I wrote a piece for Dentistry magazine earlier this year about the new Chief Dental Officer who at the time was busy on a “fact-finding” tour of her new territory. Sara Hurley’s tour was without doubt planned as a charm offensive, featuring smiling photographs with some of the movers and shakers of British dentistry. When she made an appearance at the BDA conference in Manchester her ad-lib question and answer session on the BDA stand was very successful and she came across as personable, reasonable and eloquent. “Good”, I thought, “here’s someone who wants to make friends”.

After more than a decade of her successor, Barry Cockcroft, who could not be described as any one of personable, reasonable or eloquent she seemed a breath of fresh air. But, let’s face it, the bar wasn’t set very high.

In my article I reminisced about CDOs I had encountered, I would not claim to have known any of them. I encountered Brian Mouatt when I was doing the MGDS pre-exam course just after the Conservative government announced a new dental contract, which was intended to “sort out NHS dentistry for good”.

He gave a talk on the new contract and promised that he would answer our concerns when he had finished. However having completed his prepared address he muttered something about having a previous engagement and headed for the door, our angry comments and questions ringing in his ear.

I only knew Margaret Seward because she was married to my first boss, Professor Gordon Seward, she was in post for two years and presumably wasn’t able to leave much of a mark on things, people I have met who worked with her spoke highly of her.

The other CDO I met was of course the previously mentioned Dr Cockcroft who was the highly visible mouthpiece for the iniquitous UDA system and became the exception after a line of low profile CDOs.

In view of Dr Hurley’s ease with people and obviously understanding the need for good PR I was surprised to hear that the new CDO had been far too busy to answer questions on Channel 4 in the wake of their damning reports on UK dentistry. If an NHS dentist was similarly booked solid for 6 months it would be mismanagement.

There was something that kept nagging at me and that was the somewhat cynical conclusion we reached after Brian Mouatt’s sudden departure. The CDO is a civil servant and is there to do the government’s bidding. The current incumbent has spent her professional life in the services reaching a high rank, she knows all about chain of command and is used to taking orders.

Her announcement this week at an NHS Expo (whatever that may be) that, “Going to the dentist every six months is unnecessary,” as the Daily Telegraph reported it, only undermines the position of Dentistry.  The other statements attributed to her are more “austerity” fuelled DoH propaganda.

"You don't see your GP every six months so why would you see your dentist?” Dr Hurley said. Well, Sara that is because NHS medicine is an illness driven system that is reactive and gives only lip service to prevention.

“If you go to have your car MOT, and he says, come back in six months, do you blindly adhere to that advice?” Actually Sarah if I’m driving one and a half tons of complicated machinery that I want to be safe yes I do. What does the army do about recalling tanks for servicing at the correct intervals? I would suggest that if you do them “blindly” someone could find themselves being disciplined.

She was joined on the platform by Roy Lilley who described dentistry as  “a rich man’s hobby” as a regular reader of Mr Lilley I know him to be anti-medic, and by extension dentist, who thinks that every ill in medicine can be cured with a “cuppa builder’s and a hobnob”. He criticised improved surroundings for dentistry, perhaps a return to upright chairs, woodchip wallpaper and lino; with queues on the stairs for gas sessions - would this suit him?

It has taken dentistry half a century to get the message across that regular attenders have fewer problems, stay healthier and actually prefer the reassurance. The good practices already tailor their recalls to suit patients and have been doing it for decades. Your statement is irresponsible and only fuels any criticism and scepticism of dentistry. You knew that your words would make headlines and that you were undermining the hard won confidence that most general practitioners face. However as you have never been a GDP how can you possibly understand what that really means?

It would appear that after a year in post gaining the fragile confidence of dentists, the directive has come down to the CDO, “get rid of your camouflage tunic, put on your hard hat and Kevlar, come out into the open and start gunning down your colleagues. That’s what we pay you for, not popularity - oh and Sara don’t forget there may well be a gong in it for you”.

Dental Elite is pleased to announce that it has been awarded membership to the National Association of Commercial Finance Brokers (NACFB).

Having gone through a rigorous process, Dental Elite is now a member of the UK’s trade body for business finance brokers – an accolade that only a few other companies within the dental sector can boast.

With this associateship, Dental Elite can continue to offer its clients an excellent service with the additional support of the NACFB, which exists to safeguard both its members and their clients against fraud and restrictive practices.

Its aim as one of the largest agencies in dental recruitment, finance, valuations, acquisitions and sales is to ensure that its clients receive a transparent, impartial and ethical service that ensures the optimum outcome is achieved.

For more information, contact the team today.

For more information contact DE Finance. Visit www.dentalelite.co.uk, email This email address is being protected from spambots. You need JavaScript enabled to view it. or call 01788 545 900

Who do you currently carry out DBS checks on? How often do you do this? Do your contracts and policies ensure staff have an ongoing duty to update you?

It is a CQC requirement that anyone employed by a dental practice is suitably qualified to perform the role they are undertaking. You also have a duty to safeguard the public. Therefore to ensure you are employing the right calibre of staff, you should carry out DBS checks before making any offer of employment final.

However, beware; you need to ensure you undertake the right level of check for the right role or you could be in hot water. The law also protects job applicants and employees in certain situations in relation to information obtained about their criminal convictions. Failing to comply with the law could result in you ending up in an Employment Tribunal.

In this blog we set out who you need to carry out checks on, the different types of checks available and give some practical tips to help you comply with your duties. 

Background

A DBS check, formerly a CRB check, is a check carried out on an individual before they take up new employment.  It provides certain information about that person in relation to their criminal record and whether they are on either the adult or child barring list, which means they are barred from working with these groups.

However, a DBS check is not a routine check an employer can make on any of its job applicants. It is only if one of the exceptions applies that an employer can make a request for such information. There are also different levels of checks depending on the nature of the role.

Dentistry is one of the exceptions in which a DBS check can be obtained.

Who?

The first thing you need to consider is which members of staff do you need to undertake checks on.

·         Dentists and Dental Care Professionals. You need to undertake an enhanced DBS check with barred list check on all dentists and dental care professionals. 

·         Receptionists. This will depend on the type of practice you run and the duties of your receptionist as to which check you need to carry out. The more contact that they have with patients on their own, the more likely they are to require a check.

·         Office staff. The CQC states that there is no requirement on non-clinical staff to have DBS checks. However, we would recommend seeking voluntary disclosure.

·         Practice managers. Given the nature of the role and their responsibilities we would recommend carrying out a standard DBS check, unless they will be in contact with vulnerable adults and children, then the enhanced check with barred list check should be carried out.

Types of Checks

The types of checks that can be undertaken are:

·         Voluntary disclosure. This is where you ask the job applicant to provide information about their criminal record voluntarily. However, there are limits on what you can ask for and what information you can use.

·         Basic DBS check. This contains information in relation to a person’s unspent criminal convictions, conditional and unconditional cautions or that there are none.

·         Standard DBS check. This contains information about a person’s spent and unspent convictions and cautions, as well as police warnings and reprimands.

·         Enhanced DBS check. This will contain information about a person’s spent and unspent convictions and cautions, police warnings and reprimands, and relevant police information. If the enhanced DBS check includes a barring list check then information as to whether the person is unsuitable to work with children or vulnerable adults will also be provided.

How?

The basic DBS check can be obtained by the individual themselves, without the need to be countersigned by the employer. However, the standard or enhanced DBS checks require the individual to make an application, which is countersigned by a registered person confirming their entitlement to apply for the certificate.

There is now also an online service that individuals can register with and keep their checks up to date, so if they move between similar jobs, employers can access this information more easily.

When?

All DBS checks should be carried out on staff once an offer of employment has been made. If the staff member is working with children or vulnerable adults, this will need to be done before they start that role.

If the dentist is on the NHS performers list you can write to the NHS to seek their confirmation that the dentists has passed the relevant DBS checks, to avoid having to go through the application process. If you do this you must ensure that you can evidence that you have satisfied yourself the dentist is fit to work.

What are the consequences of getting it wrong?

Given that it is a CQC requirement to ensure that staff are suitably qualified, a failure to do so could result in you failing an inspection.

What weight you attach to the contents of a DBS check or voluntary disclosure will clearly depend on the role being offered, whether the convictions are spent or unspent and whether the applicant is on either barring list.

Refusing to employ a job applicant because they have a spent conviction, unless there is a legal obligation placed on you not to employ, is not allowed. However, the reality is that, there is little a job applicant can do in these circumstances as there are no penalties for a breach of this legislation.

If you later find out someone has lied about their criminal convictions, then this is likely to be seen as an act of gross misconduct and you should take the necessary action. You should also consider if you have a duty to report the person to the GDC.

However, if you find out that an applicant did not disclose a spent conviction, unless you would not have been allowed to employ them at all as a result of this, you cannot dismiss them for not disclosing this information. Whilst this has not been tested in the tribunals, given the wording of the legislation this is likely to be seen as an automatically unfair reason for dismissal.

Practical Tips

·         Offer letters. When you offer an applicant a position you should state in the letter that the offer is subject to references and the relevant DBS checks.

·         Contract of employment. Make sure your contract places a positive duty on employees and associates to notify you should their circumstances change.

·         New circumstances. If during the course of employment, an employee is cautioned or convicted of an offence, do not have a knee-jerk reaction to this. You need to weigh up the position held, the nature of the offence and your own policies. Again you will need to consider if you need to report this to the GDC.

If you would like to discuss any part of this article or need any assistance with safeguarding issues, please contact Laura Pearce on 0207 388 1658 or at This email address is being protected from spambots. You need JavaScript enabled to view it.. 

“38% of 12 year olds have signs of tooth wear.”*¹ You can help!

According to the Children’s Dental Health Survey 2013 “up to 57% of 5 year olds and up to 38% of 12 year olds have signs of tooth surface loss on the incisors.”*¹ Now that your young patients are going back to school, their lunchboxes may include acidic fruits, fruit juices and fizzy drinks which can lead to enamel softening and tooth wear. The enamel of their adult teeth has to last the rest of their life. And once enamel is gone it’s gone for good.

How can you protect your young patients’ enamel?  

Pronamel® for Children toothpaste has been developed with dental experts to help provide daily protection from the effects of erosive tooth wear and decay.

-          Optimised fluoride formulation with 1450 ppm fluoride to help re-harden acid-softened enamel

-          Low abrasivity to be gentle on softened enamel

-          Neutral pH and SLS free

The online CPD module, developed by GSK, gives you the opportunity to find out more about how to identify tooth wear using the BEWE tool. Simply visit www.gsk-dentalprofessionals.co.uk to complete the module today!

Pronamel® has worked with leading dental experts in the field of tooth wear to develop a range of products specifically designed to help protect against the effects of erosive tooth wear,² such as Pronamel® for Children.

Recommend Pronamel® for Children to provide daily protection against erosive tooth wear and decay.

References:

1. Children’s Dental Health Survey 2013. Report 2: Dental Disease and Damage in Children England, Wales and Northern Ireland. March 2015. Health & Social Care Information Centre.
2. Final Minutes from the Expert Panel Meeting to Discuss Toothwear/Erosion

in Children. GSK Data on File. 2007

*Refers to the lingual surface of the incisor only

Trade Marks are owned by or licensed to the GSK group of companies.

CHGBI/CHPRO/0038/15c

On Monday 22 August, Denplan welcomed Chief Dental Officer for England, Sara Hurley, and Andrew Taylor, her Dental Programme Manager, to the company’s head office in Winchester. The aim of the meeting was to explore areas of mutual interest between the private and public sectors. There was acknowledgment that engagement between the two sectors centres on common patient-centred goals – not least that of offering more patient choice, and improving the long term oral health of patients in the UK.

Henry Clover, Denplan’s Chief Dental Officer said: “We were delighted to welcome Sara and Andrew to our offices, where we were able to explain Denplan’s business model and the range of support services we offer to 6,500 member dentists nationwide. We see this as the start of a conversation on potential areas of collaboration and information sharing.”

One area of discussion was the Denplan Excel certification programme, developed over 15 years ago for dentists to help support clinical governance, professional regulation and excellence in patient care and communication. The Denplan Excel programme was also UKAS accredited in January this year. Denplan explained that they would be open to future discussions with the GDC regarding continuing assurance plans, and with the CQC, to discuss the potential value of clinical service accreditation and peer review schemes. These could be useful information sources to support their inspection programmes and to help continue driving up standards in dentistry.

Henry also shared some data recently published in the British Dental Journal which demonstrated that worsening oral health correlates with worsening general health. This was derived from over 37,000 patients who had received a Denplan PreViser Patient Assessment (DEPPA)¹. The research provided further evidence for the association between high-risk lifestyle factors such as smoking and heavy drinking and poor oral health outcomes in an area of common interest in all sectors of primary care.

There were also discussions around the array of tailor–made practice training sessions that Denplan runs for practices and their dental teams – over 450 sessions per year.  Denplan Academy training covers areas such as complaint handling, legal and ethical issues and GDC standards, preparing for CQC inspections, and caring for patients with dementia to name a few.

Henry said: “It was generally agreed that any initiatives and training that improves practice efficiency and in turn improves oral health outcomes, would serve the profession well to be explored on a wider scale.”

Sara also outlined the case for a national programme to improve dental health through better co-ordinated care and empowering communities to implement their own sustainable oral health initiatives.  She will be launching the concept of “Smile 4 Life” at the Health and Care Innovation Expo next month; national support for existing community based projects, a hub for sharing best practices across Local Government Authority areas and ensuring that local oral health initiatives are complemented by innovative commissioning approaches within local NHS England Commissioning Teams and supported by the profession. 

The initial focus is “Early Years/under 5’s” with the aim to provide opportunities for families and  children to establish good oral health habits as a daily norm, be it nursery school or at home.  With encouragement and ease of access to dental care professionals, first check-up by age 1 and opportunity to continue to visit the dental team regularly for age–appropriate preventive advice, together with help to ensure problems are identified early, the prospect of a generation of children free from decay becomes increasingly real. 

Keen to expand the concept of Smile 4 Life beyond childhood, Sara also touched on an ambition for a wide-ranging programme for oral health reform – with a focus on improvements for the oral health of the over 65’s, the 16-24 age group, the homeless, the ageing well (typically aged 35-55) and those aged 85 plus – a population expected to double between 2010 and 2030. She also expressed her determination that the dental profession work together to lead and achieve the required changes.

Henry commented: “Denplan will continue to support such prevention strategies that recognise that good dental health in childhood is vital, not only for lifelong oral wellbeing, but for good overall long term general health. This is ever more so important now, given the lack of an oral health focus in the government’s recently published obesity strategy.” 

^[1] http://www.nature.com/bdj/journal/v221/n2/full/sj.bdj.2016.525.html British Dental Journal 221, 65 - 69 (2016) Published online: 22 July 2016 | doi:10.1038/sj.bdj.2016.525

About Henry Clover

Henry Clover joined the Professional Services team of Denplan in 1998, having worked as a dentist for 17 years looking after patients’ oral health in his own practice. He now holds the position of Director of Dental Policy at Simplyhealth and is also Chief Dental Officer at Denplan. Henry playing a vital role in Simplyhealth’s Leadership Team and is at the forefront of private dentistry liaising with more than 6,500 member dentists.

About Denplan

Denplan is the UK’s leading dental payment plan specialist, with more than 6,500 member dentists nationwide caring for approximately 1.7 million registered patients. Established in 1986 by two dentists who pioneered the concept of dental payment plans, Denplan has been at the heart of dental care for nearly 30 years and today the company is owned by Simplyhealth. Denplan has a wide range of dental plans for adults and children, enabling patients to budget for their private dental care by spreading the cost through a fixed monthly fee. We support regular attendance and preventive care, reducing the need for clinical intervention and helping patients to maintain healthy teeth and gums for life.

For further information visit www.denplan.co.uk. For oral health tips and advice visit www.myteeth.co.uk. Patient enquiries telephone: 0800 401 402   Dentist enquiries telephone: 0800 328 3223 
 

• Denplan Care: all routine and restorative care + worldwide dental injury and dental emergency cover
• Denplan Essentials: routine care only + worldwide dental injury and dental emergency cover
• Plans for Children: routine and other agreed care + worldwide dental injury and dental emergency cover
• Membership Plan: registered with the dentist + worldwide dental injury and dental emergency cover
• Denplan Emergency: worldwide dental injury and dental emergency cover only
• Company Dental Plans: company funded, voluntary and flexible benefit schemes 
   

Denplan also provides a range of professional services for its member dentists and their practice teams, including the Denplan Quality Programme, Denplan Excel Accreditation Programme and Denplan Training, plus regulatory advice, business and marketing consultancy services and networking opportunities.

Since it was established in 1972, Curaprox has become a leading name in oral health.

“As a team, we pride ourselves on offering proven solutions that encourage best practice, correct technique and ensure an efficacious oral hygiene regimen – and that is why we are delighted to be expanding our service to the Irish market with a new team member,” says Richard Thomas, MD of Curaprox UK.

“Though we have had a presence in Ireland since 2014 supplying our products via two renowned distributors, our goal has always been to expand Curaprox UK. That is why we have recruited Orla Sheehy to look after Curaprox Ireland as a Senior Business Development Manager.”

Orla is originally from Carlow, and has worked as an Operations Manager for a dental equipment company and for GSK.

Over the coming months Curaprox will be increasing its support to oral healthcare professionals across Ireland through regional meetings and by attending exhibitions.

Orla will also be working very closely with iTOP tutor Barbara Derham as part of Curaprox’s efforts to increase its educational presence.

In the meantime, Curaprox will continue to produce oral healthcare products that are safe, gentle and effective.

To find out more, contact Orla on 085 1644648 or email This email address is being protected from spambots. You need JavaScript enabled to view it.

For more information please call 01480 862084, email This email address is being protected from spambots. You need JavaScript enabled to view it. or visit www.curaprox.co.uk

While our love of queuing may be integral to our national identity, the truth is that we, just like everyone else in the world, don’t really like having to wait. This is particularly true in the dental practice – with waiting times being a real bone of contention amongst patients.

Of course, it may be impossible to completely eliminate your waiting times – after all, dentistry is a very, very busy profession and, while you will undoubtedly do our best to see patients as quickly and efficiently as possible, the very nature of the work that you do necessitates a level of care that can sometimes result in delays.

Nevertheless, it is always important to strive to ensure that your waiting times in practice are not unacceptable – not only since you have a responsibility to your patients, but because it can also be damaging to the reputation and success of your practice.

Indeed, waiting times can be a very important factor for patients when choosing where to go for treatment. Nowadays, patients are well-informed, organised and far more discerning when it comes to choosing dental care, and are much more likely to conduct their own research before booking an appointment – and if they find reviews of your practice that mention a long waiting time, they may simply choose to go elsewhere.

You also have to remember that this can be true of your existing patients too. Unfortunately, loyalty to one’s dentists is largely a thing of the past. No matter how good the service they receive has been before, if your waiting times begin to increase, your current patients may just leave for a practice that is more convenient for them.

As such, being in control of your waiting times is key to providing consistently excellent customer service. To be a successful, thriving practice in what is becoming an increasingly competitive profession, customer service must be impeccable from the minute a patient first makes contact. Indeed, if a patient does not believe they have received the utmost service in this respect, even if the treatment itself was a success, their opinion of the practice in general may be ruined. After all, if you go to a restaurant and are served delicious food by a bad waiter who made you wait, it’s likely the poor service that will be remembered.

