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Henriks home truths

May 2015

It is now time to resurrect Lester’s Letter to keep GDPC members and others informed about what is happening in between meetings.

I think, after this election, that we have all had enough of hot air and I believe we could do with a few hometruths to say it as it is.

I am not sure how frequently these letters will be sent out but expect them 3-4 times per year, depending on how much there is to report on.

After each GDPC meeting a letter will be sent out summarising what happened at the meeting and what was discussed. That way people should have more information and, hopefully, be more involved.

It has been a very busy time since I got elected at the end of March. We had the announcement of which pilots would become prototypes; the almostpublication of the commissioning guides, and the Doctors and DentistsReview Body (DDRB)/Department of Health (DH) decision on the 1.34% increase in contract values in England, with uplifts of 1.34% also in Wales, 1.61% in Scotland and Northern Ireland still thinking about last year’s award.

I spoke at BDA Conference and Richard Emms, Dave Cottam and I met the Greater Manchester Federation of LDCs and we are going to meet the group behind the “Alternative Contract Reform” in York at the end of May.

I have also stepped down from my positions as chairman of the London Federation and Regional Group and chairman of Ealing, Hammersmith & Hounslow LDC so I am now only a member of my LDC, giving me enough time to dedicate to GDPC.

Prototypes:

63 pilots out of 92 were selected to go into the prototypes, 5 pilots did not apply and 24 were refused permission to transfer into a proto.

The 29 pilots that are not going forward will have to return to their previous UDA contract with the same contract value and UDA requirement as before. They have been given 3 monthsnotice to do so (depending on individual discussions with their commissioner) but we have tried very hard (and continue to do so) to persuade DH that these practices have to have a reasonable and fair time frame and UDA target, which enables them to manage this transition without loss or undue stress.

The pilots that were rejected as a prototype have lost a minimum of 20% of their patients and I have problems understanding how these practices will be able to achieve their UDAs on fewer patients than before. Patients that have been taken through an extensive prevention programme will, hopefully, need less treatment than before.

We expect 30-40 non-pilot practices to be offered the chance to become protos as well so the total number of protos would be around 100. The first practices would start after 1st October 2015 and then the rest would be staggered over the next months.

We have been very clear with DH that we feel introducing UDAs in the prototypes is a step in the wrong direction, it is unambitious and the A blend is frankly a joke!

For more information about the prototypes and the different blends please see https://www.bda.org/contractreform.

Doctors and DentistsReview Body:

The DDRB recommended a pay increase of 1% for dentists this year but did not recommend a figure for expenses. This meant that for dentists in England, the Department of Health decided, on the basis of the previously used formula, to give a 1.34% uplift to contract values. This will be backdated from 1 April and hopefully paid on the July schedule. The same 1.34% will be paid in Wales, with a 1.61% uplift in Scotland intended to deliver the same net uplift. No decision has been made on uplift in Northern Ireland.

For England we told DH that we were not happy with the result as neither DH nor DDRB have any plans to address the 25% real terms pay cut dentists have faced between 2006 and 2013. If the Government had implemented the real terms pay freeze that they told us in 2009 we had to accept, then we would have been 25% better off today.

DH also reduced the rise in staff costs we have seen when they calculated the increase in our expenses. This was because DH states that no NHS staff should have an increase of more than 1%, yet we paid staff an increase of 3.2% last year. We pointed out that our staff are not NHS staff, they haven’t got the pension and other benefits that NHS staff have and the minimum wage has gone up by over 3% as well.

DH said they could not change the 1.34% as this had been directed by the Treasury, which is highly frustrating.

The details of the pay “negotiations” are different in the devolved countries but the effects are the same, we are simply not getting a fair deal.

We are discussing how to handle the next round of pay negotiations and hope that we will be able to get some robust data for expenses but access to practice accounts will help us to do this.

We would therefore ask, if you would be able and willing, to provide us with a copy of your practice accounts for an economist at BDA to have a look at the expenses in relation to private and NHS turnover. We are particularly interested in practices with over 80% NHS commitment. The data will be fully anonymised and data from individual practices will not be publicised at all. Ideally, we would want three years’ accounts to establish a trend in income and expenditure.

An exercise is already going ahead in Scotland to analyse practice accounts (in conjunction with the Scottish Government).

If you might be willing to do this, please contact Penny at the BDA by emailing her at This email address is being protected from spambots. You need JavaScript enabled to view it. I look forward to seeing many of you at GDPC and LDC Conference in June and hope you have a nice and

peaceful summer with great weather (yes I see the blue pig as well!)

Henrik

PS If you have any comments please do not hesitate to contact me or one of the vice-chairs.

Henrik Overgaard-Nielsen This email address is being protected from spambots. You need JavaScript enabled to view it. Dave Cottam This email address is being protected from spambots. You need JavaScript enabled to view it. Richard Emms This email address is being protected from spambots. You need JavaScript enabled to view it.

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