Dear Mr Brack,
I have previously been a harsh critic of the GDC, especially in the days of the previous registrar. Indeed, I wrote many blogs that were well received by the profession. With the departure of the previous registrar, there was an opportunity for the GDC to begin to repair the damage it had done to the profession by the draconian and inefficient manner in which it had been led.
There appeared to be a time when the new team seemed to be developing a far more appropriate attitude to regulation, and I therefore felt it appropriate to perhaps watch the situation without commenting further. It was disappointing when Jonathan Green left, although I did feel that with you at the head of the Organisation (for indeed it is NOT a business but a QUANGO I think you will find) then there would be a continuation of the bridge building that was sorely needed.
However, whilst there seem to have been some minor improvements, fundamentally there seems to be no real change in the way the GDC wishes to be perceived by the profession and how it executes its statutory duty. Under the aegis of protecting the public, it is actually doing more to negatively affect the public it serves to protect by continuing to prosecute its role in a draconian and often arrogant manner. There is still huge a lack of insight into the damage it is doing to the morale and the well being of its registrants; damage that can be squarely blamed on the actions of the GDC itself.
Because when a profession is so scared of its very shadow that it can no longer function as it is supposed to, then the ONLY thing that will happen is harm to the public. That these professionals are so scared of virtually every treatment they do, every comment they make (including ones like this), and every action they take is a sad indictment of the way that the GDC is systematically destroying the very profession it regulates.
By retaining the ARF at the same level again, with yet another different reason than before, is symptomatic of the disdain and the contempt with which the profession perceive the GDC have for them. The profession are happy to be regulated, but by a fair, just, and right touch regulator. The continued heavy touch that the GDC continues to use cannot continue if the profession is to survive to be allowed to serve its patients as there will come a tipping point where we will no longer be willing to accept the duress of just turning up to work. If we placed a colleague under this type of stress in our workplace then WE would rightly fear being reported to our regulator.
We are human beings who set ourselves out to care for other human beings. There is no higher privilege than to care for another. However, we make mistakes, we are fallible. You are the same as us, a fellow of the Human race.
We rarely do things wrong deliberately, but we shouldn’t live in fear that the next thing we do both privately or in our jobs could end our careers and destroy our lives.
Please think of the damage that is being done to our profession by this apparent continued lack of insight displayed by the GDC.
Kind Regards,
Simon Thackeray
Image credit - Rakka_pl under CC licence - not modified.
The GDC have recently being taking a stance over professional conduct and particularly in regard to social media. The Standards say that we must not publically criticise colleagues unless this is done as part of raising a concern. I should like to make it clear at the outset of this blog that what follows is part of me raising concerns. Concerns that I feel are not being taken seriously enough, and some not even acknowledged as being concerning at all. This blog is in 2-parts. Part 1 will look at ‘bringing the profession into disrepute’ in the context of social media. It is perhaps timely in view of Mr Hill’s recent effort of justification over the need to suspend retired dentist Mr Pate under the pretext of ‘protecting the public’. Part 2 will look at my concerns over conflicts of interests. Both will, as usual, look at this in terms of recent events and cases.
So my part 1 concern relates to a fellow dentist who is a Clinical Advisor providing early advice reports to the GDC and the material posted on the public stream of their Facebook page. Our regulator tells us that we must not post material on public media that may undermine public confidence or bring the profession into disrepute. On this public-facing social media page, there is a joke about a sexual act, several slang references to parts of male anatomy and masturbation, a profile picture that is potentially racially-offensive (depending on the generation of the particular panel that might be selected by the GDC), but the finest one has to be the picture which blames patients for their gum disease and tooth decay because they are “*insertslangformasturbators*’’. Yet this Clinical Advisor, wrote in an early advice report for the GDC that a dentist who communicated with a patient using Facebook Messenger, was unprofessional for doing so. This would be funny apart for the stress that the registrant was put under as a result of it being included in their initial allegations which contributed to the case being forwarded for a full hearing. There will be more of this to come in another blog.
I emailed the current Director of Fitness to Practise to ask him what he thought about the content on this Clinical Advisor’s Facebook profile page, and whether he felt it was appropriate for someone affiliated with the GDC. The GDC ought to know how their Clinical Advisor was behaving whilst giving potentially life-changing advice about other registrants’ professional conduct. Perhaps my tip-off might assist them in getting their own house in order after a run of bad hearing outcomes for them and at a time when the mood of the profession is resembling that at the time of the ARF debacle. At the time I had started to draft this blog I had not received any reply, and suspected that the GDC’s email filters might have kicked my email with its supporting attachments of profanities straight into their Spam Folder. I have now received my reply, so I will come back to that later.
On this particular issue of ‘unprofessional’ social media comments, 2 registrants recently received letters from the GDC reminding them of their need to uphold standards when using social media. They had both used an inappropriate word, albeit on a single occasion, on a Facebook thread and a helpful colleague had very kindly pointed this out to the GDC without raising their concerns with the group moderators or the registrants themselves. The digital evidence suggests that the anonymous informant was another registrant. In terms of the naughty word used, it was quoted ‘verbatim and in italics’ in the GDC letter. If the GDC think that word is inappropriate they ought not visit the Dr Rant page and see their ‘affectionate’ nicknames for Jeremy Hunt which are used on an almost daily basis. The GMC don’t seem to concerned however, but perhaps doctors do not refer each other to their regulator over spats and spite instigated on social media platforms.
Anyway, I felt pretty strongly that this particular display of conduct on social media referred to above really should not go unquestioned, all things being considered.
The Standards apply to all and this Clinical Advisor who is a fellow dentist, is held to the same standards as us all. No-one should believe that they sit above us mere-registrants, somehow ‘protected’ by a relationship with the GDC. A colleague has a four-month suspension for alleged religiously-offensive statements made visible only to other dental registrants, yet I found his comments less offensive that this advisor’s silly, misogynistic and sexist posts. Also, someone with the infantile mentality that is publically displayed arguably unfit to assess whether any other registrants’ behaviour is professional, surely.
Whilst waiting for my email to be replied, rather hilariously, another registrant got a letter from the GDC courtesy of another anonymous informant reminding them of their professional obligations, and advising them to take action so they too could be better behaved in the future. However, the letter gave no information on what was posted that caused offense or deserved some kind of GDC-referral retaliation. An SAR sent the GDC may well clear that one up in time.
Taking screenshots from Facebook and using them to make complaints to the GDC is a rather petty way to retaliate against another dental registrant in my opinion. Those doing it really need to take a long hard look at themselves, especially if they are in the subset of registrants whinging about our high ARF.
As it happens, the GDC Annual Accounts and Report show that by 2018, 9-10% of incoming GDC complaints (as per my little infographic below) currently arise from other registrants. This is a record year. Well done registrants!! Keep this rate of progress up and in a few years we might actually beat the patients.
So actually, never mind the GDC: we also need to get our own house in order here. Please can we all stop being so childish? If you don’t like what’s on Facebook, get off social media, leave the groups that aren’t to your taste or contain people you don’t like, block people who wind you up, or if what’s being said is about you is that bad, spend your own money on legal proceedings rather than wasting all our money artificially inflating the ARF telling tales by the use of screenshots. Still, it’s nice to see that the GDC has healthy reserves of £20 million against a back drop of a decreasing number of incoming complaints. Maybe this is in preparation for the day we achieve a level of 100% of complaints arising from all the back-stabbing and bickering going on between ourselves.
This is the problem with the ‘duty to report concerns’:
LEGITIMATE CONCERNS REPORTED TO THE GDC OFTEN END UP IN ONE OR MORE REFERRALS IN THE OPPOSITE DIRECTION.
This is the sheer reality of the dire situation that faces us. The minute you act on a professional duty to raise concerns with the regulator, you are at risk that ‘concerns’ will be raised about you, and there will be GDC referrals all round.
But back to my email: I did get a reply regarding my Clinical Advisor issue. I was advised that I should use the online form to report the matter to the Initial Assessment Team.
It looks as though we are not the only group happy to throw dentists under the bus, which is always nice to know.
Image credit - Dave Bleasdale under CC licence - modified.
GDC Watch
Response to Mike Wanless
Thanks
On 13th June 2018 the Supreme Court, the highest court in the UK, gave its long awaited judgment in the Pimlico Plumbers case.
Mr Smith was a self-employed plumber who had been dismissed after six years of service. He claimed he was a worker and therefore entitled to certain rights such as holiday pay. The court found in his favour despite Mr Smith being registered as self-employed and benefiting from this status. He claimed tax relief on a home office and had his wife on the payroll of his company.
Sound familiar? Many associates are labelled as self-employed and benefit from this status for tax purposes. However, could they challenge their status in the employment tribunal and also benefit from basic employment rights?
In recent years the courts have been awash with cases in respect of worker status. With the rise of the gig economy, companies are taking advantage of those who want a more flexible way to work by offering ‘self-employed’ contracts. But is this being done at the expense of basic employment rights?
It is often the most vulnerable that are affected by the imbalance of power in such relationships. A prime example of this is in relation to a case involving a City Sprint courier. The courier took the firm to the employment tribunal claiming they were a worker and won. However, instead of changing all contracts to worker status the firm changed the contracts 'to simplify the language in these, further clarifying the rights and flexibilities available to self-employed couriers who provide their services to us'. It should be noted that in order to enforce worker rights, a claimant will need to issue a claim at the tribunal. This can involve time and money, which many in lower paid jobs do not have.
There has been a further case in the employment tribunal against Hermes, in which their couriers have also been found to be workers. Tim Roache, GMB general secretary, said: “This is yet another ruling that shows the gig economy for what it is – old fashioned exploitation under a shiny new facade. Bosses can’t just pick and choose which laws to obey"
Pimlico Plumbers Decision
Turning now to the case in hand, however, in which Mr Smith was paid highly for the work he completed, he was also able to add a 20% mark up on materials which he got for discount via the company, and he had a great deal of flexibility in his role. Is this really a vulnerable individual being taken advantage of?
Either way the Supreme Court has determined that Mr Smith was a worker and as such should benefit from the rights associated with this. As a result of another recent decision on worker status that we reported on, his claim for holiday pay could now date back to the start of his employment.
The two main issues for the court to determine were whether Mr Smith had to perform the services personally and whether Pimlico was Mr Smith’s client or customer.
Personal Service
If a person has to personally perform the services under the contract it is likely that they will be deemed a worker. Here the court looked at Mr Smith’s right to send a substitute to determine if he had to personally perform the services.
The employment tribunal held that whilst Mr Smith could send a substitute for any reason such as illness, holiday or other reason, he could only send another Pimlico plumber. This was seen as akin to employees swapping shifts. As a result of this limitation the Supreme Court held Mr Smith had to personally perform the services.
In assicoate contracts, there will often be a right to send a locum. However, is this right fettered? Does the Practice get the final say as to who can undertake the locum role? Or do they merely require a minimum qualification, DBS check and performer number? This could have a bearing on whether the associate is a worker or self-employed.
Business Undertaking
The court looked at whether Mr Smith was an independent contractor not in a relationship of subordination with the person who receives the services.
Pimlico tried to argue that they were the client of Mr Smith and he was a business in his own right. They relied on his tax return, which put his annual gross profit at £131,000, costs of materials around £53,000 and his net pre-tax profit at £48,000. The court disagreed with this for the following reasons:
As such the Supreme Court found that Mr Smith was not truly independent as there was an element of subordination.
Whilst many associates have clinical freedom and would not be required to wear a uniform, they do have to follow Practice policies and Practices decide the fees to be charged and when payment will be made.
Conclusion
This case does not suddenly change the status of self-employed associates. As stated above, someone needs to challenge their status in order to be afforded the necessary employment rights; until then the status quo will continue. Even then, simply because one associate does challenge their status this will not automatically affect other associates are affected. It must be borne in mind that dental practices come in many shapes and sizes.
However, this case is a warning for those that employ self-employed contractors of any nature. Now is the time to review contracts and ensure they are truly self-employed. If they are not, you need to take steps to protect your position as the risk to you is much greater.
If you have any questions about this article or need a contract reviewing, please feel free to contact Laura Pearce on This email address is being protected from spambots. You need JavaScript enabled to view it..
Laura Pearce
Senior Solicitor
Boundaries for Life was founded in 2010 to provide free health checks to fans or staff at sports grounds at major matches, engaging with people who may otherwise not encounter professional medical and dental advice.
Sponsored by SimplyHealth Professionals, they hope to help even one person prevent illness, using simple health checks followed by a little more sophisticated follow up which I will detail further.
I had the pleasure of visiting Chet Trivedy and his team at the Old Trafford One Day International between England and Australia, the series that England won 5-0, on Sunday June 24th. All the team there were volunteers, and the presence of their tent was helped by The Lancashire Cricket Foundation and Healthy Stadia.Helping even one personn change the course of their future health was the aim.
Chet is the founder and clinical lead of Boundaries for Life. He is dual qualified as a dentist and medic, with an interest in emergency medicine and maxillo-facial emergencies. In addition to his clinical work, he is an Academic Clinical Lecturer in Emergency Medicine at Warwick Medical School.
Chet said: “Given that men in their 30’s and 40’s are particularly poor at presenting early symptoms of diseases to their GP, and with limitations on access to dental services, the availability of free health and dental checks in the relaxed atmosphere of a sporting event is a valuable resource in the early detection of symptoms associated with chronic diseases. We are particularly pleased to be offering fans a ‘heart age’ test for the first time in 2018, and explaining why it’s important to know blood pressure and cholesterol numbers.”
Amongst the health checks made in the small branded gazebo
Each person is given a login to review their health results online, with a secret question and answer to safeguard future logins. The subject will then get an email follow up in several months to nudge them to follow the recommendations made during the short check at the cricket ground. The Biochemistry tests and team members who do this from minute blood samples are provided by BHR Pharmaceuticals of Nuneaton.
He set up these screening events after founding the Boundaries for Life organisation, then amazingly Chet suffered a stroke, he briefly lost his vision then found he was diabetic but thankfully has returned to good health. Ironically, as a dual qualified dentist and doctor, he hadn't had his own checks!
BFL is really proud to have helped over 3500 people have these health checks over the last eight years, with your help more can be seen in the future.
An appeal to dental readers of this blog – Boundaries for Life is seeking further dental volunteers for the oral health screening at future cricket matches. The schedule of matches is planned, but the number of dental colleagues volunteering is small. On the day I was there, one colleague was working the whole day and getting more volunteers shares the load. The ones who are off duty can watch the top class cricket! The more the merrier, it becomes a win-win-win.
To volunteer please use our contact page https://www.gdpuk.com/more/contact-us and GDPUK will pass on your details. I might join you, four colleagues, we can do checks for 2 hours, watch cricket for 6 hours!
Simply Health Professionals, using their network or practice contacts are also seeking dentists to volunteer to do the oral health screening. On Sunday, one family was helping their father, with daughters measuring height, weight and measuring waists! Chet reminds us it’s all worth it - if one helps the health of one person.
Boundaries For Life also seek further sponsors, and hope to cover even more sporting events in the future, dependent on their team and their funding.
Links:
http://boundariesforlife.co.uk/
Twitter @Boundaries4Life https://twitter.com/boundaries4life
Twitter @SHP_Dentists https://twitter.com/shp_dentists
Lancashire Foundation http://foundation.lancashirecricket.co.uk
Healthy Stadia http://healthystadia.eu/ - Enabling sports clubs to influence health and behaviour.
news article http://healthystadia.eu/boundaries-for-life-fixtures-2018/
Blood biochemistry tests https://www.bhr.co.uk/ - small machines which run rapid tests of blood biochemistry.
What is HbA1c? https://www.diabetes.co.uk/what-is-hba1c.html
It was a glorious September afternoon in 1966. The sun was streaming through gleaming windows. England had won the World Cup, and I had just moved to an exciting and brand new senior school. The classroom had spanking new desks with inkwells, filled with free ink you could draw up into your refillable Parker fountain pen. All was well with the world.
Mrs Wojciechowski, who was also our form teacher, was beginning our first ever French language lesson. I was trying hard to concentrate and confess I missed the meaning of ‘je m’appelle,’ because Peter Hadley who was sitting next to me, was crushing and drowning wasps in his inkwell, with what I regarded as an inferior fountain pen – the sort that scratched, rather than flowed Quink luxuriantly on to the page. Another failing of his pen was that as a tool for Vespidacide, it was failing miserably, one poor creature valiantly struggling to get itself out of the inky torture chamber. Not knowing at that point that Peter Hadley was a distant relative of a notorious Birmingham crime family and was destined to become the school’s head ‘hard-knock,’ I nudged him out the way and offered the tip of my pen to the bedraggled Hymenoptera, so that it had a means of escape from an indelibly inky death.
I suddenly heard a scream that sounded like a French woman shouting ‘murderer,’ but later realised I was in fact witnessing my first ever French swear-word - ‘merde,’ to be precise. I looked up to see Mrs Wojciechowski (French-born, despite her name) bearing down on our twin desk with a wooden ruler in her hand, and quicker than one of my Maryland bridges falls off, she had whacked the back my hand with the EDGE of the ruler, with all the might that her 4ft 6in frame could muster.
This episode was not only painful and a miscarriage of justice, but humiliating to boot and for the rest of that year, Mrs Wojciechowski looked at me with a deep loathing, like I had presented my dentist with the post-crown for recementing after I had retrieved it from the bottom of the Armitage Shanks two days after swallowing it. Upon realising I was under constant surveillance by Mrs Wojciechowski, I made sure I was never near a wasp, bee or inkwell ever again in that school.
I switched to a BIC not long after.
“My theory is along the following lines. Ahem."
We all know inherently, that it is becoming more and more difficult to avoid complaints these days, bombarded as the public is, with targeted Internet adverts and radio advertising. Even looking up and typing ‘dental complaints’ in Google as research for this article, brought up a host of dental litigation firm’s adverts on my Facebook page and various online news sites I read regularly, within an hour.
I strolled into a colleague’s surgery the other day to catch the end of a radio advert by ‘THEM’ – you know, the Cheshire-based mob, enticing dental patients to use them for all their dental litigation needs. I was appalled – I never listen to radio in the surgery – I just inflict my old-bloke’s iTunes playlist – from the Bee Gees to The Eagles to Snoop Dogg on my nurses day in, day out. It’s the reason I oppose permanent nurses, it means they don’t fatigue and burn out on my repetitious Barbara Streisand and Pussy Riot.
I couldn’t believe that these litigation firms were so ‘in-your-face’ with their radio ads, but my colleague confirmed that she heard them at least a couple of times a day and she often talks loudly over them to distract the patient in the chair from memorising the phone number.
Not only are civil claims mediated by the specialist dental litigation firms rising at a seemingly exponential rate (if you don’t believe me, look at your indemnity organisation’s annual subscriptions year-on-year), but cases brought to the GDC’s Fitness to Practice (FtP) process are also rising faster than caseworkers can write ‘dishonest’ on a charge sheet even if you haven’t been charged with dishonesty. From 2010 to 2014, FtP cases rose by 110 per cent. What the rise in civil and GDC cases is now, in the four years since 2014, is difficult to ascertain, but I feel it’s not outlandish to bet that the same rate of rise is probably not far out.
Most of us will know someone who is currently experiencing a spot of bother with the NHS Area Team, the GDC, or more likely, some chancer who has been taken in by a law firm who has found their supply of whiplash clients has suddenly dried up. A colleague of mine has recently been pursued by a patient claiming damages for a dry socket. Sheesh.
But, is the increase in patient expectations, fuelled by the easy access to no-win-no fee legal services, the only reason for the large rise in dental patient complaints?
“Ahem. This theory which belongs to me, is as follows. Ahem. Ahem. This is how it goes. Ahem. The next thing that I am about to say is my theory. Ahem. Ready?”
Well, here goes.
We all know nowadays, that the most important issue surrounding litigation is the paperwork. Have you recorded the BPE? Have you recorded why you are taking radiographs? Have you recorded why you aren’t taking radiographs? That’s what we’re obsessed with – getting the paperwork right so the statistical algorithms down at the NHSBSA don’t flag us up, or so we have a nice neat piece of work to show your defence organisation when they summon you for a day long grilling at a plush lawyer’s office in Lincoln’s Inn Fields.
But the whole reason you have ended up in trouble is that the patient wasn’t happy with your treatment (or some pig of a dentist who never liked you dropped you in it, but that’s another matter).
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“My theory is along the following lines. All brontosauruses are thin at one end, much MUCH thicker in the middle, and then thin again at the far end. That is the theory that I have and which is mine, and what it is too.”
Before 2006 and the introduction of the UDA-based ‘new’ contract, we all had, every few weeks, a sample of completed patients pulled by the Dental Reference Service and dragged into some God-forsaken community dental clinic, to have their work checked. The Dental Reference Officer (DRO) would check that you had a) carried out what you had claimed for, and b) done it nicely and hadn’t missed anything.
Admittedly, quite a few patients didn’t attend as requested (despite the fact they had consented to do so in the small print), but as a recent graduate, I was always quite on edge knowing that my work was going to be scrutinised by dentists that I considered by be my elders and betters. Dentists had the option of attending the DRO’s examination. In the main, I chose not to go. On one occasion, I did go.
