Download GDPC Report – November 2015

General dental practice committee report – November 2015
Henrik had a brief meeting with Simon Stevens, the Chief executive of NHS England, the feeling was
that dentistry had a low priority at the moment and Simon made it clear that there is no interest in
keeping money within specific services and there is an interest in service devolution. Henrik will be
meeting with Alistair Burt, the minister for dentistry during November.
Contract reform
All prototype practices will be expected to deliver all necessary care to each capitated patient on
their list. If more treatment than the minimum level is required, practices will be expected to deliver
this within their overall contact value. Patients who received private care within an NHS course of
treatment will have to sign their agreement for this information to be shared anonymously with the
NHS otherwise the patient cannot receive NHS care at that practice. DoH is allowing for a fall of up
to 20% in band 2 and 30% in band 3 activity for the 2014/15 out turn for non-pilot practices.
If prototypes are running behind in their UDA targets they are able to take on new patients with
commissioner agreement. The DoH intend to look at another way to measure activity and there is
clear recognition that the current patient charge system does not fit with a prevention based model
(although in the pilots PCR didn’t fall as much as the volume of treatment undertaken).
Any prototype that are failing to meet patient numbers and/or UDAs (less than 90%) may well find
themselves receiving 3 months’ notice from the commissioner to exit the programme.
Practices that have been offered places are being trained and will then be told which blend they are
being offered, as well as their UDA and patient targets (not sure whether data will be available at a
performer level). The DoH accept that the payment system seemed complicated but felt that they
had to achieve a balance between simplicity, fairness and accuracy.
NHS commissioning guides
All, except the restorative guide, have been published and implementation is underway. NHS
England have disregarded all the comments made by the BDA and some regional teams appear to be
forging ahead with implementation without doing the necessary needs assessment.
28 days re-attendance
There are concerns about the BSA picking up claims that are within regulation and delays in
obtaining data from practices who wish to self-audit. There is a real fear of under-claiming as a result
of this and there will be future meetings with the BSA personnel to discuss this in more detail.
Foundation dentist clinical confidence
The results of the BDA research into confidence has been published in the October BDJ in practice.
25% responded to say they were very confident or moderately confident to carry out clinical work in
dentistry after their FD year. There was a significant lack of confidence in molar endodontics, minor
oral surgery and crown/bridgework. It has been acknowledged that it is difficult to train more
complex skills within a stressful practice environment and there was a clear role for NHS England and
MCNs to provide training and experience.
Radiographs used to age refugees
The DoH enquiry into whether radiographs could be taken to age refugees was seen as not ethical, in
contravention of the IRMER regulations and had a high margin of error. The BDAs current policy
statement was endorsed.
Orthodontic commissioning
Colin Wallis (British orthodontic society representative) reported the difficulties orthodontic
practices were experiencing in England with contracts being offered of 1, 2 or 3 years. These short
term contract were resulting in problems for business planning. NHS England has asked BOS input
into finding better quality metrics for the standard orthodontic agreement.
LDNs and DEVOMANC
The LDN would be taking the lead with commissioning in Greater Manchester under the new
devolution arrangements. Other northern cities would follow and this model was clearly the way
forward as far as the NHS England leadership is concerned.
Primary Care Support Services (PCSS)
Capita have won the contract to provide PCSS functions for area teams (primarily performer list
administration). They are due to present at the LDC Official’s day in December.
Regional reports
Scotland has a working group in place to develop ways to support dental practices away from the
NHS. Northern Ireland had to wait 12 months for the 2014/15 uplift and there was no sign of when
or if the 2015/16 uplift would take effect. In Wales the health inspectorate had so far inspected a
quarter of practices and there is still the issue of trivial matters being referred to the GDC.
GDPC response to DDRB
The executive members have reluctantly told the DoH that in return for a 1% uplift in pay for
2016/17, which is likely to equate to 0.5% of contract value, they will ask DDRB to not make a
recommendation for this same period (this would not preclude further participation in the DDRB
process in the future rounds). The risk is that in taking this approach was that DDRB
recommendation for 2016/17 may well have been less than 1%. Neither decision will affects
discussions about expenses or efficiency savings.
BDA response to the GDC ARF
The British Dental Association (BDA) has accused the General Dental Council (GDC) of hoarding
reserves, and has told the regulator that it can and should set a fee level for dentists of no more than
£500 for 2016/17.
The GDC has proposed maintaining the annual retention fee (ARF) for dentist registrants at £890, the
highest rate paid by any comparable UK health profession. BDA analysis has identified that the GDC’s
approach is flawed, and has set out key savings that would enable the regulator to easily remain
financially sustainable while focusing on its statutory duties.
The BDA has also published legal advice indicating that the regulator's consultation is potentially
unlawful. The GDC was previously defeated in the High Court in judicial review proceedings over its
handling of the consultation for the 2015/16 ARF.
•The GDC’s excessive reserve policy is keeping the ARF at £890;
•In the last 3 years the GDC has never been left with less than £13 million in its current account and
that’s on top of more than £10 million in reserves;
•The GDC has been able to draw £9 million from petty cash to fund improvement works to its
London HQ and still stay in credit.
The next GDPC meeting is due to take place on the 29th January 2016.
Toby Hancock