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Is GDS contract reform running out of road?

We are working hard in Wales to ensure that dentists and dental teams have a public voice.

Russell Gidney
Russell Gidney Chair WGDPC

NHS dentistry contract reform is at a pivotal point and its current impact on practices needs to be understood by government.

We have been gathering your views through surveys and the Welsh General Dental Practice Committee (WGDPC) online webinar and have offered support to the Local Dental Committee (LDC) surveys and discussions.

A clear negotiation mandate

The surveys and polls show a very clear and similar picture across Wales, with strong triangulation points. You have provided us with key elements for the profession's mandate that we will use for any future contract negotiations with the Welsh Government. Thank you for speaking up and sharing your stories.

We wrote to the Chair of the Health and Social Care Committee and have been giving radio and television interviews alongside featuring as the lead BBC Wales news item. Word is spreading via social media channels and we have been liaising with senior members of Senedd who are committed to finding a way out of this dead-end.

this year has been a failed mass-scale pilot"

We have made your views clear at every opportunity that this year has been a failed mass-scale pilot lacking the basic elements. The volumetrics were badly contrived, poorly introduced, and haphazardly advised upon throughout the financial year. No attention was paid to dentists carrying the lion's share of risk, which is a fundamental flaw of this experimental setting. This was despite our many discussions with dental branch officials.

Government roadblocks

The Welsh Government will not accept what we have laid out as the likely future scenario for contract reform and the possible demise of NHS dentistry. It is a classic case of sunk cost fallacy. The health minister remains entrenched in the mantra that contract reform is working, and a small number of handed back contracts are being recommissioned. Unfortunately, she is looking backwards rather than forwards and is ignoring the clear danger signals from us; the decisions colleagues are making right now to reduce NHS commitments or stop providing NHS care altogether.

a classic case of sunk cost fallacy."

It is hard to believe the health minister Baroness Morgan's claims of wanting a contract that is fair to dentists, as she did in her statement to the Senedd this week (03:06:44). It is notable several MSs responded that the minister's statement on dentistry did not match the reality in their constituencies where residents cannot obtain NHS treatment and dentists are giving up on reform.

We are not going to find any comfort in Wales about the Doctors and Dentists Remuneration Body (DDRB) award prospects when the health minister said in Plenary this week (17:04:40) that, "There are massive restrictions on the budget coming down the line, and we need to consider very carefully what our priorities are going to be in future."

The responses from the health minister and first minister have become a broken record. I have broken down the repeated comments that need debunking in a Frequently Questioned Answers document.

Your experience at the frontline

teams are being broken by the reform targets"

The lived experiences of dental teams in the last year have been held up in stark terms many times in various committees, working groups, and in closed meetings with dental branch; yet we have been treated with an indifference that is hard to fathom. We have repeatedly explained how teams are being broken by the reform targets – reflected in multiple survey results. Yet, nowhere in the contract reform programme has there ever been research conducted on the fundamental issue of the lived experiences of dentists.

When asked about your practice business model and what might have an impact, three quarters of respondents said it would be a benefit to be relieved of collection of patient charge revenue, although that is currently not on offer. But nearly 80% believed the government's introduction of new data capture systems for staff reporting and patient NHS number capture would have a negative impact on their practice.

When asked about possible impacts of the coming year's DDRB award, given the 3.5% cap in England, 85% of respondents said it would be likely to have a negative or very negative impact on their practice.

Over 80% of respondents said their current business modelling and financial planning was stressful or very stressful in the current economic climate. It is of no great surprise that two thirds of respondents stated that their practice was likely to increase private provision and a further 20% stated an intention to convert to wholly private practice in the next financial year.

Supporting you

We are aware that many of you are facing burnout and a decline in mental health with huge questions about the future of dentistry. If you are living with mental health struggles, there are several support services available.

Health Assured offers confidential support on a range of issues for members. For non-members, all dental health professionals across Wales can access confidential mental health support through Canopi.

If you need support with your business or contract, our expert advisors provide Extra and Expert members throughout the UK with unlimited one-to-one advice. Call 020 7935 0875 or email the team at advice.enquiries@bda.org to get in touch.