And frankly, these checks focussed the mind. I was never accused of missing perio during that time, though I was once criticised for leaving a sub-gingival ledge the size of Chiswick on the distal of an upper six. Knowing that ANY patient could be pulled in for post-op examination by a DRO meant you left nothing to chance, even if you did note it. The DRO’s rebuke over the ledge, to my FACE, was like Mrs Wojciechowski’s ruler across the back of the hand. I have been very wary of ledges ever since. They have a nasty sting. I've missed LOADS of other stuff, but ledges are at a minimum.
I have no evidence for my theory, but I do wonder if the increasing litigation, particularly with regard to periodontal problems, could be as a result of there being no, what I would call ‘proper,’ check on the work carried out by dentists. (And this is by no means confined to NHS dentists). Even when cases against dentists go forward, patients are RARELY actually examined.
I would frankly, welcome them.
In 1983, after I had been at dental school for a year – some ten years after leaving school, I attended a summer garden party with my wife. Across the garden, I noticed a pair of latecomers. An elderly, tall, burly, Eastern European looking man with a shock of white hair, and a petite little lady of similar vintage, hanging off his arm. I instantly recognised Mrs Wojciechowski.
Encouraged by my wife, I approached her. My former teacher clearly didn’t recognise me ( l like to think I had by that time turned into a swan), so I introduced myself as one of her former pupils.
She said three words to me (this is absolutely true) and walked away:
“Oh **** off!”
And it wasn’t in French.
By @DentistGoneBadd
This is where I stand.
A few years ago, before David Cameron adopted the foetal position and waved the white flag to the advancing UKIPS, giving them the Brexit referendum, I was stopped by a ‘kipper’ in the high street of my adopted home city. I was asked if I wanted to forever remain ‘dominated’ by some ‘faceless European bureaucrat who would force us to consume straight bananas and live in dimly lit buildings powered by puny Dutch lightbulbs, or put the ‘Great’ back in Britain.
I answered thus:
“If I were the Prime Minister and had unlimited funds, I’d build a motorway bridge from here (the Midlands) directly to Paris.”
It was a nonsense answer – the sort that Donald Trump would have given – but I thought it got my point across. I am, and always will be, a European - a citizen of the world. I think Brexit is madness, and at a time when the world is becoming more and more fragmented, I strongly feel we need unity.
In the past couple of weeks, two of my closest dental friends – both from the EU, have indicated that they are thinking of returning to their countries of origin, having worked in UK dentistry for several years. Both were worried about the uncertainty surrounding their rights to residency – an issue still not absolutely clarified by the UK Government.
Another East European friend has recently left my corporate practice to go into independent dentistry, unable to cope with the madness of the NHS, UDA system. This has left the corporate practice critically short of clinicians and attempts to bring in either a permanent dentist or long-term locum has failed. (OK, fair enough, it IS a corporate after all). Many foreign dentists I have met have all been working for a UDA rate much lower than their home-grown counterparts and it is them in the main (it appears to me) that are prepared to work at a rate UK-born dentists would turn their noses up at.
One former corporate practice manager told me recently that she was told to offer prospective dental associates different UDA rates – foreign nationals being offered two pounds per UDA less than their UK counterparts.
I know of a number of NHS practices locally, which are currently struggling to find fully qualified associates of either UK, EU or other origin and this of course contributes to the lengthening of waiting lists and reception desk grumbling. With unattractive salaries on offer, particularly from the corporates, it is no wonder some practices are struggling to recruit. I once put myself on a few dental jobs websites and despite pleading to be taken off, am daily bombarded with all manner of associate jobs, from part-time to ‘whatever you can manage.’
Besides EU nationals going home as a result of Jacob Rees-Mogg, in 2017, a private Freedom Of Information request obtained from the General Dental Council showed that foreign dentist numbers dwindled in 2016, since nearly 40% of dentists who were found to have impairment of their fitness to practice originated from the EU or outside the UK and EU. This represented just over 3.7% of the total ‘foreign’ dentist workforce as contrasted to the 0.2% of naughty UK dentists based on 2018 registrant figures.
A search of the number of dental therapists in trouble with the GDC finds no such comparable statistics. Apart from one therapist in 2005 who was erased for performing a filling without a dentist prescription and one in 2013 who forgot to pay her Annual Retention Fee, there has been an exceptionally low rate of fitness to practice cases brought against therapists.
These days, since I work in a corporate, I meet very few therapists, but I have a very high opinion of them from personal experience. I will admit, I was forced into it because I couldn’t find an associate to move out into the sticks where my practice was located, but I employed a dental therapist in my own practice for a while a few years ago and her work was very good - providing a top-notch client service as well as taking patient appointment pressures off me. Her employment was also economically, a ‘no-brainer,’ being cheaper than employing an associate at 50% renumeration. I also trained with a mature dental therapist in the early 80’s. She flew through the dental course with ease, knocking spots of her classmates.
With many practices searching fruitlessly for fully-qualified post-vocational training dentists to replace fleeing dentists (for whatever reason), I wonder if we are missing a trick? Why not put these underutilised dental professionals to full use? Even the corporates haven’t caught on to this yet – presumably because they haven’t done the sums fully. Dental therapists can perform a wide range of tasks that can leave the corporate associates more time for searching for materials or stabbing the practice manager in the back. The only fly-in-the-ointment would be the stroppy associate who resents writing a prescription, but they can always be blackmailed with ‘OK. Do you want to do a radiograph audit after 5.00pm?”
In independent/NHS practice, remuneration would be a simple matter of a salary or hourly rate. In corporates, a nod to the associate’s prescription input would have to be acknowledged, so that he can get on to providing Band 3 mouthguards for someone who may have heard a vague click in their left TMJ in 1998.
Having said all that, I WILL miss my European colleagues if they do decide to go.
When I first met her, one of my EU friends was trying to pick up some British colloquialisms, mainly taught to her by her dental nurse, a girl with a mischievous sense of humour.
I arrived with my wife at the new house she was occupying with her now (British) husband. We had a lovely traditional meal from her home country, but then she apologised for the lack of furniture, and although we were perfectly comfortable at the dining table, she pointed to a couple of ample beanie’s in the lounge area and asked “Or would you prefer sitting on the douche-bags?”
David Cameron, what did you do?
A couple of months ago I stopped part way through a presentation and asked what words of advice the audience of dentists, of varying ages and experiences with the vast majority over 40, would give to a group of 25 - 30 year old dental graduates.
I have been mulling over their responses and the subsequent post-meeting discussions since then and sharing them whenever I can.
“Emigrate” was the first shout out. When I asked why, there were a number of answers, which set the tone for the mix of the realistic, but slightly miserabilist attitude, which can tend to dominate groups of dentists. “Because this country doesn’t appreciate dentistry, nobody values what we do, it’s better elsewhere”. This attitude harks back to my last post for GDPUK, “Nobody loves us every body hates us” and I believe that dentists should come to terms with the fact that people do like their dentist but don’t enjoy dentistry.
Next response was, “Say No”. On exploration this was the heartfelt plea to be left alone to do the very best for their patients. Constant interference from government bodies and the imposition of repeated layers of untried, untested and mostly unnecessary compliance have done little or nothing to improve the condition of patient care.
There was a feeling that dentistry had been caught napping about many of the changes and that the British Dental Association could and should have been more proactive in defence. (This was not a BDA section meeting). I teased this out a little more and the mood was that the BDA should lead, rather than react to change, that they should be the early adopters instead of worrying about the laggards.
“Go Part Time,” said an associate who shared how she had just reduced her working week to 3 days. My suggestion that all dentists especially practice owners should work no more than 4 clinical days a week (preferably less) was greeted with a certain amount of suspicion - no change there. Often I find that many dentists have such a “high maintenance” lifestyle because they can borrow highly that when they do want to consider reducing their hours they are so wedded to a treadmill of their own construction that it is hard to slow down.
The words of advice started to get more measured then and the group were clearly focussing on the target group rather than their own discomfort.
“Continue with Post Graduate training.” The awareness that in many areas therapists are replacing associates, who had not developed their skills and training beyond BDS, is leading to a growing realisation that you must bring something unique or special to the party. I do meet associates who cannot see the wall ahead of them and still believe that a few local meetings a year is all they need to stay current.
“Choose the right practice.” Said with some emotion by one dentist who shared some familiar stories of promises made and not kept by several principals with whom he had worked. The nods in the room showed that was a common experience.
“Get the balance right.” Bearing in mind that the subject of my talk was the causes and signs of burnout it was no wonder that this was in delegates’ minds. Unfortunately for too many it seems that balance is something that has to be restored in their lives after a problem or two rather than being established as a matter of course.
“Good financial advice, ASAP” This contributor was keen to encourage all young dentists to start planning for their financial future sooner rather than later. Their experience it turned out had been of needing to stay working rather than wanting to because they were not going to be as well off in retirement as they had believed.
“Look after yourself, physically and mentally.” In every group where I speak, especially about the topic mentioned above, someone comes and speaks to me at the end and shares their experiences of breakdown in some shape or form. This was no exception, except there were three of them who had not taken care and suffered from the consequences. The sometimes macho culture of (UK) dentistry can certainly take its toll with life altering consequences in some cases.
“Don’t be afraid to leave.” The world of dentistry is split into two groups it appears, those who have no idea of the value that they can to deliver to the world away from the dental chair and those who have walked away and been successful. The former camp may have self-esteem problems in my opinion and possibly never thought themselves good at dentistry in the first place. It could be that having aimed at dentistry from the age of 15 or 16 they can’t comprehend a life away from it.
“Choose your company wisely.” I thought this was particularly good advice, unfortunately the Internet is full of bad stories about “things” that have happened to dentists. If you are so inclined you can spend hours wallowing in websites, Facebook groups and bulletin boards where individuals try to out do each other with either misery or boasting about their success. All these of course are exaggerated and do little or nothing to help. If the old adage, “you are the sum of the people you spend your time with” is true, and I believe it is, then be selective and stay away from doom mongers and atmosphere hoovers who celebrate misery.
Finally came this gem:
“Don’t listen to old gits who tell you how good things used to be.” This was the view of the people who were really enjoying their lives in dentistry, who had control of their own destiny and could see opportunities in the future. They knew that there have been, and would, always be challenges and that was the way that life is. The “old gits” are the same people who moaned about the 1990 contract, the move to wearing gloves, and changing burs between patients. They were probably the ones who in their day missed vulcanite (look it up), daily “gas” sessions and the inevitability of full dentures. They were the gang who were suspicious that dental hygienists would take the bread from their mouth, believed that the relaxation of advertising was the death knell of professionalism and said that they would never get rid of their upright chairs.
There’s a lot of wisdom in dental audiences, it’s a shame it isn’t shared in dental schools.
Shame about your last sentence
Thanks Paul
Old gits
In the first two articles in this series (part 1 and part 2) I’ve taken a look at how the new Data Protection Bill – incorporating the EU’s General Data Protection Regulation (GDPR) - is coming along. I’ve highlighted the importance of preparing by taking a good look at all the personal data you currently hold in the practice (a Data Audit). Where does it come from? With whom do you share it (or might disclose it to)? How long will you keep it? Do this as a practice team, because ultimately everyone is responsible for good Data Protection.
The Data Protection Bill is still working its way through the parliamentary system and further amendments are still possible, although unlikely to impact dentistry. We will continue to watch this progress closely and to update Simplyhealth Professionals practices as we move towards the implementation date of 25th May 2018.
Fees
I gave some clues as to future Data Protection fees payable by Data Controllers last month, and now we have a clearer idea, although still subject to Parliamentary approval. As predicted there are three ‘tiers’, but some careful thinking may be needed to know which one you fall into.
Firstly, if you do not do any electronic processing (at all – that includes computers, tablets, smartphones, CCTV or any form of digital equipment) – and that’s pretty unlikely I would say in 2018, or if you only use a computer for the purposes of staff employment, PAYE, business administration, and payment processing (i.e. only basic personal details) it might appear you are technically exempt from paying a fee. But, the ICO has stated that any personal data processed for the purposes of ‘healthcare administration’ you will still have to pay. (See The Data Protection Fee – A guide for Controllers at ico.org.uk)
If you have a small practice, with 10 or fewer staff (every part-timer counts as ‘one’ and that includes the cleaner, gardener, and self-employed associates, hygienists etc), and if your annual turnover is less than £632,000 then you are in Tier 1. The fee will be £40, or if you pay by direct debit, then £35. Yippee, no increase! You will get a reminder when your current registration runs out, and an opportunity to set up the direct debit then.
(A little complication: if you have an NHS contract, then you are regarded as a ‘Public Authority’ in respect of processing and fees from that contract only. Public Authorities are exempt from the turnover threshold above, so if your NHS contract turnover is more than £632,000, then you are rated only according to your sGDPRtaff numbers. So a very big NHS contract but low private fee income might keep you in Tier 1.)
Larger practices, who do not fall within the above criteria, will pay a Tier 2 fee of £60 (again presumably with a direct debit discount of £5). This covers Data Controllers with 250 or fewer staff and a turnover of less than £36 million. Large Corporates may need to do some calculating, but otherwise this Tier will cover just about every other large-ish practice or small chain.
Tier 3, at £2,900 annually, is probably not an issue for dentists!
If you are currently registered (‘notified’) with the ICO – as you almost certainly are – there is no need to take any action until you receive your reminder to renew after 25 May 2018.
Your fee level will, in most cases, be accurately anticipated by the ICO but you should check to make sure it is correct and either call or e-mail them if not. It seems likely that if your renewal date is shortly after the implementation of the new law, there will be significant delays in getting changes made, but so long as you can show you took all reasonable steps then this should not disadvantage you.
Remember that Associates will only need to register – as now – if they act as Data Controllers in their own right (see the ICO’s Information Governance in Dental Practices, September 2015).
Action Stations!
Between now and 25th May, practices will need to:
Whew!
Helping Member dentists
To help with preparation, Simplyhealth Professionals will be publishing further guidance for members on all the above, including templates for the necessary policies and assessments. However, in every case, it will be necessary to consider how these templates should be adapted for your own particular circumstances and practice.
This information will be published on the web portal for member dentists to access and it is hoped that all the necessary policies will be in place by the end of March. However, the new law is still Parliamentary ”work in progress”, so you should keep aware of any updates in monthly newsletters and e-mails.
Although ICO has said they will take a “proportionate” approach to enforcement in the early days of the new legislation, we cannot be sure the healthcare regulators (or NHS Commissioners) will take a similarly sympathetic approach. So preparedness is necessary!
A Lawful Basis
As noted when writing about Privacy Notices in previous articles, a Data Controller can only process data under the new legislation if they have a Lawful Basis to do so. Sounds reasonable, and GDPR gives six options to choose from.
Consent sounds like a good idea and as dentists we are well versed in this topic. However, remember that consent can be withdrawn at any time, and whilst you might simply and rightly stop treating a patient who decides, for whatever reason, to exercise this ‘right’ it would make life difficult for all concerned.
Necessary to fulfil a contract would apply in the case of self-employed staff members, such as associates, hygienists and so forth, so is appropriate for those cases.
Necessary for a Public Task is actually appropriate for all processing to do with NHS Contracts, since if you have one, you are regarded as a ‘public authority’ and are carrying out processing as required by legislation. So that ticks off the NHS patients and their care.
Legitimate Interests of the Controller is really the catch-all that would be appropriate for most of your private patients’ care and treatment. A ‘legitimate interest’ is really any self-evident need that an organisation has in order to function, and where a ‘data subject’ (patient) would ‘reasonably anticipate’ that such processing is necessary, provided it does not undermine any of their rights.
In order to use Legitimate Interests as your Lawful Basis, the legislation requires that you complete a Legitimate Interests Assessment (LIA). This is not too difficult provided you follow the detail of the law: firstly do you need the information? Secondly is there any alternative? Thirdly can you balance your need against the patients’ rights? And finally what actions do you take to ensure the security and confidentiality of the data? There will be a template for an LIA provided on the member dashboard during March.
Why the fuss about ‘Lawful Basis’? The legislation requires that your full Privacy Statement, freely accessible to all those persons whose data you process, specifies clearly what this basis is. On a website this must be clearly signposted (not buried in the small print), and in the practice its availability can be pointed out within a brief statement given verbally or, I would suggest, added to medical history forms and updates.
Finally…
A few odds and ends.
If your practice software provider stores or backs up your data, you should have a fully documented contract showing where the data is kept, and if it is overseas (especially if outside the European Economic Area) does it conform to GDPR requirements?
If you use patient data for marketing purposes, and also if you routinely contact patients by e-mail or text message, you will need to have specific marketing consents for these activities. Again, simple messages about forthcoming appointments can be consented with specific ‘opt-in’ boxes to be ticked and signed for. The medical history form is a good place for this too. ‘Opt-outs’ or other non-explicit methods will no longer be acceptable.
Do you need a Data Protection Officer? If you have an NHS contract (however small) the answer is “yes” as you are considered a ‘public authority’. However, authoritative guidance (from an EU Working Party) states that although ‘large scale’ processing of ‘special’ (e.g. health) data, such as by a hospital, does require the appointment of a DPO, processing of patient records by ‘an individual physician in practice’ does not. You may however feel that it is worth appointing one anyway: note that their identity will be shown in a public register held by the ICO. They are not ‘responsible’ for compliance (that remains with the Data Controller), but may be a source of expertise and advice, and may, if desired, be an external appointment.
Check your website cookie policy and make sure it is compliant (a template is on the way!)
Finally, make sure everyone in the team is aware of the changes coming up, of their increased responsibilities around data security (no more passwords on Post-It notes!), data breaches, and confidentiality, and review your training at regular intervals!
Errata - Postscript by Roger Matthews
A quick note before you read through my blogs on GDPR (or if you’re reading them again). The complexities of this new legislation (and the amendments taking place at the eleventh hour in Parliament) mean that my commentary has been “on the hoof” so to speak and based on available knowledge at the time of writing (starting last December). So there are a few points I now need to clarify and correct.
In Part 1 ‘GDPR - The New Millennium Bug?’ I mention specific consent from patients for processing data. It’s now clear that this is a bad basis to use since patients can withdraw consent. I correct it in Blogs 2 and 3. Oh, and the new law will be the Data Protection Act 2018 (not 2017).In Part 2 'GDPR - Privacy Notices and Consent' I refer to patient consent possibly being needed for referrals. This arose from some EU commentaries on GDPR (The Section 29 Working Party if you must know) whose advice was rather vague. I now think that this is unnecessary by virtue of exemptions in the Act. I also got the new ICO fees wrong – but those were the ones she was suggesting to the Government at the time… plus ça change…
Finally in Part 3 'GDPR and Data Protection', written as recently as March, we have again been overtaken by events. It seems the ICO will ‘assume’ everyone is in Tier 3 for fees, so unless you want (or need) to pay £2,900 a year, make sure you correct her when your renewal notice comes around (on the anniversary of your current notification fee). The Report stage of the Data Protection Bill happened on Wednesday 9th May when there was a whopping 138 amendments to be considered. One of those of particular note was an amendment to exempt primary care providers with NHS contracts from appointing a Data Protection Officer. Sadly for NHS providers, the Government rejected this amendment.
The Bill now returns to the House of Lords for the final stages.Roger Matthews
GDPUK thanks SimplyHealth Professionals and Roger Matthews for their permission to reproduce these three blog articles.
Image credit - Jon Worth under CC licence - not modified.
Hopefully you’re reading this after digesting the first part of this GDPR blog. If so, then even more hopefully, you will by now have done a “data audit” as recommended by the Information Commissioner’s Office (ICO).
You haven’t? Then you should: it won’t take too long. Work out all the personal data you hold: on patients, staff and contractors (Associates etc.), where do you get it from? And with whom do you share it? If you export data to a third party (a laboratory, patient referrals or cloud storage for your Patient Management Software maybe), do they have good data security (can they describe it or have a policy you can see?) and where is it stored or backed up? In particular is cloud storage in the EEA or in another country?
When you’ve completed your audit, the next thing is to consider “why” you hold the data – the “purpose of processing”. For the vast majority of practices, this is blindingly obvious – to you at least! You process patient data in order to provide safe and effective dental healthcare, you process staff data for employment law purposes, and you process contractor data to maintain effective financial and performance records. Simples!
A few practices may undertake forms of marketing which go beyond those simple purposes. They may buy in mailing lists to attract new patients, or may offer additional services to existing patients. If you undertake direct marketing in this way, you should look at the advice given by ICO (Google: ’ICO direct marketing’).
One of the relatively few (for dental practices anyway) major changes that the General Data Protection Regulations (GDPR) will introduce is that ‘data subjects’ (i.e. living individuals) whose data you will hold, store, process and ultimately delete, must be given prior notice about the data you hold, the reason/s you hold it, who you disclose it to and what their rights under the new Data Protection regime will be. This is called a Privacy Notice.
If that sounds like a complicated document, it is! At least in the sense that it needs to be drawn up carefully. It must not read like a complicated document, since you must, by law, be transparent and clear in your communication.