You should also remember that people lead increasingly busy lives nowadays, and sitting in a waiting room is simply a waste of their time – making it unsurprising that so many people are willing to forgo their dental treatments in the first place.

However, by carefully managing our waiting times, you can improve your customer service and strengthen your patients’ positive relationship with your practice. It’s also good for compliance too, since patients who are happy with the service they have received are likely to be more receptive to any advice they are given regarding their oral health. It will also encourage patients to continue attending your practice, helping you build a more personal relationship with them, one that is more communicative and trusting, which will give you the information needed to better treat their problems.

What’s more, managing waiting times will also benefit your staff. Without having to deal with consistently annoyed or impatient patients, your reception staff will be less stressed. They’ll also be able to more effectively get on with their work, without the disruptions caused by potential complaints.

Of course, to set reasonable waiting times, you have to be ruthlessly efficient about how you organise our appointment book. Using an online booking platform is an effective way of achieving this. With complete control, you can upload only the appointments you want to fill, for your patients to browse and book. This allows you to keep your daily and weekly workload at an optimal level, within your abilities to manage, and gives space for any emergencies, routine follow-ups or, in those unavoidable instances, delays. Online booking will take some of the pressure off your reception staffs too, so they can focus more on welcoming the patients who have come into the practice rather than dealing with busy phone lines and bookings.

AppointMentor from Welltime is a perfect example of this kind of system. It affords complete control of your practice’s appointment book, is accessible 24/7, 365 days a year; is easy to use, and simple for you to review and revise.

Ensuring your patients do not have to wait unduly long amounts of time for treatment is a fundamental aspect of good customer service. It will also help streamline your whole treatment system and strengthen the reputation and efficacy of your practice. Look for tools that can help you set reasonable waiting times: they allow people to get actively involved in making decisions about their care and get the most out of you, their dentist.

For more information, contact the Welltime team on 07999 991 337, email This email address is being protected from spambots. You need JavaScript enabled to view it. or visit the website at www.welltime.co.uk.

GDPUK are pleased to announce - we are running a conference on the 4th of November in Manchester for the whole of the Dental Community.

We have put together an unusual dental event, with 20 minute timed presentations, with a mixture of discussion provoking speakers.

The aim is to bring GDPUK colleagues together for an educational and a social day, with time for food and drink in a modern setting close to Old Trafford, Salford Quays and City Centre Manchester, with all the transport links and facilities close to the venue.

The day is a great opportunity to celebrate the GDPUK community and dentistry. We also hope it is a chance for Dentists to meet up and spend an invigorating, inspiring and interesting day together. 

Please look at our minisite to learn more about the day. Full agenda and timings can be found on the website. 6 hours of verifiable CPD in a modern, friendly environment.

www.gdpuk.com/conference

For further information please follow this link - www.gdpuk.com/conference

Following the unveiling of the Government’s long-anticipated Childhood Obesity Strategy, the UK’s leading dental payment plan provider, Denplan, has criticised the plan for overlooking oral health.

“The strategy shows small steps in the right direction but has ultimately been widely slammed by campaigners as being ‘weak’ and ‘watered down’,” says Henry Clover, Chief Dental Officer at Denplan. “Not only does the strategy omit the desired restriction on junk food advertising and multibuy promotions, it was also hugely disappointing to see that childhood tooth decay was only referenced once in the entire report. Although the strategy focuses on obesity, the knock-on effects of implementing tougher sugar restrictions on manufacturers and retailers could only have been positive for our children’s dental health too.”

The strategy fails in the eyes of many health experts, campaigners, and MPs to fully tackle the issue of unhealthy eating habits and does not impose tough enough restrictions on manufacturers and retailers.

Central to the Strategy is the Government’s ‘challenge’ to manufacturers and retailers to voluntarily reduce the sugar content of produce popular with children by 20 percent by 2020, with a five percent reduction in the first year. George Osborne’s already-announced sugar tax on soft drinks was also referenced in the plan, but the expected restrictions on junk food advertising during peak family TV shows and bans on supermarket cut-price promotions on unhealthy foods were ignored.

“It’s fair to say that the long-anticipated Childhood Obesity Strategy was expected to be a lot more robust,” says Henry. “Asking manufacturers and retailers to reduce sugar content on a voluntary basis may not achieve what is needed to both reduce childhood obesity and tooth decay. Far too many children experience tooth decay, and it remains the single most common reason for five to nine year olds in England to be admitted to hospital, with many of those children needing multiple tooth extractions under general anaesthetic.” [1]

About Denplan

Denplan is the UK’s leading dental payment plan specialist, with more than 6,500 member dentists nationwide caring for approximately 1.7 million registered patients. Established in 1986 by two dentists who pioneered the concept of dental payment plans, Denplan has been at the heart of dental care for nearly 30 years and today the company is owned by Simplyhealth. Denplan has a wide range of dental plans for adults and children, enabling patients to budget for their private dental care by spreading the cost through a fixed monthly fee. We support regular attendance and preventive care, reducing the need for clinical intervention and helping patients to maintain healthy teeth and gums for life.

For further information visit www.denplan.co.uk. For oral health tips and advice visit www.myteeth.co.uk. Patient enquiries telephone: 0800 401 402   Dentist enquiries telephone: 0800 328 3223

• Denplan Care: all routine and restorative care + worldwide dental injury and dental emergency cover
• Denplan Essentials: routine care only + worldwide dental injury and dental emergency cover
• Plans for Children: routine and other agreed care + worldwide dental injury and dental emergency cover
• Membership Plan: registered with the dentist + worldwide dental injury and dental emergency cover
• Denplan Emergency: worldwide dental injury and dental emergency cover only
• Company Dental Plans: company funded, voluntary and flexible benefit schemes

Denplan also provides a range of professional services for its member dentists and their practice teams, including the Denplan Quality Programme, Denplan Excel Accreditation Programme and Denplan Training, plus regulatory advice, business and marketing consultancy services and networking opportunities.

For more information about Denplan:

Sara Elliott

Denplan Press Office

Tel: 01962 828 194

This email address is being protected from spambots. You need JavaScript enabled to view it.

Insight is a wonderful thing

It carries so many meanings.

The GDPs view

Many of you demonstrate it in your daily work, by understanding what makes patients tick. They say one thing to you and you apply years of experience, so that after a few moments of reflection, you translate what the patient just said into a proposal for treatment with a couple of options. Our younger colleagues of course find this the hard bit of clinical practice, but with experience time and dedication all Dentists and DCPs in patient contact can become masters of this art.

At the other extreme, when it all goes wrong and some of our colleagues face GDC proceedings, the ability to reflect upon your circumstances is critical. The ability to show insight at the events that led to the GDC may be critical to a Panel taking a benevolent view.

Insight is an essential attribute for any dentist.  For sure, lack of an ability to apply insight will often lead to trouble. It may compromise your relationship with your patient. You may finish up treating a patient despite the warning signs being there perhaps in the body language, or in the tone of voice used during a conversation.

Time? Not a lot of it about!

We recognise the application of insight as a skill and an attribute amongst our colleagues, and we admire those who have mastered the art of its use.

Of course the need to reflect and to gain insight require something that your NHS masters are reluctant to give you too much of: time

Even the GDC require time to reflect and gain insight. 

So why is it that I think the top of the GDC may lack leadership, and the insight that is required to be effective?

There are at the GDC six Registrant members of the Council and numerous panel members who all, in their work and their practice have to find time to reflect and develop appropriate insight into their cases of regulatory work.

The Times -  6^th August 2016

So it was with some surprise that the Chairman of the GDC, a certain Dr William Moyes PhD Esq, found himself demonstrating what seems to be a surprising ignoranceof the workings of NHS funded dentistry at the weekend, if The Times quote is to be believed.

Many of you will of course regard the summer as the season of slow news and will know that dentists are an easy target.  If I were you I should take it as a compliment.

What never fails to amaze me though is how the media absolutely fail to gain any true understanding, insight dare I say, of the problems associated with the Government offering for the nations dental care

And so it was in last Saturday’s edition of The Times. Front page news no less. It was probably pure coincidence that the de Mello case was about to be started at the GDC.  In fact, it was – a leading colleague single-handedly was trying to have the issue properly addressed. It is now behind a pay wall, but I have copied it below.

The Thunderer bellowed …

The article so nearly nails the issues, and in many respects it almost goes so far as to highlight “The Big Lie” and identify the lack of “Clarity of the Deal”.  A big up to our colleague, Dr Kotari, for getting “High Street Dentistry” on the broadsheet agenda. Patently he did not write the copy.

The message was clear though. Even someone without deep insight into the NHS Dental Service can see it is trying to do too little for too many.  There is only a certain amount of money, and the way it is spent simply does not allow for the provision of a broad range of highly complex procedures for everyone.  There is a very good blog on the BDA site reflecting after this article by a young colleague Dr Robert Chaffe at https://bdaconnect.bda.org/bad-dental-press/ .  The BDA through Dr Mick Armstrong were pretty robust in their reponse at  https://www.bda.org/news-centre/press-releases/bda-response-to-the-times .

And as FtP numbers prove, the dentist’s lack of time to reflect and develop insight into the problems of a patient cause that patient to feel abused and make that first GDC contact.

It’s not a difficult loop to get your head around, is it Dr Moyes?

Clearly, it’s about clarity

Anyone with half a brain can see that the future must involve a clear demarcation of what is and what is not available as NHS treatment. The post-code lottery that is exemplified by the extraction -versus- endodontic treatment fiasco reveals the problem that everyone is shouting about.  The only people who will not engage on this matter for no other reason than political fear are the dunderheads at the Department of Health.  Even the BDA recognise that it will have to come - but everytime it is mentioned at DH or NHSE level senior officials shake their heads. "Can't be done dear chap".

UDA Targets are set by …

The message is equally clear about high levels of UDA targets – the dentists do not set these. The Local Area Teams do.  In cases such as that of Dr de Mello, these colleagues may genuinely think they are doing the Governments dirty work for them in an efficient manner, bringing access to the masses at minimal cost.  That is what the Government want, isn’t it?  Dentistry is a broad church and while I would not poersonally be able to cope with a high UDA contract requirement, I know some can.  Does that make them wrong in themnselves?

When I wonder will NHS management be called to account instead of the dentist who is the low hanging fruit of accountability? 

What’s that you say? Never?

Soundbites

So when Dr Moyes, as GDC Chairman is reported in The Times as stating on behalf of the GDC, and I quote from the article:

The General Dental Council says that it cannot act because a lack of professional guidance allows dentists to claim that extraction is a legitimate option. “I’m sure that if patients had a full understanding they’d be quite appalled,” Bill Moyes, the council chairman, said.

What exactly can he mean? Is he saying there is a massive problem? Or is he demonstrating considerable ignorance similar to that which his infamous Pendlebury Lecture highlighted? Shall we assume Mr Chris Smyth, Times Health Editor, is including a quote relevant to the thrust of the article for now.

Can Dr Moyes really have so little insight into the working of dental practice?  It certainly looks like it.

Did Dr Moyes not reflect upon the magnitude of the meaning of his comments?  It certainly appears not. With that one comment Dr Moyes has revealed all that is wrong with his Chairmanship of the Council.

We now have a decent working team in the GDC Executive Leadership. But the Chairman has revealed that he is not neutral, and strategy driven. Instead, he appears to be a simple supporter of that broad-brush vox-pop opinion that “all dentists are trying it on”.

Last call for Dr Moyes…

The time has come for the Chairman of Council to shape up, learn about the long standing problems of NHS funding of dentistry and take on the causative Department of Health as part of the GDCs Strategic role.

Or he must step aside and let a more capable person take the role on. 

It IS clear that it is time for Dr Moyes to reflect upon his position, for the sake of the profession he seeks to regulate and yet for which he patently has scant regard.

Slow news day my foot – have a great break if you are away.

-----------------------------------------------------------------------------------------------------------------------------------------------------------

TIMES INVESTIGATION
The great dental rip-off
Thousands of teeth needlessly extracted as surgeries accused of putting profit before patients

Chris Smyth, Health Editor | Katie Gibbons
August 6 2016, 12:01am,
The Times

Regulators said that dentists were extracting teeth to avoid offering complex treatment, for which they are paid the same by the health service

Thousands of people are losing teeth needlessly because it is more lucrative for NHS dentists to take them out than try to save them, an investigation by The Times has found.

Regulators said that dentists were extracting teeth to avoid offering complex treatment, for which they are paid the same by the health service. The investigation has also found that some dentists earn almost £500,000 a year in a system that rewards them for cramming in as many patients as they can.

Dozens are claiming for the equivalent of more than 60 check-ups a day, in what has been condemned as an unethical conveyor-belt approach to patients. The upper limit is considered to be 30 a day for one dentist.

Under reforms introduced a decade ago, dentists are paid about £25 for every “unit of dental activity” (UDA) that they carry out. Each check-up, or simple examination, is classed as one UDA; tooth extractions count as three, along with fillings and root canal work, irrespective of how long the treatment takes. Root canal treatment usually lasts more than twice as long as an extraction.

NHS figures seen by The Times show that 30 dentists were paid for more than 15,000 UDAs last year — the equivalent of about 60 simple appointments a day over a standard working week. Ten dentists were paid for more than 18,000 UDAs, equivalent to about £450,000.

Alex Wild, of the TaxPayers’ Alliance, a public spending watchdog, said: “The amount of work dentists do will obviously vary significantly, but the figures at the top end appear totally implausible . . . an urgent review is essential.”

Dentists routinely weigh up how much time and treatment a patient needs against a desire to maximise earnings, say professional leaders who concede that the payment system is causing an “ethical compromise”.

The warning comes before the disciplinary hearing next week of the dentist responsible for the biggest patient alert in NHS history. More than 20,000 people treated by Desmond D’Mello, 62, were called for HIV and hepatitis testing after he allegedly failed to change gloves or clean equipment between appointments in an attempt to see as many patients as possible.

Mike Waplington, president of the British Endodontic Society of root canal specialists, said that extractions had jumped by a fifth and root canal treatment had fallen by almost half after the contract that paid the same for both was introduced in 2006. Root canal treatment could take three times as long as an extraction. “There is an incentive from the system and some dentists may say to patients ‘I can take this tooth out simply’.”

More than two million teeth were taken out on the NHS last year, but Mr Waplington said that many could have been saved, estimating “over the lifetime of the contract it would have affected tens of thousands of teeth”.

Many dentists also feel more comfortable taking teeth out, as only 277 out of more than 40,000 are registered as specialists in root canal work.

Trevor Lamb, co-founder of the Saving Teeth Awareness Campaign, said: “The public are too quick to accept that teeth should be removed. They are unaware of the alternatives and some dentists exploit this. You wouldn’t go into A&E with a broken arm and expect it to be amputated.”

At least 2,000 dentists claimed for more than 8,000 UDAs, equivalent to the upper limit of about 30 check-ups a day. Neel Kothari, a Cambridgeshire dentist seeking reforms, said that it was difficult to do more “in any ethical sense”, with 60 patients a day impossible without cutting corners.

He warned that dentists intent on maximising income might skimp on treatment as well as hygiene. “It’s as if you went to a top restaurant and they served you a Big Mac disguised as a gourmet burger,” he said.

Nigel Carter, chief executive of the Oral Health Foundation, said: “To do a proper assessment of the patient would probably take 20 minutes. But that hasn’t been what the health service has been paying for. There is a bit of an ethical compromise.”

The General Dental Council says that it cannot act because a lack of professional guidance allows dentists to claim that extraction is a legitimate option. “I’m sure that if patients had a full understanding they’d be quite appalled,” Bill Moyes, the council chairman, said.

----------------------------------------------------------------------------------------------------------------------------------------------------------------------

GDPUK Topic

https://www.gdpuk.com/forum/gdpuk-forum/the-saturday-times-front-page-the-great-dental-rip-off-22696?start=50#p250635

----------------------------------------------------------------------------------------------------------------------------------------------------------------------

Letter to The Times, Tuesday 9^th August

Sir, Your report and editorial suggest that dentists can claim as many UDAs as they like. On the old system, dentists could earn more by carrying out more treatment, and the annual dental budget could only be estimated. The current contract was designed to allow a budget to be set in advance. Each dentist is contracted to carry out a certain number of UDAs a year. If a dentist exceeds the number of UDAs contracted to them they get no additional pay. If they fail to complete the contracted number, their fees are clawed back. The dentists have to tender for contracts each year. Whose fault is it if dentists are paid for a large number of UDAs? However, to claim that the upper limit of patients is 30 per day is unrealistic. In the 1990s I used to work with three staffed surgeries and treated 70 to 80 patients a day. That would equate to more than 30,000 UDAs a year. On a four-day week, I hardly ever ran late.

William Eckhardt

Retired general dental practitioner

Haxey, S Yorks

Johnson & Johnson, the makers of LISTERINE®, are delighted to bring you new online content, to help support the ongoing CPD needs of dental healthcare professionals in improving and maintaining the oral health of their patients.

This is free to complete and each module accounts for 1 hour of verifiable CPD.

Through our programme, we aim to deliver recent clinical findings, useful information for in-practice management of oral diseases and patient communication strategies for improved preventive home care, as well considering the effects of lifestyle and other external influences on your patients’ oral health.

Please visit http://www.listerineprofessional.co.uk/cpd-educational-programme to earn verifiable hours from our continuously expanding library, including our newest pieces on:

• The adjunctive benefits of a daily use mouthwash

• Evidence-based decision making

• Communicating with children

• Dr Elizabeth Kay: Psychology in communicating with patients.

In addition, soon to be made available are CPD articles on:

• Dental care for older patients

•  In support of prevention

Upon completing each module successfully, you can either select to save and print your certificate and/ or have a copy emailed to you directly.

For further information, please email This email address is being protected from spambots. You need JavaScript enabled to view it.

A dental chair is the focal point of any surgery: the central cog in a machine that allows for the provision of exceptional treatment. These products see almost constant use throughout the day and the average practitioner can expect to spend almost 27,000 hours with each chair over the course of their career. As such, it is vitally important for practitioners to choose wisely when selecting a new chair, to ensure that they are making a wise investment for the future.

The first consideration is reliability. Any savings made on a cheaper model will likely be lost if constant and expensive repairs are needed to maintain a chair’s ability to perform at its best, let alone the lost business caused by chair down-time. Investing in a dental chair that has renowned reliability will eliminate these unnecessary overheads. It will also provide essential peace of mind; indeed, being able to trust in the reliability of such an important piece of equipment is a factor that simply cannot be overstated.

It’s also important to invest in a chair that can stand the test of time – that’s future proof. Dentistry nowadays is advancing at an astronomical rate, with new innovations appearing on the market on an increasingly regular basis. This makes it very easy for some products to depreciate in value incredibly quickly. Therefore, a chair that can easily be adapted or updated to suit the rapidly changing needs of modern dentistry is a must.

On this basis, it is hard to beat an A-dec dental chair. With a longstanding reputation of unsurpassable quality, A-dec chairs are also easy to refresh and upgrade. They have both the durability to last for years and the flexibility to change when needed. This is something that Dr Wayne Williams, principal of Smile₂0 in Wokingham recently discovered. He says:

“I’ve had my A-dec 500 for 12 years. In fact, I think it was one of the first of this model to be installed in the UK. It’s an incredibly reliable chair – in over the decade I’ve worked with it, I’ve never felt the need to change it. Recently, however, I did make a small change: I had one of the new A-dec LED lights fitted.

