I have spent most of my career involved in representative politics, but the NIC was a new learning curve. The BDA was restructured in 2012, separating the governance function which sets the strategy and policy which is carried out by the directly elected Board or Principal Executive Committee (PEC) from the equally important function of representing our members through the Country Councils and craft representative committees.
The restructure has strengthened the representative impact of the NIC, both in Northern Ireland (NI) and nationally. I succeeded as chair the brilliant and savvy Seamus Killough, whose sage advice has been, and remains, invaluable.
What work is carried out by NIC?
NIC is not a negotiating committee. That is the role of the NI Dental Practice Committee (NIDPC), led by Ciara Gallagher, the NI Community Dental Committee, led by Ann McAreavey and the Hospital and Academic Group, led by Gerry McKenna and Darren Johnston.
These Committees, with the support of the fantastic team in the NI Office, led by Tristen Kelso, work hard on behalf of our members to improve the terms and conditions of NHS contractors and employees. The NIDPC also advocates for associate dentists and practices who are transitioning to give alternative options to patients, supported by an increasing array of BDA advice and resources.
Although we do not negotiate with government directly, we have three main roles: to receive reports from other committees; to take forward the issues that cut across different groups; and along with my fellow country chairs, to lead UK Council.
Bringing everyone together
We receive reports from other Northern Ireland committees and ensure that matters being discussed by one committee, do not have unintended consequences on another service in the "village" of NI dentistry. An example of this is the recent adoption of the updated Scottish Dental Clinical Effectiveness Programme Conscious Sedation Guidelines by the Chief Dental Officer (CDO).
Our role is to convey the information to the negotiating committees so that points can be taken forward.
The guidelines provide clarity of the requirements when carrying out sedation, which we have been requesting for some time. Adoption of the guidelines has little impact on practitioners with experience in conscious sedation, but there are significant training implications for new providers. We are concerned that the CDO has no plans to provide sedation training in NI.
There is a significant amount of conscious sedation carried out in NHS practice in NI. Figures show that 143 dentists have used the 2571 code 3973 times in 12 months. Use of alternative techniques, while preferential to avoid pharmaceutical answers to dental anxiety, takes time that is not recognised under the SDR, and many within this group are not suitable for alternative approaches. Some of these patients are the most disadvantaged in our society who would be unable to pay for private care.
Any unintended consequence to displace this work to the CDS, or the HDS in the case of oral surgery procedures, would have a massive resource implication on services which are already under significant pressures with long waiting lists. Our role is to convey the information to the negotiating committees so that points can be taken forward, as well as informing the CDO of the potential unintended consequences of disincentivising conscious sedation in the GDS.
We work on moving forward cross cutting issues impacting dentistry. We are currently working on ensuring a long-awaited dental workforce review, carried out on behalf of the DoH in 2016 is published.
We work on moving forward cross cutting issues impacting dentistry.
Although some elements of the review are now quite out of date, and other issues such as the DCP workforce have become more urgent, it is still important that this document is put in context and published so we can tackle workforce issues. We are also pressing for completion of the two DoH Oral Health Option Groups for Older people and Children, to provide strategic direction for the dental care of these two high need groups.
NIC also has a national role to lead UK Council, meaning the representative committees can help direct the PEC in developing strategy and policy that is responsive to members needs. This demands a certain amount of nimbleness in what is quite a large and complex organisation. Members needs must be reflected, irrespective of location, diversity, or employment type.
The chair of the UK Council rotates around the four nations, and I have just completed my term. I would like to thank my fellow country chairs, the PEC, and the BDA Senior Management Team, particularly BDA Chair, Eddie Crouch, who has been a constant source of help.
Eddie also has a knack of popping up on prime-time TV and radio, conveying that the problems in accessing NHS dentistry are not the fault of dentists, but a failure of the contract, inadequate funding to meet the needs of the whole population and the difficult regulatory environment we work in.
It has been a busy year, but there is much still to do. While I plan to take a few days away from this important work over the festive period, I hope you too get an opportunity to take some time to recharge your batteries. I wish you and your dental teams, friends and families, a peaceful Christmas, and a happy and healthy New Year.
Together we are stronger.