The ICO helpfully suggests that you do not need to spell out the full details of your Privacy Notice when patients (or staff, or contractors) first engage with you, but you must signpost it to them so that they can easily find it. That’s easy on a website (“click here for further details”), but perhaps a little more difficult when patients telephone or present in person.
You could, for instance have a short Privacy Notice at reception, or on a practice information leaflet, and either display a full version on the premises or laminate one that is available for patients to read. However you do it, a Privacy Notice is a must!
Again, you can read about Privacy Notices on the ICO website, and/or you can sign up (for free) to www.dpnetwork.org.uk which is an open access website for small businesses and charities. They have good legal opinions backing them.
Now let’s have a closer look at “consent”. Don’t confuse this with the professional and dento-legal term: in this case, it is defined as one of six ways in which you can lawfully process personal data. I have seen it rumoured that you will need to have explicit, clear and unambiguous consent from every patient/employee/contractor before you can even access the personal data you already hold! Whilst possible (maybe), that’s a very big ask.
Fortunately, the GDPR allows other ways for organisations to lawfully process data. One of these is the “legitimate interest” test. Essentially, this means that if the data subject would reasonably expect you to collect, hold, etc., their data for, effectively, self-evident purposes, and you only collect and process data for such essential purposes, and you are not contravening or infringing their rights to privacy in the process, then that’s OK.
Well, it’s sort of OK!! It is recommended that in order to validate your choice of “legitimate interest” as a lawful basis for processing, you should carry out a Legitimate Interest Assessment (LIA). This would set out firstly, what those essential interests are; secondly, identify the necessity for processing the data; thirdly, to balance the needs of the organisation against the rights of the data subject; and finally, what actions will be taken to ensure that processing is not excessive or invasive.
Again, the ICO and DPNetwork have excellent advice on how to carry out an LIA and it’s strongly recommended that you do this before relying on this basis. But it does avoid the need for a blanket consent exercise.
All that having been said, it remains true under the new legislation that health-related data about an individual is regarded as more sensitive (“special” in GDPR-speak). Thus article 9 of the GDPR states that processing health-related data (and other categories, similar to the existing UK Data Protection law) is prohibited, unless one of a number of exceptions apply. One of these is ‘…medical diagnosis, the provision of health or social care or treatment …pursuant to contract with a health professional’. So again, that seems OK, but… the EU Working Party looking at consent still hasn’t produced its final guidance and in its final draft it gives an example which suggests that explicit consent is required, for instance, when transferring a patient’s health data to a referral practitioner or specialist.
So for caution’s sake, when getting updated medical histories, having patients sign treatment plans, or submitting treatment claims, it is probably advisable to get patients to clearly indicate that they consent to the use of data as in your Privacy Notice (which should be available to them to read if they wish). And refreshing that consent (e.g. at medical history updates) is a good idea too. The use of pre-ticked boxes, inaction or silence on the part of a data subject can no longer be relied on, either.
It’s anticipated that generic templates will be available for Privacy Notices, LIAs and other key components of the new Data Protection legislation in the coming months, but it’s a good idea to have some drafts in your mind now to stay ahead of the game.
In the third and final part of this GDPR blog, we’ll look at Data Security, dealing with Subject Access Requests and complaints, and an update on how the new Data Protection Act is going through Parliament.
PS: Annual Registration Fees with the ICO
Parliament hasn’t yet approved a new fee-scale for registering with the Information Commissioner after the new Data Protection Act becomes law in May 2018. But the ICO’s draft guidance to the Government has suggested a three-tier approach. Very small, or new dental practices which process fewer than 10,000 personal records will be Tier One with a fee “up to £55”; but those with larger patient bases will fall into Tier Two: “up to £80”. It’s likely that existing annual notifications will be valid until their expiry date. Watch this space!
Part 1 of this blog https://www.gdpuk.com/blogs/entry/2123-gdpr-the-new-millennium-bug
Part 3 of this blog https://www.gdpuk.com/blogs/entry/2125-gdpr-and-data-protection-part-three
Errata - Postscript by Roger Matthews
A quick note before you read through my blogs on GDPR (or if you’re reading them again). The complexities of this new legislation (and the amendments taking place at the eleventh hour in Parliament) mean that my commentary has been “on the hoof” so to speak and based on available knowledge at the time of writing (starting last December). So there are a few points I now need to clarify and correct.
In Part 1 ‘GDPR - The New Millennium Bug?’ I mention specific consent from patients for processing data. It’s now clear that this is a bad basis to use since patients can withdraw consent. I correct it in Blogs 2 and 3. Oh, and the new law will be the Data Protection Act 2018 (not 2017).In Part 2 'GDPR - Privacy Notices and Consent' I refer to patient consent possibly being needed for referrals. This arose from some EU commentaries on GDPR (The Section 29 Working Party if you must know) whose advice was rather vague. I now think that this is unnecessary by virtue of exemptions in the Act. I also got the new ICO fees wrong – but those were the ones she was suggesting to the Government at the time… plus ça change…
Finally in Part 3 'GDPR and Data Protection', written as recently as March, we have again been overtaken by events. It seems the ICO will ‘assume’ everyone is in Tier 3 for fees, so unless you want (or need) to pay £2,900 a year, make sure you correct her when your renewal notice comes around (on the anniversary of your current notification fee). The Report stage of the Data Protection Bill happened on Wednesday 9th May when there was a whopping 138 amendments to be considered. One of those of particular note was an amendment to exempt primary care providers with NHS contracts from appointing a Data Protection Officer. Sadly for NHS providers, the Government rejected this amendment.
The Bill now returns to the House of Lords for the final stages.Roger Matthews
GDPUK Thanks SimplyHealth Professionals and Roger Matthews for their permission to reproduce these three blog articles.
If it hasn't already happened to you, it will! Over the next few months you'll be approached with numerous offers to guide you (for a fee) through the 'demanding processes' of compliance with the EU's General Data Protection Regulations (GDPR).
"Aargh," you may say, as you read the doom-sayers' predictions of harsh fines and imprisonment (or both), here comes yet more compliance pressure on my overworked dental team!
However, you should be reassured by the Information Commissioner's statement that anyone (or any organisation that complies with the existing Data Protection law, is already well on the way to achieving compliance with the new requirements.
GDPR was issued by the EU in May 2016, giving all member states two years to comply. It's provisions will apply in the UK from 25th May this year. However, each country has some freedom to amend a few details and the UK Government has also decided to 'tidy up' and 'tighten up' on the existing law, the Data Protection Act 1998.
so, on 25th May there will be a new Data Protection Act 2018. This will encompass the GDPR requirements and the draft legislation is currently lumbering through Parliament. The
House of Lords has been debating it since October and it probably won't get the Royal Assent until sometime around Easter.
While we don't absolutely know what the final version will look like, we do know most of it, given that much of the discussion will not really be relevant to dentistry in particular, or primary healthcare in general.
The Information Commissioner's Officer (ICO) has already issued a '12 step guide' to the GDPR which is a useful start to check your current status. As a responsible practice you'll already be registered ('notified') with the ICO (don't be fooled by the earlier news that GDPR will abolish notification or annual fees!) Plus, you'll have a Data Protection Policy and an Information Security Policy (Information Governance compliance too, if you're an NHS contract-holder).
It is worth checking some things at this early stage, however. Do you obtain 'specific and explicit' consent from your patients to store their data? Do you have a privacy notice that tells patients (and prospective patients, for instance on your practice website) exactly what data you hold and who you share it with?
It may seem simply - you keep their personal details and health records and because you know all about professional confidentiality, you
keep it all to yourselves. But what about your IT system? Is it backed-up in-house? Is it held in ‘the Cloud’? And if so, where exactly? Do you send patient information to any third
parties, such as insurance companies or Simplyhealth Professionals, for instance? You can be certain that Simplyhealth has rigorous security, but do others? Do you? Is any data taken home or stored on USB sticks or personal computers? It’s worth thinking it through and conducting an audit to look at all the data inflows and outflows.
When you know exactly where all your patient and staff data comes from and where it goes, you can rest assured that you’ll have ticked off one important stage in preparing for the 25th May deadline.
A quick note before you read through my blogs on GDPR (or if you’re reading them again). The complexities of this new legislation (and the amendments taking place at the eleventh hour in Parliament) mean that my commentary has been “on the hoof” so to speak and based on available knowledge at the time of writing (starting last December). So there are a few points I now need to clarify and correct.
In Part 1 ‘GDPR - The New Millennium Bug?’ I mention specific consent from patients for processing data. It’s now clear that this is a bad basis to use since patients can withdraw consent. I correct it in Blogs 2 and 3. Oh, and the new law will be the Data Protection Act 2018 (not 2017).In Part 2 'GDPR - Privacy Notices and Consent' I refer to patient consent possibly being needed for referrals. This arose from some EU commentaries on GDPR (The Section 29 Working Party if you must know) whose advice was rather vague. I now think that this is unnecessary by virtue of exemptions in the Act. I also got the new ICO fees wrong – but those were the ones she was suggesting to the Government at the time… plus ça change…
Finally in Part 3 'GDPR and Data Protection', written as recently as March, we have again been overtaken by events. It seems the ICO will ‘assume’ everyone is in Tier 3 for fees, so unless you want (or need) to pay £2,900 a year, make sure you correct her when your renewal notice comes around (on the anniversary of your current notification fee). The Report stage of the Data Protection Bill happened on Wednesday 9th May when there was a whopping 138 amendments to be considered. One of those of particular note was an amendment to exempt primary care providers with NHS contracts from appointing a Data Protection Officer. Sadly for NHS providers, the Government rejected this amendment.
The Bill now returns to the House of Lords for the final stages.
Roger Matthews
GDPUK Thanks SimplyHealth Professionals and Roger Matthews for their permission to reproduce these three blog articles.
By Chris Tapper
One working day in April 2018, precisely at 4.50pm, ten minutes before the unseemly scramble by the dentists to get out the door to avoid the dry-retching of the nurse’s as they clean the filters out, I was presented with a sheet of paper.
A nurse delivered the A4 sheet with a flourish and the warning that our corporate practice manager required my signature before five, since she was going away for a few days.
A space had been left for me to make my mark and I noticed all my colleagues had already signed the sheet, with that day’s date. My colleagues had all apparently attested to the fact that they had completed in-house training in needlestick injuries, they had all read the practice policy on needlestick injuries, and they had then participated in a ‘facilitated practice discussion’ about needlestick injuries. The top of the sheet stated that all the training and accompanying requirements had to be completed by the end of January 2015.
I certainly hadn’t completed the in-house training in question personally and definitely hadn’t noticed a facilitated practice discussion, unless I missed it because I was engrossed in Facebook at the time, doing a fun quiz on ‘is your line manager a homicidal psychopath?’ (My answers were probably of great value to Cambridge Analytica and the ‘Leave’ campaign).
More interestingly, three of my colleagues hadn’t even been employed by the corporate around the date mentioned and I figured that two of them couldn’t possibly have done the training since they are new trainees, though they MAY have read the policy during induction. One of them admitted they had only signed the policy sheet “To avoid a lot of hassle.”
I dismissed the nurse with an “I can’t sign it since I haven’t done the training,” to be met a few minutes later by a text from the head nurse with a link to a video on, presumably, needlestick injuries.
The upshot was that I actually went online and found the subject on the website of a training organization I occasionally use, and produced a CPD certificate before six and signed the form anyway.
Yup, I wimped out rather than be met with the ‘I’ve Been Bagging Angry Wasps Into A Sack With My Bare Hands Face’ of my corporate practice manager.
Of course, the nub of the above was that someone in management (I don’t know at what level) had fouled up and had realised that CQC requirements had not been met. In order to meet requirements, staff had been browbeaten into fraudulently signing a statement that would give the authorities the impression the company was complying with regulations.
And the reason I have outlined the above?
Corporate Bullying
At this time of year, independent dental providers are bidding for contracts against the corporates and increasingly, they are being undercut by the latter, who use their low wage, high trainee workforce ratio and dubious interpretation of NHS regulations to undercut independent practices.
NHS commissioners are desperate people. They need to secure services at the lowest possible rate and the corporates present them with exactly what they need to satisfy the number-crunchers at the Department of Health - high numbers at low prices. To quote from a popular 70’s sitcom, “Never Mind The Quality, Feel The Width.”
It’s a subtle form of bullying, but it’s bullying nonetheless. The Independent practices cannot possibly hope to compete on an equal footing with companies that run their practices on trainee nurses and (largely) EU dentists willing to work for £8 to £9 per UDA until Brexit is put into effect.
It’s the equivalent of being elbowed in the face by the school thug as he pushed into the lunch queue.
I have worked for a corporate for over five years after selling my own practice, and during that time we have had a huge turnover of nursing staff. As nurses qualify, they leave within months for the independent sector - not once has a qualified nurse been replaced with a qualified nurse. The company just takes on another trainee, and often the £9-per-UDA associate finds him/herself providing the in-surgery training.
The playing field is definitely not level. Low quality materials, poorly maintained equipment and restrictions on which laboratories can be used all contribute to the ‘Poundstretcher’ mentality. At one point last year, we had absolutely no x-ray facilities while head office sourced the cheapest scanner possible.
Unfortunately the commissioning Area NHS Teams are either oblivious to what is happening in the corporates, or are turning a blind eye. And by no means is my corporate the worst offender - I’ve seen worse with my own eyes. As corporates go, mine is considered to be one of the ‘good guys.’
So what is to be done? Your guess is as good as, although I would LOVE to see widespread and coordinated unannounced CQC inspections nationwide at 9.00am. Or else a mass walkout of the Nash by the independents? The corporates definitely wouldn’t cope - few of them hit their contracts annually anyway.
As for me, I’m off to Poundland.
On the 20th April 2017 HMRC updated their ‘Internal Status Manual’ regarding the employment status of dentists. This made clear that where dentists are practicing as associates in premises owned and run by another dentist and are subject to a BDA or DPA approved associate contract, and the terms are followed, then the associates income will be assessed under ‘trading income rules’ and not as an employed income. In short, associates are self-employed and as such will be liable for Class 2/4 National Insurance, not Class 1 National Insurance. Despite changes bought into effect by the NHS General Dental Services Contract, which changed the way that dentists were paid, allowing for less fluctuation in income, HMRC were of the view that as long as associates continued to pay their share of laboratory fees and follow the terms of their associate agreements, then they will remain self-employed.
So what has changed?
Over the last 6 months there have been a number of landmark legal cases before the UK courts. Laura Pearce of JFH Law wrote in June last year that the tide was turning for dental associates following the Court of Appeal decisions in the cases of Pimlico Plumbers and City Sprint, which were hot on the heels of the earlier decision in the Uber in October 2016.
These cases all revolve around the ‘gig’ economy, where companies have traditionally relied upon casual or flexible labourers, who get paid for the work they do, rather than a weekly or monthly agreed salary. These people are often categorised as independent contractors, but the legally reality can be very different.
The Court of Appeal has ruled that despite the fact that the individual’s contracts defined them as self-employed, and certainly in the case of the Pimlico Plumber, they had benefitted financially from the arrangement for many years, they were in fact ‘workers’ not ‘self-employed contractors’. This means that they are entitled to the national living wage, holiday pay and statutory sick pay and the right to pension auto enrolment.
One of the key definers for whether an individual is a worker or self-employed is whether they have an unfettered right to send a substitute. If a dental associate is obliged to undertake the work personally, and can only send a substitute in the event that they are unavailable (for example when they are unwell or on maternity leave), or the right to send a substitute is dependent upon the consent of the practice owner, then it is highly likely that they will be defined as a worker by the employment tribunals. Pimlico Plumbers have appealed the judgement to the Supreme Court and judgement is currently reserved.
However, could an associate dentist go further and argue that they are an employee; thus obtaining all of the benefits of employment, including the right not to be unfairly dismissed? As no associate dentist has yet challenged the status quo within the Employment Tribunal it is not possible to answer this categorically. It will depend on the nature of the working relationship, the mutuality of the obligation between the parties; i.e. is the dentists obliged to offer work to the associate? Is the work done within fixed hours at a price fixed by the Principal? Finally, is the associate obliged to undertake that work themselves? If the answer is yes to all of these questions, the dentist could well be an employee.
What does this mean for tax purposes?
To date, if an individual is defined as a worker by the Employment Tribunal, that has not automatically affected their status as ‘self-employed’ for the purposes of paying their taxes. Indeed there have even been circumstances where the Tribunal has determined that an individual is employed for employment law circumstances, but self-employed for tax purposes. As such a ‘worker’ and an ‘employee’ can be exempt from PAYE and pay Class 2/4 NI contributions.
In 2017, HMRC had clearly taken the view that regardless of the personal nature of the services offered by dentists, they were content to allow them to continue as self-employed. However, the indications are that this is likely to change in the not too distant future. There is little benefit to HMRC under the current arrangement, and they are likely to see a change in associate dentist’s status as an opportunity to increase NI contribution and tax revenues. Furthermore, with the Government’s current focus on shifting responsibility of pension provision away from the state onto third party employers, it is likely that the writing is now on the wall for many associates self-employed status.
This has major implications for practice owners. Whilst any change in status for the purposes of HMRC is unlikely to be retrospective, bearing in mind their current guidance, this may open the floodgates for claims from associates against their principals before the Employment Tribunal. With the tax benefits of self-employed status gone, associates may think it’s worth arguing that they have been workers or employees for years. They can then claim back unpaid holiday since the commencement of their employment and demand enrolment in workplace pension schemes.
If you are concerned about your employment status or want to discuss the content of this dental bulletin contact Julia on This email address is being protected from spambots. You need JavaScript enabled to view it. or call us on 0207 388 1658.
Julia Furley, Barrister and Partner
If you’re a practice principal you’ll no doubt be familiar with the term ‘exit strategy’. What you may not know is that your plan should be in place at least five years before you actually intend to leave. This gives you time to get all your accounts in order, identify the appropriate exit strategy and identify your personal goals for the future. Not to mention that it will help you secure a smooth exit and gain maximum return on your practice.
If you plan on selling the business as a way of securing monetary funds for retirement, then that time can be used to implement strategies that will help to maximise turnover and profits. Advertising and branding can help with this, as can having a dental practice valuation from a specialist valuations company.
As part of your exit strategy you should also decide whether you want to sell the practice outright or stay on part-time as part of a deferred consideration deal. Admittedly the eventual outcome may be outside of your control, but it’s definitely something to give thought to and plan. Especially if your intention is to depart immediately and settle for a smaller sum, as you may need to start your exit plan even earlier.
Of course, the better the planning, the more likely you are to achieve your personal and business goals. So if your heart is dead set on walking away from the practice and avoiding being tied into a part-time contract for several years after the sale, you’ll need to plan in advance to make that happen. Naturally, it’s best to contact a specialist dental acquisitions and sales agency that can help you to establish the most appropriate exit strategy that matches your objectives.
They will also be able to warn you of potential pitfalls to avoid. For instance, don't make the mistake of taking on fewer patients and reducing working hours too soon. All too often practice principals make this mistake, resulting in stagnation of growth and loss of income. As your profits decrease, so will the practice’s attractiveness to potential buyers and banks.
In regard to your staff, be sure to look at the way in which your associates are remunerated in your exit strategy to create an accurate overview of your practice’s performance and potential. Official associate agreements will be needed as well to protect the goodwill of the practice and assure potential buyers that the clinical team plans to remain with the business for the foreseeable future.
If retirement is on your mind or you’re thinking of moving on, then it may be time to start thinking about an exit strategy. Call Dental Elite for a free valuation, healthcheck and expert advice that will help you to achieve your long-term goals and realise your practice’s potential.
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
By Chris Tapper
Six years ago, I attended a two-day residential course. It was a CPD course I hasten to add, not the usual anger management or ‘appropriate behaviour in the workplace’ type of thing I used to have to attend before they found the right tablets for me.
Anyway, it was very interesting, although I freely admit I never put a single thing I learned into practice – mainly because the dental corporate I work for wouldn’t shell out for the equipment I needed unless I could produce a business plan that proved I could earn them at least a tenner for every quid they invested. But that is by the by.
On the evening of the first day (a Friday if I recall correctly), the ten participants plus the lecturer and two representatives of the sponsoring company, enjoyed a meal in the hotel where the course was being held. After a very pleasant starter and main course, I moved to where a gaggle of four youthful dentists were sitting and enquired as to where they were in terms of their careers. It transpired that all four had graduated from the same Northern dental school and had all been qualified roughly two years. They were all general dental practitioners and had all taken up associateships in NHS practices.
As the most experienced dentist on the course – actually, why mince words, the oldest – I was interested to see if the youngsters were enjoying their chosen profession so far. I think I was trying to vicariously re-establish myself with my early enthusiasm for dentistry.
I posed, what I felt, was a fairly innocuous question to the group:
"How’s it going?"
One female dentist confessed that she cried every night when she arrived home from work, and sometimes did it during surgery sessions. One of the males said he was so anxious about work that he threw up most mornings and that brushing the lingual aspects of his teeth was impossible, while the other female said she had trouble sleeping and had been put on antidepressants six months earlier.