“The upgrade process was very easy and it took less than an hour for our A-dec authorised dealer, Marz Dental Equipment Ltd., to come and do the installation. We’re so impressed that we are likely to do the same refreshing upgrade for our other chairs too – and I envisage being able to continue to use them for many years more!”

A-dec focusses on providing the equipment that dentists need to deliver first rate dentistry. Since modern dentists need the ability to be able to adapt to new technologies, techniques and materials, A-dec has worked hard to ensure that they have the products that allows them to do so.

With equipment solutions that allow for easy and innovative upgrades, A-dec has future proofed its chairs, allowing practitioners to change the individual aspects of their chairs to suit their individual needs, across many years of use.

And, indeed, Dr Williams’s example is simply the tip of the iceberg; A-dec chairs are extremely versatile, allowing practitioners to choose precisely the options that compliment their clinical preferences. For instance, another dentist, Dr Patricia Seyf from Seyf Dental in Barnes, has recently purchased an A-dec 500 without a cuspidor. She says: “Having no spittoon makes for a far more hygienic treatment centre. I can autoclave my funnels between each appointment and be completely assured that my surgery is cross-contamination compliant. It also allows me to have a direct, face-to-face conversation with the patient – something which I think is very important for putting them at ease and encouraging a strong patient-practitioner relationship.”

This level of customisation is indispensable. Practitioners can quite literally purchase the dental chair they need at the time – without having to worry about what is coming around the corner, since they also have the option to refresh and upgrade at a later date.

Investing in an A-dec chair is investing in your future in the dental profession. No matter what challenges or changes come about in the years to come, A-dec will continue to provide relevant and applicable options to those dentists aspiring to offer the very best dentistry.

For more information about A-dec Dental UK Ltd, visit

www.a-dec.co.uk or call on 0800 2332 85

Midlands based Theresa Riley has joined cost effective and technology embracing dental payment plan provider – Patient Plan Direct, heading up the company’s business development support in the Midlands. Theresa brings to Patient Plan Direct a huge amount of experience in nurturing practice’s private growth and the implementation and development of private dental plans.

Following an initial career in dental nursing, dental radiography and teaching, Theresa moved into dental corporate management and quickly advanced up the career ladder to run the specialist department within one of the UK’s largest dental corporates. Thereafter, Theresa has held several senior management and business consultancy roles, recently consulting on the design and implementation of a dental plan administration solution, thereafter introducing the plan solution at several practices either converting from NHS to Private or switching their plans from another plan provider.

With regards to her new role, Theresa commented; “I wanted to further expand my knowledge and work within the plan sector, but due to my previous consulting work it just wasn’t possible, so when the opportunity came along to join Patient Plan Direct, the company, role and team seemed the perfect fit. I can’t wait to get started”.

Simon Reynolds, commercial director of Patient Plan Direct explains; “As we continue to evolve and build on our strong reputation as a low cost plan provider offering first-class support, Theresa brings to the mix an unrivalled level of experience and knowledge. Theresa’s skills set will benefit the practices we already work with in further developing and growing their respective dental plans, as well as new practices not already working with Patient Plan Direct who wish to take advantage of maximising the profitability of a dental plan at their practice.”

Theresa added; “I was attracted to joining the Patient Plan Direct team after taking the time to understand more about their service proposition and technology. Patient Plan Direct’s streamlined, practice branded and web based approach to dental plan administration along with the support and advice that is delivered for £1 per patient per month is the right fit for so many practices both clinically, financially and operationally.

“I’m really looking forward to meeting Patient Plan Direct’s existing clients and seeing how I can help them grow their plan patient base further as well as connecting to new clients to see how our solution can benefit their practice whatever their objective; transferring from another plan provider to make significant cost savings, launching a plan for the first time or making a move away from the NHS.”

Patient Plan Direct is a highly cost effective dental plan provider working with over 300 practices nationwide, embracing 21st century web-based technology to offer a sophisticated solution to running practice-branded dental plans. Thanks to an administration fee of £1.00 per patient per month (including worldwide dental A&E cover and VAT), Patient Plan Direct often proves to be 2-3 times more cost effective than working with other plan providers.

Web: www.patientplandirect.co.uk

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.   or  This email address is being protected from spambots. You need JavaScript enabled to view it.

Tel: 08448486888

Following the recent announcement that the US government is withdrawing its recommendation to floss from its dietary guidelines, based on the lack of definitive scientific studies to prove its effectiveness on gum disease and tooth decay, Denplan has shared its response.

“When talking about evidence and studies, it’s important to distinguish between the terms ‘flossing’ and ‘cleaning between teeth’,” says Henry Clover, Chief Dental Officer at Denplan. “Floss, whether it’s tape or string, is only one of the methods to clean between teeth and some studies have shown that traditional floss is not always effective for some people. This is partly due to patients not always being able to use the floss correctly and the fact that a thin piece of floss might only remove a proportion of plaque and food particles between teeth. There is, however, strong evidence* to show that other methods of cleaning between teeth, such as interdental brushes, are highly effective in removing plaque and helping to prevent or treat gum disease.

“Tooth brushing only reaches around 70 percent of tooth surfaces, so if you’re not regularly removing plaque from in between your teeth, there will be bacteria building up and potentially causing problems. This includes an increased risk of gum disease, tooth decay and bad breath.

“It’s vitally important that patients don’t misinterpret the US government’s recent withdrawal of the recommendation to floss as a message that they only need to brush their teeth, and never clean in between them. We would strongly urge patients to follow an evidence-based approach continue to clean between their teeth, as advised by their dental team, using whatever method work best for them, be it floss, interdental brushes or waterpiks.”

*Sources: http://www.ncbi.nlm.nih.gov/pubmed/19820738

                 http://www.ncbi.nlm.nih.gov/pubmed/19138177

About Henry Clover

Henry Clover joined the Professional Services team of Denplan in 1998, having worked as a dentist for 17 years looking after patients’ oral health in his own practice. He now holds the position of Director of Dental Policy at Simplyhealth and is also Chief Dental Officer at Denplan. Henry playing a vital role in Simplyhealth’s Leadership Team and is at the forefront of private dentistry liaising with more than 6,500 member dentists.

About Denplan

Denplan is the UK’s leading dental payment plan specialist, with more than 6,500 member dentists nationwide caring for approximately 1.7 million registered patients. Established in 1986 by two dentists who pioneered the concept of dental payment plans, Denplan has been at the heart of dental care for nearly 30 years and today the company is owned by Simplyhealth. Denplan has a wide range of dental plans for adults and children, enabling patients to budget for their private dental care by spreading the cost through a fixed monthly fee. We support regular attendance and preventive care, reducing the need for clinical intervention and helping patients to maintain healthy teeth and gums for life.

For further information visit www.denplan.co.uk. For oral health tips and advice visit www.myteeth.co.uk. Patient enquiries telephone: 0800 401 402   Dentist enquiries telephone: 0800 328 3223

• Denplan Care: all routine and restorative care + worldwide dental injury and dental emergency cover
• Denplan Essentials: routine care only + worldwide dental injury and dental emergency cover
• Plans for Children: routine and other agreed care + worldwide dental injury and dental emergency cover
• Membership Plan: registered with the dentist + worldwide dental injury and dental emergency cover
• Denplan Emergency: worldwide dental injury and dental emergency cover only
• Company Dental Plans: company funded, voluntary and flexible benefit schemes

Denplan also provides a range of professional services for its member dentists and their practice teams, including the Denplan Quality Programme, Denplan Excel Accreditation Programme and Denplan Training, plus regulatory advice, business and marketing consultancy services and networking opportunities.

For more information about Denplan:

Sara Elliott

Denplan Press Office

Tel: 01962 828 194

This email address is being protected from spambots. You need JavaScript enabled to view it.

Just recently things have been relatively quiet in the area that I usually write about. The GDC seems to have realized the mistakes of the past, and the new executive appears to be making overtures about re-engaging with the profession. Slowly but surely many think there might be a break in the thunderclouds and a glint of sunlight over the profession where our continued regulation is concerned.

One would like to think that there are significant inroads being made by the BDA on our behalf as a result of the regime change at Wimpole Street. However, I think many will doubt this, especially when the GDC themselves have actually questioned who leads our profession.
Surely this is an indictment of the profile of our Trade Union and representative body if those at the regulator have to question whom is actually in charge of dentists? It isn’t the Chief Dental Officer, who is more of an advisor to Government than a figure the profession can rally round. Its definitely not the Head of the GDC. There are many ‘celebrity’ figures in Uk dentistry who give themselves the title of ‘KOL’ (key opinion leaders) but again they are really not the leaders of our profession, often just opinionated souls who have some form of medium through which to express their thoughts (and pictures of their cars!). It’s certainly not organisations like Dental Fusion (or should that be Dental Futile?) and other professional organisations who have very limited memberships.

It really is quite obvious then that it should be the BDA. Whilst there are some strong figures within the organisation, and the work that is done by the employees is excellent, it still seems to suffer from an apparent inertia and lack of awareness as to what it could actually achieve. Whilst it no doubt provides some excellent member services, (such as employment and general advice and the library) it seems to frequently live up to the expectation of the profession as a body that drives really changes.

Take for instance the removal of registrant addresses from the GDC website. I’m pretty sure this has been on the ‘Work in Progress’ list at the BDA for some time. Yet it takes one petition by an individual and the GDC not only look at it, but actually manage somehow to change the entrenched view of Chairman Moyes himself. Now the BDA can say that they have done lots behind the scene, but there’s no use doing this and seemingly not achieving anything, especially if it has been going on for years. To then jump on the bandwagon and claim that the issue being raised by the GDC earlier this year was solely as a result of the BDA exerting pressure (when I happen to know that people at the GDC acknowledge the pressure came from the petition) is a little bit naughty.

The BDA is also the only dental body invited to the table with the DoH when negotiating a new contract. To give an analogy from mother nature; This is a little bit like a seal sitting down with a Great White shark and agreeing on the least painful way of being eaten alive. Evolution has taught many creatures to not get involved too closely with the apex predators, yet the BDA continues its same path in the forlorn hope that one day the shark might have indigestion and the seals won’t get eaten. It will always argue that it is there because of those of its members who haven’t any option other than to be seals and swim in the same sea as the shark. Evolution by supporting other options for these practices has always seemed to be low down on the agenda. Shouldn’t leaders of the seals be telling its members to try to keep away from sharks? Won’t the sharks have to evolve themselves or eventually starve to death?

Another example is the pressure that the BDA should still be putting on the CQC. The CQC has not been the subject of my blog at all in the past, and given the fact that I have been a huge critic of them has surprised even me that they haven’t suffered from my ire yet. Since the appointment of John Milne as their National Advisor there has been a distinct increase in the quality of the inspections generally. There has also been the publication of the ‘Mythbuster’ series of articles on the CQC Website . However, it is apparent that even these can suffer from misinformation. In particular the one regarding radiation protection is riddled with errors that make the further entrenching of incorrect information more likely to be referred to as absolutes when they are not. The fact that these errors might then be referred to by the GDC as the CQC is seen as an authority when charges are brought against a practitioner mean that there can be potential for miscarriages of natural justice.

Whilst there is no intention to mislead, when there is an incorrect interpretation of the legislation, rules, regulations etc. by such as the CQC (who we can argue should be an authority themselves anyhow and shouldn’t make errors like this at all) then the BDA should be swift to bring these errors to the attention of the CQC and more importantly the profession in general. This shouldn’t be in a ‘behind the scenes’ manner, but much more publically. We would then know what they are doing. This is not to embarrass the CQC in any way, but merely to demonstrate the obvious authority the BDA should be seen to have, and command the appropriate respect. Once again these errors were brought to the CQCs attention by an individual.

There is a quite frankly ridiculous amount of legislation that governs the practice of dentistry these days, so much so that it is virtually impossible for individuals to keep on top of all the different aspects of compliance. It is vital therefore that whoever leads our profession has an organizational structure that should know all the things governing and legislating dentistry so intimately that at the first sign of a new urban myth appearing somewhere (and they should be aware of where all these myths originate – looking on GDPUK r Facebook is usually a good place to start) there should be a very public and robust re-affirmation of the real legislative and regulatory situation, and with absolute authority and clarity such that the myth is immediately disproved.

I’m sure we can already hear the cries from the BDA that they already work in this way at the moment for their members, and this is true to a degree, but this is usually in a completely reactive and individual manner, and you usually have to actively seek out this information yourselves. Given the sheer volume of stuff that is out there to comply with it is very simple to get caught up in some of the less controversial urban myths such that they become the new fact, and thus perpetuated more. So you actually have to know something is wrong before you question it, otherwise you will automatically accept it is true and thus it becomes the ‘done thing’ as everyone ends up believing the myth. Just like the obligation to record batch numbers of LA in the notes is a myth.

What about jumping on the incorrect use of standards by Expert Witnesses when these are used in GDC hearings and further entrenched by the rulings? Why hasn’t the BDA produced a definitive standards document regarding an acceptable (not minimum or aspirational) standard that items like a simple dental examination should include, and be recorded in the notes? After all, there is enough expertise within the BDA that a consensus document could be produced simply enough. If it has (and I may have missed it admittedly), why aren’t the Expert Witnesses then referring to a document like this as authority? Why haven’t the Indemnifiers mentioned the existence of a document like this in the defence of colleagues? (and why haven’t the indemnifiers produced one either, perhaps by working with the BDA on it?).

Why haven’t the BDA come down like a ton of bricks very vocally on those LAT’s that transgress or selectively (incorrectly) interpret the regulations? If they have, why haven’t they shamed them so publically so that other LAT’s know they are a force to be reckoned with and won’t try it on with other practitioners?

Finally, what about the headlines in The Times this weekend about (surprise surprise) dentists ripping off the public? There doesn’t seem to have been any attempt by the journalists to even contact the BDA for a comment. Surely one of the first organisations to be approached for comment on a story like this would be the association that is supposed to lead dentists. Or is it that even the press think that a comment from the BDA would be about as strong as a wet tissue? At such a time there should be an automatic and robust defense of the professionals, whilst simultaneously showing the failure of the SYSTEM that they work within, and laying the blame squarely at the door of the DoH and Government.

The BDA really should sometimes show its teeth much more readily (no pun intended). But the only time they have done anything approaching this was the Judicial Review into the ARF in 2014. Even then there didn’t seem to be an ability to press home the victory and hitting the GDC whilst they were still reeling. Rather it seemed to all be ‘behind the scenes’ as usual and waiting for the Health Select Committee to grill Gilvarry and Moyes. Where was the tactical approach of ‘putting the boot’ in when it was most needed?

I will admit that political activism often needs to be done behind closed doors, but we need to know that when this is what we are told is happening, something IS actually being done, rather than just being talked about. The reputation of the BDA is such that many feel it never seems to be achieving anything, and therefore people think that it never does. There are so many issues in dentistry that appear at any time, and the BDA suffers from having to be everything to everyone. But surely there is a common theme amongst all in dentistry that our professional association should be there to lead the way vocally and proactively. Instead it often appears to be more a reactionary organisation with the attitude of ‘mother knows best’.

Well I’m sorry, but given the achievements that individuals have made recently in engaging more successfully than the BDA have, would lead me to suggest far from ‘mother knowing best’, mother is now someone who needs to realize they might actually be past it and new ideas and a new approach are needed.

There are a few vocal people in the BDA, but there are also others who seem to be anonymous and conspicuous by their seeming lack of inspirational leadership. Leadership means setting a visible and vocal example that others can then assist them in taking things forward and more importantly want to take forwards despite the obstacles in the way. It’s certainly not getting behind other people’s crusades and then saying look at what we did to get this done. I know of a good many people within dentistry, many of them household names (and for all the right reasons) who are disillusioned that there is no flag we can rally round as a profession; so much so that groups of like minded individuals are now beginning to draw together in order to do what the BDA should be out there doing.

Which is to Lead the profession.

At the same time, there has to be an acknowledgement of the postion that dentistry is in within the bigger sphere of healthcare. We will never have the public support that the doctors can call on, and we only have to look at the way the Government have played hard-ball with them over the recent contract ‘negotiations’. Lets face reality here. We will not get any concessions, there will be no more money and the conditions will not improve. We have to accept this and move on. The definition of stupid is often said to be doing the same thing over and over again and expecting different results. I think we can quite easily argue the BDA continue to do the same thing over and over again…..

No doubt many of the BDA hierarchy will be offended at this piece; but quite frankly they perhaps need to be. I’m sure there will be suggestions that I should put my money where my mouth is and stand for the PEC. Perhaps they are right. But since I don’t have all the answers I shouldn’t put myself forward as a leader of the profession. But even if I did, the problem with this is that one person will always come up against the establishment, which believes ‘this is the way we’ve always done it’ and ‘we must think of the members’. Paralysis by fear of the unknown results. It would need a radical change to the entire structure and I’m not convinced the more traditionalist members within the BDA would go for that. Open up votes to those disillusioned and no longer members of the BDA then it might be a completely different situation, but then that obviously couldn’t happen.

I’m sure those most annoyed with this blog will be those who have the least reason to be because they probably feel I am not acknowledging the things that the BDA have actually achieved. I’m not having a go at any individuals; but it’s those who wear the BDA badge and don’t do anything vocally, visibly, or productively to manifest change. Being hamstrung by the often archaic position of the trade union often means it is easier to maintain the status quo or just score pyrrhic victories than really trying to elicit the change that is needed.

The recent membership questionnaire is a start to finding out just what members think; the problem is it’s not the members they need to be asking how the BDA can engage more. The very people who are disillusioned with the BDA are not going to be members by definition. Bleating on about joining so your voice can be heard is beginning to wear a bit thin to many of us I’m fairly sure; why join something so you can submit a survey once in a blue moon especially when they refuse to listen to why you might not be a member? It’s a Catch 22 situation that needs to be broken.
 

The BDA needs to ask the ENTIRE profession what it thinks about it. The GDC seems like it is going to try to engage with us as a result of unprecedented problems and the change in executive manpower bringing a fresh look at the issues. If they can do it when constrained by legislation then there is no reason the BDA can’t either.

Its time for the BDA to show just what sort of leaders they really have.

There are so many little things that can impact considerably on our life. The world has recently been subjected to the devastating effects of the tiny Aedes aegypti mosquito that is believed to be responsible for spreading the Zika virus, causing microcephaly in new-born babies. Equally, small gestures such as a friendly smile, a word of encouragement or a genuine ‘thank you’ can lift the spirits and really make a difference to the day. Minor things such as wearing our favourite jumper, having a good belly laugh or getting into a bed with clean sheets, can make a big impact on how we feel. Similarly, by making a slightly different lifestyle choice, taking a different attitude to a matter or discovering a slightly more efficient way of carrying out a task has the potential to make giant strides in our success.

It is not always possible to change or improve some things immediately but by beginning with small manageable activities there is much more chance of achieving bigger targets. Take the marathon runner as an example; most people cannot wake up one morning and decide they will run for 26 miles, they need to begin slowly and gradually to build and develop the stamina they need to run long distance. Another example is when we are faced with never-ending list of little jobs to do. It can soon become overwhelming even though they may not critical. However the completion of just one small task can make us feel a whole lot better. It is the same for dental patients, if they make regular appointments that only take a little time, they can avoid lengthy, more invasive treatments. Dental professionals constantly reinforce oral hygiene instructions because if patients pay attention to these details much larger dental issues can be prevented.

