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What it takes to rescue NHS dentistry

Scrapping the discredited UDA contract is a must, but in the interim motions passed at this year’s LDC Conference to amend the current contract might curtail the exodus from the NHS.

There was overwhelming support for motions calling for immediate improvements to the current contract to stem the exodus of dentists from the NHS. This includes one from Birmingham LDC calling for an increase in the number of Units of Dental Activity allocated to repairing dentures to three per repair to cover the cost of providing the service.

Tees LDC argued that there needs to be a legal footing to ensure that Integrated Care Boards (ICBs) don’t divert money away from dentistry to shore up shortfalls elsewhere in the NHS. North Wales LDC called on national governments to compensate practices for lost clinical time arising from failure-to-attend appointments.

A motion from Birmingham called on ICBs to collaborate with LDCs, before undertaking any procurement initiatives in dentistry, since LDCs possess valuable local expertise that can contribute to the success of these initiatives.

More ‘right touch’ regulation in dentistry would help to recruit and retain NHS dentists, argued Mark Green, presenting the motion from North Yorkshire LDC.  He said "right touch" approach is not the same as light touch.  The GDC, the Business Services Authority, the CQC, and dental law firms, have all instilled a culture of fear in dentists, he said, with the effect of deskilling the profession.  The level of regulation in NHS dentistry has expanded exponentially, Mark said, making it easier for dentists to walk away from the service.

Liverpool LDC called for the reinstatement of the NHS Dental Reference Service in England, similar to Scotland's system. Presenting Bill Powell said this service provides on-site inspections, peer review, and support to practices, potentially improving patient care and identifying struggling practices early.  “Peer review fosters behavioural change and excellence dissemination,” Bill said, adding: “Mandatory random clinical audits, including visits, ensure public accountability.” It also raises the question why there is no reference service in England, he said.

Enfield & Haringey LDC argued that the next iteration of HTM 01-01 should be formulated with as much concern for sustainability and the environment as for its primary remit of decontamination.

Lancashire Coastal & South Cumbria LDC called for an overhaul of NHS dental regulations that are fit for purpose and reflect the realities of contemporary dentistry and in language that is easy to interpret and understand.  Presenting, Stuart Johnson said the current NHS regulations and guidance are outdated, poorly worded, and open to misinterpretation.  He criticised the NHS’s lack of progress and said this was leaving the burden of proof on dentists. Why should the cost of achieving such clarity rest upon registrants, he asked, with more cases going all the way to the court of appeal?

West Sussex LDC called for the creation of a central access point for all primary guidelines, so these reach their target audience in a timely manner. Toby Hancock said in presenting. "We call for the establishment of a single central point of access to all guidelines applicable to those who practise in primary care, which can refresh and send out updates when reviewed or published".