Perhaps the most troubling response was from the other male, who confessed that he had on a number of occasions, thought of ‘ending it,’ having realised that he had made a dreadful mistake in going into dentistry, and couldn’t see any way out. My concern for him diminished a little when I saw that he had an incredibly healthy appetite, demolishing his own rhubarb crumble and a female colleague’s lemon sorbet in less than three minutes.
When I questioned them more closely, the reason for their universal despair was not down to the pursuit of ridiculous UDA targets or the student debts they were saddled with, but the fear of dental litigation.
All four were constantly worried that they would see their careers end either in a GDC meeting, or more likely, through the bad publicity and financial ruin brought about as a result of a civil action facilitated by a dental litigation firm. They felt that the chances of those events happening to them were high, since one of their fellow students had already found himself in the middle of litigation as a result of an NHS root-filling having not worked.
Now that was six years ago, and I would argue that since then, the UK dental profession has slipped into a febrile anxiety that I have never previously witnessed in the 30 years or so that I have been working in dentistry.
Never have I seen dental colleagues (and even strangers) so jaded and so preoccupied with fears of dental complaints and ‘the dreaded letter’ from a certain Northern dental litigation firm.
I will freely accept that I have no scientific evidence for my observations and that my views are based purely on the empirical, but I personally know of no dentist who has not recently entertained thoughts that a patient might ‘turn legal’ if the wind blows the wrong way.
Over the past 18 months, I have been offering support to a close young colleague, being pursued by an extremely aggressive young solicitor (she IS young, I looked her up) who is alleging ‘negligence’ after her client developed dry socket after a routine extraction of an upper first molar. Rightly or wrongly, my colleague decided she did not want to consult her defence organisation and so I have been (rightly or wrongly) equally aggressive in demanding expert witness or consultant reports in support of their absurd claim. So far, the solicitor has failed to provide any evidence of negligence or give any reason why an expert assessor’s report has not been provided. All I know is, it has been fun ‘having a go’ back, but it to me illustrates a sad fact – nobody in the UK-based dental profession is safe from opportunistic punts from patients who want to make a quick quid from the no-win-no-fee mob.
A few months ago, a solicitor I know told me that during a local meeting of his legal colleagues, a speaker said that a lucrative and growing new source of business was dental litigation and that it was “something to think about” since the clampdown on spurious ‘whiplash’ claims and ‘Benidorm Belly’ – where package holiday tourists claim compensation for stomach upsets caused by dubious calamari and fries - had resulted in less opportunity for successful claims.
Recent experience has taught me that dental litigators are a tenacious and avaricious species and are unlikely to give up easily on an area of medical law that they consider to be easy pickings. Certainly, according to my legal friend, lawyers see it as a much easier area to be successful in than medical litigation.
Soon, the cost of dental defence subscriptions will be prohibitive to viable practice, and the profession, once all our European colleagues go back home, will find itself unable to cope with patient demand. What is the answer? Your guess is as good as mine.
Until then, I am going to have a rhubarb crumble and some sorbet.
Ahead of the impending Soft Drinks Industry Levy on 6th April, one in five UK adults (21%) say that potentially paying a little bit extra won’t bother them if they want a sugary drink.
According to survey figures* released today by YouGov and Simplyhealth, the experts behind Denplan payment plans, just over half of the nation (59%) supports the new tax, but a significant number of people would not be deterred by potential price hikes of sugary beverages. In the same survey, 20% of adults admitted they are addicted to sugar.
Nicknamed the ‘sugar tax’, the Soft Drinks Industry Levy is a completely new measure that comes into force on 6th April 2018. Plans for the tax were announced in the Government’s 2016 budget in response to the nation’s alarming levels of obesity and poor oral health.
The tax primarily targets manufacturers and importers of sugary soft drinks and encourages them to adjust their recipes and reduce the levels of sugar in their drinks, thereby avoiding the tax or paying a lower level. However, consumers could also be affected and be forced to pay more for sugary drinks if manufacturers decide to not reformulate their recipes and pass on the tax to consumers.
Under the new levy, drinks with a sugar content over five but below eight grams per 100ml will see 18p added to the price of the drink per litre, and drinks containing over eight grams of sugar per 100ml will face an increase of 24p per litre.
“It’s encouraging to see that the majority of people support the new levy and understand the urgent need to address the alarming levels of obesity and poor oral health – particularly those of children - in the UK,” said Henry Clover, Chief Dental Officer at Simplyhealth, the experts behind Denplan payment plans. “However it’s concerning that one in five people say they would not be deterred by potential price increases of sugary drinks, suggesting that sugary beverages are seen as a staple item in some people’s daily diets. Sugary drinks are a leading cause of tooth decay and acid erosion and offer little to no nutritional value.”
Encouragingly, 53% of respondents in the survey claimed they don’t drink sugary drinks, and 17% would consider choosing less sugary and potentially less expensive options, of which 10% didn’t like the thought of paying extra and 7% who definitely don’t want to pay extra.
“It will be interesting to observe consumer buying behaviour over the next year as well as seeing how many manufacturers have adjusted their recipes,” says Henry. “Reducing access to high sugar drinks options and encouraging people to choose less sugary options is likely to have a positive effect on the nation’s oral health, particularly in children and young adults. Sugary drinks should always be seen as an occasional treat and only drunk as part of a meal. Water and milk are far more tooth-friendly options.”
The survey also revealed that one in four adults (25%) admit to struggling to understand the sugar content on food and drink packaging labels, highlighting that many people may be unwittingly consuming much higher levels of sugar than they realise. Worryingly, amongst these, only 56% of 18-24 year olds knew that honey is a sugar, and only 41% of the same age group knew that molasses, fruit juice concentrates (44%) and maltose (50%) are also types of sugar.
“Confusion over food and drink labelling and a lack of awareness of the recommended daily limits almost certainly contribute to the nation’s high sugar consumption,” says Henry. “It’s important that manufacturers and retailers make it as easy as possible for consumers to know what they’re purchasing and are transparent with their ingredients and labelling. There is also a role for dental teams and other healthcare professionals to help patients understand the effects of a high sugar diet on their health and help them make more informed choices.”
*Online survey conducted YouGov on behalf of Simplyhealth. Total sample size was 5,264 adults. Fieldwork was undertaken between 12th -19th February 2018. The figures have been weighted and are representative of all UK adults (aged 18+).
About Simplyhealth:
For 145 years we’ve been helping people to make the most of life through better everyday health. In 2017, Simplyhealth and Denplan united under one Simplyhealth brand and today we’re proud to be the UK’s leading provider of health cash plans, Denplan dental payment plans and pet health plans.
We help over three million people in the UK access the health and care products, services and support that they need, when they need them and at a price they can afford.
We’re proud to donate 10% of our pre-tax profits to health-related charitable activities every year, and this amounted to over £1 million in 2017. Our Simplyhealth Great Run Series partnership raised an additional £42.6 million for charity.
Simplyhealth is a trading name of Simplyhealth Access, which is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority.
Carestream Dental is delighted to announce that it has been shortlisted in two categories for the National Sports Technology Awards 2018.
This is an internationally-recognised accreditation that celebrates technology-led innovation throughout the world of sport.
It is thrilled to be a finalist in the following groups:
Best Participation Technology
Most Innovative Sports Equipment or Apparel
In collaboration with the mouthwear suppliers and dental laboratories involved – Forcetech Mouthwear, Rhino Mouthwear, Fairbanks Dental Laboratory and Wessex Dental Laboratory – the company has also been shortlisted in the Most Innovative Sports Partnership category.
We look forward to the awards ceremony and are hopeful for a win!
For more information please contact Carestream Dental on
0800 169 9692 or visit www.carestreamdental.co.uk
For all the latest news and updates, follow us on Twitter @CarestreamDentl and Facebook
Simplyhealth Professionals has produced a range of templates and draft policies to support its practices in preparation for meeting the enhanced data protection requirements, coming into force on Friday 25 May 2018. The company has also been providing detailed information and guidance on the implication for practices of the new data regulations with a three part blog written by Roger Matthews, Honorary Life President and former Chief Dental Officer (https://www.denplan.co.uk/dentists/blog).
Between now and Friday 25 May, the recommendations are that practices will need to:
Complete their data audit (as recommended by The Information Commissioner’s Office (www.ico.org.uk/gdpr)
Check where back-ups are stored (ask your software provider/s)
Consider how to present Privacy Notices to patients
Consider revising their Data Protection and Information Security policies
Update their Cookie policy if they have a website
Carry out and document a Legitimate Interest Assessment (in simple terms how you lawfully process personal data)
Draw up a Data Breach policy and procedure (if not already done)
Appoint a Data Protection Officer
To help with preparation, Simplyhealth Professionals has published several templates for members on their web portal in a GDPR toolkit. There are templates available for a Legitimate Interest Assessment, a Privacy Notice and a Data Breach. However, in each case it will be necessary for practices to consider how these templates should be adapted for their own particular circumstances and practice. Further resources will be published on the portal in the coming weeks in the form of a Cookie policy, a Data Retention policy, a Data Protection policy and an Information Security policy.
As the new law is still a Parliamentary ‘work in progress’ and subject to some further amendments, Simplyhealth Professionals intends to keep members fully updated on any further developments.
Henry Clover, Chief Dental Officer at Simplyhealth Professionals, said: “We shouldn’t forget that confidentiality, consent and security of sensitive information – to name but three factors – have already been an integral part of dental practices for a long time. This is the embodiment of data protection in our professional lives, so much of this is not actually new.
“However, there is still some preparation required by practices and they will need to become familiar with some different language. Similar to the support we provided with regards to CQC inspections, we have again attempted to simplify the complex and make generic data protection requirements relevant to dental practices.”
About Simplyhealth Professionals:
In February 2017, Denplan rebranded as Simplyhealth Professionals.
Dental
Simplyhealth Professionals is the UK’s leading dental payment plan specialist with more than 6,500 member dentists nationwide caring for approximately 1.7 million patients registered to a Denplan product.
Simplyhealth Professionals provides the following range of leading Denplan dental payment plans under the Denplan name:
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
Denplan for Children: routine and other agreed care + worldwide dental injury and dental emergency cover
Denplan Membership: registered with the dentist + worldwide dental injury and dental emergency cover
Denplan Hygiene: A dental payment plan without dental insurance for all types of practice from NHS, mixed and private to support patients commit to a consistent hygiene programme.
Denplan Emergency Insurance: worldwide dental injury and dental emergency cover only
Simplyhealth Professionals also provide a wide range of professional services for its member dentists and their practice teams, including the Denplan Quality Programme and Denplan Excel Accreditation Programme. Plus regulatory advice, business and marketing consultancy services and networking opportunities.
Dentist enquiries telephone: 0800 169 9962.
For patient enquiries telephone: 0800 401 402
For details of all of our products, visit www.denplan.co.uk
Adam Christie the CEO of CALCIVIS was interviewed by BBC Scotland this week. He spoke comprehensively about the development of the CALCIVIS imaging system and told viewers how this innovative new dental device is helping to revolutionise preventative dentistry.
Filmed at a dental practice in Edinburgh, Adam showed how the CALCIVIS imaging system works and explained:
“Using a recombinant photoprotein, the CALCIVIS imaging system identifies free calcium ions released from actively demineralising tooth surfaces.”
Viewers saw how the CALCIVIS imaging system produces a very short, low-level flash of light that is detected by an integrated intraoral sensor and presented as a glowing, digital map at the chair side. It was agreed that CALCIVIS offers dental practitioners an early detection device to identify enamel demineralisation in the earliest, most reversible stages, which enables them to plan prompt management to prevent dental caries.
In addition, the non-invasive CALCIVIS system helps patients to understand their risk of dental caries more easily and motivates them to improve oral hygiene levels.
As Adam Christie explained to the BBC, “CALCIVIS is a first for British Dentistry. Never before has it been so easy to detect areas of active demineralisation so efficiently.”
If you would like to know more about this remarkable technology, contact the CALCIVIS team today.
To find out more about CALCIVIS visit www.CALCIVIS.com
or call 0131 658 5152
A recent Court of Appeal judgment has criticised the fairness and scope of the former Parliamentary and Health Service Ombudsman’s procedure for investigating clinical complaints against healthcare professionals. The GPs in the case were jointly represented by the MDU and another medical defence organisation but the judgment will also have positive implications for dental professionals.
The court considered exactly how the Ombudsman applied her discretion to investigate a complaint. It found an investigation should not begin where a complainant has another legal remedy open to them (other than complaining to the Ombudsman) unless the Ombudsman “is satisfied” that it was not reasonable to expect the complainant to use the alternative legal remedy. The Ombudsman must obtain and analyse information related to the complainant’s particular circumstances and not simply refer to general criteria.
The court also provided welcome clarity on the standard applied by the Ombudsman to determine whether or not the exercise of clinical judgement was reasonable.
The judge commented:
“The standard chosen by the Ombudsman is beguilingly simple but incoherent. It cannot provide clarity or consistency of application to the facts of different cases. There is no yardstick of reasonable or responsible practice, but rather a counsel of perfection that can be arbitrary. It runs the risk of being a lottery dependent on the professional opinion of the advisor that is chosen. It is unreasonable and irrational and accordingly, unlawful.”
John Makin, Head of the DDU said: “This judgment will have positive implications for dental professionals. When their clinical judgement is criticised, the Ombudsman can investigate what happened, reach conclusions and make recommendations if service failure is found. It is essential that the standards used by the Ombudsman to judge the clinical care provided to a patient are appropriate. Dental professionals should not be held to unreasonably high standards. It is also important that the Ombudsman stays within its legal powers and does not investigate exactly the same facts as a court would consider as this could present double jeopardy for dental professionals.
“Those facing an investigation into their clinical practice should have reassurance that the processes being followed by the Ombudsman are fair and just. This judgment is good for healthcare professionals, and will also benefit patients who can be assured that the investigation was properly and fairly carried out.”
The DDU, the specialist dental division of the MDU, is a not-for-profit organisation wholly dedicated to our members’ interests. Our team is led and staffed by dentists with real-life experience of the pressures and challenges faced in practice.
We offer our members expert guidance, personal support and robust defence in addressing dento-legal issues, complaints and claims. Our customised services range from legal assistance to indemnity to appropriate CPD.
Kirsty decided to use her £20 to help a gentleman who had battled and overcome his fight with alcoholism. He was honing his technology skills on a tablet with his social worker, but was devastated when it broke and he was unable to replace it.
The story inspired the whole team in the Carestream Dental Head Office, who decided to donate to the cause as well. The amazing £230 raised enabled Kirsty to buy the gentleman a brand new tablet, as well as a cover and other accessories, enabling him to continue working on his skills from his own home for the very first time.
This is just one example of how a little incentive like the £20 from Practice Plan can really make a difference to someone. Thank you to everyone who donated!
For more information please contact Carestream Dental on
0800 169 9692 or visit www.carestreamdental.co.uk
For all the latest news and updates, follow us on Twitter @CarestreamDentl and Facebook
Southern Dental, the nation’s third largest chain of dentists, is now known as Colosseum Dental UK Ltd. The name change coincides with the first anniversary of Zurich-based Colosseum Dental's acquisition of Southern Dental, which made it not only Europe's fastest growing dental group, but also the only one with a network spanning the continent.
With a patient base in excess of 500,000, the majority of Colosseum's 80 practices in the UK will undergo an extensive refurbishment programme, introducing a new look and feel to waiting rooms with upgraded treatment areas and clinical facilities as part of a £5,000,000 investment in the company. Peter Keegans, CEO, explains, “Our new owners have a long-term, 20-year vision which is enabling us to invest in upgrading our clinics to be state-of-the-art practices offering the highest standards.” Colosseum Dental Group’s ambition is to be Europe’s leading dental provider within five years.
LOCAL PRACTICES SERVING THEIR COMMUNITY
One of the pillars of Colosseum’s recipe for success in the UK will be embedding each practice as a “good neighbour” in its local community. Peter continues, “We want to break with convention from other dental chains. Each of our 80 practices will be known by the local name patients have always referred to it. If, for example, ‘Hollybush Dental’ is how a practice has always been known colloquially, we've no intention of simply re-badging it as ‘Colosseum Dental’. In this way, each practice will retain its connection as an integral part of its community."
In addition to being a good neighbour, Colosseum has two other refreshingly simple cultural values; to be a provider of exceptional patient care and to be a great employer. As Peter explains, “Our name change marks a new era: a renewed energy and focus, an opportunity for cultural change and to align ourselves with the values of our European colleagues. Armed with a long-term vision, we can now invest in our practices and staff with confidence, knowing our patients will be the ultimate beneficiaries. Everyone wins.”
EUROPEAN SCOPE FOR PROFESSIONAL DEVELOPMENT AND PATIENT CARE
Being part of a European group means dentists have the chance to provide best practice based on the ability to observe long-term clinical outcomes in a huge, European-wide patient base. Treatment protocols, guidelines and KPIs are currently being developed across the group to provide highly informed patient care, and present the best possible treatment options to patients. Ravi Rattan, Clinical Director at Colosseum Dental UK, who joined in 2016, is excited to be part of these changes: “At Colosseum Dental, we’re committed to raising clinical standards and offering more advanced treatment options and procedures to our patients. Our new specialist referral centres in Kettering and Kingston offer private as well as NHS treatments such as orthodontics, implants and facial aesthetics. Patients there will benefit from 3D CBCT scanners to enable better, safer treatment planning. Having new investment means we can continue to set up such centres: Our European colleagues are highly experienced in managing large referral centres, and we are learning from their success.”
The group’s aim is for no differences to exist between treatments available at, say, a practice in Switzlerand, and those available at one in Southern England. Lars Armbäck is Chief Dentist at Colosseum Dental Group. Armed with 30 years’ general practice and a special interest in prosthetics, implants, quality and treatment strategy, his focus is on best practice, dentist development and quality assurance. He’s excited by the addition of the 80 English clinics, noting, “Patients everywhere should be able to benefit from digital technologies that enable them to make informed choices about their care. Hence, as a group, we recently chose to invest in intraoral scanners for all patients, and our size means we can negotiate to help keep diagnostic and treatment prices affordable.” He adds, “Dentists at our UK practices will benefit from committees we have set up to examine best practice in treatment planning and workflow. With time, we’ll be able to compare patient outcomes across Europe, and thereby identify best treatment strategies and best practice overall. It’s this type of sharing which sets us apart from any of our competitors.”
COMMITTED TO PROFESSIONAL DEVELOPMENT
Career choices at various levels are being made more flexible, in line with changing lifestyle requirements such as increased female and part time dentists in post. Samaneh Nezamivand-Chegini, a dentist who practises in Central London, having joined in 2012, now sits on the Clinical Board. She says, “It’s great to see my suggestions have been noted, despite my being relatively newly qualified. Peter [Keegans] and his team have listened and acted, which is in turn inspiring my clinical colleagues. On a personal level, I’m being supported to further my career and income via training in implantology.”
Sharyn Wilson, HR Director at Colosseum Dental UK, notes, “Our improved ways of working and communicating are being appreciated by all our staff, from receptionists to dental specialists.” Career progression for non-clinical staff is also being strengthened. For example, the new Advanced Treatment Co-ordinator has progressed from earlier roles as nurse, Practice Manager, then Resourcer. As a sign of its commitment to professional development, Colosseum Dental UK will hold its first Annual Conference on 20th April, where keynote speakers will include Seema Sharma, an expert in transforming dental practices, Joe Bhat, a Fellow of the International Team for Implantology and Jas Gill, who was voted in at No.12 in the Top 50 most important people in UK Dentistry.
ABOUT COLOSSEUM DENTAL UK LIMITED
Colosseum Dental UK Limited is the third largest chain of dental practices in the UK, with 80 clinics spanning 19 counties. The company supplies high quality general dental care, as well as specialist services for NHS and private patients. It has more than 900 employees and Associates, including over 250 dental professionals, serving more than 500,000 patients. Its mission is to be the ‘best in class’ dental group in the South of England by providing modern, quality dentistry services for the benefit of patients, dentists, employees, shareholders and striving for continuous growth and excellence. www.colosseumdental.co.uk
We had two Budgets and three Financial Bills in 2017, which for many, was more than enough! The Spring Statement lasted a grand total of 25 minutes, and was essentially a review of the public finances. It was also an opportunity to publish consultations before any announcements in the Autumn Budget.
So, nothing headline grabbing, but here’s a glance over the Spring Statement and how it may relate to your business.
VAT
From April, the VAT threshold will remain at £85,000 for the next two years, as per a previous announcement. Mr Hammond said he would consult on whether growth could be incentivised by looking again at how VAT is structured.
Digital payments
Payments/settlements systems (including the Bank of England’s) are to be renewed in order to harness the power of the latest technologies. The government pledged its support to these changes, and it will be consulting on them.
On a related note, views will also be sought on how online platforms could help users comply with their tax obligations.
Entrepreneur’s relief
If an individual now owns less than 5 per cent interest in a company, because the company has issued trade to raise capital, they should be able to claim Entrepreneur’s relief, says the government.
Business rates
Views had previously been sought on this topic. It was announced that the first of more frequent, three-yearly revaluations for business properties would be in 2021.