Inflammation of the gums or gingivitis is another case in point. As dental professionals will know, if detected early it can be treated successfully with relatively simple steps before it develops into more serious periodontal disease. When periodontal disease develops however, pockets form between the teeth and gums that collect plaque and rapidly breed perio-pathogenic bacteria. If this is not addressed damage to the supporting tissues can occur and ultimately lead to tooth loss. To treat these cases effectively, practitioners must first perform root surface debridement (RSD) to clear away toxins and often follow this with maintenance therapy to prevent recolonisation. PerioChip^® is an ideal adjunct for this purpose, because although very tiny, is able eliminate a wide spectrum of microbes. PerioChip^® can be placed directly into periodontal pockets of 5mm or deeper and slowly releases chlorhexidine digluconate to eliminate 99% of perio-pathogenic bacteria over 7-10 days.[1] This little chip then continues to suppress the growth of microflora for up to 11 weeks[2] allowing time for pockets to heal and the teeth to stabilise. Clinical studies showed a pocket reduction of more than 2mm in almost three quarters of patients when PerioChip^® was placed every three months in combination with RSD,^[3] which confirms that something very small can make a substantial difference.

PerioChip^® is available exclusively from Dexcel Dental, to order or for further information call 0800 013 2333 or email This email address is being protected from spambots. You need JavaScript enabled to view it.

Summary of product link;

http://www.old.health.gov.il/units/pharmacy/trufot/alonim/PerioChip_dr_1337488974840.pdf

The GDC Specialist Lists were introduced in the UK in 1998 as a result of developments in European Legislation. As of October 2015 of the 40,953 registered dentists there were 4342 registered specialists; an increase of 31 on the previous year. A significant number of patients require specialist dental treatment each year; in 2012/13 approximately 3.5% of all NHS outpatient appointments were in a dental speciality clinic. There is no precise data as to the number of private treatments being carried out by specialists each year, but it is likely to be in the millions.

Whilst the state of the nation’s teeth used to be a cause for international mirth, over the last decade our love affair with cosmetic dentistry has blossomed. Implants are so popular that there are now calls for implant dentistry to be added to the already voluminous list of dental specialities; the UK has more recognised specialities than any other European country. On the face of it specialist dentistry is big business, but for who? Is it the practitioners themselves, or those who provide and regulate the training?

Becoming a Specialist:

One thing is clear, it is hard work. To be entitled to enter onto one of the specialist lists the dentist has to complete a recognised training programme, ranging from three to five years, have a National Training Number (NTN) and to hold the agreed qualification awarded by one of the Royal Colleges. In total there are in the region of 500 specialist trainees each academic year; many of whom do sadly not complete or meet the programme requirements.

It is the GDC who set the standards required for specialist training, approving the curricula and quality assurance. The Joint Committee for Postgraduate Training in Dentistry (JCPTD), through the Royal Colleges and the Specialist Advisory Committees (SACs), is responsible for the development of curricula, devising assessments and examinations and making recommendations to the GDC on specialty training.  The GDC embarked upon a review of the regulation of specialists in 2015; our dental bulletin considering this review can be found here. The second stage of the review began in 2016, and the first results are expected in the autumn. They propose creating a generic template that will serve the basis for all the speciality curricula, bringing a uniformity of language and structure.

The alternative “assessed route” is also under consideration by the GDC. This is where an applicant is required to illustrate to the GDC Specialist List Assessment Team that they have the knowledge and experience derived through academic or research work which they might reasonably be expected to acquire had they completed the specialist training. However, there is limited guidance from the GDC as to what this actually means, the approach to assessments lacks continuity, and applications are routinely returned having been deemed incomplete. Many applicants feel that the only way to ensure success is to seek legal assistance. What is clear is that clinical experience is not evidence of equivalence.

The decision of the GDC not to include clinical experience as admissible evidence is a frustrating one for many, particularly bearing in mind that many dentists were effectively passported onto the lists under the “grandfathering” scheme. This allowed experienced practitioners entrance to their chosen list where they could illustrate that they have the requisite knowledge and experience, wherever acquired. The scheme remained open for two years after the formation of each list. As such it is possible for dentists with no postgraduate qualifications and having passed no exit examination, such as the MRD or equivalent mono specialist exam, to hold the title of specialist.

Is this fair?

Patient safety must be paramount in this argument. The assessment of specialist trainees is so rigorous that members of the public can generally be satisfied that they are receiving treatment from an appropriately qualified dentist.  For those “assessed” or “grandfathered”, there is less clarity as the assessment criteria appears to be reasonably subjective, and dependent upon the assessors view of a paper application rather than any face to face assessment over time.

There are also a limited number of training posts available; and recent attempts by universities outside of the “Big Three”, KCL, The Eastman and Queen Mary’s, to increase supply has been met with some resistance.  The lack of available NTN’s has also frustrated many applicants hoping to enter onto a training post. The Dentists Gold Guide (June 2016) states that the purpose of NTNs is for “Education planning and management” enabling Postgraduate Deans to keep track of trainees and “Workforce information”, to document within each country and speciality how many trainees are in each programme and to provide information as to when training is likely to be completed. There is anecdotal evidence that some dentists working in hospitals and universities can wait years for a training number to become available. Whilst there is a clear advantage to requiring a minimum number of placements to ensure there are sufficient specialists available, it is hard to justify a cap on the maximum. A large number of specialists do not practice in the NHS, and commercial interests will inevitably dominate private practice. An increase in the number of specialists would allow greater freedom of choice and drive down costs for patients. Why not simply maintain competitive entry onto programmes and keep a register of all specialist trainees, doing away with the NTN system in its entirety. Thus removing the lottery of when a number may come up.

The inequality of the playing field for those entering training is another problem. A three to five year, expensive training programme and a limited number of NTNs inevitably means that established practitioners, particularly practice owners, can rarely afford to take the time or money out of running their businesses to undertake the programme. Many of these individuals have been honing particular specialist skills in practice for a decade and simply don’t require extensive clinical training; indeed it is not unheard of for dentists who have limited their practice to a particular area teaching on Masters programmes in their chosen field. They missed the grandfathering window, and can’t afford to have a three year career break, but they can’t rely on their considerable clinical experience to show that they are already practicing at the level of a specialist.

A further disparity arises in relation to European dentists registered in the UK. At present a broader test is applied to European Citizens than is applied to UK dentists, who are assessed on the basis of all their experience, including clinical. So whilst an extremely experienced Spanish endodontist may rely on the number of treatments she has completed in practice, her English equivalent cannot. Although the rules were designed to give individuals coming from European countries, that follow different training pathways and recognise different specialities, an equal playing field, they have arguably ended up allowing European applicants an easier ride. Of course, post Brexit, this may all change.

Looking to the future, what could the GDC do to improve the current position?

1.       They could scrap the assessed route in its entirety. This would ensure uniformity across the specialisms and create a clear quality control of all specialists.

2.       Alternatively they could include clinical experience as a factor in the current assessment process, applying the same equivalence rules to all practitioners, regardless of their origin. This would open up the lists to a vast number of practitioners and has the potential to drive up competition in the fields. However this process would be open to criticism as the assessment process is hugely subjective, and there is no hands-on assessment required.

3.       I would propose a third option. The GDC could create a more structured assessed process; mapping an individual’s experience, both academic, research and clinical, against the specialist training programme, require a minimum number of years PQE and the successful completion of the relevant exit exam for each speciality. There would remain an element of subjectivity of course, but considerably reduced, and a candidate’s ability would be appropriately tested through the examination. 

The GDCs 2015 review talked about “tightening up” the assessed access, but gave no guidance as to how this would be done. They also considered doing away with it in its entirety. That in my view would be a mistake. The assessed route allows diversity and experience that would be lost should all specialists follow the prescribed training programme. It would also unfairly discriminate against older applicants who would not have the years of practice ahead of them to recuperate the considerable costs involved. We wait in anticipation of the results of the next stage of the review, and can only hope that good sense prevails and a fit for purpose assessment route is unveiled.  

Julia Furley is a barrister with a special interest in dentistry. She has assisted and represented a large number of dentists at both the application and appeal stages of their specialist list applications and has an extremely good record of success. If you are interested in applying for entry onto the GDC specialist list you can email Julia on This email address is being protected from spambots. You need JavaScript enabled to view it., or call us on 020 7388 1658.

My understanding is that the GDC do not agree with the criticism that too high a standard is being applied in FtP hearings. As it happens, last month I was asked by a colleague for some concrete examples of use of the ‘gold standard’ by expert witnesses, so I went specifically looking for it in my review of June’s FtP hearings.

June kicked off with a performance review hearing of a plethora of clinical issues involving a non-engaging registrant who had neither attended nor provided any representation at either hearing, which is always a bad move in my opinion. The case was initially heard in May 2015. Professor Morganstein was instructed by the GDC in this case, and is still according to Google the Dean of Dentistry of the University of Buckingham Dental School that I’m not sure has any dental students. There was a fair amount of criticism in the charges levied at instances of alleged failed treatment and inadequate discussions which the panel did not find proved, and when an allegation that the registrant had provided inadequate care by not giving a patient with an orthodontic retainer specific advice on using a fluoride mouthwash, tooth brushing and reducing sugar consumption the determination states that the Committee considered the expert had applied the gold standard rather than that of the reasonable dentist.  This registrant was initially suspended for 12 months and then a further 12 months at the review hearing. The panel had no other choice due to the lack of engagement and attendance in the process and had there been any evidence of insight and remediation the registrant may well have been able to continue practising under conditions. It has been demonstrated in a paper written by Professor Kevin Dalton that registrants who do not attend their hearing and are unrepresented face a significantly higher risk of a high sanction being imposed than those who attend or are represented.

In another review case heard this month the GDC-appointed expert was found by the Committee to appear to be ‘applying a ‘gold standard’ with respect to the diagnostic quality of the radiographs’ at the initial hearing in January 2015. The lesson here is that coned off radiographs are not necessarily poorly-positioned if it is possible to get adequate diagnostic information from them. There is also reference to not recording LA batch numbers and expiry dates in this case which another ‘gold standard’ recording is keeping requirement at best.
Next up a Committee was of the opinion that: ‘in some cases, Mr Expert was advocating a ‘gold standard’.

Some examples of the not proved allegations in this case that probably fit into the ‘gold standard’ bracket included:

• Not recording the clinical process involved to extract a tooth;
• Not taking radiographs that the Committee considered were not actually clinically necessary
• Not providing preventative advice (except that smoking advice was given);
• Not adequately assessing levels of plaque and calculus (recording it is present was alleged to be not enough);
• Not recording appropriate detail as to why crowns required re-cementing (the committee considered this to be self-evident);
• Not recording dietary advice provided (the patient was caries-free).

So there are three cases here providing some evidence that the gold standard is/was being used (and being identified by Committees) in a sample of new and review hearings held only during June 2016. 

The statistics for June were:
Interim Orders held 20 new hearings and 13 review hearings resulting in:

• 7 suspensions or suspension extensions;
• 20 conditions orders or conditions orders extensions;
• 5 no orders;
• 1 conditions order revoked.

Practice committees held 29 new hearings and 4 review hearings resulting in:

• 5 erasures;
• 8 new suspensions, 1 suspension extensions and 1 suspension revoked;
• 1 new condition orders, 1 extension of conditions orders and 1 conditions order raised to a suspension;
• 4 reprimands;
• 4 adjournments;
• 1 not impaired;
• 2 registration appeals (1 dismissed, 1 decision substituted);
• 1 restoration hearing (refused);
• 2 health related hearings with one suspension and 1 set of conditions replaced with a suspension;
• 3 cases of no misconduct/facts found proved do not amount to misconduct.

Per registrant type there were 46 dentists, 7 dental nurses, 11 technicians and 2 clinical dental technicians involved in hearings this month.
June was a bit bare on any interesting charges such as bouncing balls of impression material in corridors, bringing children to work or having untidy hair. However there were a high number of erasures that month, and dental technicians brought in front of a PC or IOC for acting out of scope in June also featured quite heavily.
Briefly, the main reasons for erasure were:

• Not having indemnity over an extended period and forging an indemnity certificate;
• A conviction for fraud and false accounting;
• Having a sexual relationship with a patient, providing free treatment in return for physical contact and dishonestly claiming to be a specialist whilst not on a specialist register;
• Making decisions about treatment plans without informed consent, plus failing to engage (note that the registrant was not present and not represented);
• Working as a hygienist when registered as a dental nurse, plus dishonest behaviour relating to a lack of indemnity and misleading behaviour relating to website material.

With regard to the technicians, pretty much all of these cases related to acting beyond scope; taking impressions when not trained to do so and working without a prescription. This is clearly an area that the GDC are tackling very proactively.
One no misconduct case was particularly interesting in terms of how it ever managed to get so far. It involved a registrant who had sent a letter to some patients of the practice asking for their consent to release their records to the GDC who were investigating a previous partner of the practice over financial irregularities on the basis of concern being reported by the registrant. The letter must have raised a few eyebrows as the GDC alleged that it was:
 

• Designed to convey the impression that the correspondence was sent with the knowledge and consent of the GDC when this was not the case;
• Designed to convey the impression that the correspondence was sent on behalf of the GDC when this was not the case;
• that this was misleading and dishonest;
• By stating in the letter that the colleague was currently the subject of an investigation by the GDC this was failing to treat the colleague fairly and with dignity;
• By failing to inform the staff at the practice about the letter, the team members were not treated fairly and with dignity.

It is worth noting that Dental Protection had provided guidance and advice on this letter before it was sent, and the registrant had not discussed it with the staff in order to protect the integrity of the investigation, yet the case still progressed. The patients ought to have been told why their consent was being sought to hand over copies of their records in my view. So all in all, it appears to me that someone who fulfilled their professional duty to raise a concern and assist in an investigation found themselves on the wrong end of the FtP process by way of thanks. It is not clear to me what the GDC hoped to achieve by bringing this case, and how this will encourage or protect those who may need to raise concerns in the future.

The vast majority of dental practices in the UK have some form of practice management software. It’s important to uses these systems to their full potential in order to truly maximise return on investment.

Organisation for All

It is not unusual for a dental business to operate from several geographical locations. This can create challenges in terms of communication and co-ordination from one site to another. The premium practice management systems currently on the market can easily cater for such situations; they allow “multiple clinic set-ups” meaning information is held on one central system that can be accessed from any approved location.

It is not just multiple sites that can test the effectiveness of communication channels in a business, but also the management of every member of the dental team’s diary. Dental care professionals, treatment co-ordinators, oral health educators and even practice managers are taking on greater responsibilities and so have more duties when it comes to caring for and communicating with patients. It is therefore essential that the practice management software is accessible to the whole dental team and can incorporate each individual’s schedule, whether they be a clinical or non-clinical professional.

Patient Recalls and Communication

Patients are more dental-savvy now than ever before and with greater understanding of the options available come higher expectations and the greater need for clear and effective communication from the professional team.  Many systems allow for patient records to be sent to them via email and with accompanying e-material, such as information leaflets to aide treatment explanations and encourage informed consent. Cutting-edge practice management software can also make the patient recall process run smoothly if fully utilised, with minimal need for user intervention. Once a patient’s communication preference has been selected, the recare cycle can be highly automated helping to improve on revisit frequency.  The patient record will display when the recare appointment has been booked or an alert will be sent when it is due.

Further considerations when choosing a practice management system for your practice might include the reputation of the provider, as well as the training and on-going technical support available for the team. The CS R4+ practice management software from Carestream Dental, for example, offers outstanding customer service alongside all the benefits outlined above, plus the capability of delivering real-time data for highly accurate practice performance analysis. Find out more today.

For more information, contact Carestream Dental on 0800 169 9692 or visit www.carestreamdental.co.uk

For the latest news and updates, follow us on Twitter @CarestreamDentl and Facebook

Did you know that AllMedPro can assist you with any of the following products and services?

• Medical Indemnity Insurance (individuals and vicarious entity cover)
• Practice Insurance (buildings, contents, public & employers liability)
• Practice Overheads / Locum Cover
• Online Dental CPD & Document Resource Library
• Pressure Vessel Inspection Cover
• Property Owners Insurance (buy-to-let, holiday home, unoccupied)
• Home Insurance
• Hands & Eyes Insurance
• Directors & Officers Liability Insurance
• Dental Laboratories (including products liability)
• Aesthetics Medical Indemnity Insurance
• Private Medical Insurance
• Travel Insurance

We can also refer you to one of our specialist partner firms for:

• Financial Advice
• Legal Services
• Accountancy Services
• Practice Sales
• Patient Payment Plans

Just pick up the phone and give us a call to discuss any other insurance requirements you may have on 01793 820100

or email us on This email address is being protected from spambots. You need JavaScript enabled to view it..

Top tips for finance

As the demand for high end, elective dentistry increases, so too does the importance of providing suitable finance options to your patients. Unfortunately, doing so is not necessarily a simple process – so here are a few helpful tips to help take the stress out of consumer credit.

#1 – Secure FCA authorisation

As of April 2014, the Financial Conduct Authority (FCA) took over the provision and management of consumer credit from the Office of Fair Trading. Now, it is mandatory that any institution that wishes to offer a deferred payment scheme is authorised by the FCA – which stringently upholds the guidelines that have been set out in the Consumer Credit Act. These rules apply unequivocally to all businesses and individuals who wish to offer any form of consumer credit, even if the treatment is ongoing.

#2 – Don’t try to do it yourself

The process of applying directly to the FCA in order to become fully authorised to offer consumer credit can be a complicated and drawn-out task. Not only are there many regulatory matters to tend to, but there are also regular reports that need to be sent and ongoing compliance factors that must be constantly addressed. This would, of course, be on top of the other administrative duties that a practice owner must account for.

As such, it might be wiser to look for providers that have been granted full permission to act as a Principal Firm and are in the position to authorise and manage a practice as an Appointed Representative on their behalf. From a legal perspective, and as a general guideline, the chosen financial provider should be able to:

• apply for and complete all FCA regulatory reports that must be made
• issue regulations and procedures designed to prevent any non-compliance
• carry the liability if anything goes wrong

#3 – Careful advertising

When advertising their new finance options to the public, practice owners must be particularly careful to comply with the FCA’s regulations in regards to financial promotions. Whether it’s in print or online, the FCA oversees all advertising with a great deal of scrutiny, to ensure that there are no misleading financial adverts on display, and that they comply with all of the rules.

To ensure this does not happen, it is worth working with a financial provider who fully understands the ins and outs of financial advertising – one who can ensure that all documentation and promotional materials are compliant before publication. Not only will this save time, but it will also help ensure full compliance.

#4 – Talk to the experts

Dental professionals are already busy enough without having to deal with the extra pressures and legal responsibilities inherent in patient finance. An easier option would be to give the matter to a team of experts who can manage the whole process on their behalf, securely and safely – so professionals can concentrate on providing nothing but the very highest quality dentistry to their patients.

As one of the UK’s leading providers of finance to dental practices, Chrysalis Finance is the ideal solution for you. Contact the team today to find out just how they could help arrange simple and secure patient finance.

For more information about Chrysalis Finance call us on 0333 32 32 230 or visit www.chrysalisfinance.com

As you all disappear on your long errant holidays – take note.

Finally the GDC have issued a small puff of white smoke from their chimney in Wimpole Street.

After much personal hard work by our colleague Dr Vicky Holden, and an uncertain amount of work by our representative body at the other end of Wimpole Street, the Council of the GDC voted to remove all address details from their on line register.  60,000 mainly female DCPs will I suspect be mightily relieved.  20,000 odd female dentists will rest a little easier.

