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Scotland: Our ongoing fight for dentists

Blog Author David McColl

Blog Date 28/09/2020

David McColl outlines 10 things BDA Scotland is doing on your behalf right now and why it’s vital that we stick together.

 

 

Anxiety, uncertainty and frustration are just some of the emotions dentists have described since returning to practice in July. We are well aware of what a difficult time this is for our sector. As your BDA representatives we are doing everything we can to ease this burden.

 

We are honoured to be in a position in which we can do this. The Scottish Government and Ministers have made it clear that the BDA is the only dental association they wish to liaise with. We know that no other organisation can represent your interests at this level and we are determined not to let you down. You can be assured that we communicate regularly with the Government and represent the interests of all colleagues – practice owners, associates and VDPs – in our discussions.

 

Below are 10 issues that we are ardently campaigning for on your behalf. On some we have made great strides, and others are still a fight which we are pursuing every day. We believe that with your help, by tackling these challenges together, we can keep dentistry strong.

 

1. Securing additional funding for dentists

As Scotland moved to Phase three of reopening in July, we urged the Scottish Government to reassess the financial support available to dentists. While we welcomed the additional funding – an extra 30% to the General Dental Practice Allowance and a 30% increase to the GDPA cap – we argued that it did not go far enough. Achieving the necessary financial support for dentistry to remain viable is one of our core concerns and we are resolute in our pursuit of this.

 

We are currently discussing with the Scottish Government how to raise the funding available to dentists through the reintroduction of patient charges and an increase in NHS financial support payments. We will keep you posted on developments.

 

2. Seeking financial support for mixed practices

In August we wrote to the Minister for Public Health, Sport and Wellbeing with evidence of the stark financial situation facing mixed practices.

 

The vast majority of dental practices in Scotland are mixed, and the results of a recent BDA survey showed how precarious a financial situation many are facing. In his reply, the Minister stated that “robust, independently verifiable evidence” would be required to take the matter further. We will look to work with Scottish Government officials to collect evidence from dentists and practices that are affected and use this to make the case for additional financial support for mixed practices.

 

3. Objecting to ‘net off’ payment plans for closing courses of treatment

We have raised strong objections to the Scottish Government’s plan to “net off” payments for closing courses of treatment that were started before the pandemic from the COVID financial support. Our view is that closing open courses of treatment should be paid in addition to COVID support payments as the two are not related and dentists regard the deduction as unfair and possibly discriminatory. Unfortunately, the Government has reiterated its view (having sought legal opinion) that the current financial support measures are designed to ensure that dentists receive a minimum income guarantee. We continue to press the Government to mitigate the financial impact of this decision on practices.

 

We are also pursuing “lapsed” patient status with the Scottish Government in relation to continuing care payments as we are unable to re-register these patients in the normal manner due to current restrictions. This has significant financial implications for dentists as our inability to re-register lapsed patients reduces our monthly continuing care payments by 80%.

 

4. Pushing for a full 2.8% pay uplift

We are continuing to negotiate with the Scottish Government regarding our pay increase for 2020/21. We have been urging the Government to apply the 2.8% uplift to 100% of previous Items of Service as well as all other allowances.

 

5. Influencing post-COVID NHS funding model

Looking to the longer term, there is widespread acknowledgement that dental practices will not be returning to previous ways of working before the pandemic struck. A new funding model will be required, and we recently established a working group to contribute to discussions with the Scottish Government and other stakeholders. This will be a long-term initiative requiring a national consultation and possibly legislative changes.

 

6. Achieving financial support for VDPs

In September the Scottish Government took note of our concerns and confirmed additional financial support for Vocational Dental Practitioners (VDPs) moving to an associate position. This also applied to vocational trainers. We are pleased by this progress, having regularly raised the issue of the financial consequences VDPs in Scotland faced should they move to an associate position at the end of their VDP year in August 2020. We continue to seek clarification on a number of supplementary queries from individual members.

 

7. Raising concerns about expired PPE

We have repeatedly sought firm evidence from National Services Scotland (NSS) that the expired PPE provided to dentists has been robustly assessed and is safe to use.

 

Enhanced PPE has been provided free of charge to dentists in urgent dental care centres and in dental practices. However, when some of the boxes of 3M 1863 masks were discovered to date back to 2001, with expiry dates going back to 2012, we felt compelled to raise concerns.

 

The inspection of dental practices involves a check that equipment has not passed its expiry date. Using masks which are nearly 20 years old and almost a decade out of date may present significant risks to patients, dentists and their teams. This is unacceptable.

 

Dentists willingly donated their PPE to hospices, pharmacies and hospitals at the onset of the pandemic. In return, NSS has supplied out-of-date masks, and no strong evidence they are safe to use.

 

We have called on NSS to make alternative arrangements for supplying ‘in date’ PPE to dentists as soon as possible. We have also written to the CDO and Minister for Public Health, Sport and Wellbeing to highlight our concerns and to explain our stance.

 

8. Supporting individual dentists

We continue to support individual dentists during the pandemic crisis. Members regularly seek our advice on financial issues among other support, which we pursue with the Scottish Government or NHS Practitioner Services Division (PSD) and respond as quickly as we can.

 

We met with PSD officials recently to discuss dentists' queries about COVID-19 support payments. The answers to many queries can be found on PSD's COVID-19 Frequently Asked Questions which are updated regularly. We previously peer-reviewed PSD's process for calculating the financial support payments to individual practitioners, and were satisfied that the approach was fair and transparent.

 

9. Working for local resolution of low-level concerns

We continue to work with the Scottish Government to develop a system for resolving low-level concerns regarding dentists’ performance locally. This would reduce the number of referrals to the GDC which we know is time-consuming and highly stressful for dentists. We were pleased to approve the Government’s initial proposals in principle and recently commented on a revised system.

 

10. Contributing to the national flu vaccination programme

We were recently approached by the Scottish Government about the possibility of dentists helping to deliver the 2020/21 NHS flu vaccination programme. We supported this proposal provided it was on an opt-in basis. We subsequently secured clarity from the Government on payment, training and indemnity for dentists. As healthcare professionals we are proud to play our part in delivering this national programme.

 

We meet with the CDO and his team almost every week, and we continue to campaign ardently on your behalf. It is vital that we stick together at this time. We are stronger together.

 

 

David McColl
Chair, Scottish Dental Practice Committee