Self-funded work-related training
Have you – or a colleague – undertaken this? Well, the government is going to look at how tax relief can be extended and how the system can be both simplified and protected from misuse.
Coming up in April…
No new tax measures were introduced, but some previously announced changes are coming into force in April. The personal allowance is rising to £11,850 (for basic rate, to £34,000 and higher rate, £46,350). This excludes Scotland, who will have five new tax bands for 2018/19. If you are on a higher rate in Scotland, this isn’t great news as the threshold is going to start at £2,920 below the rest of the UK. As previously announced, the dividend tax allowance will be reduced to £2,000.
The national insurance contributions (NICs) threshold is also increasing by 3 per cent and Class 2 NICs will now be phased out for 2019/20.
If you have a company car, tax will rise for all by the highest emission vehicles.
The residence nil rate band for Inheritance tax (IHT) will rise; the main rate band will remain unchanged. There could be changes afoot by the Autumn Budget, however, a review of IHT conducted by the Office of Tax Simplification is due to report around then.
As for pensions, the minimum contributions for workplace pensions under automatic enrolment will increase. The lifetime allowance will rise in line with inflation (it’s been on a downward path since 2012).
Finally, both income tax and NICs will apply on all payments in lieu of notice (PILONs) in 2018/9.
Other dental accountants also available. Nasdal.
Lansdell & Rose on 020 7376 9333,
Or visit www.lansdellrose.co.uk
On 29th November 2017, the European Court of Justice (ECJ) handed down its decision in the case of King v Sash Windows. It is another case in a long line on holiday pay and has opened the flood gates for workers to claim unpaid holiday dating back 20 years.
Why is this relevant to dental practices?
At present most associates are working under a self-employed contract and as such will not be paid holiday pay. However, there is a risk, especially for those associates employed by a dental corporate, that in fact the reality is that associates are workers and therefore entitled to holiday pay.
Mr King’s case does not change the legal test for establishing who might be a worker. However, prior to this case, it was thought that workers could only claim up to two years back dated holiday pay. This meant the risk to dental practices if an associate was wrongly classified was fairly limited.
Now a dental practice is at risk of having to pay anyone found to be a worker unpaid holiday from the start of their contract or from 1998, when the Working Time Regulations came into effect, if the contract began before then.
Definition of a Worker
Before looking at this case in any detail, it is important to understand what the definition of a worker is. This is another area of employment law that has had a number of high profile cases in recent years. In essence the test is as follows:
Most associate contracts contain a right to send a substitute. However, if the right is fettered this
could result in the associate being found to be a worker.
If you have an NHS contract, you need to ensure that the associate meets their UDA targets. This
therefore could infer into the contract a mutuality of obligation.
No; the customer is the patient. The associate is providing their services for your customers.
Facts
Mr King was a self-employed window salesman. He began working for Sash Windows in 1998 and was paid on a commission only basis. He never asked for holiday pay and he never received it. On average Mr King took fewer holidays each year than a worker is entitled to. Just before his 65th birthday Mr King’s contract was terminated on the platform of Victoria Station due to his age.
Mr King pursued various claims including unfair dismissal and age discrimination. Here we will just deal with his holiday pay claims, of which there were three, namely:
The employment tribunal found Mr King to be a worker and all three holiday claims were successful. He was awarded £27,257.96 in total for this element of the claim.
The case was appealed and there were cross appeals in relation to various aspects of the findings. The issue in relation to the holiday pay claim was ultimately referred by the Court of Appeal to the European Court of Justice.
Firstly, the only holiday pay claim subject to appeal was in respect of claim 3 – holiday pay due for any days not taken from the annual leave entitlement.
Sash Windows’ main argument was the ‘use it or lose it’ principal, which in essence states if a worker does not use his annual leave entitlement in the applicable holiday year he will lose it entirely. This is because there is no automatic right to carry holiday entitlement from one leave year to the next. They also suggested that a worker would have ‘double recovery’ if they received pay for holidays that they in fact worked and were paid for.
Mr King argued there were circumstances beyond his control that meant he could not take the annual leave and so it should roll over. In this case it was argued that the circumstances beyond his control were his employer’s intentional failure to pay him holiday pay.
Decision
The Working Time Directive was enacted to ensure the health and safety of workers; to allow employees sufficient time away from work to ‘recharge’. Therefore workers should not be deterred from taking their annual leave entitlement. Given this underlying principle the ECJ found that:
An employer who does not allow a worker to exercise his right to paid annual leave must bear the consequences.
Therefore whilst there may be double recovery, that is a risk the employer takes in not granting a worker his paid annual leave. The ECJ felt it was for the employer to correctly categorise staff and ensure they are given their employment rights, as workers are in a weaker bargaining position.
The case has been referred back to the domestic courts for a final decision. However, the Court of Appeal will no doubt follow the ECJ’s decision.
This means that an associate can continue to claim they are self-employed and then on termination seek to argue they were in fact a worker and claim back dated holiday pay. There would be no down-side for the associate, as employment tribunal fees have been abolished and there is no costs regime. Also as the test for employment status is different for HMRC and the tribunal, a retrospective change of status would have no bearing on this. The risk is therefore all on the dental practice.
Further, the definition of a worker under the Working Time Directive is wider than the UK law, which an associate may be able to rely on when pursuing their claim.
Practical Tips
First and foremost, make sure you correctly categorise your workforce from the outset and provide a contract that reflects the true basis of the relationship. Whilst this means front loading time and costs, it is likely to save you a hefty legal bill later down the line.
This decision only affects the 4 weeks annual leave granted by the Working Time Directive. Not the additional bank holidays given by UK legislation. Consider amending your contracts to state that UK bank holidays will be deemed to be taken last. You would not need to add this to associate contracts, but if it is in your employment contracts you will be able to rely on this as evidence should a claim be pursued against you.
When buying a practice do your due diligence on the workforce. Make sure the old practice is complying with the Working Time Regulations. Ensure the sale agreement contains indemnities in case staff have been wrongly categorised. Consider implementing your own contracts that are genuinely self-employed, time limits for presenting a claim against you would then start running from the date of the sale.
When selling a practice be careful what warranties you give to the buyer. You would not want to be liable for the entire claim, especially if the new practice has also continued with a contract that was not genuinely self-employed.
If you need advice or assistance in relation to employment status and protecting your position, please contact Laura Pearce on 020 7388 1658 or email her at This email address is being protected from spambots. You need JavaScript enabled to view it..
Laura Pearce
Senior Solicitor
The most effective means of eradicating infection is a combination of chemical and mechanical debridement, because when irrigation is introduced alongside instrumentation the chance of removing inflamed and necrotic pulp tissue, microbes and debris is significantly higher.
As it stands, there is little evidence to prove that certain irrigants are more effective than others, but research has shown that no single irrigant on its own holds all the required characteristics needed to effectively eradicate and prevent infection.[i] Only a combination of two or more solutions in the appropriate sequence can predictably obtain safe and effective irrigation.[ii]
Perhaps the most commonly used irrigant is sodium hypochlorite (NaOCI) in concentrations varying from 0.5 to 6.00%, as this can dissolve organic tissue and has a broad antimicrobial spectrum allowing it to effectively kill biofilms adherent to the root canal walls.[iii] For those who prefer to use sodium hypochlorite, it is worth bearing in mind that a high concentration NaOCI has demonstrated better results than 1% and 2% solutions. [iv] In cases where NaOCI has been used but has been ineffective, it may be that the strength of the formula – or lack of – has compromised the success of the outcome.
The downside of NaOCI is that it does not remove the smear layer. This can be overcome, however with subsequent irrigation with Ethylenediaminetetraacetic acid (EDTA), as it can dissolve inorganic material, including hydroxyapatite. Importantly, EDTA is also biocompatible, able to condition dentine and has shown positive effects on the root canal seal.[v] Nevertheless, it is important to remember that EDTA must be used as a final rinse, not as an alternating rinse with NaOCI.
Another possible irrigant is chlorhexidine digluconate (CHX), which has good antimicrobial activity and is biocompatible. As it is incapable of dissolving organic tissue it cannot replace sodium hypochlorite. One could also opt for hydrogen peroxide, but again, this lacks antibacterial activity when used alone and cannot dissolve tissue.
Whichever combination is used, it is important to choose quality irrigation products from a trustworthy manufacturer of endodontic solutions. At COLTENE, all products are designed and produced using the latest materials and technology to guarantee optimal results. The range of solutions includes CanalPro NaOCI in 3% and 6% formula, CanalPro EDTA 17% and CanalPro CHX 2%, providing all the characteristics needed for effective irrigation. For best results, use alongside HyFlex EDM NiTi root canal files, also available from COLTENE.
The role of irrigation and its impact on the overall success rates of root canal treatment is clear, so be sure to consider your choice of irrigants.
To find out more visit www.coltene.com, email This email address is being protected from spambots. You need JavaScript enabled to view it. or call 01444 235486
[i] Fedorowicz Z, Nasser M, Sequeira-Byron P, de Souza RF, Carter B, Heft M. Irrigants for non-surgical root canal treatment in mature permanent teeth. Cochrane Database Syst Rev 2012; 9: CD008948. Accessed online January 2018 at https://www.ncbi.nlm.nih.gov/pubmed/22972129
[ii] Haapasalo M, Shen Y, Qian W, Gao Y. Irrigation in endodontics. Dent Clin North Am. 2010; 54 (2): 291-312. Accessed online January 2018 at http://www.endoexperience.com/documents/IrrigationinEndodonticsHaapasalo2010.pdf
[iii] Zehnder M. Root canal irrigants. J Endod. 2006; 32 (5): 389-98. Accessed online January 2018 at https://www.ncbi.nlm.nih.gov/pubmed/16631834
[iv] Haapasalo M, Shen Y, Wang Z, Gao Y. Irrigation in endodontics. Br Dent J. 2014; 216 (6): 299-303. Accessed online January 2018 at https://www.ncbi.nlm.nih.gov/pubmed/24651335
[v] American Association of Endodontists. Root Canal Irrigants and Disinfectants. Chicago: American Association of Endodontists, 2011. Accessed online January 2018 at https://www.aae.org/specialty/wp-content/uploads/sites/2/2017/07/rootcanalirrigantsdisinfectants.pdf
Once again the new patient charges have been announced for the NHS, and once again they have gone up far more than the amount dentists will get for their UDA’s. The third consecutive inflation-busting rise in patient charges means that an ever increasing number of dentists will find themselves as unpaid tax collectors for the government, with the added pleasure of having to continue to practice in a hostile environment where the threat of litigation and GDC involvement is ever present.
So what will it actually take for dentists to wake up and smell the coffee? Patients are paying an increasing amount for their care, and as they do so, direct their annoyance as ever to the dentists. Its unlikely that they will understand or accept the explanation given that the charges are in effect a taxation, as they are too closely linked to the provision of a service.
Why do many of the dental practices seem to forget that they are in truth independent contractors within the NHS, and as such only have to refuse to contract to the NHS in order to retake a degree of control of their own future once again? It can’t be that working within an NHS contract is too easy; we increasingly hear of the demands on the practitioner’s time to fulfil the contract requirements. This time of year is full of comments on social media about the increased flurry of activity in order to hit the UDA’s targets once again or suffer claw-back.
By raising the patient charges, the government is contributing less and less each year to the cost of dental provision. The population of the UK isn’t reducing, and the cost of providing dentistry isn’t either. But for less and less contribution the government is still dictating the terms of the contract, and dentists continue to accept it.
Will it actually take the government to raise the patient charge to £30 for an exam (whilst still paying £25 for the UDA) for dentists to realise that they would be better off just charging the patient £30 and sticking two fingers up at the government? Or is it the NHS pension that people are holding out for? Or the continued chance to pay an associate £10 per UDA when they are really getting £30?
Practice owners (and particularly the bigger practices and corporates) definitely have the whip hand here. I can remember the times when associates were few and far between. It appears that the reverse is now true in many areas of the UK (particularly in metropolitan areas), which allows the principal to reduce the unit price of a UDA paid to an associate. An increase in patient charges will likely bring a drop in the number of patients visiting practices, and in one fell stroke this will reduce the PCR, and reduce the chances of the UDA targets being met, and therefore a claw-back occurring. I know of many associates that are made liable for the gross amount of any claw-back due to their individual underperformance (rather than the net amount they have been paid per UDA). Add this to the NHS pension of the principal that is effectively enhanced by paying a smaller percentage of the UDA value, this hardly puts the principal under any immediate pressure to withdraw from the NHS system they are still aligned with. However, I suggest that it is now causing a much greater ‘Us and Them’ situation with associates than ever before.
So why is it ok to make money out of the associates and not charge the patients a decent amount for their care? Whilst a business has a duty to its shareholders and owners to keep its costs low, with the introduction of the minimum wage this means they don’t tend to be propping up their bottom line by charging their staff for the privilege. They tend to charge their customers for it with the increase in the charge for the product.
Unless you happen to be in a fixed price system…so the only way money can be made (let’s forget upselling to patients using the NHS as a way to get them in the practice for now) is by reducing the costs of the workforce and investment in the business. However the government expect more and more for less and less (look at the next round of orthodontic commissioning that is going on) and it becomes impossible to square the circle unless someone actually pays for it. That certainly isn’t going to be the government.
Given that some patients will not be able to afford the hike in charges does not mean that many others would not pay for a decent service if they had to. Surely having fewer patients (but of the sort that don’t sue and complain) that are being charged a fair amount for the service provided, with no third party dictating targets has to be better for the stress levels of both dentists and patients under their care?
Will it take associates to actually walk away from the profession and retrain? With the current environment of stress due to the GDC, threat of litigation, and the real time reduction in associate income, then this has never been more possible than it is now. And that will lead to a reverse in the associate market again, especially if the (currently unknown) effect of Brexit results in European dentists returning to their home countries – and who wouldn’t if it meant avoiding the GDC and Litigation!
So what will it take for the profession to see the light? That we need to realise the government would still wish to control us if they only contributed £1 in every £100 charged and only then will we react? Or do we need to remember that everyone who owns a practice is a private practitioner already and they should just tell the government:
‘No More’.
Image credit - Pascal under CC licence - not modified.
Employers should be aware that they are required to consider a request from an employee for flexible working hours. A request of this nature must be made in writing, setting out details of the request, the date it is made and disclosing the date of any previous request. A request must be dealt with and responded to within three months of the request being made.
What many employers are probably not aware of is what can happen if that request finds its way to the bottom of a pile of everything else a practice owner has to deal with, and the practice owner fails to consider and deal with the request.
Providing an employee has 26 weeks of employment with the employer, the employee has a statutory right to request flexible working hours. If the employer fails to consider the request, it is possible for the employee to bring a claim in the Employment Tribunal and assert this statutory right. The claim that would be brought by the employee is a breach of statutory rights.
If the employment tribunal were to make a judgment in favour of the employee, they could do one of the following:
The statutory maximum for this type of award is £4,064 from 6 April 2018.
As with all statutory or contractual breaches, discrimination claims could be tagged on to claims such as this which could have grave financial implications, as well as unfavourable publicity exposure for an employer.
Where a request is rejected, a record of this should be kept and reasonable business justification should be set out when confirming the rejection. Where a request is accepted, a variation to the contract of employment should be issued and signed by both parties to note the variation to contracted hours.
It is important to have policies and procedures in place to deal with flexible working requests in a compliant and efficient manner, in order to avoid ending up in the above situation.
It is also worth noting that an employee may only make one request in any 12 month period.
Latest on the Taylor Report – Extension of Employee Rights?
As we have already touched upon, any changes in employment legislation are likely to take longer than usual, whilst the political landscape is dominated by Brexit-related legislation.
However, last month, the government issued its response to the Taylor Report. The points to note in this response are that none of these proposals are guaranteed to happen and will be subject to legislation. Moreover, these proposals will certainly not be implemented before March 2019, save for the issue of payslips.
There is a suggestion that employees could benefit from new ‘day one’ rights that give workers the right to being provided with payslips from the commencement of their employment, which would have to include the number of hours that the employee is being paid for where the employee is not salaried.
What else is being proposed?
Whether these proposals are going to make it into law and regulations will depend upon if trade unions have an appetite for these concessions, if they will be rejected in the pursuit of more far-reaching protections and rights for employees, or whether employers and business groups are willing to accept such changes – given some of their considerable practical hurdles and, arguably, increased bureaucracy.
Statutory Sick Pay – the Facts
The issue of when, how much and for how long statutory sick pay (SSP) is payable by the employer is often a point which is misunderstood or simply ignored. This has the potential to be financially detrimental to a business and/or in breach of the law.
Without going into extensive details, here are some of the common misconceptions:
The increase in SSP rates which were announced in December are due to come into effect from 6 April 2018 and from which date will be £92.05 per week.
The new Flexible Payment Plans will make treatments more accessible and affordable for all patients as they can set the price and payment length with their dentist so it suits individual budgets. Patients can opt for treatments that they might have previously thought were unaffordable.
Dentists will agree with each patient how much they pay each month and how long their treatment will take. They can offer the patient an ongoing monthly plan for more regular treatments, or a choice of three to ten monthly payments for a one-off treatment, helping the patient to spread the cost of treatment and make it more affordable for them.
This is the first time that Simplyhealth Professionals has created a payment plan that can be tailored to support dentists providing an increasingly diverse mix of cosmetic dental and facial aesthetic treatments in their practices. Flexible Payment Plans will encourage patients to opt for new or higher cost treatments which they previously might not have considered due to the price.
We would love to know your opinions and find out more about the kind of ‘added value’ services you would like to see from your dental suppliers.
‘Added value’ can mean any number of things; from free patient information leaflets, banners and posters - to staff training opportunities, marketing support or patient give-aways. Alternatively, you may be looking for training in social and digital media, practice marketing or business development, but don’t know where to start?
Let us know your opinions today. The Dental Survey 2018 will only take a few minutes of your valuable time and for respondents who are happy to leave their contact details they will be entered into a Prize Draw to win £500 worth of John Lewis vouchers!
The Dental Survey 2018 is available HERE
The closing date for entries is Saturday 31st March 2018* so don’t delay! Good luck!
*The winner of the Prize Draw will be notified by email no later than Saturday 7th April 2018.
Fill out the form here or click on any of the images and see how much you can save today for your dental practice or business.
The Simply Select portal contains a wide variety of templates, such as factsheets, posters and referral cards that can be personalised by members to help them promote individual Denplan payment plans and special offers. This will help to draw in new patients to the practice, or encourage existing patients to consider new or alternative treatments or plans. Marketing campaign material will also be added to the portal on a regular basis.
The templates are very simple to use with areas that practices can personalise with specific information that is relevant for them. There are templates for posters, referral cards, cost comparison posters and social media templates. Simplyhealth Professionals will continue to create new templates and add to the existing range throughout the year.
Sandy Brown, Director of Dentists at Simplyhealth Professionals, said: “We wanted to offer a really easy process for our member dentists to help them to market their individual Denplan payment plans and personalise each product to attract new patients and retain and grow existing ones. We have a dedicated in-house practice marketing team available for more complicated requests or special events, but often practices just want to be able to quickly print off a simple form or poster and do this themselves. Simply Select now means they have the best of both worlds.”
Simplyhealth Professionals also provide a wide range of professional services for its member dentists and their practice teams, including the Denplan Quality Programme and Denplan Excel Accreditation Programme. Plus regulatory advice, business and marketing consultancy services and networking opportunities.
Dentist enquiries telephone: 0800 169 9962.
For patient enquiries telephone: 0800 401 402
For details of all of our products, visit www.denplan.co.uk
John Makin, head of the DDU, said:
“The announcement of a Civil Justice Council working group to examine excessive legal costs in clinical negligence claims is a delayed but still welcome first step. Proposals to make claimants’ lawyers costs more proportionate to the compensation their clients receive were first mooted back in 2015. We hope that things will move ahead faster now.
“Even with dental claims, which are generally lower in value than medical awards, the fees charged by claimant lawyers are still, on average, above the level of compensation awarded and that cannot be right. For example in one settled claim, the claimant’s costs were more than quadruple the settlement figure received by the patient.
“Patients who believe they have been negligently harmed must have access to justice, but fixed costs are fairer and will help to establish some much needed balance to the system.
“We will be happy to take part in the working party to represent our members’ views. However, disproportionately high costs charged by claimants’ lawyers are only part of the problem. The cost of litigation is becoming unaffordable for the dental profession and the NHS. The Government needs to take more decisive action. We urgently need more radical legal reform to restore balance to the system for clinical negligence claims.”
The NHS are currently in the process of putting out to tender a number of specialist NHS dental contracts, including orthodontics. The NHS are advising practices who intend to re-tender or bid for the first time to seek advice in relation to TUPE (Transfer of Undertakings (Protection of Employment) before they do so. But why?
TUPE applies where an economic entity transfers from one business to another. This can be a whole business or part of one. It applies in a number of situations, not just when a dentist is buying or selling their practice. It can also apply when a business takes services back in-house or outsources services.
The Transfer of Undertaking Regulations, or TUPE for short, offers enhanced protection for employees who transfer from one business to another. It is an extremely complex and confusing piece of legislation.
In this article we set out the key principles to help dentists better understand when a TUPE situation may arise during the NHS tendering process and what their responsibilities are.