If you have not been on the end of unwanted attention, it can be many things. Embarrassing … alarming … irritating … flattering …  laughable …  but worst of all of course is when it becomes frightening … perhaps even sinister.

Many of us will have had nurse as employees who find themselves on the receiving end of unwanted attention from some admirer- in-waiting.  Some of us may have even had to step in on occasion

How the previous CEO of the GDC even thought there was any justification in the first place remains a mystery.  But then the workings of the previous CEO were a mystery of course.

Our patients are entitled to know we are registered. In fact 99% of them assume we are.

Perhaps we should put our GDC Number on all correspondence … estimates, invoices, letters etc. I know many do. It’s not a secret.

But it is right that patients with ulterior motives should not be able to pursue an alternative and unwanted agenda.

So hats off to our GDC.  Of course you might ask why the Council did not do this 2 years ago when it still scorchingly obvious to anyone with half a brain that the matter needed addressing, so to speak.

The Council

This episode suggests that the new senior executive management at the GDC are quite different. There is a sense that their agenda may well be one we could subscribe to.

But perhaps this whole ‘address’ saga says more about the Council. It was those 12 Members, 6 of whom are Registrants, who ducked the issue 2 years ago.

It rather confirms in my mind that we have a better Executive in place at the GDC but we still lack a strong Council who will do the right thing at the right time.

Ah yes ...  that brings me to ‘ole Billy boy.  The Old Guard still sitting in that position at the middle of the table I see. Still writing twaddle-blogs! 

Good job he has been able to keep his address secret all these last few years what with all the FtP debacle!!  Perhaps we can look forward to a new method addressing Dr Moyes in the near future:  The Former Chairman …  Then we might see some real changes.

Have a great holiday. May your sun shine on your upturned cheeks!

Riz Akhtar, Co- Founder of dental specialists RA Accountants, has begun training for the marathon of his life - a seven-day, 250km footrace across the Atacama Desert in an aim to raise charitable funds for Bridge2Aid.

Taking place from 2-8 October this year, the 4deserts Atacama Crossing Challenge is a 250km race which crosses Atacama Desert, around San Pedro de Atacama in Chile. Riz will face 6-stages in seven days with almost four Marathons in four days, then 74 km and a final stage of 11 km.

As one of the few deserts on Earth that doesn’t receive any rain, Atacama is a plateau in South America, covering a 600-mile (1,000 km) strip of land on the Pacific coast of South America, west of the beautiful Andes Mountains. Whilst the desert has an awe-inspiring and unique landscape of salt lakes, volcanoes, lava flows and sand dunes, it is fifty-times dryer than Death Valley. He will have to endure unpredictable terrain, harsh climate and an altitude that averages at 2,500 meters (8,000 feet).

The one-week challenge is self-supported, which means he will have to carry his clothes, sleeping bag, mandatory equipment, medical/safety kit and seven days’ worth of food in his backpack whilst journeying across the desert.

Noting his decision on Bridge2Aid as the chosen charity Riz, he said,

“I have always admired the work that Bridge2Aid have done through the years and it is remarkable how they have made a huge impact on individuals especially through the act of educating and training.”

Bridge2Aid aims to free communities in the developing world from chronic pain by teaching vital new skills to rural health workers. Over 70% of the world has no access to any form of safe treatment for oral diseases and infections. People are abandoned to agony for months and years. They face life-threatening infections and pain that is so severe that they cannot work, go to school or feed their families. The charity’s aim is to provide a unique solution by providing intensive practical training to existing in emergency dental skills to treat and educate. 

Not a newbie to marathons, Riz previously completed the six day and six stage 250km 4Deserts Gobi challenge run across China’s eastern province of Xinjiang last year, in line with the launch of RA Accountants charity RA Foundation.

Stay updated with Riz’ progress and journey in October by searching #RAforB2A on Twitter and Facebook. For more information or to sponsor Riz Akhtar on his 4Deserts Atacama October challenge visit:

http://www.justgiving.com/RAforB2A

www.raaccountants.com

Systems for Dentists, leading UK dental practice management software specialists are breaking new ground as the first dental practice management software company to gain accreditation in Scotland for use of their Wireless Signature Pad technology in Scotland as a replacement of the paper GP17pr form.

The enterprising company are delighted to offer the solution to their rapidly expanding client base.

The accreditation allows Systems for Dentists to release the product for live use to dental practices from today, the 28^th of July 2016. That’s fantastic news for Dentists in Scotland who will now officially be able to use the technology to capture patient signatures electronically as acceptable evidence of a patient’s status for payment toward NHS treatment, willingness to have treatment and confirmation that they have received dental treatment under the NHS in Scotland.

Ryszard Jurowski Managing Director said today:

“We have been involved in this innovation from the very beginning, having assisted with the piloting of electronic signatures for this function. Many of our clients have been excited about finally being free of copious amount of paper, costly and time-consuming filing processes; which with our system, they can now replace with an efficient, robust and secure solution. I am delighted to be able to offer our clients this extra service, and look forward to hearing more success stories from our current and future clients.”

In addition to their Wireless Signature Pad, Systems for Dentists offer a fully featured and agile dental practice management system, which offers clients the benefits of reducing administration times, providing the perfect operational platform to assist accurate claiming of NHS Dental charges and increase dental practice productivity.

For further information contact:

Nathan Ross at Systems for Dentists

This email address is being protected from spambots. You need JavaScript enabled to view it.

Direct line; 0845 643 2828

The British Dental Industry Association (BDIA) has produced a post-Brexit manifesto, ‘Shaping the Future,’ which sets out the industry’s views on how government should positively influence the future for oral health, dentistry and the dental industry.

BDIA Policy and Public Affairs Director, Edmund Proffitt, comments, “There is a window of opportunity for the dental industry to share its positive vision for the future with key politicians, civil servants and decision makers. If Government can build the right regulatory environment and provide targeted investment in oral health it can make a significant contribution to protecting the UK’s oral health for years to come”.

‘Shaping the Future’ concentrates on six key areas:

-          Creating a favourable business environment

-          Investment in the nation’s oral health

-          Protecting patients

-          Investment in the NHS

-          Building a better future

-          Championing innovation

‘Shaping the Future’ is being circulated to key opinion formers within Government, political parties and the Government departments, as well senior civil servants, the NHS and other key opinion formers.

The document can be viewed here. 

Nils Bohr was a Danish hero who received the Nobel Prize for Physics in 1922. The national brewer, Carlsberg, built Bohr a house. The home was next door to the brewery and allegedly had a direct feed from it, he fathered six children thus providing an early inspiration for the Carlsberg “refreshing the parts” adverts.

He once said, “Prediction is very difficult especially when it’s about the future.” Difficult or not I’m going to look at the future for young dentists in (general) Dental Practice.

It would be wrong to stare into the crystal ball without a quick glance over my shoulder. A sage told me in 1988 that in the future in the UK, “There will be NHS clinics and Private Practices”. With hindsight I’m surprised it took so long to get to where we are now.

Post Brexit, one big hitter remaining in-post is the Health Secretary Jeremy Hunt. There is still no money. The UK doesn’t care what Europe thinks of it, I know, but sometimes you hear the truth. A medic on Irish radio this week said, “The Tories don't like the NHS and Jeremy Hunt is doing his best to dismantle the basic principles of it”. In dentistry many of those basic principles are long gone and the remaining ones are being eroded as we watch.

No more money for education either. University fees and associated living costs are on the rise. Without free movement across borders in the future, university incomes from overseas may fall and UK student fees must rise accordingly. Dentistry is one of the most expensive courses to run, why not make the fees reflect those costs? Dentistry may well become the domain of the privileged, whose parents can afford to subsidise their offspring or arrange the loans for them.

With the recent relaxation of University status perhaps “a large corporate” could create or take over one or more of the Dental Schools to provide cadetships. The armed services have done this for many years. Five undergraduate years in receipt of a bursary and the tuition fees paid. The opportunity for vacation work/internships getting experience of all sorts at flagship practices and the indoctrination / assimilation becomes complete. Post-qualification you commit to, say, 10 years of service or have to repay their investment.

It is possible with this model that corporate dentistry can provide the closest thing to a career structure in general practice, something that the NHS has failed to do and significantly prevented private practice from doing.

The status of NHS associates does not bear close examination. In England and Wales there are fixed targets. Countrywide, associates do not provide their own equipment, are not directly responsible for marketing, wages, materials and so on and by any stretch of the imagination cannot retain the privilege of being self employed for much longer.

A quick flick of the pen by someone senior at HMRC would convert the status of associates to salaried employees. This might be welcomed by many dentists, young and old, especially those who have responsibility for childcare or who have spouses or partners who are in reasonably rewarded jobs.

Time and attitudes have changed and full ownership or traditional partnerships aren’t for everyone. The baby boomers who qualified before compulsory VT/FD and are now the (predominantly) male/pale/stale retiring on the proceeds of the corporate cash which many once derided. They may well be the last of their species.

Many young dentists look at the price of practices, the bureaucracy and the day to day pressure of practice ownership and decide that is not for them. The NHS has evolved into “turn up, get your UDAs, keep your nose clean from the GDC & CQC and go home”. Sounds like a job to me - not a vocation. The millennials are, allegedly, not keen on being tied to one particular practice.

In 2015-16 the admission target, for English dental schools only, was 809, presuming a 10% drop out rate and excluding overseas students there will be another 700 new dentists joining the ranks of the profession year on year. Of these about two-thirds will be female. At present the profession’s mix is 50-50 but it’s a fact that women work less than men over the course of a career, men don’t have babies and predominantly childcare duties fall to mothers not fathers.

This trend started with medicine and has had a profound effect both in   general and hospital practice. Interestingly the sex-mix pendulum has swung back in some medical schools.

One reaction with medical GPs is the change in status in response to the difficulty in recruiting partners by expanding the number of salaried doctors.  The government sees this as easier to control and privatise. Those GPs in favour of becoming salaried has now reached nearly 30%, nowhere near a majority but significant numbers are beginning to think the unthinkable.

In my last piece for GDPUK I wrote, “Meanwhile many quiet, thoughtful young dentists are taking a long view and working at their skills.” They are realising that to escape the mire of the NHS demands a commitment to growing themselves and that the sacrifices don’t stop with a BDS. In fact the years of serious dedication are just starting.

So the future, NHS clinics run by a handful of large corporates with salaried dentists and therapists, and private practices where an M.Sc is the starting point for consideration.

Your choice.

BioHorizons is proud to announce that, Ken O’Brien, General Manager for the UK & Ireland, has raised over £3,200 by cycling from Malin Head ? Ireland’s most northerly point ? to Mizen Head in the south, in support of DKMS, an international charity dedicated to the fight against blood cancer.

Ken’s fiancée’s father sadly passed away from mantle cell non Hodgkin Lymphoma. His bravery spurred Ken on to raise awareness of blood cancer and to increase understanding of the need for stem cell donors On average, 72 people are diagnosed with blood cancer every day in the UK. What’s more, 2,000 people per year need a donor and only 50% of them will find a suitable match. If you can, please spread the message about stem cell donation among your colleagues, friends and families.

To make a donation, please go to https://www.justgiving.com/fundraising/Phelim-Shields. Ken, his fiancée Roisin Shields and DKMS would like to thank everyone for their kind support and donations. For further information, please visit www.dkms.org.uk or www.biohorizons.com. 

Denplan encourages families to Brush-Up this summer

For a second year, Denplan is running ‘The Big Summer Brush-Up’ to encourage families to make the most of the summer holidays to visit the dentist and spend time practising brushing techniques with their children. The national PR campaign is running for two months throughout July and August and Denplan is encouraging member practices to take part. This year, the PR campaign also features the inspiring Katie Piper, who will act as the campaign’s celebrity Mum ambassador.

A survey of parents of children aged 1-11 from Denplan, has revealed that almost a third (30%) of parents think that it is acceptable for a child to have experienced tooth decay before they have reached their teenage years[1].

According to the survey many parents try a multitude of methods to help their children manage their oral health effectively. However, 30% of parents surveyed stated that they think it is acceptable for a child to develop tooth decay due to the difficulty in controlling how effectively they clean their teeth on a daily basis.

Difficulties regulating children’s sugar consumption was also cited as a reason why many parents now accept tooth decay. Over a quarter (26%) of parents surveyed admit this with a further 29% of parents surveyed believing that potentially painful oral health conditions, such as tooth decay, are pre-determined by a family history of oral health complaints and weak teeth.

Worryingly, more than 1 in 10 parents (14%) claim that they think that decay in children’s teeth is acceptable as all children will inevitably lose their milk teeth as they develop.

These statistics come as the government announced plans to introduce a sugar tax on the soft drinks industry, due to come into effect by 2018. Denplan’s research suggests that the tax could be warmly welcomed by parents with almost half (45%) of parents surveyed claiming that they believe that tooth decay can be prevented by limiting the amount of sugar in a child's diet. A further 40% of parents believe that tooth decay can be prevented by ensuring that children regularly see their dentist for a check-up. Despite this, when asked what actions they take to prevent their child developing decay just 1 in 5 (18%) of parents said that they take their child to see the dentist once a year as soon as their first tooth appears.

Henry Clover, Chief Dental Officer at Denplan comments: “As the poor state of children’s oral health continues to dominate the headlines, and dental caries continues to be one of the most common chronic (but also largely preventable) diseases in UK children, Denplan will continue to champion improvements in children’s oral health. 

“Whilst parents have the best of intentions with their children’s dental health, the research shows that it can be hard for parents to keep up good habits amongst a backdrop of hidden sugars in our food and drinks and children’s reluctance to follow a good oral health routine. Denplan’s Big Summer Brush-Up campaign, along with the accompanying materials Denplan has produced has been created to help practices support and guide families on their oral healthcare.  Providing the right advice and encouragement from an early age or even from when a child’s first tooth appears, could make a lifetime of difference when it comes to their oral health.”

Denplan’s ‘Little Book of Healthy Smiles’ has been produced, containing handy advice from dentists and tips on how to enthuse unwilling children to brush up on cleaning teeth, written for parents by parents. For further information and downloadable content such as a brushing chart and the Little Book of Healthy Smiles visit www.bigsummerbrushup.co.uk.

In this blog we look at two recent cases, one before the Fitness to Practice Committee of the GDC and one before the Health, Education and Social Care first tier Tribunal (‘HESC Tribunal’), and consider what lessons dental practitioners can learn from them.

Darfoor –Fitness to Practice Hearing  

Dr Darfoor, a dentist, was before the Professional Conduct Committee (PCC) on 18^th January 2016. The allegations against him concerned the treatment of three patients during the period 2011 to 2014. The charges against Dr Darfoor ran over three pages of the judgment and included allegations of failing to adequately explain and/or record explaining to the patients the treatment they were to receive and thus failing to obtain consent.

The most serious allegation against Dr Darfoor was an allegation that he had failed to obtain consent and was dishonest in his failure to do so. It is this allegation we are going to focus on in this article.  

Dr Darfoor was carrying out treatment on Patient C for composite restorations and bone grafting. Dr Darfoor informed Patient C that the bone would be “synthetic”. In fact the bone was xenograft, which as you all know is bovine derived. Dr Darfoor had made the same assertion to Patient B, however, what made this allegation against Patient C more serious was the dishonesty element. Patient C had informed Dr Darfoor on a couple of occasions that he was a vegetarian and would not want animal products to be used on him.

Dr Darfoor denied knowing Patient C was a vegetarian but the Fitness to Practice Committee found that he did know this but went ahead with the procedure using xenograft in any event. The allegation of dishonestly failing to obtain consent was therefore found to be proven.

On 22^nd April 2016 the Fitness to Practice Committee was reconvened to consider if Dr Darfoor’s fitness to practice was impaired as a result of his dishonesty. Dr Darfoor had previously been before the GDC before in relation to allegations of failing to obtain consent and this factor was taken into account. The Fitness to Practice Committee determined that Dr Darfoor’s fitness to practice was impaired and he was suspended for 12 months.

Every dentist knows the importance of obtaining consent from a patient. In Issue 5 of our Dental Bulletin we set out the legal issues surrounding consent.  Essentially, in order for consent to be valid it must be given voluntarily and freely, by an informed person and by a person who has capacity to give consent. In the recent case of Montgomery the court put a greater burden on dentists when obtaining consent in that it held a medical professional will need to look at what a reasonable person in the patient’s position would consider was a material risk and this places a duty on the medical professional to advise on that material risk. Therefore if the dentist has knowledge of a patient’s wishes or beliefs he must take this into account when providing information as to the procedure that is being undertaken.

Dr Darfoor had also failed to provide Patient C with other information about his treatment. However, it was the knowledge of Patient C’s vegetarianism and his failure to inform the patient he was using animal material that made his actions dishonest.

This case highlights the importance of ensuring you have an open and frank discussion with patients about the treatment you are providing. Make sure you listen to any concerns or queries raised by the patient, as this could affect the information you provide to them. Dr Darfoor also failed to keep adequate notes. Therefore, if a patient does raise an issue, make sure this is in your notes along with any advice you have provided in response and the patient’s final decision. 

If you would like to read the judgment in full you can find it here.

Mr Corney and Mrs Webb v CQC

This is an interesting case, in which the CQC’s decision to cancel registration was challenged at the HESC Tribunal. It highlights that the CQC’s decision is not final and can be reviewed by an independent body.

However, we would not recommend following the path of Mr Corney and Mrs Webb when deciding if you should challenge the findings of an inspection report.

The couple purchased a care home in 1994 and described their philosophy of care as being based on the ‘European Style’, which they say meant living in the home with the residents and caring for them as if they were their relatives.

The home registered with the CQC in October 2010. Between January 2013 and April 2015 there were six inspections carried out. Each recorded a finding of ‘inadequate.’ In fact on the last visit by the CQC the couple and staff refused to speak to the inspector or show him any documentation; his visit lasted 17 minutes! If only all inspections were that quick. In August 2015 the CQC issued a notice of proposal to cancel registration.

In addition to the action taken by the CQC, in November 2013 Dorset County Council ceased to commission the care home due to safeguarding concerns they had with the home.

Mr Corney gave evidence on behalf of the couple. He was adamant that the findings of the CQC were wrong but produced no additional or expert evidence to support his case. He maintained throughout that the CQC and the local council were working together to shut his business down. The couple failed to make any changes to their practices or procedures despite having clear recommendations from the CQC.

The HESC Tribunal found that the couple were unwilling to change and to keep up to date with current standards and regulation. They went so far as to say ‘Mr Corney also has an unmoveable conviction that he is right.’ The cancellation of registration was therefore upheld. The full judgment can be found here.

We consider this is a rare case; most providers when issued with an inadequate report will do all they can to improve standards. Not wait for a further five inspections to take place. However, what it does highlight is that if you can challenge the CQC’s findings, with say additional or expert evidence, you can pursue the matter via the HESC Tribunal.

It also shows the importance of accepting where errors may have been made and looking to improve on standards or change procedures. Mr Corney clearly did not like change and we consider this factor and his failure to work with the CQC played a part in the removal of the couple’s registration.

We would comment that with the new regime for inspection that came into force last year for dentists, there is less of a focus on a ‘tick box’ exercise.  Inspectors have five key questions to consider and should be taking into account all relevant factors when assessing if the regulations have been met. 

Image credit -Tori Rector under CC licence - 

The Campbell Academy Directors – Colin Campbell and Andrew Legg

The first two members of the faculty to introduce are myself Colin Campbell and Andrew Legg.

