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Urgent answers sought ahead of new financial year

We have written to the Department of Health seeking urgent clarification for Northern Ireland on the General Dental Service (GDS) financial arrangements for 23/24.

Ciara Gallagher
Ciara Gallagher Chair of the Northern Ireland Dental Practice Committee
A calendar showing 31 March


Letter to the Department of Health

The current Rebuilding Support Scheme (RSS) concludes on 31 March, what comes next? Surely not a return to baseline Item of Service. With just one month until the beginning of the new financial year, we need to know where we stand.

We do know that the 4.5% uplift to the Statement of Dental Remuneration (SDR) is forthcoming – and will be backdated until April last year. However, it is shocking that the pay uplift for 22/23 has still not been implemented as we approach the end of the financial year, considering that we have already progressed the 23/24 round of submissions.

Departmental pressures

We do know that the Department is facing unprecedented budgetary constraints and its own battles to address health priorities and inequalities. We recognise recent initiatives from the Department such as the denture enhancement of 25%, the PUPAS Pilot for unregistered patients and the children’s registration initiative.

Positive though they are, they represent a sticking plaster on a haemorrhage and on their own will have little effect on the decline of an exodus from NHS dentistry.

Cost of care

We have repeatedly asked the Department of Health (DoH) to commission an independent cost-of-service review to inform a recalibration of fees. The DoH has no official figures on practice costs to provide care, they have no dental business model on which to track changes, and therefore no measure of how the economics of their contract translate at practice level. In our recent media coverage, we shared examples of practice-level costs, alongside the fees that are publicly available in the SDR to illustrate the dire economics of NHS dentistry.

It's vital that the public fully understands the pressures of providing NHS care."

It's vital that the public fully understands the pressures of providing NHS care in many dental practices throughout Northern Ireland. If the business model worked, we would not have the current problems in terms of access to, and availability of NHS dentistry.

Media spotlight

As a public service broadcaster, the BBC recently contacted us to ask why many people are having difficulties finding and registering with a health service dentist. On Tuesday 14 February, we took the opportunity to tell our story. BBC NI featured problems with accessing health service dentistry as a lead story throughout the day – including BBC Talkback, Good Morning Ulster, hourly radio coverage and more detailed television coverage on BBC Newsline.

Shining the media spotlight is one tool we have to support our members."

Shining the media spotlight is one tool we have to support our members; liaising with political representatives is another route, and we note the response by the Permanent Secretary Peter May to correspondence from Alliance MLA Paula Bradshaw.

The absence of an Assembly, Executive and Health Minister, impacts the DOH the decision-making process, and therefore hinders progress of negotiations towards a new contract for GDS in Northern Ireland. The ramifications of this are being felt by patients and practitioners throughout Northern Ireland.

Next steps

In the Spring, BDA will be conducting a Timings study to establish evidence of the time involved in completing various clinical treatments. This will also help to establish the labour costs of treatments, and lab fees, and will provide an evidence base to support contract reform across the UK. The study will replicate and update the 1999 Heathrow Timings Study and predecessor studies.

Practices need help, they need hope, and they need urgent action."

Alongside a cost-of-service investigation, we want to create the evidence base to support contract reform across the UK, and a recalibration of fees based on modern realities. An objective piece of work by a third party will validate the issues we are campaigning on.

In the meantime, practices need help, they need hope, and they need urgent action from the department to know that they have a future. They need support so that they are not being financially starved out of the NHS.

We will continue to press for a fair and equitable outcome as we liaise with the Department on this and other issues and I welcome your views, please get in touch to share your opinions.