TUPE requires a business that is buying another business to take on any employees connected with that business.
It applies in three situations:
1. Where one business buys the whole or part of another business;
2. Where a business decides to take services back in-house, for example they use an IT contractor but wish to start undertaking the services themselves;
3. Where a business decides to outsource a service, for example it tenders for cleaners to undertake the office cleaning or it re-tenders that contract.
Whilst it is obvious TUPE will apply when you buy a practice, the question of whether TUPE applies when you tender for an NHS contract is more complicated. The NHS is a business which is outsourcing its services. A move from one provider to another would normally come under point 3 above. On the face of it therefore TUPE would apply.
In order for TUPE to apply the business that is being sold must be an ‘economic entity’. This means:
– It is an economic entity with assets, employees, goodwill etc that is operating as a business;
– There is a transfer of that economic entity; and
– The economic entity retains its identity after the transfer.
Again when you buy a practice it will retain its economic identity as you are buying all the goodwill and assets of that business.
Unfortunately this is not an easy question to answer. It will very much depend on whether patients are transferring from the old practice to the new one. A group of NHS patients that moves with the NHS contract could be seen as an economic entity. Any employee who provides treatment to those patients for the majority of their time at work would therefore transfer with the contract. This could mean the nurses and support in a specialist practice that loses its NHS contract will be TUPE transferred to the practice that has won the contract.
Remember TUPE applies to employees only; not workers or those who are self-employed.
Any employee automatically transfers from one business to another and their existing contract survives. In effect the new employer is stepping into the shoes of the old employer. There are very few rights that do not transfer, such as occupational pension schemes. Otherwise all other rights and liabilities will transfer. There are also very limited circumstances in which you can amend an employee’s contractual terms.
You will also need to inform and consult any employees who are affected by the transfer. This duty is on both the old and new employer.
In addition you cannot dismiss an employee as a result of the transfer unless you can show an Economical, Technical or Organisational (ETO) reason for doing so. For example, if you are a practice that wins a new NHS contract and has to take on new employees but you have sufficient employees for the work you tendered for, you may have an economical reason for dismissal, namely redundancy.
If you are taking on employees from another business you need to make sure you do your due diligence. You will need to obtain information about those employees, including whether they have any outstanding grievance or disciplinary matters. As set out above, any liabilities pass to you and if you are not aware of an outstanding grievance you could have a claim issued against you.
You also need to ensure you have a well drafted transfer agreement, so that if the above were to happen, you will be indemnified by the old employer in respect of any claim issued against you.
That is a lot to think about!
TUPE is a complex area of law with many nuances. If you have any concerns about whether it applies, take legal advice and get proper agreements drawn up to protect you. The consequences of getting it wrong can be high.
If you need advice or assistance on TUPE, please contact Laura Pearce on 020 7388 1658 or email her at This email address is being protected from spambots. You need JavaScript enabled to view it..
If you find this article interesting, please like, comment and share it!
Laura Pearce, Senior Solicitor
In response to a consultation by the Department of Health, it says it is not convinced that combining dental regulation with that of other professions could save money while retaining the required understanding of the dental professions, and that in the absence of evidence to the contrary, the interests of patients and the profession will best be served by the continued existence of a regulator dedicated solely to dentistry.
The Faculty says that decisions on the regulation of health professions should instead be guided by the risk of patient harm, and that as such there can be no optimum number of healthcare regulators. It also suggests that as the UK has over 70 regulators, “including four for social care, and six each for legal services, financial services and privatised utilities…nine regulators for healthcare, covering 1.5 million professionals in 32 occupations, does not appear excessive.”
FGDP(UK) also expresses concern over proposals to create a single adjudication body for fitness to practise, a single register of all health professionals, and a single set of standards in lieu of profession-specific ones, and rejects the suggested use of mediation in regulatory proceedings and proposals for employers to be represented on the General Dental Council (GDC).
However, FGDP(UK) agreed that the currently statutorily-regulated professions should be reassessed to determine the most appropriate level of oversight, and that the regulator should be accountable to the Scottish Parliament, National Assembly for Wales and Northern Irish Assembly in addition to the UK Parliament.
Dr Mick Horton, Dean of FGDP(UK), said:
“While the GDC itself acknowledges that there are improvements to be made to the way in which it regulates, it has nonetheless developed specialist knowledge of dental patients and the professions that treat them, each of which exhibit characteristics and contextual factors which are not necessarily the same as those of other medical professions and their patients. In an amalgamated regulator, this sector-specific knowledge would either be maintained at additional cost, or, more likely, lost in a drive to harmonise procedures and cut costs. For these reasons, the onus is on the government to produce convincing evidence that its own stated objectives for regulation – public protection, performance management, and professional development and support - would not be all the harder to meet if dental regulation were to be amalgamated with that of other professions.”
The Faculty of General Dental Practice (UK) is the only professional membership body in the UK specifically for general dental practice. Based at the Royal College of Surgeons of England, it provides services to help those in general dental practice raise standards of patient care. It does this through standards setting, providing education courses and assessments, CPD, policy development, research and publications. Membership of FGDP(UK) is open to dentists and other registered dental professionals.
There have been many episodes I’m sure we all know about where a colleague has done something that has been their eventual professional downfall. Examples like the well publicised cases of Joyce Trail and Desmond D’Mello are a demonstration of how a professional has destroyed their own career and reputation through their actions, whether it be an illegal act, or a dangerous one.
But none is more worrying then the Case of Bawa-Garba. I am sure you are all aware of this, but if not, very briefly this involved a junior paediatrician being charged and found guilty of gross negligence manslaughter due to the tragic death of one of her patients whilst under her care. However, what is unusual about this sentence is that it was not only a very short one, but also suspended; something that very rarely happens in a case like this. As is then the usual route of action, the doctor was referred to the GMC for the associated disciplinary hearing that comes with a conviction. The tribunal found that her fitness to practice was impaired, but allowed her to stay on the register. However, the GMC appealed this decision, and she was subsequently struck off by the High Court last week. Interestingly, an interim orders committee of the GMC suspended the doctor initially, which was overturned on appeal by the high court who ruled that even a serious criminal charge did not always mean that suspension was necessary or appropriate to protect the public.
As someone with a conviction for manslaughter, then one could always argue that a professional actually should not be allowed to practice their art on the public again, but there is case law that supports the more subjective approach that was taken in this case initially. But this case (without going into even more detail) is as much, if not more, of an indictment of the systematic failings of leadership and organisation inherent in the environment Dr Bawa-Garba was working in. That the tribunal found no impairment was significant, as the doctor had engaged in insight, and had placed her reflections on the tragic event on her e-portfolio.
And that is the problem.
By honestly reflecting on the events and committing them to the permanent record of her E-Portfolio, this allowed the GMC to use this reflection against Dr Bawa-Garba, and subsequently was part of the case that was successful against her. In effect, by complying with the requirements of the GMC, she has committed professional suicide by recording her reflections as required. It is fine to record ones reflections to show insight, but to then have them used against you is surely unfair. You would have to trust the regulator implicitly when committing your reflections to a permanent record, and the actions taken by the GMC will have served to destroy any trust that our medical colleagues would have had in their regulator. Given that the GMC has always seemed to be to be a more considered and pragmatic regulator than the GDC of late, then once can only wonder just what manner of jeopardy we will have to place ourselves under as a result of this ruling.
In one fell swoop, the GMC have removed the chance for professionals to show they have learnt from their mistakes and develop in a no (or low) blame environment (as indeed occurs in the aviation industry) and installed a culture of fear that I think even the GDC at its worst a couple of years ago would have struggled to create so effectively. However, with the new GDC rules on CPD and reflective analysis requirements that we now have, is there anyone amongst you that thinks that the same couldn’t possibly happen to dentists? Once a regulator has set a precedent, it is likely that they will all act in the same manner.
I suspect the GMC realise there will be a problem with personal reflection now, and given the release of a blog by the GMC on this issue at the weekend, this might be seen to confirm it. The amount of internet noise coming from the medical profession over this matter is significantly higher than anything we have been able to generate, and as a result one must hope that there is a higher likelihood of something significant developing over the next few weeks and months as a result of this case, something which hopefully will roll down to the GDC as well. Even Jeremy Hunt has raised concerns about this case and its unintended consequences.
Once cannot forget the tragedy of the death of a child in the case, but there has to be consideration of the bigger picture of how a ruling such as this will now probably affect the analysis of mistakes in healthcare that are needed to protect the public. Furthermore, unless the use of reflective writing is somehow protected, the use against us of our own insightful learning could be our eventual downfall.
Image credit - James Cridland under CC licence - modified.
Correction
Correction
The Academy has also worked hard to meet the new requirements of the General Dental Council’s (GDC) CPD quality assurance. With the new changes to Enhanced CPD starting in January 2018 for dentists and August for dental care professionals, this will further reassure members of Simplyhealth Professionals, the providers of Denplan payment plans, that they are receiving the highest level of training support.
The GDC has introduced changes to CPD in 2018 now called Enhanced Continuing Professional Development (ECPD) and have stated that all providers of dental CPD need to have clear aims, objectives and anticipated outcomes that fit with their four development outcomes. CPD providers also have to offer quality assurance that their courses are fit for purpose.
Louis Mackenzie, Head of Clinical Training at Simplyhealth Professionals, said: “We have always employed the highest levels of quality assurance to ensure all of our courses satisfy the educational needs of dentists and their teams. The BDIA Code of Practice process has been an excellent opportunity to formalise our rules and reassure all our members that the entire range of Simplyhealth Professionals CPD activities will satisfy all of their statutory obligations for verifiable CPD.”
All courses run by Simplyhealth Professionals have quality controls in place, help members choose CPD products that match their individual requirements and fields of practice, and provide certificates that show that the registrant has met their aims and objectives. Members have nearly 60 modules that they can choose from.
Simplyhealth Professionals’ training team provide customised training days for member practice staff to help them stay up to date with industry knowledge, regulatory compliance, and techniques for dealing with all of their patients’ needs. The team are all qualified trainers who come from a range of backgrounds, from finance, health and social care, education, and dental care.
Jo Banks, Head of The Academy, said: “The Academy has always strived to provide the highest quality training for dentists in many subject areas. The BDIA Code of Practice and the meeting of the new ECPD standards for all our training can reassure dentists that in choosing Simplyhealth Professionals to deliver their training they are meeting all current requirements. We provide an outline of the aims, objectives and anticipated outcomes of all our courses with links to how they fit with the GDC’s four development outcomes. Our CPD certificates have been adapted to meet GDC requirements and will now display the relevant GDC Development Outcomes A, B, C and/or D.”
To find out more information about the range of CPD courses available from Simplyhealth Professionals visit http://www.denplan.co.uk/
Simplyhealth Professionals is the UK’s leading dental payment plan specialist with more than 6,500 member dentists nationwide caring for approximately 1.7 million patients registered to a Denplan product.
Simplyhealth Professionals provides the following range of leading Denplan dental payment plans under the Denplan name:
· 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
· Denplan for Children: routine and other agreed care + worldwide dental injury and dental emergency cover
· Denplan Membership: registered with the dentist + worldwide dental injury and dental emergency cover
· Denplan Hygiene: A dental payment plan without dental insurance for all types of practice from NHS, mixed and private to support patients commit to a consistent hygiene programme.
· Denplan Emergency Insurance: worldwide dental injury and dental emergency cover only
Simplyhealth Professionals also provide a wide range of professional services for its member dentists and their practice teams, including the Denplan Quality Programme and Denplan Excel Accreditation Programme. Plus regulatory advice, business and marketing consultancy services and networking opportunities.
Dentist enquiries telephone: 0800 169 9962.
For patient enquiries telephone: 0800 401 402
For details of all of our products, visit www.denplan.co.uk
Loving your humour!
The new rules, which have now been made into the law as of Saturday, will mean all surcharges are banned when businesses process card payments.
So there will be no charges for paying by debit or credit card, including American Express and linked ways of paying such as PayPal or Apple Pay.
As an example, when booking flights, you will no longer be charged extra for paying via credit card. Below are a few examples of charges. (from Money Saving Expert)
It is estimated that surcharging cost Brits £166 million in 2015.
The rules will apply to any UK company which is selling to UK consumers.
The reason this is being mentioned in a blog on GDPUK is……
One because of our offer for members, where we can save dental practice money on their card payment fees, which are obviously different area when compared to the new law above but still relevant.
Secondly, businesses often charge these extra charges as listed above (especially smaller businesses such as dental practices) because of the fees the business was paying the merchant supplying the card service and they were passing on the charge to the consumer.
So therefore checking your card machine rate is more important than ever.
One of way of helping small business owners reduce these costs is by checking your rate. Card payment services can be very costly to dental practices and other small businesses. By comparing your rate, you can reduce your monthly bills by up to 60%. That could mean an annual saving of several thousands of pounds.
Find out more info here via GDPUK Services. Just fill out the form at the bottom of the page and within a few days you can be making savings. Just Switch and Save!
This offer is primarily for dental practices but we can also look at other businesses that take card payments on a daily basis and see how we can help reduce your costs. Just enquire via the form on the GDPUK Services page.
Further info about the EU Payment Services Directive here.
The GDPR is a new set of rules which will apply to all organisations that collect or retain personal identifiable data from any European individual. The idea behind it is to standardise data privacy laws and mechanisms across industries, and to ensure that fundamental rights of individuals are protected in today’s increasingly data-driven digital economy.
6 Things you need to know now
It is extremely important that everyone in your dental practice is made aware of the rules surrounding the new data regulation. Preparing for the GDPR will require changes in the practice’s culture, which you should start to plan in advance of the May 2018 deadline. Keeping everyone informed will ensure that your practice follows the proper procedure, and the GDPR is handled with the utmost care.
Here are 6 steps that will help your practice prepare for the changes today.
Under the new regulation, dental practices will be required to keep a record of how and when the patient gives consent to store and use their personal data. Consent will need to be clear and distinguishable from other matters and provided in an intelligible and easily accessible form, using clear and plain language. Consent cannot be inferred from silence or inactivity of the user.
Further requests for consent will need to be separate from other terms of engagement. In practical terms this means you will need to clearly explain to your patients what you are intending to do with their personal data.
It must be borne in mind that consent once given can be revoked, and it must be made equally easy to withdraw consent given.
The GDPR also introduces a requirement for parental consent. Where services are offered directly to a child, practices will need parental consent to process the data of under 16s.
To do list:
– Identify the categories of personal data processed within your practice.
– Consider the legal basis applicable to the processing of personal data within your practice, and make sure these grounds will still be complied with the GDPR.
– Where consent is relied on, check that it will be: freely given, specific, informed, and unambiguous.
– Consider introducing processes to promptly honour any withdrawals of consent.
– Make sure you keep a record of consents given to demonstrate compliance.
Aside from the need to obtain consent, your practice will be under an obligation to ensure that the processing of data is fair and lawful. Also, appropriate information must be given to your patients as to how their data is to be used. This is normally done in the form of a privacy notice. The GDPR has a mandatory list of the information which must be given to patients where data is obtained directly or indirectly from them. You will be expected to explain to your patients what data relating to them will be collected, how it will be used, the purposes for which it will be used and how their data may be shared.
To do list:
– Get to know your data. Consider what information is being collected, who is collecting it, how and why it is being collected.
– Consider how the information obtained will be used and who will it be shared with.
– Consider what possible effect the information obtained could have on the patients concerned.
– Consider building a data catalogue (if you haven’t got one in place) and drafting a meaningful privacy notice.
There will be a significant change to records of processing activities. The GDPR does not distinguish between internal and external records anymore. Dental practices will now require only one kind of record: an on-demand internal record. A practice will be required to maintain records of the entire practice’s processing activities internally. Moreover, these will need to be available to supervisory authorities upon request.
To do list:
– Consider introducing a full compliance program for your practice incorporating features such as regular audits, HR policy reviews, and training.
You will be required to appoint a Data Protection Officer (DPO) if the dental practice is:
– A public authority (except for courts acting in their judicial capacity) (Art. 37(1)(a));
– Carrying out systematic monitoring of individuals on a large scale (Art.37(1)(b)); or
– Carrying out processing of special categories of data or data relating to criminal convictions and offences on a large scale (Art.37(1)(c)).
Dentists providing NHS care will be regarded as public authorities. Thus, even a small NHS practice will require a DPO. It is anticipated that the Clinical Commissioning Groups (CCGs) will be providing Data Protection Officers in primary care settings.
If you don’t want to recruit, it will be possible to appoint a single DPO to act for a group of practices, provided that a DPO is easily accessible from each establishment. Alternatively, you can contract the services out.
For those organisations to whom the requirements do not apply, they may still choose to appoint a DPO.
– Assess whether your practice is obliged to appoint a DPO.
– Consider who will be your DPO.
– Consider whether your practice should appoint an internal or external DPO.
– Compile information on data processing activities within the practice.
– Ensure that those to whom you have designated responsibility, their duties do not lead to a conflict of interests of their own role.
The rights of individuals under GDPR are the same as those under the Data Protection Act 1998 with a significant enhancement of the right to data portability. Under the GDPR, patients will have the right to receive the personal data which they have previously provided in a ‘commonly used and machine readable format’, and have the right to transmit that data to another controller. This information will need to be provided free of charge, thus removing the previous £50 subject access fee for dental records. This will apply only to data processed by automatic means, and not to paper files.
To do list:
– Consider whether the technical capabilities of your practice will comply with data portability requests.
– Make your patients aware of their right to data portability. Does your company send out e-bulletins and/or newsletters? Let your subscribers know by including a short paragraph at the end of the article.
Any practice in breach of GDPR can be fined up to 4% of annual global turnover (not profit) or €20 million – whichever is greater. This fine can be imposed for the most serious infringements, for example for not having sufficient customer consent to process data. The practice can also be fined 2% for not having their records in order, or for not notifying the supervising authority and data subject about a breach, or not conducting impact assessment. In the case of a breach, practices will be required to report the breach to relevant authorities within 72 hours. The practice will be obliged to give full details of the breach and offer proposals for mitigating its effects.
You should be preparing for the new requirements that will affect your practice. Considering the above steps in the context of your practice is the very first step you can take in order to prepare for the upcoming legal changes. Do not assume that you will be able to claim innocence through ignorance of the rules – the whole point of the GDPR is to keep your company better protected and able to deal with breaches in security. If preparation is approached in the right way, your practice will be well-prepared in time for the regulation coming into force, and your business will be secured for years to come.
We will be running a workshop on 22nd February aimed at dental practices to help them prepare for the new GDPR requirements.
Really CCG be Data Protection ...
One of the aims we have always looked to achieve at GDPUK is saving money or producing special offers from our advertisers and partners for our 11,000 members. Running and operating a dental practice (or any business) can be extremely expensive and time consuming. Not all expenses or direct debits, will get checked every month because they aren’t always the first priority but often expenses can go out of our control.
Below is a short guide we have produced that looks at some ways you can save money and time in your dental practice in 2018.
**Disclaimer** A few of the money and time saving suggestions, are services that are offered by GDPUK via third parties. These services are available elsewhere but the suppliers we have mentioned have produced excellent savings for our members and provide a service that they have been extremely happy with. Only our opinion!
Insurance
Dental Practices need all sorts of insurance. Insurance is always worth shopping around for when you consider the amount of cover a dental practice needs on a regular basis.
There are a number of insurances that a dental practice may choose to buy such as dental practice insurance, dental locum insurance, pressure vessel inspection, keyman protection insurance. All the policies are worth comparing the market, with a number of companies specialising in this area such as All Med Pro, Lloyd & Whyte and MIAB.
Dental Supplies
Over the years on the GDPUK Forum, our members have found that it is worth doing a price audit on their top 20-30 supplies in the practice based on volume per month and it can be found that with a bit of shopping around of dental suppliers, you can make some considerable savings for the practice. Obviously, credibility, reliability and efficiency of the suppliers also need to be taken into account for important supplies but some considerable savings can be made. This is certainly worth auditing a couple of times a year.
Credit Card Fees
We’re always looking to help you reduce costs without compromising the quality of your patient care. That’s why we’re working with nexpay to ensure the fees you pay on credit card processing are extremely competitive and save your dental practice money. Just contact us by the link below, nexpay will review your existing account and undertake a full market comparison. They will then produce a report that shows you the potential new tariff savings. Some GDPUK members are saving thousands of pounds a year on card processing fees.
You still provide the same service to your patients but save on the processing fees, which over a calendar year can often be quite a saving! Find out more here.
Water
Water is used a lot in an average dental practice. On 1 April 2017, businesses were given the freedom to choose which water supplier to buy their water and wastewater services. This means there are loads of dental practices that will be paying over the odds for their water supply, certainly worth a quick shop or call around. Companies like amber energy and openwater will offer a comparison service and advice on what is a good offer. Once again a great opportunity to reduce costs in the new year.
Energy
GDPUK.com has teamed up with a leading independent business energy brokerage who is constantly striving to source the best products and most competitive market rates for businesses. With a vast array of suppliers and products available to the business market, quite often businesses are left without clear guidelines as to which is the best deal. Our broker can offer a comprehensive panel of suppliers who are vying for your business. For more information, please follow this link - https://www.gdpuk.com/energy Other similar type services are also available.