Andrew has worked with me at the practice for the past four and a half years and has been an inspiration and an exceptional clinician providing superb treatment for our patients. He has embarked on a teaching career previously with Tipton Training and other independent providers and is now my Co-Director at The Campbell Academy. He has placed and restored thousands of dental implants from the most straightforward cases to the most complex and has a gentle skill of teaching which I have seen rarely in anyone else.

For my own part, my practice is limited to surgical implant dentistry. I am a Specialist in Oral Surgery with considerable experience within the ITI and the Leadership of the ITI within the UK. I have placed in the region of 4,000 dental implants and have restored approximately 1,000. I have been teaching in implant dentistry since 2000.

I have been the architect and designer of many implant courses previously for other organisations and now The Campbell Academy takes a considerable amount of my time in providing implant and dental education the way I think it should be done.

Michael Bornstein

I have blogged about Michael Bornstein on many occasions and Michael already teaches on The Campbell Academy CBCT course where he has generally been fantastically accepted as he was when he provided an ITI Study Club and Master Class for us in 2014.

It is a delight that Michael has agreed to come back to discuss imaging in implant dentistry and medical conditions and he will provide an exceptional level of teaching for people entering into implant dentistry, the like of which they would only usually get at Congresses in implant dentistry.

Colin Burns

Colin Burns and I have known each other for a considerable period of time having grown up in the same town in Scotland and we went to the same school. We also went to the same dental school although Colin was a few years ahead of me and then our paths crossed again on a course on implant dentistry some years ago.

Colin and I sat together on the Leadership Team of the ITI UK & Ireland Section where Colin is still the Study Club Co-Ordinator and he has an MSc in Implant Dentistry from the University of Warwick specialising in surface technology.

Colin is a fantastic clinician and a compassionate provider whose teaching skills are second to none. He has the ability to pass on concepts and ideas in a non-threatening, caring way and is a huge asset to The Campbell Academy. It is a huge privilege for us to work with him over the coming years.

Neil Poyser

Neil Poyser is one of our clinicians at The Campbell Clinic. Neil is a Consultant Restorative Dentist who will be providing the vast majority of the restorative component of The Year Implant Course. He has been placing and restoring implants for well over a decade from straightforward cases to huge complex cases in his head and neck service at Queens Medical Centre.

Chris Barrow

We will not overlook the need to be able to source and secure patients within your practice environment and to this end we have brought in one of the best known names in marketing in dentistry, Chris Barrow.

Chris has been active as a consultant, trainer and coach to the UK dental profession for over 22 years. His main focus now is on 7connections, a privately-owned company that provides coaching and mentorship in independent dentistry and also provides Lifecycle Marketing training and support services to clients.

Beatriz Sanchez

Beatriz is one of our dentists at the practice who is soon to finish her MSc in implant dentistry at the University of Central Lancashire. We feel it adds a great balance and roundness to the course to have younger speakers and younger members of the faculty.

For more information please contact:

0115 9823 919

This email address is being protected from spambots. You need JavaScript enabled to view it.

www.campbellacademy.co.uk

In May we launched the 2017 Year Implant Course. I guess it’s interesting that we get the opportunity to talk about ‘features and benefits’ which is real sales talk in an Alec Baldwin style. I guess though, if you want a list of features and benefits they are here and if you want to talk to us then our details are below.

What the course is:

1. A high quality introduction to straightforward implant dentistry provided by people with a passion for education.

2. An interactive, fluid, movable programme which responds to the needs of individuals to let them reach their greatest potential after one year.

3. A course which encourages online collaboration and discussion between delegates in between course modules to learn as much as possible.

4. A course which is heaped full of hands on and practical elements to get you better at basic surgical skills and into implant placement as soon as possible.

5. A course which is inextricably linked to mentoring and has a long term view of the five years it takes to become a fifty implants per year practitioner.

6. A course which is linked into a programme of more advanced courses afterwards, a mentoring scheme and contact with a group of people who want you to be better at implant dentistry and want you to provide ethical, honest, high quality implant dentistry for your patients.

7. The course is 12 days of lectures, discussion, practicals, thought provoking interaction, live hands on surgery on patients prepared by you and us and demonstrations.

What the course isn’t:

1. It’s not quick.

2. It’s not cheap.

3. It doesn’t tell you that after one year you will be able to place as many implants as you want on as many people as you want safely without any difficulties.

4. It’s not stack ‘em high and price ‘em low – it’s restricted to twelve people.

5. It’s not one guy talking at you all the time; it’s a host of individual high quality lecturers with different perspectives.

6. It’s not multi system, it’s based around the Straumann Dental Implant System. We strongly believe that if we teach you more than one system it may confuse you and you may have difficulty picking things up.

7. It’s not in London.

For more information please contact:

0115 9823 919

This email address is being protected from spambots. You need JavaScript enabled to view it.

www.campbellacademy.co.uk

The Year Implant Course is our blue ribbon course that is the top of the tree for us (at the present time). Our aim is to take ethical and competent dental practitioners and guide them on a path of development in implant dentistry to safely and confidently place fifty implants per year, year on year.

There is a pathway required to get to this, both in academic study and practical application and we hope to be able to set people on the right path after one year but not lose them in the crown afterwards. We keep in touch though various courses, activities and events which will see the vast majority of attendees though to the goal listed above.

Ours is not a short term, intensive, quick fix to get you into implant dentistry. If you’re looking for that you can find it in hundreds of different places and spend your money there. Ours is a course for grown up people who are open to discussion and development, who are thirsty to learn and have their patients best interests at heart. People who ‘graduate’ from this course will do well in implant dentistry, both spiritually and economically in the years to come.

Ours is not a programme that is set in stone, it’s small group teaching and we take on board the individual requirements. Ours is course where you continually discuss and share cases and experiences on our online discussion forum. We have a Spotify play list for the course.

You will likely make friends on the course that you will stay in contact with for many years to come and share the implant journey going forwards, certainly we hope you’ll do the same with us at The Campbell Academy.

Incidentally we would like you to bring your existing friends too – if you book as a pair your get 10% off and if you book as a four you get 20% off. People who know each other on courses are much more relaxed and learn better.

To download our NEW digital The Year Implant brochure please visit our website and  share this with anyone who might fit the profile of someone who wants to learn and be part of the next generation of implant dentists in the UK.

For more information or to book a place please contact:

0115 9823919    

 This email address is being protected from spambots. You need JavaScript enabled to view it.           www.campbellacademy.co.uk 

Now is the perfect time to take part in the NHS Confidence Monitor, organised by Practice Plan, offering all dental professionals the opportunity to communicate their views on the future of NHS dentistry.

Have you ever wondered what effect your responses to the survey may have on the future of dentistry? The truth is that the significance of having your say has never been plainer, with the GDC now taking notice of respondents’ confidence levels in NHS dentistry.

At a GDC meeting in June, it was duly noted on the agenda that, as a result of the Monitor’s results thus far, the GDC needs to consider the evidence of stress among dental professionals, the implications of this on morale among the profession and how the GDC should respond to these trends.*   

With this kind of proactive response from such a powerful governing body, it is more important than ever before that all dental team members – irrespective of whether they work in the NHS or private sector – have their say.

Commenting on the survey, dentist Judith Husband, a participant of Practice Plan’s Insights Panel, which meets to discuss each survey’s results, and a member of the BDA’s Principal Executive Committee, said: ‘As the first of its kind in the UK and leading the way in informing the dental team, it is wonderful that we are now in a position to use the data gathered to offer advice on a continuing basis, helping everyone working in dental practice to rise above any perceived challenges and improve the situation for professionals and patients alike.’

To take part in the latest NHS Confidence Monitor and share your thoughts, please visit https://www.surveymonkey.com/r/PracticePlanNHSConfidenceMonitor4 before the closing date of 31st July 2016. The survey should take approximately three minutes of your time.

For detailed results from the last three surveys, visit www.nhsdentistryinsights.co.uk. Here you can also access the discussions from our previous Insights Panel, made up of key opinion leaders and experts from the dental profession who explore and debate the significance of the survey results and their implications for the future of the NHS.

* For full details visit http://bit.ly/29be2vS (see page 12, item 62).

In 2015 the dental implant market slowed to an overall growth of around 4% across the four biggest implant companies. The market appears to be consolidating at present and there are several possible reasons for this:-

1.     The level of litigation and fitness to practice cases has risen exponentially over recent years resulting in many practitioners treading with increasing caution over the treatment they provide.

2.    The implant market is forever being diluted by the number of companies selling implants. 

3.    Delegates on implant courses are leaving courses and not continuing the journey into surgery in practice. Industry figures quote up to 90% of surgical course delegates not going any further in placing implants in practice.

The philosophy at The Campbell Academy is to set delegates on a 5 year pathway to competency in implant dentistry. We have set a target of 90% of our delegates continuing to place implants after they have left one of our courses. Whether it be the three day Live Skills introduction course or our Year Implant course we have the infrastructure to support delegates as they develop their implant careers.

We work with Straumann, one of the biggest and most researched implant manufacturers in the world. Incidentally they experienced 10%+ growth in 2015, outperforming the other big companies! They provide amazing support to both The Academy and our course delegates and are instrumental in getting new implant dentists set up in their own practices.

Alongside our implant partners, Straumann, we have been instrumental in the formation of The Straumann Clinical Mentoring scheme. All our delegates will automatically feed into this scheme and be linked with a local mentor who will continue the journey they start with The Campbell Academy.

The philosophy and infrastructure that we have in place at The Campbell Academy will mean that a slowdown in implant growth is less likely to affect delegates who have set off on the right track from the outset.

For more information or to book a place please contact:

0115 9823919

 This email address is being protected from spambots. You need JavaScript enabled to view it.           www.campbellacademy.co.uk

So…
Two weeks after our vote, give or take and it has been an interesting period to put it mildly.
If you voted Leave, it has been quite hard to lean on the positive, but that is changing. The FTSE 100 is back up, the ‘250 is trailing but improving, and while the Pound has taken a hit, many would argue that has been a trend waiting to happen. Despite Mr Osborne using this week as an excuse to drop his 2020 Deficit promise, the fact is he was a million miles off the mark BEFORE the vote. And then there are the personalities and the power broking.

Non, je ne regrette rien
As a GDP who voted ‘Leave’, do I have regrets? No. Perhaps in future, politicians will take their people seriously instead of overriding our worries with their ‘we know best’ soft speak.
Viz, Mr Cameron, who failed to take Referendum matter seriously enough to have a plan in place, it appears. Similarly, I am surprised to say, the Leave leadership who I suspect were as surprised as the PM that the vote went 52%:48%
I did suggest that it would be a revolution and I do think that is exactly what has happened. About time too, many might suggest.

So what has changed?
Nothing, in the next two years and in reality some greater time than that actually changes. We remain in the EU bound by EU Treaties and Law, making our payments and presumably supplying our MEPs
Now call me cynical.
No sooner had the count been completed than the EU declared that Mr Cameron’s ‘EU Deal’ negotiated in February was declared invalid and was withdrawn! So much for the EU being on Mr Cameron’s side.
Is it me? The EU cannot wait to be shot of us anyway. They have been waiting for this to happen for years.
Where were the ‘Remain’ MEPs during the Referendum campaign? Where were the EU Officials, doing a Grand Tour to report what they the EU does do for us? Quite.
Of course, there has been a huge amount of posturing, and superior sounding comment made by all parties. But the dust is slowly starting to settle and realpolitik is starting to become the accepted wisdom.
The chase for the top job in the Tory party is underway; surely a Brexiteer has to take the job?

The outlook for Labour is unclear as I write this, it appearing that Mr Corbyn feels he does not need the Parliamentary Labour Party on board for him to have another go at winning the leadership.
Just when we need a strong Opposition, they decide to go to the beach!!

A mandate for change, or a vote for planning change?
Now there is a valid point that only 38% of the Electorate voted Leave. There is widespread concern about the Union, given Scotland’s quite specific vote to remain. There is the Irish matter of how to handle and nurture the peace, allied to the thinning border.
It is all very well to say ‘” We voted exit” but accepting that logic recognises that any way forwards has to take account of the 62% of the Electorate who did not vote or voted Remain, it has to take account of Scotland, and it has to take account of Ireland.

That is not a circle that needs squaring – that is a complex multi axis movement joint with a multitude of ways to be set, and this needs arranging BEFORE Article 50 can be invoked. An inclusive approach by the next PM will be critical.

It is my opinion that the result of the referendum, being notable but NOT a mandate, is only a start to such a process, and we are simply not there yet.

It is my opinion that Mr Cameron was mistaken not to create some strong ground rules for the Referendum, in particular to the nature of the need for a vote of in excess of 50% of the Electorate. In any other Committee the world over, that vote was inconclusive enough for the Chairman [ie Mr Cameron] to place his casting vote for the ante status quo.
Burt what is done has been done. What should not happen now is that there should be a rush to make more political mistakes.

Better preparation, and a proper mandate
Despite what has been suggested only today [Sunday 3rd] by Mrs May, there must surely be a General Election to restock Parliament with MPs based upon a final Leave or Remain campaign, before Article 50 can justifiably be invoked. I say that as someone who voted Leave.
The biggest challenge now is for a leader of quality to unite the country in its way forwards. If Mrs Theresa May is the bookies favourite, and given Tory party leadership campaign history of old, Mrs Andrea Leadsom is a likely bet.
These are by all measure the most extraordinary times in which we live.

Hi ho, Hi ho, it's off to work we go ...
And yet tomorrow, we all go off and drill, fill and bill. Nothing changes, except the mood and the strangely opaque vacuum that is the political parties we see around us.
If the past two weeks have been a Political revolution, we must be careful not to cause a Geographic revolution by poor leadership and ill thought out ways forwards.
The leadership elections various at least buy everyone some time, despite what our huffy and impatient EU Leaders might suggest.
The summer vacations could not come at a better time, to allow everyone to take a deep breath.
Leave? What, now? No, in about 3 years time - perhaps even at the 2020 Election time?

The Autumn is when the real work begins.


http://www.andrealeadsom.com/

http://www.europarl.europa.eu/news/en/news-room/20160628IPR34006/MEPs-call-for-swift-Brexit-to-end-uncertainty-and-for-deep-EU-reform
MEPs call for swift Brexit to end uncertainty and for deep EU reform

http://audiovisual.europarl.europa.eu/Page.aspx?id=2885
MEPs call for swift Brexit
Top Story - 28-06-2016
Official visit of the President of the European Parliament in London. A general view of the EPIO London, Europe House on June 18, 2015 where the President of the European Parliament Martin SCHULZ today visited and gave interviews with selected journalists. UK-European Flags

http://europa.eu/rapid/press-release_MEMO-16-2328_en.htm?locale=en
European Commission - Fact Sheet
UK Referendum on Membership of the European Union: Questions & Answers

Dentisan [Quadralene] is delighted to announce that Managing Director Andy Corley, has been invited to take part in the CBI’s MSB (Medium Sized Business) Summit 2016, entitled ‘Meeting the Productivity Challenge’.

This prestigious event, being held on 7 July in Central London, will explore the challenges that medium-sized businesses face in raising productivity and highlight some of the practical steps that such businesses can take to increase output and unlock new growth.

Designed for CEOs and senior leaders of MSBs, the Summit will include keynote and panel sessions and Andy will participate in one of the key case studies ‘Staying innovative in a growing business’.

Whilst companies such as Dentisan [Quadralene] have a proud legacy of developing new and exciting technologies and innovations, the UK as a whole underperforms when investing in Research & Development. Addressing this issue is essential for international competitiveness and plays a crucial role in making the UK a place in which to invest and grow a business. During the session Andy will highlight the steps Dentisan [Quadralene] has taken to become an innovator within its market, and explain the important role that R&D has played in its success.

Andy commented, “I am delighted to be taking part in such an important event. Innovation is central to our business ethos, and we could not succeed without significant investment in R&D. It has been a lynchpin of our business, and concentrating on innovation has helped us to both attract new employees and release the latent potential within our existing team. I am very much looking forward to sharing our experiences with other like-minded business leaders.”

For more information, visit www.dentisan.co.uk

Twitter: @DentisanLtd

Facebook: Dentisan Ltd

The Brexit vote has had an immediate and dramatic effect on the UK’s credit rating and the value of Sterling. The UK is now seen as a less safe place to invest in and less secure to lend money to.

PFM Dental Director, Jon Drysdale, says: “The decision to leave the EU could affect your plans to purchase a dental practice and makes it even more vital to have a robust business plan. Lenders will undoubtedly pass on the increased costs of borrowing although against this it unlikely the Bank of England will impose an interest rate rise.”

The UK remains one of the world’s largest and strongest economies with good banking liquidity, relatively low unemployment and perhaps the potential for improved terms with global export markets. If you subscribe to this view, the cost of borrowing money will probably stabilise and remain at a reasonable rate.

All of this emphasises the need for buyers to examine their business plan and the cost of running a business. Are you being realistic about the interest rate you can achieve? Do your projections stress test for rise in the cost of borrowing?

For more information about PFM Dental services go to: http://pfmdental.co.uk

Richard Lishman from Money4Dentists shares his thoughts on Brexit and what it will mean for Dentists in the UK.

So it’s happened. Voters in this country have supported a split from the European Union and, for the first time in just over forty years, the UK will be heading out into the future without its Continental neighbours.

When the news broke on the 24^th, there was a lot of panic and uncertainty. The FTSE 100 dropped approximately 8.7 per cent, the strength of the pound plummeted to levels unseen for almost 30 years and the Prime Minister, David Cameron, announced his plans to step down in October. A pall of hysteria seemed to envelop the country… but is it really that bad?

Well, the most important thing to remember is that nothing is going to happen over night. A lot of things are up in the air right now, but they will settle. The market has gone up and down for years but it has always normalised. If we look back to the Scottish referendum, the FTSE experienced similar turmoil, but it went back to normal quickly enough. The main thing is to stay calm and not be too hasty in despairing.

In some cases, there may even be a chance for people to make a little money. In terms of equities, some may stand to make money if they buy carefully whilst prices are down and wait patiently for when the market returns to normal. Indeed, by being careful and investing wisely there can be much to gain at the moment. Of course, many individuals may be tempted to sell rather than buy right now, but this is more a product of inexperience than financial foresight. People are anxious and when they start to see the risk, they can panic and make mistakes.

It would be far better to approach this change with consideration and patience. Once the market has settled and the smoke has cleared, people will almost certainly have forgotten about the day we Brexited.

For dentists, one of the most crucial things to remember is that people will always have teeth – whether they’re part of the EU or not. The population will not suddenly stop needing to go to the dentist. There may be an initial dip in attendance whilst uncertainty reigns, but this will more than likely return to normal in due course – dental pain, after all, is and likely always will be a constant.

One thing, however, that some dentists may need to consider, if they achieved their qualifications in the EU but now practise in Britain, is that these may not be valid once the UK become independent. Of course, this is an eventuality that is still a long way away from becoming a reality, but it is something that might be worth researching to cover your bases.

But on the other hand, there may even be a chance for the UK dental economy to flourish. UK dental laboratories could see an increase in business if practitioners no longer have the option to work with overseas laboratories due to quality and standards incompatibility. Similarly, dental tourism may begin to tail off if EU dental qualifications lose their value in the UK and flights abroad increase in price.  

