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LDC Officials Day and LDC Special Conference - Friday 5

th

December 2014

 

LDC Officials Day

Mick Armstrong described difficult times for dentistry. The BDA are preparing for the

Judicidal Review against the GDC

Mick has written to the Secretary of State to remind him of the impending JR.

Rt Hon Paul Beresford MP is going to let parliament know the situation with the

GDC.

2. Update from John Milne

John Milne spoke of Simon Stevens, the Chief Executive of the NHS, who has

published a document called 'A five year forward view'. This document

describes a vision for the future of the NHS and tackles financial problems in the

NHS. Although this document does not specifically mention NHS dentistry, the

document encompasses all sectors of healthcare . The vision includes the

integration of primary and secondary healthcare. This vision may inspire

corporate healthcare provision. We must be ready to adapt to this concept in

Dentistry as this vision is greater than simply the expansion of corporate

dentistry, it is much greater than that. It may inspire companies that can provide

healthcare in the future.

Alternative Contract Reform (ACR) was mentioned by John Milne. The GPDC are

going to work with ACR in the future and GPDC exec are going to consider the

ACR at their meeting in December.

John is going to meet with David Geddes, NHS Enlgand, soon, to talk about

clawback, reinvestment of clawback, difference between area teams, pay rises.

LDC Levy is still a problem. The Levy collection is working in some areas but not

in others.

GPDC are engaging with the software companies regarding the software for

contract reform.

3. Contract Reform Update - John Milne

Is this being viewed as low priority/oral health is seen to be improving/few

complaints/ access is OK???

It does matter! The difference between being rich and poor: at aged 65+ poorer

people have 8 fewer teeth than richer of the same age.

Principles of new contract are to align incentives and enable good practice. The

practice should not be penalized because they do the right thing.

Prototypes:

st

blended prototype

52% activity (band 2 and 3 type items)

10% quality and outcomes (clinical outcomes/patient experience/DQOF etc)

38% capitation (band 1 type items)

 

The second blended prototype (more based on Steele)

68% capitation (band 1 and 2 items)

22% activity (band

3,

modified UDAs)

10% quality and outcomes (clinical outcomes, patient experience, DQOF etc)

Capitation Section

This would include items such as urgent care? Acrylic dents? Routine endo,

perio, fills, prevention, assessment and diagnosis, radiographs.

Activity section

This would include molar endo, metal dens, crown bridge veneers.

The prototypes are due to start in 2015-16, then run for 2 years before

implementation, which seems a long way off.

The government does not necessarily have any ambition to change access/levels

of care/increase funding.

4. Peter Howitt Deputy Director of the Department of Health gave us an update

on contract reform along with Barry Cockroft.

Barry Cockroft informed us about a very important document called 'The Five

year Forward View" (mentioned by John Milne) Commissioning guidance work

is based upon the recommendations in this document. This document is focused

on prevention in the wider NHS as a whole. The future of dentistry is described

in this document (even though dentistry is not specifically mentioned in the

document).

 

Timeline for protoptypes:

January 2015 - calls for expressions of interest in the prototypes

Spring 2015 - prototypes selected

Summer 2015 - prepare for protypes, training, and software update.

Autumn 2015 - prototypes go live.

Engagement exercise

Early findings of this have already been published.

There will be more detailed findings from this published by DoH in January.

Of the engagement papers:

Paper 1: clinical philosophy

Results are that the preventive pathway approach is the correct approach. The

pathway does not work for patients who want urgent and casual care, and the

pathway needs to be modified to accommodate this.

Paper 2: quality and outcomes

Clinical effectiveness, patient experience, and safety - all three aspects are

correct for the DQOF.

Paper 3: remuneration approaches

Spectrum varies from full UDA system to full capitation. The engagement

exercise concluded that a blended remuneration approach was going to work

best.

Next steps

Publication in January 2015

Final proposals for prototypes

Calls for expressions of interest

Indicative timetables for national change

Detailed findings from engagement exercise.

5. LDC Special Conference

Dental Protection (Speaker Brian Westbury) gave their view of the GDC

problems, PDL's view is that they would prefer a reformed GDC rather then risk

introduction of a new unknown regulator.

Motion for special conference

'This conference believes the GDC has failed in it's role as the regulator for

Dentistry in its current model, and demands a reformation of the GDC that

will protect patients and re-establish the support of the dental profession."

A vote took place at the conference and the motion was carries unanimously.

6. Presentation from the British Dental Guild

Guild donations are down by 75% compared to last year.

Suggested guild donations are £25/ per dentist in your area / year

7. Dentist Health Support Trust

Donations can come out of the statutory levy and can be donated to the trust.

8. Benevolent Fund

They are also reminding us to donate from our LDCs.

9. Dentists with Enhanced Skills DBS

Level 1= GDP post foundation training, for 1 - 2 years after FT

Level 2= dentists with additional or enhanced skills

Level 3a = dentists on specialist lists

Level 3b= consultants

What is the problem that needs solving?

There are increased referrals to Oral surgery and for children

There is a funding imbalance between primary and secondary care (hospital

takes 20% of the budget but delivers 5% of the activity)

Skill level of FD trainers

Pros and Cons of DBS

Pros

Career pathway

Additional fudning for practices

Greater effeiciency for NHS

More convenient for patients

Cons

Additional time and cost of training

Divisive NHS /PVT

Undermines generalists

Undermines secondary care training

Medicolegal risk

Commissioning guides for DES in all the following specialities are under

construction:

1. restorative

2. oral surgery and related specialities

3. special care dentistry

4. orthodontics

10. Richard Birkin, National Director BDA Wales gave a presentation about

current issues in NHS contracting

Dentists are getting letters from BSA re red flags

These letters are asking the dentist t reply with comments. DO no reply without

getting advice from the BDA.

2 month rules - completed claims need to be submitted to BSA within 2 months.

GDPs can refer pts to hospital for OPG as part of'advanced mandatory services'

Xmas opening hours can be subcontracted but you need to write to LAT with

your formal arrangements.

Occupational Health arrangements

More work is needed on this

Urgent continuations as per recent advice published from BSA - the BDA are

seeking a legal opinion on this, so watch this space.

DO NOT reopen the previous course of treatment if the patient returns within 2

months with a problem

 

 

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