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​Innovative thinking needed for future of NHS dentistry

04 December 2020

 

LDC Officials’ Day took place virtually on Friday 27 November and was dominated by the impact of COVID-19 on dentistry and the issues surrounding the current UDA system of dental contracting.


First on the agenda was an update on the dental contract developments over the last year. This session had a heavy focus on the dire situation for dentists throughout the COVID-19 pandemic and hopes for the future of NHS dentistry.


Reflecting on the challenges we’re facing, General Dental Practice Committee (GDPC) Chair, Dave Cottam said: “UDAs are not fit for purpose. The pandemic has exposed the failings of the UDA system more clearly than ever, and now is the time for commissioners to commit to some real changes. Dentistry needs more funding, to help keep us afloat during this crisis, but also to ensure our patients can have improved access to NHS dentistry going forward.”


The GDPC has fought long and hard to get a workable and sustainable solution for practices across the country. GDPC Vice-Chair Shawn Charlwood’s presentation outlined the work of the committee over the past few months. This included the extensive and often difficult weekly meetings with NHS England about the contracting arrangements for dentists during the pandemic.


Shawn also highlighted the issues some associates have been experiencing. He said that although he believes 95% of practice owners are doing the right thing, he reminded all contract holders that under the agreement with NHS England, payments must be passed onto their associates.


The continuation of 1/12th contractual payments with no abatement is a very significant lifeline for many practices. It has enabled hundreds of thousands of patients to access care and ensured dental team members have been able to keep their jobs. However, the future for all dental practices is still very uncertain.


Negotiations continue with NHS England on what the arrangements will be going forward for payments, and there is frustration that the process taking so long.


Shawn commented, “There has been a clear levelling-off of activity in practices during October and November, which shows any desire to increase activity by NHS England is unworkable, and we have made this case strongly to them. We know that UDAs were inappropriate pre the pandemic, and we know that they certainly are not appropriate during it.”


Tinkering of the current system is not a viable way forward. Shawn added: “We have called on NHS England to provide financial clarity for providers, so they can ensure their businesses stay afloat during this crisis. Going forward, we need a more flexible, transparent process of commissioning, to ensure we can deliver on patient access and practices can be sustainable.”


The GDPC feels going back to UDAs would be a wrong move on NHS England’s part and there needs to be more innovative thinking on the way forward. The ACORN process in Wales, which is trialling a different approach based on preventive care and needs assessments, was cited as an example of innovation. The results of this should be shared across the UK nations, to see what can be learnt.


The GDPC has also had several meetings with Ministers and other key stakeholders to put the profession’s views across, and they will continue to strongly make the case for dentistry.


Updates were also given by Richard Graham, Chair of the Northern Ireland Dental Practice Committee, Phil Grigor, BDA Scotland Director, and Tom Bysouth Chair of the Wales General Dental Practice Committee, on the different situations in their countries during the pandemic.


The afternoon sessions featured an update on the BDA’s work on equality, diversity and inclusion in dentistry, frequently asked dento-legal questions, recent work from the CQC and GDC, as well as case studies on work being done by a range of LDCs across England.


The final presentation from Roz McMullan, Chair of the Probing Stress in Dentistry Group, focused on tips to help support teams through the pandemic, and important sources of support.


Looking ahead, the next LDC Conference is scheduled to take place in Manchester on 3-4 June 2021, and further details will be released in early spring.


However, at this recent meeting LDC officials made their message clear. Dentists all over the country are working hard in the face of tremendous challenges right now. But innovation is needed to secure the future of NHS Dentistry.