There are a lot of negatives that could come out of Brexit, but there are also a lot of positives that can be found – and these are most certainly worth looking for. Of course, if you are ever uncertain or concerned about your financial situations in the days and weeks following Brexit, it is always worth contacting an Independent Financial Adviser for, if nothing else, a little reassurance.

For more information please call 0845 345 5060 or 0754DENTIST.

Email This email address is being protected from spambots. You need JavaScript enabled to view it. or visit www.money4dentists.com

Calm Down, Calm Down, Calm Down

The words of Harry Enfield’s bubble permed Scouse's of the 1990’s are perhaps the most apt at the moment to describe how I feel about the outpouring of angst on the result of the EU Referendum.

Alternatively, to plagiarise somewhat Winston Churchill,

            "Never has so little sense been spoken by so many in so few hours"

I am probably about to join that increasing pile of rubbish, but thought rather than add fuel to what appears to be some as a bonfire of Liberalism and Tolerance I’d try to get a bit of perspective back. I’m certainly no political commentator, (and once you read this you’ll probably agree!!) but I do feel quite strongly how this has developed over the weekend. The sheer vitriol that has been produced in such a short time has been nothing short of shocking, but at least we now have got some real political debate and possibly change on our hands. However, we all need to calm down and stop falling out, because BOTH sides have valid points in my opinion and the only way to move forward now is if we calmly look at the big picture once again.

Because we haven’t actually left Europe. Not yet, and we will not in the next few weeks, months, or years. The referendum was a non-binding one, and merely the biggest opinion poll that has been run in this country for years, albeit with slightly more weight than most have. Unlike the Alternative Voting referendum in 2011, which had a legally binding result, there is no legal duty for a Government to act upon the result of Thursday’s result.

That’s right, Government has no obligation at all to actually heed the result.

It’s certainly monumental that the UK has voted in the way that it has, and there are a multitude of reasons why individuals will have done so. Many of them will have been misguided in other’s eyes, but all of them were personally valid ones to the person who was actually entitled to put their cross in the box. But we have seen the biggest turnout for years that has galvanised the electorate in way that I thought would never happen (now if only we could mobilise dentistry the same way…). This was always going to be a subject dear to the hearts and minds of the populous. It’s a shame that many of the most vocal of those who now feel betrayed by the decision were the ones with the lowest percentage turn out (the 18-24’s having less than 40% turnout). Perhaps there should have been a button on Facebook, or Text your Vote to allow that sector to vote? After all, many of them expect instant and easy solutions without having to actually physically get up and do something…. In addition, a democracy can keep continuing to vote and vote and vote until it gets the answer it wants.

Politically, I am of the opinion that David Cameron has played a political masterstroke. Unlike many, I was not shocked at all when I heard of his resignation. This is a man with an exceptionally astute political mind, and the outcome (although unexpected by many) will have been modelled by advisors. If we read into what he has said in the past, he had only alluded to the fact that a leave vote would result in the British public ‘expecting’ the process to leave the EU to be started straightaway.

An expectation by the public is not the same has an obligation by a politician though, and with his resignation, he has delivered what can only be described as a Hospital Pass to his successor as Prime Minister. For the formal process of leaving the EU to begin, Article 50 of the EU agreement relating to departure has to be formally invoked. Now, it is unclear if the invocation of this can be made by only the Prime Minister, or whether (more likely in my opinion) it has to have been voted on by Parliament in order to become formal. However, the result of the referendum, DID NOT invoke this process, and no matter what the EU Bureaucrats say, the UK is the only entity that can start this process.

So, a political hot potato has been deftly delivered by David Cameron as his last act in office. A new Tory Leader from the Leave side will have to either go against the referendum result, which will immediately destroy their personal credibility and therefore the faith of many people in their suitability to be Prime Minister, or they will have to activate Article 50, which then will probably have to go through parliament to be voted on. If they don’t do this immediately, then doubts about the suitability of the new leader to govern will set in as well. Is this not a most beautiful revenge on his once close allies Boris and Michael? In one fell swoop Cameron has called their bluff magnificently. ‘Leave’ now has to put up or shut up, and either enter into negotiations with the EU saying it was all a ploy to get further concessions, or activate the Article 50 clause, which might be their own political suicide if they don’t truly believe in what they have achieved.

I think we will then have the prospect of a snap General Election that could once again change the political face of the UK and re-establish a new political balance. One that might have Remaining in the EU as one of its fundamental promises. That’ll give the electorate who are currently appealing for a ‘best of 3’ approach to democracy to have another go at influencing the decision. However, quite as possibly with be a further endorsement of the desire to leave, but then there becomes a true mandate for a new Government to act upon. It’s like pressing the Reboot switch.

We have now heard that the Scottish MPs under Sturgeon will actively block the departure of the UK from the EU if this goes through parliament for a vote. So nothing at the moment is a given for the UK actually managing to leave the United States of Europe. The majority of the political commentators will know all this but cynically I’m of the opinion it serves the purpose of the media to keep all the froth and agitation going at the moment to confuse the populous even more and influence how they think whilst selling papers.

And the leaders of country with such political ability in the world didn’t see this outcome as possible?????

I suppose I should have a few opinions on what this means in Dentistry then. Well, for a start the GDC isn’t going to be affected by it at all. The Dentists Act 1984 is a piece of UK legislation and whilst it has EU aspects covered by such as the Human Rights Act and Data Protection Act, and has to be compatible with EU tenets of law, nothing within the day to day interpretation of the Act is likely to be affected by what happened last week. The same is true with the CQC. The UK is wonderful at developing infrastructure like this, and certainly doesn’t need the EU to make a business out of bureaucracy. There certainly won’t be a bonfire of the dental Quangos whether we stay in or out is my prediction.

There are a significant number of EU graduates working in the UK, and I don’t see any evidence that coachloads will be shipped back through the Channel Tunnel before it is bricked up overnight. What might actually happen though is that the corporates might find their supply of naïve EU dentists dries up due to the uncertainty of the future direction of the UK, and they might actually have to pay a competitive income to get people to work for them. This will no doubt affect their bottom line somewhat, and they might actually find they are now susceptible to the same pressures that normal practices are under and have to adapt the same way as we have all done. This can only be a good thing in order to restore the competitive balance in our profession.

What also might be beneficial to dentistry from leaving is the restoration of parity to our own graduates. Those who graduate from the UK have to complete foundation training before being allowed to work in the NHS, yet those from the EU don’t. Not only that, because the EU training is seen as equivalent to the UK, we cannot impose requirements like the ORE on them. Are all the EU Dental training courses the same quality? I think some of us might disagree that every single course is.  Surely this has benefitted those from the EU more than our homegrown graduates, and this potential discrimination can be possibly now be addressed in the future.

We still don’t really know what will happen with the prices of dental goods in the long term. Much of it is indeed made in the EU, but the USA and Asia are also vast markets, and not necessarily unified like the EU. China as an emerging market has already rocked the world of the dental technicians, and there is no reason why that cannot happen in the rest of dentistry. Admittedly controlling quality is going to be the issue, which worries me, but there are also some highly ethical businesses there that would work well within dentistry. There will be inevitably be some adjustments of prices because of the strength of the pound, but equally there is now an opportunity for entrepreneurs within the dental supply chain to start ‘disrupting’ the usual model.

The one thing we are unsure of is the overall effect on the general public and their incomes. Potentially this is huge, and the instability that is coming will affect them to an unknown degree. It is notable that the professional advice from the likes of the Bank Of England is to keep calm, whereas those who have a self interest, either towards the EU, or financially, in keeping the markets volatile is to Panic and Run Away. I know what I shall be doing. At times like this speculators usually manage to be the overall winners anyhow, so it’s in their interest to keep earning their money how they always have done.

But all this pre-assumes we will actually leave. I’m afraid I don’t believe the upper echelons of political power (and by that I don’t mean government but the high level civil servants who are in post despite what political flag is flying over Westminster) haven’t already worked out what their long game is and planned their chess moves accordingly.

So, we need to keep calm, because we haven’t actually left yet, and I personally don’t think we were ever going to….

Though the real question is can we trust any of them anymore?

Image credit - Muffinn under CC licence - not modified.

Credit options are becoming increasingly important in UK dental practices. The increasing demand for elective dental treatments, combined with the ubiquitous search for cost-effectiveness, has made the provision of finance very attractive, and it can be an important USP for many practices.

However, even if a practice is offering credit options, it may be the case that they are not seeing the best return on this facility as possible.

This is simply due to the fact that many dental professionals lack the necessary marketing skills to properly promote the services they offer patients – and this could really be to their detriment. Indeed, opportunities missed through poor marketing can actually be the difference between a practice achieving and one that is excelling.

Your practice’s website is, perhaps, the most obvious place for you to start promoting your credit facilities. By making sure the information is easily accessible and easy to understand, any visitors to your website will immediately be informed of the options they have with you.

Similarly, maintaining a regular and consistent social media presence, in which patients are kept informed and included, can be a very efficient way of getting across a desired message. Posting information about credit options on your practice’s social media page is a sure-fire way of increasing your patients’ knowledge on how they can benefit from what you have to offer.

You could also include a message in your phone system’s ‘on hold’ message. Ideally, you don’t want your patients to be on hold for very long – but on the occasions where they do have to hold the line, it is good opportunity to promote your credit options (which will be far more useful to you, and less frustrating for your patients, than playing a tune like Greensleeves while they wait!).

Quite obviously, appreciating that these methods should and could be implemented and actually implementing them are two very different kettles of fish. Effective marketing takes time and considerable effort – two commodities that are too often in short supply for busy dental professionals. Therefore, it may be advantageous to recruit the services of an expert marketing team to help you come up with a consistent and appropriate strategy for your practice. Of course, it may present an upfront cost, but it is an investment that will almost certainly pay dividends in the future.

Of course, there is a very simple and effective solution: Chrysalis Finance, the UK’s only provider of simple, licence free credit options, also has the marketing savvy needed to help you and your practice get the very most out of their exceptional finance facility. Its services range from printable material, to assistance with your website, helping you ensure that your patients are up to date on the great finance options you can offer them.

For more information about Chrysalis Finance call us on 0333 32 32 230 or visit www.chrysalisfinance.com

During May I spent some time reading the Medical Practitioners Tribunal Service hearings list.  MPTS deliberated issues including inappropriate relationships with patients, physical altercations with patient family members and performing inappropriate intimate examinations of patients without chaperones.  Comparably, the FtP panels of the GDC were reconvened to consider the issues that NHS England probably ought to be dealing with.  Charge sheets were littered with allegation minutiae of the usual failures in record-keeping, and whether bouncing balls made of impression material in corridors might contribute to a finding of misconduct.  It’s not specified if the balls were alginate, addition or condensation-cured silicone, or Impregum, and they may or may not have been bounced in front of colleagues or patients and the date of the alleged bouncing was unknown. But those facts aside, I am sure it was fairly clear-cut!

If anyone is interested like I am in comparing the differences between the MPTS and GDC FtP charge sheets to see how MPTS put theirs into the public domain, let me give you an example:

MPTS announcement:
‘The tribunal will inquire (note the inquisitory tone) into the allegation that in April 2014, whilst working as a Specialty Trainee in Obstetrics and Gynaecology, Dr X’s actions towards a patient were not clinically indicated and were sexually motivated’ (and then some further housekeeping information and notes for interested journalists).

GDC announcement:
‘Charge (note the accusatory tone) that……..(insert pages and pages of specific individual allegations painting a poor picture of the registrants practice and behaviour)......
And that, in relation to the facts alleged, your fitness to practise as a dentist IS IMPAIRED (note the suggestion that the outcome is already proven) by reason of your misconduct +/- deficient clinical performance’ (and if only deficient clinical performance then perhaps add some dishonesty for good measure).

I know which presentation of the forthcoming hearing sits better with Article 11 (presumption of innocence).   Furthermore, if the charges are not meant to be taken literally (as I am advised they should not be without knowing the relevant context of the case), then it begs the question whether they ought to be made public?   Dishonesty I will touch on later but I feel the GDC ought to be looking at how they present their charges of these public hearings and I believe that a new approach to how the charge is put into the public domain is needed.

But back to last month’s cases of interest of which there were a few:

Interim Orders acted extremely swiftly to curtail two attention-grabbing business ideas with potential to breach GDC standards, or encourage UK registrants to. One related to provision of orthodontic aligners direct to the public without a prior examination and the other was referral incentives for implant treatments referred to a clinic abroad.  Both registrants had conditions imposed clipping their entrepreneurial wings.  I later received an email from another company looking to ‘partner-up’ and offering me payment for helping with certain aspects of their ‘ortho-direct-to-patient’ business.  Possibly the best of both ‘GDC standard-breaching’ worlds in that email, but seemingly no UK-registrant behind it to take through an FtP.

The PSA failed in their appeal of a health-related case.  The PSA alleged that the case was under-prosecuted by the GDC, and that an unduly lenient sanction was given with insufficient reasons.  The registrant, who was placed on conditions by the Health Committee for what appears on reading the determination to be extremely cogent and reasonable reasons, had complied with all the conditions and made huge efforts at remediation.  He was extremely anxious about the prospect of the matter being remitted back for reconsideration and is obviously now very relieved.  He told me that the GDC have been a life-saver to him, and that his case shows how some good can come out of FtP procedures, although the time left in limbo has been tortuous.  Additionally, it is worth giving credit to the GDC for their handling of the appeal, as they described the conduct in broad terms and kept the health condition out of the public view.  The PSA did not however, and some very private material relating to this registrant has now been read out publically in court, which was awfully nice of them.

In the conduct arena, Mr Radeke ‘won’ an appeal in March 2015 against an incorrect PCC decision to erase him over dishonesty and the case was remitted for a new PCC to reconsider the appropriate sanction.  He remained suspended only until the end of May 2016 when the case was finally reheard.  When I say ‘won’ an appeal, this is really in a loose sense of the word.  The wins on appeal are often pyrrhic victories.  Registrants who have gone through FtP and appeals suffer enormously through stress, anguish, accusations (perhaps false), public humiliation, financial turmoil and can still find themselves unemployable after a ‘victory’ not to mention their families breaking down or having to go bankrupt in the meantime.  I do not wish for second that anyone who reads my blog on FtP thinks that any sarcasm or satire is an attempt to trivialise something that I take tremendously seriously and have had, at times, invading my own sleep.  Nonetheless, Mr Radeke’s case involves an unarguably disastrous patient death following treatment, but the original panel had attached incorrect significance to the ASA of the patient prior to treatment and ostensibly decided that the registrant had committed perjury to the coroner; which is a criminal offence.   This case, along with the Kirschner case, suggests to me that dishonesty is something that we need absolute confirmation from the GDC that their selected panel members are capable of handling appropriately, given that the GDC like to levy it at registrants at such a high rate (45% of conduct cases include a dishonesty charge if my memory serves me correctly on that FOI data).  If you are going to accuse, and then find someone guilty of dishonesty, you had better be sure you are getting it right, and that you properly understand the legal test.  Panel member names are redacted from final determinations, but in the interests of transparency ought not those who are the judge have their names kept in the public domain?  We do not see judiciary member names redacted in their judgments.  Perhaps someone in the know can comment on why this is the case?  For those interested in the Radeke appeal judgment to see what the problem was in the PCC decision-making, and it is worth reading just to compare the tone,  it can be found here:

In the ‘no misconduct’ case a registrant was reported to the GDC by the ‘GoodThinkingSociety’ (who profess to ‘encourage curious minds and promote rational enquiry’) for allegedly promoting the dangers of amalgam, misleading patients over the benefits of homeopathy and serving alcohol in the practice, and they are unrepentant about the outcome from the emails I have exchanged with them.  Why this case warranted a full hearing when we have false advertising attracting an unpublished warning in others is not obvious to me.  However, for reasons that evade us registrants who politely entertain patients with ‘alternative’ beliefs, a full hearing was considered justified.  The GDC scored the own goal this month by their appointed expert being shown evidence that changed his opinion at the last minute, and presenting a witness who maybe did not realise they were being engaged as a prosecution witness and seemingly blew the GDC case apart by being extremely supportive of the dentist at the centre of the hearing.  Aside from his obvious incredulity of being called as a witness (I think he may have written to the GDC to complain about the withdrawal of the 15cc of champagne on offer before an examination and then ended up being called) he told the panel that he could make his own mind up on what was good for him…….and if that was a small bottle of champagne before a check up, who are the GDC to say differently?  I am glad to hear that the residual champagne has now been consumed.  Cheers!

Finally, the statistics for May are:

Interim Orders held 17 new hearings and 8 review hearings resulting in:

Practice committees held 28 new hearings and 6 review hearings resulting in:

By registrant type, there were 46 dentists, 11 dental nurses and 2 dental technicians involved in hearings this month.  As far as I could see, only 5 registrants were not present and not represented this month.

The fog is burning off.  The focus is clear.  And so it should be for you.

On balance the case swings clearly.  We are part of Europe. We are European. And yet we should not be part of the political and fiscal force majeure that is the EU.

So I urge you to vote, and if you are open to simple argument, I urge you to vote Leave.

The time has come to lead Europe from outside the EU, not from within.

This Thursday is the most important in the political life of this nation to date. Please make use of your democratic right, to maintain those same rights.

Q. Would you like to reduce the cost of running your practices’ dental plans?

Q. Do you question the value of the fees your existing plan provider charges; Denplan, Practice Plan, DPAS, CODE, IndepenDent or another provider?

Q. Are you tired of admin fee increases applied by your exiting plan provider?

Q. Are you unsure of the exact fees you pay to your existing plan provider and would like help in completing a cost-benefit analysis?

If the answer is ‘Yes’ to any of above questions Patient Plan Direct would like to meet with you to explain and explore how they can help your practice achieve a successful plan provider transfer and save thousands in costs year on year thanks to a £1 per patient per month admin fee which includes: practice-branded solution, Worldwide Dental A&E cover, support from a dedicated client services team and business development manager, as well as plan promotional material and much more.

To contact Patient Plan Direct and book an exploratory meeting Call: 0844 848 6888 or Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Or to find out more visit www.patientplandirect.co.uk

No matter how many plan patients you currently have, Patient Plan Direct can help you make big cost savings.

Your practice could achieve the same benefits and results as the following sample of practices that have already transferred their dental plan administration to a practice-branded solution with Patient Plan Direct…

BV Owen Dental Practice, North Wales

• Almost 1,000 Care plan patients.
• Previously paid their plan provider nearly £2.50 per patient per month.
• High patient retention when transferring.
• Now saving over £15,000 per annum in plan admin fees.

“These cost savings have helped towards a practice refurbishment we had been keen to undertake for sometime. Patient Plan Direct deal with things quickly and proficiently and our plans run like clock work”

Read the full story HERE

High Street Dental Practice, West Sussex 

• Previously paying fees for access to services they did not require.
• Needed a provider that was flexible and low cost.
• Transferred to Patient Plan Direct with a high retention rate.
• Now saving thousands in costs.

“We found the transfer to be hassle free.  As proved by the loss of members in the transfer being less than 1%.  We have gained approximately 18% more members over the last 6 months. And it continues to grow”

Read the full story HERE

Farleigh Dental - North East Surrey

• Principal questioned the value of their previous plan provider shortly after purchasing practice
• Almost 1,500 plan patients.
• Needed an approach to running the practices’ dental plans that included simple and secure administration, low running costs, a quality A&E cover for patients and access to expertise to help with all things plan related as and when required.
• Transferred to Patient Plan Direct and significantly reduced plan administration costs by around 50% which represented huge operational cost savings.