CQC and Regulation
Compliance is changing faster and faster. From the CQC Fundamental Standards in 2015, to the GDC standards in 2014 to changes in employment law, health and safety, sharps regulations and a whole lot more. Because the volume of compliance and regulation in a practice can seem to be overwhelming, it can be difficult for a dental practice owner or practice manager to keep on top of it all.
Services such as icomply and rightpath4, help to tell you what to do and keep you updated on the latest changes and legislation. This can help to save the practice a lot of time, stress and misunderstanding. It does help having everything in one place.
Right Path 4 who have always been great supporters of GDPUK have a special offer on for members of GDPUK. All future updates to the Right Path 4 system are included in this monthly fee. Further information here on how they can help you in your practice.
Software Systems
Although not necessarily saving you money in the short term, dental practice software systems certainly make your practice streamlined and more efficient for all members of the team.
You can save a lot of time in your practice by going paperless. One of these paperless systems is offered by iSmile, who offer your very own branded Patient Portal, where you can give your patients the ability to fill in medical history forms on their desktops, tablets and mobile devices prior to their appointment. iSmile can automatically email medical history forms to your patients, which are filled out securely online and then transmitted back to iSmile and stored within the patient's file, significantly reducing workload and paperwork at the dental practice reception.
Further information on this subject can be found via the GDPUK Forum:- Going Paperless.
The Dental Industry Event of the Year is back! The Digital Symposium 2018 takes place on 27-28 April in London and this year it’s thinking big, it’s thinking holistically and it’s thinking differently.
Recognised as Dental Industry Event of the Year at the Dental Industry Awards 2017 held in association with the BDIA, the Digital Symposium is the ultimate digital experience for dental professionals. Driving innovative solutions in terms of predictive treatment, diagnosis, management, treatment and prevention, the Digital Symposium is an opportunity to witness the transformative power of these emerging technologies first hand and hear from some of the industry’s most influential educational and motivational speakers.
BREAKING NEWS: The Medical Futurist confirmed as Keynote speaker
A “geek physician” with a PhD in genomics and an Amazon Top 100 author, Dr Bertalan Mesko, the Medical Futurist, predicts the impact of digital health technologies on the future of healthcare, helping patients, clinicians, regulators and industry organisations make it a reality. He will talk to delegates about a range of digital health technologies, including artificial intelligence, health sensors, 3D printing and how social media can impact public awareness.
The Medical Futurist is joined by an impressive line-up of other speakers including Colin Campbell, Sinead McEnhill, Adam Nulty and Josef Kunkela. For a full list of speakers, visit hsddigitalsymposium.co.uk/speakers-2018
Book before the end of January 2018 to take advantage of our Early Bird and Previous Delegates’ offers.
To book at our discounted prices or to find out more about The Digital Symposium 2018, visit www.hsddigitalsymposium.co.uk/
To find out more about Henry Schein Dental’s range of digital solutions, contact Henry Schein ConnectDental on 0800 028 4870 or visit hsdconnectdental.co.uk.
Twitter: @HenryScheinUK
Facebook: HenryScheinUK
With more and more patients having access to smart phones and emails, iSmile can cater for a completely paper free experience. With your very own branded Patient Portal, you can give your patients the ability to fill in medical history forms on their desktops, tablets and mobile devices prior to their appointment. iSmile can automatically email medical history forms to your patients, which are filled out securely online and then transmitted back to iSmile and stored within the patient's file, significantly reducing workload at reception.
Getting client feedback and disseminating the data into easy-to-understand reports is an important part of any business. Patient Portal allows you to create a patient questionnaire in iSmile which is automatically emailed to patients after their appointment. Data collected back by iSmile can then be displayed in a range of reports which allows you to analyse trends over a series of time periods and see how your business is changing, allowing you to identify where improvements can be made.
Patient Portal is upgraded with features all the time and now includes mobile signatures - there's no need to purchase clunky digital signature equipment as Patient Portal works on any tablet and any mobile phone - both inside and outside of the practice!
If your practice would like to join RP4 today, there is a special offer * for GDPUK Members (£59.95 a month INCL VAT).
*New GDPUK members are invited to a friendly online tutorial (Google Hangout) where you share our screen and we set up the RP4 system for YOUR practice so that it’s ready for you to start using right away and we’re supporting you 7 days a week!
You can join now using this link - https://pay.gocardless.com/AL00016VCPR74Z
RP4 are the EXPERTS by experience, there’s no joining fee and no ongoing contract tie in. RP4 BLUEPRINT are the ‘go to’ people for more than 750 practices. Our Experts are all dentists with detailed experience of working with the Regulators and Indemnity Providers at the highest level.
Below is video created by Keith, which explains the RP4 System.
Sign Up Today, click here to start today.
What is Right Path 4?
Right Path 4 offer a system that covers everything you need for CQC Inspections and Visits.
Who makes up RP4?
RP4 is a small team of professionals who have a great deal of experience. We’re passionate about using this experience to help our colleagues to work within a team dedicated to providing the highest possible standards of health care.
What do you receive?
RP4 BLUEPRINT Modules on Clinical Risk Management, NHS Contract Management, PDP and Reflective writing and now ‘keeping your eye on the ball. All written by EXPERTS just for RP4 members.
RP4 are the EXPERTS by experience, there’s no joining fee and no ongoing contract tie in. We have the lowest fees and we have produced an RP4BLUEPRINT, the ‘go to’ people for more than 750 practices. Our Experts are all dentists with detailed experience of working with the Regulators and Indemnity Providers at the highest level.
Inspired by the CQC, Blueprint gives you the complete plan and Blueprint is only available to RP4 members
Below is video created by Keith, which explains the RP4 System.
If your practice would like to join RP4 today, there is a special offer for GDPUK Members (£59.95 a month for GDPUK Members), if you follow this link - https://pay.gocardless.com/AL00016VCPR74Z
For further information about RP4 and the team behind the system, please visit - https://www.rightpath4.com/blogs/
The 8th November marked just one year since dental partnership group, Dentex, secured its first dental practice, and what a year it’s been. The first twelve months of any business is meant to be the hardest, but in this time Dentex has accumulated 17 practices as part of the group, with a further 18 in due diligence; and secured £21m in funding. Not bad for an organisation that began with just six members of staff.
Since its inception, Dentex has almost taken on a life of its own. Driven by Barry Lanesman, CEO, Pat Langley as Chief Dental Officer and Rob Paxman as Director of Partnering, all of whom have long-term experience within the dentistry field, the organisation has sought – and succeeded – to fulfil a very great need in the dental industry: enabling dentists to share in the value created through a dental collective.
They differ from typical dental corporates by offering much better long-term wealth creation opportunities to their partners. Dentists are able to extract equity from their practice, but continue to stay involved and benefit from the growth whilst preserving their clinical independence. Dentex provides support to dentists as partners, enabling growth without removing a practice’s autonomy; so, dentists continue to run their practice, expanding and thriving, no longer having to constantly focus on cash flow and financials.
In a year that has seen the group awarded the ‘Highly Commended Award for Innovation of the Year’, as well as finalists for ‘Product Launch of the Year’ – Dentex has found success in a model that challenges the traditional dental corporate pattern. There is no management takeover, no rebranding, as happens when joining a corporate franchise; partners maintain their autonomy, gaining input and assistance only where they require it. This allows practices to retain their individuality, which is important for practitioners and patients alike. And with two partnership models – Regional and Practice – it’s possible for Dentex partners to either reduce their responsibilities or enhance them, either focusing on their core interests at a local level to ensure a premium patient experience is delivered, or building a portfolio of surgeries in order to broaden their potential remit. Once approved and passed through the stringent Dentex criteria for partner selection, the choice of how they wish to proceed is left to the individual member.
There is an acute focus on finding the right partners. Integrity, respect for each other and highest ethical standards are just a few of the values that make up Dentex’s foundations, and all members of the group are expected to share this ethos.
Dentex is not about running a business model that’s dictatorial, it’s about helping dentists work together. Dentists often face similar challenges, so partners are encouraged to build and grow in a collegiate way.
Barry Lanesman, Dentex CEO, comments:
‘With a five-year plan which aims to see the Group at 150 partnering practices by 2022, it’s still early days for Dentex, but so far, the company is very much on track, thanks to its unique offering. This time last year there was a gap in the market. Dentex have filled it admirably.
But while the organisation’s phenomenal growth is certainly worth marking, Dentex’s driving force is quality over quantity. Each Dentex partner wants to share growth and remain involved in the development of the practice, not exit at the earliest opportunity. They are genuinely enthused and motivated about clinical dentistry and use their partnership with Dentex to help overcome regulatory, compliance and administrative barriers.
The partnership allows them to focus on areas of dentistry they’re truly passionate about. Each one of the partners excels in their field with an unswerving commitment to deliver premium patient care, sharing best practice for the common good of the group – and ultimately the patient.’
Dentex has shown significant growth thanks to its unique offering. They have ambitious growth expectations and so far, are on track to hit their target of 150 practices by 2022.
Dentex Regional Partner, Bhavna Doshi of Perfect Smile dental studios, explains why she joined the group. ‘Dentex is a partner that has allowed us to preserve our ethos and way of business, and provide a collaboration of mastermind. We have been able to keep our business identity, leadership philosophy, quality of dentistry and exceptional patient care. At the same time, they have given us the financial and business support to grow our group of practices.’
Andrew Birrell, Executive Director of Universal Partners, Dentex’s largest investor said ‘The Dentex message continues to resonate with clinicians who wish to release equity whilst retaining upside, and continue to enjoy the clinical freedom to deliver for their patients before joining the group. The company is performing ahead of our expectations and we look forward to seeing it prosper in future”
Further information on Dentex here.
It has long been recognised that dentistry is a stressful profession. It has long appeared in the list of “top ten” most stressful jobs, along with teaching, prison officer and working in the emergency services. But now it is official; the British Dental Association has conducted research into stress levels in the profession. They have found that a shocking 39 per cent of community dentists surveyed and almost half of GDPs reported high levels of stress. This is compared to an average of around 15 per cent for all British workers.
High levels of stress can have a very negative impact on the running of any dental practice. Ensuring staff are happy and relatively stress free, will lead to better productivity and higher morale in your workforce. However, there are additional pitfalls to ignoring staff stress levels as work related stress can lead to a claim being issued against the practice for damages.
Managing work place stress
The BDA’s Evidence to the Review Body on Doctors’ and Dentists’ Remuneration for 2017/18 found that 51% of the dental profession would not recommend a career in dentistry. The same report found that both practice owners and associates considered their morale to be ‘low’ or ‘very low’ at 29 per cent and 32 per cent respectively.
In response the BDA is undertaking research on dentists’ well-being at work and why they experience ‘burnout’, but this does not help you tackle the problem in your practice now.
What is Stress?
According to the Government stress is a reaction to a person’s circumstances and surroundings. It is not an illness of itself but often causes other illnesses. Its effects are shown in a number of different ways, both physical and mental. For example, lack of concentration, sleeplessness, low mood, susceptibility to colds/flu, skin irritations, the list goes on.
It is important to remember that there is a difference between pressure and stress. Pressure at work can be healthy, as can some level of stress. However, too much pressure can cause stress to become harmful to health and employees will react differently to the pressures they face.
What duty does a practice principal owe to their workforce?
Employers have a common law duty to take reasonable care of the health and safety of their employees. If an employer breaches that duty, and that breach causes the employee a personal injury, the employee can bring a claim for damages.
A personal injury can include stress. However, the injury must be a medically recognisable psychiatric injury. Therefore, not all cases of work related stress will give rise to a claim for damages.
In order to succeed in such a claim, an employee will need to prove the following:
1. That the employer breached the duty of care;
2. That the breach caused the employee injury;
3. That the injury was foreseeable.
It should be noted that whilst we have used the phrase ‘employee’ above, the protection will extend to workers and could even extend to a self-employed associate, if they can show that they are owed a duty of care by the practice.
Easton v B&Q [2015]
Hatton v Sutherland is the leading case in personal injury claims relating to stress at work. The court re-visited the test in Easton v B&Q and also gave some practical advice in dealing with such cases.
Mr Easton was a manager at a B&Q store. Prior to this he had worked as a manager for 10 years at a large supermarket chain. Mr Easton alleged that as a result of B&Q’s breaches of the duty of care he had suffered work related stress. Mr Easton further claimed that the way his return to work was handled, following a period of stress related ill health, caused a relapse of his condition.
There was no dispute from B&Q that Mr Easton had suffered a psychiatric illness. The issue in this case was whether the injury was foreseeable.
The key findings of the court were as follows:
1. Lack of promotion
The court recognised that Mr Easton’s condition affected his perception of the events that had taken place. However, the court found Mr Easton had persuaded himself that a promotion was in line and this could not therefore be a breach of duty. The court commented that employees should try to look at events objectively.
Tip: employers who can show they have acted fairly and in line with any policies are unlikely to be in breach of the duty of care. If an employee has taken exception to a decision you have made, try sitting them down and clarifying why it is needed, rather than saying ‘I am the boss, my decision is final’.
2. Removal of night time staff
The court found that the effects of this were not as dramatic as Mr Easton made out and that Mr Easton failed to make any complaints about this to his employer at the time.
Tip: An employer cannot be expected to foresee an injury if it is not aware of the concerns the employee has to begin with. However, if a member of staff raises any complaints with you, you should take them seriously and deal with them accordingly, even if that means explaining to the employee why their concerns are invalid.
3. Rejection of a grievance
Although not in fact argued by Mr Easton, the Court took the opportunity to clarify that when an employer rejects a grievance, as long as a proper procedure was followed, this cannot be a breach of duty simply because the employee does not feel justice has been served.
Tip: this is often an issue for employers. Employees not agreeing with a grievance outcome and feeling they have been dealt an injustice. However, as long as you have properly investigated the issues and provided a reasoned response to the same, it is unlikely you will be criticised.
4. No knowledge of stress
The court found that B&Q had no knowledge that Mr Easton was suffering from stress. The court took into account Mr Easton’s previous role as manager for a large supermarket chain and concluded that he was therefore capable of doing the role. In the absence of Mr Easton informing B&Q of his concerns, B&Q were not on notice of any issues.
Tip: An employer is entitled to take what his employee tells him at face value, unless there is good reason to think to the contrary. Therefore unless an employee reports to you they are feeling stressed, you do not need to take action. However, if they do you should take heed and ensure you have dealt with any concerns the employee raises.
Conclusion
Whilst work related stress should be taken seriously, employees need to show that the employer did know, or should have known, that their actions would cause an injury (the foreseeability test) in order to succeed in a claim. Most claims fail on this basis, as it is a high threshold. A common misunderstanding by employees when arguing a claim for personal injury is that simply because they have suffered from work related stress, that the employer must be liable.
Irrespective of this, as an employer you will want to ensure your staff are as happy and stress free as possible. There are a number of ways you can do this:
1. Appraisal process;
2. Having an ‘open door’ culture so employees feel safe talking to you;
3. Undertaking staff meetings so staff feel part of the practice;
4. Ensuring changes to procedures are properly explained before they are implemented, to help staff understand the reasons for them.
Also remember that whilst an employee may not have a stress at work claim, they may be able to bring claims for disability discrimination or harassment, unfair or constrictive dismissal or breaches of health and safety requirements.
If you have queries regarding the content of this article please contact Laura Pearce, Senior Solicitor, on 020 7388 1658 or by email at This email address is being protected from spambots. You need JavaScript enabled to view it..
We’re all members of a cult. Whether we like it or not, since mankind first appeared on earth, there has been a need for the majority of humans to flock together in some form or another. Whether it was for protection by strength of numbers, or to increase the genetic variety of a group, the formation of cults, tribes or groups has always been something that the human race has experienced.
I’m not talking here about race-related groupings of human, because that is something far more fundamental. That is all about the genetics that make you part of one race or another, and there is precious little you can actually do about the genes you were born with.
What I’m thinking about here is the tribal nature that makes you support one football team over another, or a different political party to someone else. Religion may also be part of this, but I am going to steer well clear of that for obvious reasons. However what is apparent is that most of these tribes and cults are based on the shared values and belief structures that the members of the cult have.
“Where is he going with this blog?” I can hear you all thinking. This is not one of my normal types of observational commentary on the state of dentistry where I’m having a go at some (dis)organisation or system in dentistry.
Or is it?
Because it actually is exactly the same as usual in that I’m pointing out something that I believe is fundamentally inherent to the problems that we are experiencing in the profession at the moment.
Cults and tribes are collections of people who flock together under one belief structure. The profession of dentistry is such a tribe. We all share the same skill set fundamentally, and are working together to provide the same goal of health for our patients.
But within a tribe are often sub-tribes and cults. These are the things that seem to me to be dividing the profession in more ways than one and can often cause problems. When we look internally we see the infighting between some of the orthodontists and those providing GDP orthodontics. You can guarantee a lengthy ‘discussion’; when some of the more evangelical on both sides come out to discuss their views on this subject. The same is true of the two cults of private and NHS dentistry.
It is actually possible to be a member of different cults at the same time, and cross over seamlessly from one to another depending on the situation. You might find yourself agreeing with someone from another cult one minute, and then vehemently arguing the next.
When your strongly held values and belief structure is in disagreement with someone else’s equally strongly held views then conflict is almost inevitable. Only the control of the emotional aspects of these differences is what prevents the breakdown of the relationship between these two sides. Some people are able to control it more than others and agree to disagree, but many others are not.
Dentistry is absolutely full of cults.
More so than I think it has ever been before. I personally think the rise of social media and the ease with which one like-minded individual can find others who are from the came cult has been at least partially to blame.
The problems arise when the cults cause not only infighting in the profession, but also are responsible for the perception of the profession to the public (who I’ll just take as one big tribe at the moment).
Within the profession we have the cult of the Key Opinion Leader, some of whom seem to have opinions based on their parallel membership of the financially motivated cult, and who can pay them the most. Then we have the Celebrity dentist cult, often admitting to no personal or clinical failings and who may have sprung from anonymity in record time, with fawning acolytes who can see no fault in their heros. Given the following of some of these two groups, I’m actually waiting to read in the BDA news that 600 cult members have all drunk copious quantities of Hypo in a mass attempt to align their teeth. Ok, maybe that’s a bit far, but what will usually happen is the acolytes will be the ones who get left in the lurch either with the GDC or with a load of obsolete materials when the Guru-esque leader moves onto the next best thing since the last best thing.
There is the huge cult of the NHS dentist, who can often see no way out of the cult, but stay because they are also members of the ‘I’m alright Jack, my pension’s great’ cult or the ‘We cant go private where we are’ cult. There is also the sinister ‘Gamers’ cult, where you’re a member but don’t admit to it, either because you don’t want to, or because you don’t realise you are.
I could go on and on with this but I think I’ve made my point.
I’ve probably managed to alienate a huge chunk of my readers now with those analogies (perhaps it would have been more sensible writing a blog on the various religions after all !) because I’m sure you now will find yourself both agreeing and disagreeing with me and become annoyed at me in some way.
The point I’m making is that the values and beliefs that we have developed place us firmly in pigeonholes and groups in such a way that someone else can make an observation that can start a conflict if you don’t like it. I’ve done precisely that in the previous paragraphs.
But the above is all a myth based on your belief structure, which can be changed if you really want it to. Do you want to be a member of the cult of materialistic egotistical, self-promoters? Fine, do that, but then don’t be shocked when others take issue with that.
Until we have the unification of the profession behind one overriding cult then we will always be divided. Since these cults are nothing to do with our genetics but only down to our beliefs, it is all an entirely fictional situation that causes the problem; a brainwashing due to our desire to hold onto our beliefs and opinions.
We need to not become a profession against itself especially as we have enough external factors affecting us already. Unity and a sense of purpose is more important now that it ever has been.
Image credit - Legominifig under CC licence - not modified.
A week ago saw Sheffield host its third Dental Charity Ball, in support of Dentaid – a charity that supports people, both here in the UK and around the globe, to gain access to quality dental care.
The evening was attended by many dentists as well as those wanting to kick off the festive season whilst supporting a great cause. Mr John Elkins, Finance Director at Dentaid, gave a talk on their work before Dr Barry Oulton, from Haslemere Dental Centre, and Helen Everatt, from S4S Dental Laboratory, hosted games, pulled raffles and opened the dance floor. Organised by S4S Dental Laboratory, Smilelign clear aligners, 4Health, and John Holland prestige car dealership, the event raised over £2500 for the charity, and will be used to help equip, treat and educate where the need is the greatest.
Watch the video of the event here, generously donated by True Glass Film.
s4sdental.com/charityball2017/
The recently published ‘State of Child Health’ report revealed that 31-41% of 5-year-old children across the UK are affected by tooth decay and this is the single most common reason why children aged five to nine are admitted to hospital. This represents a significant, but avoidable challenge to our NHS.
To tackle this problem, it is up to all professionals that work with children to spot the signs of poor oral health and take the appropriate action. In turn, we believe this will drive improvements in child oral health, leading to less hospital referrals and less complications later in life.
