debating the big issues

NHS dentistry – debating the big issues

Nigel Jones NHS Dental Landscape Leave a Comment

Ahead of hosting two NHS dentistry Q&A sessions with industry experts, Nigel Jones takes a look at how the profession has fared so far this year…

The year got off to an auspicious start for the dental profession, at least in terms of increasing the public’s awareness of the issues facing dentists. Alongside headlines in national mainstream media such as The Mirror, The Guardian and The Telegraph, Eddie Crouch’s appearance on The One Show was a particular highlight.

Eddie deftly separated the profession from the problems of the design and funding of ‘the stupid system’ while coming across as caring about the plight of patients. Driven by the more proactive stance taken by the BDA in the era of Mick Armstrong, it does very much seem as if that message is finally getting through and to see, for example, the spin of ‘extra’ dentists being dismantled so effectively was remarkable.

The importance of this strategy cannot be underestimated, especially as, media headlines aside, it was a less promising start for NHS dentistry, particularly in terms of seeing any positive change when it comes to contract reform.

An invitation from NHS England for expressions of interest to become a fourth wave prototype practice brought further confirmation that the prototype regulations have been extended for another two years.

“Some cynics might suggest that inviting new practices to the party could be an attempt to dilute the negativity surrounding the current approach, given that those prototypes that have struggled the most have also previously been in the pilot programme.”

This is, of course, being positioned as further evidence of the desire to get the contract design perfected before undertaking any major roll-out.  However, there’s been no change to the structure of the prototype contracts – despite widely reported issues, as typified by 2018 LDC Chairman, Joe Hendron’s open letter resigning from the reform programme that he says ‘has lost its way’.

Some cynics might suggest that inviting new practices to the party could be an attempt to dilute the negativity surrounding the current approach, given that those prototypes that have struggled the most have also previously been in the pilot programme.

Others might believe that it’s simply another example of NHS England buying time after painting itself into a corner by creating a contractual structure that has much to commend it but will be unaffordable for either government or the profession.

Whatever the reasons, it means two further years working under the current contract which, if the evidence submitted by the BDA to the Review Body on Doctors and Dentists Remuneration 2018/19 is anything to go by, will be a very long two years indeed.

The BDA’s submission makes for fascinating, if depressing, reading and pulls few punches in highlighting the extreme pressure felt by dentists trying to deliver patient care under the current NHS arrangements in England. Amongst the many sobering statistics, such as poor morale and reducing income, one that caught my eye was the huge £30 million hike in clawback, a stark indicator of the current contract’s failings and a trend that looks like it’s continued in the current year.

These topics will undoubtedly be up for discussion in the Dental Business Theatre at the British Dental Conference and Dentistry Show later this month, where I will be holding two Q&A sessions with experts including Eddie, and his BDA colleague, Tony Kilcoyne, about the issues that matter in NHS dentistry.

I asked Eddie in the run-up to the event what he thought about the big issues facing the profession, and he said: ‘With the rise in clawback in England jumping from £55 to £81 million in one year and 330 practices now having a UDA rate below the band one charge a patient pays, and with real problems in recruitment and contracts being handed back, when will NHS England acknowledge the crisis in NHS dentistry?’

“These topics will undoubtedly be up for discussion in the Dental Business Theatre at the British Dental Conference and Dentistry Show later this month, where I will be holding two Q&A sessions with experts including Eddie, and his BDA colleague, Tony Kilcoyne, about the issues that matter in NHS dentistry.”

Tony added, ‘As we pass yet another 1st of April with a combination of increasing clawbacks, increasing patient tooth-taxes and limited NHS commitment for dentistry centrally (compared to mainstream NHS medical services), ever-increasing overheads and patient expectations, are we seeing the gradual demise of NHS dentistry by default?’

These may not be questions we can answer definitively during our sessions at the event – but it will certainly make for an interesting discussion.

The NHS Q&A sessions will take place at the British Dental Conference and Dentistry Show from 2.20pm – 3.05pm on both Friday, May 18th and Saturday, May 19th. For more information or to see the full speaker schedule visit: https://www.practiceplan.co.uk/events

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