed Personal protective equipment (PPE) and Infection and prevention control (IPC) protocols in order to resume care. Protocols also provided guidance on which patients should be prioritised. Aerosol-generating procedures (AGPs), such as those that include the use of a high-speed dental drill which can result in the release of airborne particles, could go ahead if practices met the necessary PPE and IPC requirements.

Contracts were expected to deliver 20% of their usual activity volumes.

From 1^st January 2021 to 31^st March 2021:

From this point contracts were measured on their standard metrics, units of dental activity (UDA), units of orthodontic activity (UDO) and courses of treatment (COT).

Contracts were expected to meet the following targets:

45% for UDAs

70% for UOAs

Funds were subject to clawback if targets were not met.

From 1^st April 2021 to 30^th September 2021:

Contracts were expected to meet the following targets:

60% for UDAs

80% for UOAs

Funds were subject to clawback if targets were not met.

From 1^st October 2021 to 30^th December 2021:

Contracts are expected to meet the following targets:

65% of UDA targets

85% of UOA targets

There will be ongoing contractual protection for practices unable to deliver their full contractual activity between October and December 2021. During this period clawback will not be applied to practices delivering at least 65% of contracted UDAs and 85% of contracted Units of Orthodontic Activity (UOAs).

The rate of clawback would reduce proportionally down to a lower level of:

52% for UDAs

60% for UOAs

For quarter 3 the conditions of income protection remain as previously described, including that practices ensure that face-to-face urgent dental care is available for all attenders via direct contact or referral via 111, that efforts are directed towards patients at highest clinical risk and to addressing health inequalities.

Dental practitioners are unhappy as they received short notice on the changes coming into effect from 1^st of October. Dental contract changes result in uncertainty for NHS Dental practices.

Practices were reminded that they should not prioritise patients of lower clinical need over those in higher clinical need, such as urgent care or a member of a priority group such as children. As there is no patient registration within dentistry patients must be prioritised against clinical need and priority groups regardless of whether the member of public is on a practice’s business list or not – this is a condition of ongoing financial support. Patients are only on a list whilst they are in an active course of treatment.  It was noted that some patients are of the opinion that when they were treated at Urgent Dental Care Centres, that they are “registered” at said practice.

Recruitment:

Shortages of dental nurses, newly qualified dentists as well as experienced dentists remain a challenging problem.

SNOWMED:

The implementation of SNOWMED from the 1^st of September has been deferred.

Treasurer’s report:

The Cambridgeshire and Peterborough LDC continues to be financially stable and secure.  Performer contribution is at £10 per performer. Another donation to The Benevolent Fund, funding courses for nurses eg. X-ray course and audits were considered.

4. Secretary’s Report: Amiras Chokshi:

The next GDPC meeting is scheduled to be held on Friday 8^th October 2021. Previous meetings were cancelled and postponed at short notice.

Most dental practices achieved their 45% target for the first quarter. The data shared by NHS England on practice activity show that a significant proportion of practices are struggling to meeting the 60 per cent threshold. This would inevitably result in huge clawback.

Abatement:

The current abatement that is being taken from the contract is only for the 9 weeks shut in first covid lockdown. The GDPC continue to argue that the 16.75 per cent abatement is unacceptable and have supplied information to NHS England on the increased costs that practices are facing.  Also, that the abatement had been imposed, and not agreed as had been incorrectly stated in some communications.

Fit Testing of masks:

It was noted that some courses for Fit testing were only valid for 1 year.  This would imply that those who had been Fit tested previously would have to be re-tested. The question arises on who would be responsible for Fit Testing.

Integrated Care Systems:

Integrated care is about giving people the support they need, joined up across local councils, the NHS, and other partners. It removes traditional divisions between hospitals and family doctors, between physical and mental health, and between NHS and council services

Integrated care systems (ICSs) are new partnerships between the organisations that meet health and care needs across an area, to coordinate services and to plan in a way that improves population health and reduces inequalities between different groups.

The NHs Longterm  Plan confirmed that all parts of England would be served by an integrated care system from April 2021.  However, due to Covid pandemic this has been deferred to April 2022.

Current ICSs in place are:

North West, North East and Yorkshire, South West, South East, Midlands, London and East of England,

East of England are divided as follows:

• Bedfordshire, Luton and Milton Keynes
• Cambridgeshire and Peterborough
• Hertfordshire and West Essex
• Mid and South Essex
• Norfolk and Waveney
• Suffolk and North East Essex

Friends and Family Tests (FFT) Questionnaire:

FFT is a feedback tool that supports the fundamental principle that people who use the NHS services should have the opportunity to provide feedback on their experiences. Primary dental service providers have to complete and submit the forms each month. The form is only available for the first 12 working days of each month to allow submission of data collected within the previous month.

It is reported that a number of dentists were unable to complete this as they did not receive the link to do so.

Treatment of Covid positive patients:

Remote risk assessment and triage should be the first line of action with possible Antibiotic Cover and then face to face assessment and treatment after 10 days.

General consensus is that Covid Positive patients in severe pain be seen at the end of the working day.

5. Francis Scriven – Orthodontic update:

Changes in NHS regulations regarding Orthdontic contract procurement are expected. Orthodontic agreements in the Midlands and East of England to be extended by another two years, and the procurement process could take an additional two and a half years, which implies that some practices would have a roll on of four and a half years of their agreement from April 2022. The availability of UOAs across the regions are insufficient with no access to orthodontic services in many areas of East Anglia.  It is suggested that providers of current orthodontic services would continue to offer treatment and that providers would need to apply for procurement in new areas.

6. Special Care Dentistry: Julia Hallam-Seagrave

Dental Access Centres (DAC) are very busy. They are working steadily through the backlog with a reduction of patients on waiting lists.  However, lots of patients are still being turned away.  A 10% reduction in contract value was implemented in order to offer emergency slots to patients.  It is worth noting that the DAC contracts will come to an end in June 2022.

7. Other Business:

A request from newly qualified dentist, Rachel Botrugno to attend the next LDC meeting has been approved.

8. Next Meeting:

19^th January 2022