New targets for practices in 2022 set: 85% for UDAs 90% for ortho contracts
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- Published: Wednesday, 22 December 2021 14:59
- Written by News Editor
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“This policy might suit the Treasury, but will put patients, staff, and the very sustainability of NHS dentistry at risk.” Shawn Charlwood, Chair of the BDA’s GDPC said, adding “These new NHS targets are the wrong choice at the wrong time. The country faces a tidal wave of infection. Dentists are understandably nervous about easing restrictions, and patients are already cancelling in droves.”
The BDA has condemned the government’s decision to impose unrealistic activity targets on NHS England dentists during the Omicron wave. From 1 January 2022 NHS practices will be obliged to meet 85% of their pre-COVID activity levels or face financial penalties - 90% for orthodontic contracts. Nearly two-thirds of practices currently estimate they are incapable of achieving these levels.
The BDA says: “Bringing in close to pre-pandemic volumes of patients into high intensity NHS practices is entirely at odds with wider measures set out by government in response to the new variant and will put both patients and staff at unnecessary risk.
“We have stressed that NHS England must be prepared to rapidly review, reverse and potentially reduce existing NHS target levels, if the new variant achieves anything like the levels of cut-through currently modelled. Practices are already reporting a major spike in cancellations and staff sickness.
“While several pandemic restrictions in dental settings were eased last month, nearly a third of dentists (33%) have said they have no intention of relaxing COVID precautions, with half saying the arrival of the Omicron variant has had a high impact on their willingness to change tack. Until the changes took effect, dentists had to maintain gaps of up to an hour between most treatments, to reduce the risk of viral transmission, an approach that has radically reduced patient numbers.
“NHS dentists have been working to targets since 1 January 2021, which has had a devastating impact on morale and financial sustainability in the service. Over 40% of NHS dentists indicate they are now likely to change career or seek early retirement in the year given the current pressures. Over half state they are likely to reduce their NHS commitment. 1 in 10 estimate their practices will close in the next 12 months. Nearly 1000 dentists have already left the NHS in the last year according to official data.”
The NHS England letter, signed by CDO Sara Hurley and Ali Sparke
NHSE Director for Dentistry, Community Pharmacy, Optometry and the NHS Standard Contract, says that GDS contracts will continue to be in place for 100% of normal volumes, and it will continue to be a requirement that all NHS funded capacity is used to deliver the maximum possible volume of safe care for patients.
The letter continues: Between January and March 2022 clawback will not be applied to practices delivering at least 85% of contracted UDAs, reflecting the level many practices have already been delivering below this threshold normal clawback will apply, although mitigating circumstances for under-performance will be taken into account through the exceptions process, which will remain in place, providing a safety net for practices.
For orthodontic contracts clawback will not be applied to practices delivering at least 90% of contracted Units of Orthodontic Activity (UOAs). “Practices should plan on the basis that NHS income protection will come to an end in April 2022 and we will revert to usual contract management arrangements,” the NHSE letter explains.
The BDA adds: “Under new arrangements NHS dentists will also be obliged to prioritise new patients and urgent cases. However, there are no changes to their contractual arrangements to ensure these patients - often with higher needs - can be provided the necessary time under the target-based model.
It’s the wrong choice at the wrong time.
— Shawn Charlwood (@ShawnC_GDPC) December 22, 2021
We face a tidal wave of infection.
Dentists are nervous about easing restrictions, & patients are already cancelling in droves.
These targets suit the Treasury but will put patients, staff, & the sustainability of NHS dentistry at risk.
NHS England explains: “In Q4 contractors will also be required to maintain a short notice cancellation list and to proactively contact patients to offer appointments in order to ensure that any clinical downtime is minimised. This will
benefit both patients and contractors, in allowing slots to be filled more quickly and
capacity maximised.
“Contractors are also required to update their dental profiles within NHS UK and work with their regional commissioner to ensure that the Directory of
Services is up to date during Q4. This is needed to make it easier for people seeking
care to find a dentist.
“As we take these steps to further recover NHS Dental services it remains critical that we continue to ensure that those most in need of care are able to access it. Patients must be prioritised against clinical need and the priority groups detailed in the SOP,
regardless of whether the member of public is on a practice’s business list or not.”
The BDA concludes: “We have accused officials of succumbing to pressure from the Treasury to maximise patient charge revenues, which collapsed during lockdown. Revenues, which form an ever-growing share of the budget for NHS dentistry, fell by nearly £600 million in 2020/21 compared to the previous year. The funding gap has been filled by government contributions.”
🚨85%: A new imposed target.
— BDA (@TheBDA) December 22, 2021
Dentists in England are being instructed to churn through NHS appointments in the face of the Omicron wave.
It’s the wrong choice at the wrong time. https://t.co/KKhF4T4Irb
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