“Did I lose lots of patients as a result of the transfer? No, we lost a handful of plan patients – no more than we would normally expect as a result of an annual price increase mailing to plan patients. Am I glad we took on the move? Absolutely”

Read the full story HERE

To show its dedication to the industry, Dental Elite recently pledged its support to the Annual Conference of Local Dental Committees 2016 for the fourth consecutive year.

As Gold Sponsor of the event, the leading practice sales agency was proud to be able to offer its knowledge and services to dental professionals debating about the wider issues of dentistry, having already acted for a large number of the attending delegates successfully in the past.

If you missed Dental Elite at the conference, don't worry – the team will be exhibiting at various top calendar events and supporting more local LDC meetings and study groups throughout the next year.

If you are interested in receiving support for your event, contact the team today.

For more information contact Dental Elite. Visit www.dentalelite.co.uk, email This email address is being protected from spambots. You need JavaScript enabled to view it. or call 01788 545 900

?

Tony Jacobs BDS, dentist, publisher of GDPUK.com

Image credit -Fernando Butcher under CC licence - not modified.

The BDA Benevolent Fund bought a smile to people’s faces at this year’s BDA Conference. They came armed with a photo-booth full of fun props to spread the word about how their support changes lives. Dentists from every corner of the UK need to know that if disaster strikes, they will not be alone. By giving one-off and regular grants to help those in need, the BDA Benevolent Fund is often the only lifeline when there is nothing else to hold on to. It’s not only about financial aid either, but support, comfort and friendship.

(Pictured above having fun with the Benevolent Fund is GDPUK's very own Michael Watson)

The fact is none of us is immune to sudden misfortune or a dramatic change in circumstances; a curveball can get thrown at any time. Think about it: how would you and your family cope if you had to stop work for any reason? Who would you turn to for help? The Fund is showing that, as a profession, we look after our own and will be there for colleagues who are going through dark times.

Conference delegates who stopped by the stand had the opportunity to meet with some of the Trustees, and find out about the diverse range of cases the charity has helped. Chronic illness and injury can mean lengthy time off work, as can family problems like divorce or bereavement and issues around personal debt. Sudden redundancy can set off a dramatic chain of events if the dentist is the breadwinner, with a family to support.

Modern dentists face a challenging and unique mix of pressures that can affect their mental wellbeing, such as ever-changing targets and regulations, keeping up-to-date with technology and techniques and making a decent living in a competitive industry. In its 2015 Annual Report, the Fund notes that a significant number of applicants had experienced stress-related illnesses. Accepting help is needed is the first (and probably the hardest) step, but once a dentist has made the call, their case has been assessed and a decision made, they can be sure of a timely intervention.

The testimonials from dentists who have been helped by the Fund really do speak for themselves. Recent recipients have said: “The way the profession has responded has been overwhelming,” “No-one can appreciate how important your work is until they need your help” and “There is a big light at the end of the tunnel and now I am confident I will come out at the other side”. Comments like these are reasons why raising awareness at industry events is so vital. An independent charity, the BDA Benevolent Fund is supported by a committee of volunteer dentists and, with no assistance from the government, is reliant on the generosity of donations. Behind the wigs, feather boas and cheesy grins, the BDA Conference was all about the essential promotion of Fund’s vital work.

The BDA Benevolent Fund exists to shine a light in times of trouble and show that brighter days can be just around the corner. Support the Fund and you will not only be helping dentists who have found themselves in desperate need, but you will be laying the foundations of support for future generations too. Find out more, then spread the word. Regular donations mean the Fund can reach out to even more people and the easiest way to donate is online, via the secure Just Giving page. One day, it might be you who has to make that call.

The BDA Benevolent Fund relies on your help to continue its work,
so please contact us on 020 7486 4994 or This email address is being protected from spambots. You need JavaScript enabled to view it.,
or to give a donation today go to www.bdabenevolentfund.org.uk.

https://www.facebook.com/bdabenenevolentfund/
 

And if you are in need of help yourself, please contact us now.

All enquiries are considered in confidence.

Registered charity no. 208146

As a GDP I am really struggling to focus on what my vote should be. So I have set myself the task of reading across the campaigns this weekend.

It’s a busy week, and you too need to do your final reading. If only this was vCPD eh? 

Well why not?    It’s clear that this affects your dental practice, so go reading, message me privately and I will send you a simple feedback document, and a certificate for vCPD. Allow 2 hours.

What is they say about a divorce? You must have a reason to go and a reason to leave.

Do we? Have we?

Here are your links for the Remain and Leave campaigns [also knon as the  “Innit” and  “Exit” !] and other information sources or repute.  If you read over these there will be lots of facts, and a degree of balance.  I have tried to avoid opinion.

https://leave.eu/

http://www.voteleavetakecontrol.org/campaign

http://www.strongerin.co.uk/

http://www.bbc.co.uk/news/politics/eu_referendum

http://www.telegraph.co.uk/eu-referendum/

http://www.theguardian.com/politics

EXIT  If at the end of this, you vote for the UK to exit, you will be lighting the fuse for the first cannon shot in a bloodless revolution.

No less, no more.  The aftermath will be a change in the political landscape of the UK not seen for centuries. Make no mistake, in the past, civil conflinct started over less.

REMAIN  If we vote to stay in, we will have the same group of leading politicians weakened by the arguments in the campaign, but a stronger case for lead influence in Brussels.  Perhaps a vote to remain is a vote for change we do not expect?

Polls

http://whatukthinks.org/eu/opinion-polls/poll-of-polls/

But if the polls are to be believed there is a groubndswell of decided opinion forming. Watch out - the UK electorate has a habit of suprising the pollsters.

If we do indeed vote to exit the political treaty that is the EU two things have to happen.

Firstly, the present political leadership must go.

Secondly, therefore, by any logic,  there must be a snap General Election.

And there begins 5 years hard work to re align our political and trading arrangement with the EU and the world, under new elected leadership.

And, guess what happens if we vote to remain?  Exactly the same.  UK politics will never be the same for this generation.

This is  a big job and on Thursday when you vote, you are not voting for no change.

You are voting for how you want the change to occur and when.

Should we lead from outside the EU and try and lead from within?

Whatever you do, Vote

Whatever you do, respect your neighbour and his or her opinions.

That right to vote is something we have taken for granted these last hundred years.

It’s a new privilege and a new right in many of our Eastern European neighbours home states

And good luck, friends and colleagues.

This really is a momentous event, in which you are free to both witness and partake.

Go use your your freedoms, as wisely as you can, and we will met on the other side.

It’s no secret that I’m firmly in the Remain camp.

Until recently, the EU was a largely irrelevant part of my life; something that is there, that I don’t need to worry about, that was barely noticed in the background. But the claims by those wishing to leave have turned passing indifference into passionate support.

I am strongly pro-free market, I believe in personal liberty, and in economic liberalism, but with fairness for all, meaning the removal of artificial barriers and monopoly trading. The EU has delivered this in spades; we know that if we buy Romanian pork, it is made (or rather should be) to the same standards as pork produced in the UK; we know that if we travel abroad, we will be treated according to over-arching laws.

The EU provides regulatory framework; it makes sense that where trans-national trade is concerned, the rules are arrived at through trans-national organisations. But we must also place human rights into the fray – it is not right that a company in one country can produce an item using labour that is forced to work 60 hours a week whereas another country can only allow 35 hours. Trade is increasingly globalised and our companies compete with companies from all over the world. What the EU promotes is a level playing field for all companies, allowing survival of the fittest, while ensuring that competitive advantage is not derived by transferring the costs from company to workers. If we all play by the same rules, only the strongest company will survive. If the rules are different, then one country can make their workers’ pay for the success of their businesses.

We also have harmonisation of regulations. This means that our companies have access to other countries’ internal markets that could otherwise be blocked through unnecessary or discriminatory legislation – perhaps the best example being the German purity laws, which created an artificial barrier for non-German beer to be sold in Germany. The EU forced Germany to remove these barriers for imports, and as a result, you can buy a can of Tennent’s Super in a supermarket in Bremen, should your fortunes be so unkind.

Britain has always been a trading nation, from the tea clippers in the days of empire, to the financial trading of the 80s and the digital marketplace of the naughties. We must remain relevant. We must modernise as life changes around us. We are better placed to trade as part of the EU, we are stronger in the EU and we share a bright future trading with our European brethren.

I have already voted to stay in the EU, not because of what I fear we will lose if we leave, but because of what we stand to gain by remaining part of the EU.  

Duncan Scorgie is a dentist practising in Midlothian

Image credit -Abi Begum under CC licence - not modified.

“Patriotism is the last refuge of a scoundrel,” stated Samuel Johnson.

We have seen England football fans with their aggressive displays of false patriotism, Nigel Farage with his “blokey” 1950s English image, both suggesting that the past was some sort of rosy era that we can head back to. The whole Brexit campaign smacks of a distasteful arrogance that the British are better than the continentals.

I am a Special Care dentist, and I remember being startled and gratified in equal measure to find that a profoundly autistic non verbal man presents exactly the same dental treatment challenges in Ireland as in France as in Greece.

Your non verbal autistic man has no concept of Brexit and Patriotism, but maybe he can teach us how shallow, ignorant and superficial our debate and thinking has become on this issue. 

I have many friends as dentists whose origin is from countries such as Bangladesh, India, Spain, Ireland, Italy and Greece. We have far more in common being dentists than our national and cultural differences divide us.

My late father landed in Normandy on D-day plus six, and often told me he never wanted to experience war again. The EU has many failings, but has kept the major players in Europe from warring with each other. That is why I would vote to stay in.

Neil Martin is a Special Care Dentist in Northamptonshire.

Image credit -Abi Begum under CC licence - not modified.

We must stay in!
We are the civilised and ancient democracy!
We must strive to exert change from within.
Our mistake was not joining at the beginning and before you start I know it was personal politics De Gaulle etc!

The whole argument has horrified me because...there are NO Facts just subjection!!!

I feel we are in a smaller world with more connections..why do I want to leave and become smaller??
I like my European family and think they have so much to teach US!!
We should be paying MORE because we are so lucky!
We should be caring for the less fortunate!
In fact I think that we should STAY BECAUSE IT IS RIGHT!!

Dr Alisdair McKendrick is a GDP in Northamptonshire.

Image credit -Abi Begum under CC licence - not modified.

Regardless of the outcome on this very important choice presented to the British public, it is unlikely that a seismic shift will happen. The UK will not collapse if it leaves the EU or decides to stay within. I fear a large amount of campaigning already underway and yet to come, is riddled with slick speeches oiled with dubious premises and unsubstantiated claims. Exaggeration and obfuscation are rife and even an alert and politically savvy observer will struggle to separate the wheat from the chaff.  

Image credit -Abi Begum under CC licence - not modified.

Once upon a time someone started to blow a bubble.

All Pixar films have a simple story structure which can be summed up as:

“…Once Upon a Time…

Every Day…

One Day…

Because of that…

Because of that…

Until Finally….”

So if Pixar did the story of recent Dentistry, here’s the movie storyline.

Once upon a time nearly every new dentist went and worked as an associate in General Dental Practice with an NHS contract.

Every day, 5 days a week, they worked for 8 hours and had an hour for lunch. Some of them were better than others and some were worse. Some were faster than others and some were slower. The faster they worked the more they earned. Every month encouragement came from the practice owners, “get your backside in the air and get your gross up”. Every dentist in every practice did the same thing - they repaired broken and diseased teeth. Some liked to spend half a day a week making dentures or braces or using a scalpel - but that was just a diversion from drill’n’fill.

At the end of the month the owner let the associates keep half of what they had earned. This was often a lot of money for a young, newly qualified person. Their friends from university who had studied medicine, accountancy and the law couldn’t understand how dentists could justify the amounts they earned when they were so young and inexperienced and were envious. Secretly many young (and old) dentists agreed, but they couldn’t bring themselves to suggest a change. These were the golden years, there was lots of disease, plenty of patients and the Prime Minister’s purse was bottomless. In fact there were too many patients so in some places people queued to have their teeth out or tried to do it themselves, or so the TV said.

One Day the Prime Minister, Mr Blair, an ex-lawyer, said, “This is not good enough, something must be done”, and he decided that market forces must be applied. But firstly he made the NHS the National Religion and everybody must be an acolyte, for to speak against the NHS was sacrilege. Then he applied the rule of supply and demand, so he opened up lots of new dental schools where intelligent young people could become noviciate monks and nuns of the NHS. Although the words “private” and “dentistry” were considered blasphemy “private” and “university” were compulsory so the novice dentists were made to pay for the privilege of half a decade of confrontation and humiliation. Saint Tony also sent messengers out to all corners of Europe welcoming dentists to England and Wales where the NHS was the envy of the world and the dental streets were paved with gold.

Next his Grand Vizier, HenHouse and his Lord High Chancellor, Broon, said that the purse was closed, there would be no more money, each dentist must make do with what they had last year and the year before that.

Because of that even the fastest of new dentists were not able to get their backsides in the air and the slow ones earned the same as the fast ones. The practice bosses saw that where there had been queues of patients there were now queues of new dentists who had to repay their loans and were competing to work in the NHS churches. Some of these bosses saw this as an opportunity and competed to see who could pay the least. Some were allowed to keep a quarter or a third of what they earned. In his retirement villa St Laurence de Lando looked down, smiled broadly and said, “I told you so”.

Because of that lots of young dentists said, “We must buy our own businesses. We shall become dental entrepreneurs, what ever that is.” So they hocked the family silver, mortgaged their future earnings and sold their soul to the NHS (praise be its name), and in the subsequent sales frenzy this let St Laurence’s contemporaries buy much bigger villas on golf courses than they had ever dreamed possible. “We are the bosses now” trumpeted the new owners, “we shall buy lots of practices and screw down those associates who were not clever dental entrepreneurs like us. Then we shall sell out at the top of the market and make a shedload of cash.”

Meanwhile many quiet, thoughtful young dentists took a long view and worked at their skills. They saw that in the long term the religion would be exposed for the sham that it was and patients would choose between private practices with personal service and Nash clinics where they chose a number and waited their turn for the announcement, “dental cubicle number thirteen please.”

Until finally, one day the bubble burst, NHS dentistry was handed over, lock stock and barrel, to Tesco and many churches became empty shells, a testament to a great failed experiment.

Image credit - Isabelle Acatauassú Alves Almeida  under CC licence - not modified.

Every dental practice knows that it can take years to build up a loyal patient following but a matter of days for this to be destroyed by an ex-associate. Normally, a practice seeks to protect its goodwill by adding restrictive covenants into an associate, or even an employee, contract.

However, will your covenants stand up in court if you need to enforce them further down the line?

Most practice owners are under the impression that if a covenant is in the contract and the ex-associate breaches that covenant then they will be able to enforce the agreement. However, this is simply not the case.

Enforceability 

In order for a restrictive covenant to be enforceable you must show that:

1. You have a legitimate business interest that needs protecting; and
2. The protection is no more than necessary in all the circumstances.

A patient base is more than likely to be a legitimate business interest, as it provides the main income for any dental practice. However, you must remember patients are free to choose who treats them and so you cannot completely restrict an associate from treating those patients.

When determining if a covenant is necessary a court will consider the reasonableness of it taking into account factors such as; the duration; the geographical area covered; the patients it refers to and the seniority of the person who is subject to it. This is not an exhaustive list. Given that the courts will consider each case on its own merit, it is difficult to provide specific advice in this article on each of these points.

The courts are very wary when it comes to enforcing restrictive covenants, as they do not want to restrain trade and prevent a person from being able to earn a living. Therefore, if a clause is drafted too widely, without consideration for the business interest you are seeking to protect, it is unlikely that it will be enforceable.  

It should be noted that a court will not amend a clause to make it more reasonable and therefore enforceable; they will simply reject it altogether, leaving you totally unprotected.

You therefore need to carefully consider which covenants are required to protect your business interest, and that the scope of those covenants are neither too wide nor too narrow. 

Types of Covenants

The main types of restrictive covenants are:

Non-solicitation. This prevents a positive act by the associate of contacting former patients of the practice, or making an initial approach, with a view to obtaining their business. Merely informing a patient that they are leaving, and even providing their new address, is unlikely to be seen as solicitation.

Non-compete. This prevents an associate working for a direct competitor. Such clauses are harder to enforce than non-solicitation clauses, given the courts reluctance to restrain trade. However, one must bear in mind the skills of a dentist and the time it takes to build up the goodwill of a practice. We would therefore recommend adding such a clause to a contract, providing it is well drafted.

Non-dealing. This prevents an employee dealing with any customer or potential customer of a business. Given that a patient is free to choose who treats them such a clause is likely to be unenforceable in an associate contract.

Non-poaching. This prevents an associate from taking staff with them to a new practice. The idea behind this covenant is to ensure a stable workforce. In the dental industry, a practice will want to ensure that Specialist Dentists are not enticed to a new practice by a member of staff who is leaving.

You can use just one restriction or you can use a combination, depending on the business interest you are trying to protect.

Practical Tips
The most important piece of advice we can give you is not to use standard clauses for all staff members no matter what their position and situation; this is giving no consideration to the test ‘necessary in all the circumstances’.

You can create standard clauses for each level of staff, but you also must ensure that when you offer a new contract to a new employee or associate you consider whether the covenants are reasonable in their circumstances. For example, if you know an employee cannot drive and you live in a small town with no public transport, stating that this employee cannot work in that town is unlikely to be reasonable; especially if a non-solicitation clause could be used in the alternative.

You need to be able to explain why the covenants are for a certain period, cover a specific geographical area or are in relation to a set of patients. It is also worth periodically reviewing the covenants to ensure they are still fit for purpose (although see below in relation to seeking to amend a contract whilst it is still in force).

Normally, restrictive covenants will be contained within the contract. This means an associate has to agree to them in order to secure work. Consider instead having a separate document containing the covenants and paying for the associate to obtain legal advice on them. If an associate has been advised as to the effect of the clauses and signs to confirm their agreement, this is likely to make them more enforceable. However, you will still need to bear in mind the above tests and ensure the covenants are necessary; this will not give you carte blanche to insert anything into the contract.

If you seek to change the covenants part way through employment, recent case law has confirmed that unless you give some consideration to the other party for signing the new covenants, such as a pay rise, the covenants may not be enforceable even if signed.

No article can ever replace legal advice, and this is even more true in the case of restrictive covenants, which are highly specific to the facts and circumstances at hand. If you are considering using restrictive covenants, we strongly recommend that you seek legal advice.  As the text above demonstrates, merely having them in place will not necessarily protect you.

Up to 86% of patients are affected by food becoming trapped under their dentures.¹ This can lead to discomfort and can cause bad breath.

Results have shown that Poligrip® denture fixatives have the ability to seal out food particles helping to reduce gum irritation² and lead to increased levels of confidence, comfort and chewing efficiency.³

The Poligrip® range of fixatives include:

• Poligrip® Flavour Free Fixative Cream

• Poligrip® Ultra Denture Cream  

For further information on Poligrip® and dentures, why not complete the Poligrip® distance learner module and earn up to 1.5 hours of CPD. Simply visit            www.gsk-dentalprofessionals.co.uk today!

-ENDS-

References: 1. Data on file, GSK, Canadian Quality of Life Study, 2005. 2. GSK Data on File. Murphy et al, 2012. 3. GSK Data on File. Durocher et al, 2008

Trade Marks are owned by or licensed to the GSK group of companies.

CHGBI/CHPOLG/0018/16