But, we can only achieve this by working together, with dental professionals, like you.
‘Insights: Why Children’s Oral Health is Everybody’s Business’ is a new event from the Royal College of Paediatrics and Child Health organised in partnership with the Office of the Chief Dental Officer and the British Society of Paediatric Dentistry. The event aims to bring together those who work with children including paediatricians and teachers, as well as dental professionals, to share best practice, compare experiences and hear insightful talks from leading voices.
Speakers confirmed for the main event will form a prestigious line-up, including Baroness Floella Benjamin OBE, Sara Hurley, Dr Jenny Godson and many more.
Here’s what Sara Hurley, Chief Dental Officer England, had to say about the summit:
“This event is a vital response to the call for multi-agency collaboration to tackle the complex interplay of factors that cause childhood diseases. A real opportunity to understand why childhood dental decay is everyone's business, the nature and extent of childhood oral health issues and how it impacts on general health and well-being. At the heart of the event is an opportunity to develop a progressive, collaborative approach and strengthen the links between the paediatric and the dental care communities to the benefit of our patients.”
Find out more about this event at www.rcpch.ac.uk/insights-oral
Children's Dental Health.........
NASDAL have taken a look at the Autumn budget from a dental perspective for GDPUK.com
Given the weakness of the Conservative Government as a result of the General Election and the tortuous negotiations with the EU over Brexit, it was perhaps no surprise that Chancellor Philip Hammond’s Autumn Budget should have avoided, if not evaded (!), making any major changes to the tax regime for the majority of businesses and individual taxpayers. However, Charles Linaker, a tax partner with UNW, which has a dedicated Dental Business Unit headed by NASDAL Media Officer, Alan Suggett, says that the Chancellor will still have to find ways of raising extra tax from somewhere and warns that dentists should be on their guard.
Those who are currently self-employed will recall that, in his Spring Budget earlier this year, Hammond announced increases to the rate of Class 4 NIC from 9% to 10% and then from 10% to 11%, which he then had to withdraw with indecent haste when it was pointed out that they breached a manifesto pledge made at the 2015 General Election. Had the Government been in a stronger position, those increases would surely have been reintroduced but the Chancellor confirmed that they will not now be implemented.
Similarly, dentists who operate via limited companies might have expected a possible reversal of the previously announced staged reduction in corporation tax rates, which many commentators thought could be implemented with relatively little controversy, not least because it would have been difficult for Labour to have opposed such a measure. But again, it was a case of no change as the Chancellor confirmed that 19% would remain as the rate for three years from 1 April 2017 and then fall to 17% from 1 April 2020.
On the personal tax side, Hammond could have decided to abandon, or at least delay, the previous proposals to increase the personal tax free allowance, but he confirmed that for 2018/19 this will increase from the current figure of £11,500 to £11,850 and that the basic rate band will increase for 2018/19 from the current figure of £33,500 to £34,500 (with the exception, it should be noted, of Scottish taxpayers).
Of course, it needs to be remembered that not everyone has the benefit of the full personal allowance. There is a reduction in the personal allowance for those with ‘adjusted net income’ over £100,000, which is £1 for every £2 of income above £100,000. So for 2017/18 there is no personal allowance where adjusted net income exceeds £123,000 and for 2018/19 there will be no personal allowance available where adjusted net income exceeds £123,700.
Capital Gains Tax was also left untouched in so far as the main rates of 10% and 20% remained unchanged and the annual exemption of £11,300 for 2017/18 was increased to £11,700 for 2018/19. Moreover, for any dentists contemplating retirement in the near future, not only did the 10% rate applicable for Entrepreneurs’ Relief remained unchanged, it was announced also that the Government will consult on how access to Entrepreneurs’ Relief might be given to those whose initial holding in their company is reduced below the normal 5% qualifying level of shareholding as a result of raising external investment for commercial purposes by means of issuing new shares.
An early major casualty post-Election and pre-Budget had been HMRC’s much vaunted Making Tax Digital (“MTD”) programme whose implementation for income tax is now postponed until 2020 at the earliest – and later in the case of corporation tax. Only MTD for VAT will adhere to the original timetable from April 2019, which typically does not affect dental practices. Nevertheless, dentists would be well advised to plan on the basis that ultimately the proposed MTD requirement to file quarterly returns of income and expenditure to HMRC will be implemented.
A key argument from HMRC for the introduction of quarterly reporting under MTD is that it will help them close “the Tax Gap”. While HMRC estimates that it loses more than £1.5bn a year in tax through avoidance schemes (in which at least some dentists will have participated), the Department reckons that it loses in excess of £5bn a year through the hidden economy (i.e. payments made cash in hand) and that SMEs pay a total of £15bn less tax a year than it estimates they should.
The statistical probability is that there will be some dentists in both of those categories and the Chancellor has allocated an extra £155 million in resources to HMRC in its continued war against evasion and avoidance. Given the Treasury’s need for increased revenue, an increase in HMRC enquiries over the next few years is on the cards and the dental sector can expect to bear its fair – or possibly even unfair - share of attention. You have been warned.
For further information on Nasdal (Specialists in dental business accounting and law), they can be found at - www.nasdal.org.uk.
Michael Lansdell is a founding partner of specialist dental and medical accountants Lansdell & Rose and a chartered accountant. Here, he gives a breakdown of the Autumn Budget 2017…
November 22nd was Budget day and therefore time for the ubiquitous articles on who were the ‘winners’ and ‘losers’ and what the Chancellor’s plans would mean for you. The heads up that the winning team was probably going to be rather smaller in number was the prediction from the Office for Budget Responsibility (OBR) that economic growth will be below 2 per cent for the next five years. For context, that’s one of the gloomiest forecasts that many can remember.
Philip Hammond faced a rather unenviable task, then, although no one was expecting any show-stopping statements either. Back in March, Hammond made a dramatic U-turn, scrapping the planned rises to National Insurance that he had announced in his Spring Budget just days before. For all sorts of other reasons, delivering a safe, steady and non-controversial Budget was always going to be the Chancellor’s intention.
Of course, there is always one thing that grabs report writers’ attention and this time around it was the decision to scrap stamp duty for first-time buyers on properties up to £300,000. We need to look behind the headlines to find out what will be most relevant to dental practice owners, though! Here’s what may impact on your financial planning for the year ahead…
Income tax
Both the personal and higher-rate thresholds were increased by around 3 per cent, which is in line with inflation, so no surprises there. For basic rate taxpayers, the personal allowance will increase to £11,850 and for those paying a higher rate the new figure will be £46,350. If you don’t want to see your personal allowance reduced, act now! If you make a pension contribution, or gift to charity, you can bring your income down to inside the new threshold.
Savings and investments
On the other side of the coin, anyone putting money into a pension saw the lifetime allowance increased from £1 million to £1.03 million (from 6 April 2018; no change to the annual allowance). If you are lucky enough to have funds that already exceed the £1 million limit, you might want to wait before you take your benefits. For those choosing an Individual Savings Account (ISA) or Lifetime ISA (LISA) the annual subscription limit will also remain unchanged, at £20,000 and £4000 respectively.
Capital taxes
A new 30-day payment window – between a capital gain arising and the payment of capital gains tax (CGT) – is now deferred until April 2020. With regards to inheritance tax, the nil rate band is to remain at £325,000. But don’t forget an important change due to start from 6 April 2018, when the inheritance tax residence nil rate band will rise to £125,000. If you don’t plan for this now, you could be significantly out of pocket when the time comes.
Property taxes and business rates
If you have been affected by the so-called ‘staircase tax’ (for businesses that occupy more then one floor of a building) you will be able to ask for your valuations to be recalculated. Another potentially relevant change was the switch to consumer price index (CPI) being bought forward to 1 April 2018. Also noteworthy is that the business rate discount for public houses with a rateable value of up to £100,000 will continue (subject to conditions) and non-domestic properties will be re-valued every three years following the next one, in 2020. In terms of planning, half of any interest for personal, buy-to-let borrowing will be limited to a 20 per cent tax credit from 2018/19, so make sure you understand if and how it will impact on you.
And finally!
The much-feted Making Tax Digital (MTD) scheme is still a work in progress – no business will be required to use it until 2019. When it has been shown to be successful, we can expect a roll out, but that won’t be until 2020 at the earliest. Getting prepared now won’t harm you at all though, as any business or individual within MTD will have to keep digital records and update HMRC quarterly. Maybe now is the time to review your record keeping.
The message? Plan ahead! A ‘steady-as-she-goes’ approach – while being meticulously organised and with the support of the right experts – will keep you focused and ready for anything as we embrace another year and whatever it may bring.
To find out more, call Lansdell & Rose on 020 7376 9333,
Or visit www.lansdellrose.co.uk
The Faculty of General Dental Practice (UK) has awarded Fellowships to thirteen individuals in recognition of their exceptional contribution to the profession. Fellowship is the highest award offered by FGDP(UK), and is a pinnacle of achievement for the profession. Two people have been given Honorary Fellowship, seven Fellowship by Election and four Fellowship Ad Eundum. The awards will be conferred at the annual FGDP(UK) Diplomates Ceremony, which will take place on 12 March 2018.
Honorary Fellowship
Professor Keith Horner
Keith Horner qualified as a dentist in 1981 from Leeds University and held several hospital posts in Leeds and Sheffield. He has served on influential working parties and advised bodies such as the Health Protection Agency and the IAEA Radiation Protection of Patients Unit. He is also Co-Editor of the FGDP's Selection Criteria for Dental Radiography guidance.
Mrs Fiona Erasmus
Mrs Erasmus is a former Director of FGDP(UK) (2013-2016), and has been recognised for her leadership skills and distinguished service to FGDP(UK).
Fellowship by Election
Dr Graham Douglas Stokes
Dr Graham Stokes has been providing dental implants for over ten years, and obtained the FGDP(UK) Diploma in Implant Dentistry in 2009. Clinical Lead at a practice in Bromsgrove, where he has been based since 1991, Dr Stokes also lectures widely across the UK on implants, full dentures and treatment planning.
Mr William Paul Cushley
Mr Cushley has worked as a Vocational Training Adviser for NHS Education in Scotland for the last 16 years, and has been an examiner on the DGDP, MFGDP and latterly the MJDF for the Faculty.
Mr Bruce Hogan
Mr Hogan graduated from Glasgow University in 1987 gaining BDS with honours. Currently Chair of FGDP(UK)'s West of Scotland Division, he is also an examiner for the Faculty of Dental Surgery of the RCPS Glasgow, and serves on the Board of Dental Education, Training & Professional Development at the College. He regularly lectures to VDPs on the use of local anaesthetics.
Mr Tony Wyn Jones
In addition to practicing dentistry since 1982, Mr Jones has served in Afghanistan as an RAF Dental Officer. He was an examiner for the MFGDP and later the MJDF from 2003-2012, including examining in Hong Kong.
Dr Pearse Stinson
Dr Stinson obtained his dental degree in 1981, after which he commenced an associateship in General Practice. He opened his own practice in 1986 and has been active in the FGDP since its inception, serving as a Board member for twelve years.
Dr Derek Maguire
Dr Maguire qualified 30 years ago from Queen's University, Belfast. He has also been awarded Membership of the Faculty of Dental Trainers with the Royal College of Surgeons of Edinburgh (MDTFEd).
Fellowship Ad Eundem
Mr Nicholas John Lewis
Dr Daniel Chi Kwok Ng
Mr Anish N Shah
Dr Kenny Siu Keung Tong
Spare a thought for those within the profession who are struggling with financial difficulties this Christmas. Circumstances can change suddenly for many reasons, leaving families feeling the pinch and less than cheery as the festivities get underway.
BDA Benevolent Fund offers additional financial support at this time of year to ensure that families don’t miss out.
If you, or a dentist you know, are facing financial difficulties, please contact BDA Benevolent Fund, in confidence, on 020 7486 4994, or visit www.bdabenevolentfund.org.uk for more information.
The charity relies on donations. To donate, please visit www.justgiving.com/bdabenevolentfund or send a cheque, payable to ‘BDA Benevolent Fund’, at BDA Benevolent Fund, 64 Wimpole Street London W1G 8YS. Every £1 donated goes directly to a dentist and their family in crisis so your help really does support someone in need.”
The BDA Benevolent Fund wishes you a fantastic festive season, and thanks everyone who has supported them throughout the year.
No one can deny that modern technology has been a revelation in recent years. The use of it to improve diagnostic yields in radiography, to allow mainstream imaging in practice of aspects of dental tissues that we couldn’t previously visualise the same way can only benefit our patients. Computerisation of dental notes and management systems, (whilst restricted in the choice of manufacturers) have probably improved the efficiency of most dental practices far beyond that of the old paper systems. Digital marketing tools, online presence through websites and blogs, and social media are all here to stay, and have driven the profile of the profession upwards. All in all, I think most of us would agree, technology has been largely a good thing for the profession
But one thing that I am REALLY struggling with that has come about as a result of this type of technology is the increase in Referral Portals for NHS referrals. On the face of it is would seem to be a streamlining of the process needed to refer into secondary care, and reduce the costs and problems with paper referrals. Entering the data via a computer linked to the patient database and directly into the referral systems would seem on the face of it far more efficient that writing a letter and posting it.
So why do I have an issue with it? This sort of advanced technology is right up my street normally. However, because of the way these systems seem to be implemented, I can see potential problems for registrants falling foul of the GDC Standards when they are forced to use them. The GDC standards that I personally think relate to this type of system are :
Standard 1.7 – Put patients interests first before your own or those of any colleague, business or ORGANISATION – these systems tend to be imposed unilateral decisions that don’t seem to have any guarantee that they are better for the patient (or indeed tested fully).
Standard 4.2.6 - If a patient allows you to share information about them, you should ensure that anyone you share it with understands that it is confidential – How does a faceless system with no identification of who receives the data comply with this standard?
Standard 6.3 – Delegate and refer appropriately and effectively. However, someone else often choses where the patient goes and who they see, with the clinician often having no idea of the degree of expertise that clinician actually has. Referrals are even rejected if often irrelevant (but required) tickboxes are not filled in.
Standard 6.1.5 – You must ensure that all patients are fully informed of the names and roles of the dental professionals involved in their care - How does a portal allow us to do this? Do we give all our patients Bill Gates’ name as its done on a PC?
Standard 6.3.1 - You can delegate the responsibility for a task but not the accountability. This means that, although you can ask someone to carry out a task for you, you could still be held accountable if something goes wrong. You should only delegate or refer to another member of the team if you are confident that they have been trained and are both competent and indemnified to do what you are asking.
For me this is the big problem. This alone is where the entire concept falls down unless we are indemnified for the errors of the system. What if this is a life changing referral such as a tumour? You are going to be ultimately responsible as you have to make the referral, and you can guarantee the powers that be who thought it was a good idea to impose the portal will NOT indemnify you against the failure of the referral in some way, nor will the GDC. If the referral is rejected because of some missing tickbox that is largely irrelevant to the immediate urgency but required because some software engineer hasn’t allowed any flexibility in implementation then I personally cant see how this should ever be the responsibility of the clinician. The fact I might for example omit the patients GP because I’m more interested in the speed of the referral is a pedantic bureaucratic issue and not one of patient care.
I can’t comprehend how we as a profession have allowed this type of loss of control of patient care to creep into our referral systems. I am fairly sure there are practices that are on referral pathways that our patients will be allocated to that many of us would not be happy for them being treated in. Part of being a professional means that you take on the ultimate responsibility for the care of a patient, and the GDC standards means that includes ensuring they are referred to an appropriate colleague. Unless every single one of these referrals is triaged by a clinician then there will be mistakes made. And this pre-assumes the system actually works like it should…..
I have had the misfortune recently of being forced onto a pilot in my local area of just one of these systems. Due to the obviously more knowledgeable people in charge of procurement in my area, they foisted a system onto practitioners without actually discussing anything with them first. To say I experienced problems was an understatement, and I know many others did too (despite the LAT saying the response to their questionnaires about it was overwhelmingly favourable – presumably because the portal lost as many bad responses as it did referrals). To be quite honest, I would have been better served learning how to send smoke signal referrals rather than use the system that was imposed. I did some research into the actual system and found that it had been dropped by at least one area as it was unsatisfactory, and another region have accepted that the same system isn’t good, but it’s the best they’ve seen. Hardly a glowing endorsement is it?
For example, in the 2 months I used it, we experienced a plethora of problems. I don’t think it is particularly useful to have to spend over TWO HOURS trying to upload a Periapical radiograph, knowing that if it wasn’t sent the referral would have been rejected. This was a compressed file of just 103kb. I don’t think it is particularly helpful to have half the tick boxes missing for medical histories, or dropdowns that you can’t fill in because they are incorrectly populated. A spell check that allows only the incorrect spelling of a drug is also pretty useless. It’s not useful that the system doesn’t tell you if the referral has gone correctly, or instead forever been lost in the ether of the internet. It’s not professional to have no idea who you have just referred the patient to or who is going to read the information. Not particularly useful if your patient who doesn’t have an email address (like many of my elderly patients) can’t even be referred at all as the system refuses to accept the referral without their email address. It also falls foul of my data security policy of allowing an unknown (to me) commercial third party installing software onto my system (which is massively firewalled both by hardware and software – which would appear to more than can be said for the NHS system if the recent Cryptolocker problem is anything to go by).
But having the system obviously ticks another box for those who confuse boxticking with patient care. By having a system that once again means all the responsibility still lies with the registrant even though they have no control of it is highly convenient for the powers that be. They get to have a load of committee meetings about the procurement, knowing full well that if and when it fails, and if and when patients suffer from it, it will be the clinicians who will get the blame for it. Having a system imposed from above without actually making sure it works is nothing new: lets face it the NHS hardly have a great track record in getting IT infrastructure correct out do they? Heaven help us if our friends at Capita get involved with implementing one of these systems; patients will probably end up with an 18 month wait instead of an 18 week wait. Still, at least losing patients in the system will make the waiting lists look good for the managers and they can get their bonuses for being so successful…..
So unless we get some form of indemnification from those who perpetually get to wash their hands of responsibility, I can’t see how we can use these portals and still adhere to our required standards. Please correct me if I’m wrong.
Nice Idea shame about the impl...
Below you will find some of the top news and blogs posted on GDPUK, week commencing 6th November.
1. At LMC Conference, doctors will vote on GPs leaving the NHS https://www.gdpuk.com/news/latest-news/2771-gps-to-vote-on-leaving-nhs
2. BDIA takes initiative towards Brexit https://www.gdpuk.com/news/latest-news/2776-bdia-leads-initiative-on-brexit
3 .MPs debate child oral health https://www.gdpuk.com/news/latest-news/2778-mps-debate-child-oral-health
4. @DentistGoneBadd posts a serious blog https://www.gdpuk.com/news/bloggers/entry/2037-dentistry-is-not-immune-from-harbouring-sexual-abuse-we-must-be-vigilant-too
5. Portsmouth graduate wins student of the year award https://www.gdpuk.com/news/latest-news/2780-portsmouth-graduate-wins-student-of-the-year-award
6. Coca-Cola ‘threatened to cut investment’ over sugar tax https://www.gdpuk.com/news/latest-news/2779-coca-cola-threatened-to-cut-investment-over-sugar-tax
7. Enough is enough: BDA demolish case for ARF levels https://www.gdpuk.com/news/latest-news/2770-enough-is-enough-bda-demolish-case-for-arf-levels
It is always a very sensitive time when a practice is transitioning to new ownership. Practice owners can feel a great attachment to their team, having spent time and resource on their development, as well as getting to know them on a personal level. When told the news, team members can feel vulnerable and anxious about what the future may hold and so delivering the right message at the right time is critical for success.
Before the transition
Whether the proprietor has decided to sell to an individual or a corporate group, the value of the dental team is recognised by potential buyers and they will often seek to retain staff. It is understood that the front-desk team’s relationships with patients adds goodwill, as does the approachable and professional dental nurses and hygienists. If the seller is unable to tell the team of the change early on in discussions, they may want to consider ways in which they can help the team to prepare for the change so that they do not feel exposed when they are told the news. Are the team up-to-date with their training and educational needs for confidence in what they have to offer the new owner? Is their appraisal detailed with all their achievements to date? Have their personal development needs been identified and an action plan put in place?
All in the timing
When to tell the team about the sale of a practice is a debated subject. Too soon, and it opens up a window for gossip and uncertainty, particularly if word gets out to patients who may then look to switch practices or be reluctant to commit to more extensive treatment. Too late, and the team might feel let down and shocked by the imminent change in management. Unfortunately there is no mathematical equation for working out the right moment and it will vary depending on the individual practice.
Supporting the team
The team emotions are often one of the heaviest burdens on a principal and so selling to an experienced purchaser who can be trusted to continue looking after all members of staff. Rodericks Dental, for example, offers a quick completion so that the “secret” does not need to be kept for a lengthy period. Further still, they can visit the practice out of working hours, even at the weekend, and they offer extensive training and support services for all professionals to advance their careers.
Selling a dental practice can opens up great new opportunities for the owner and the team. Managing the team during the transition can be challenging but with the right approach and support, it can go smoothly.
For more information please visit www.sellyourdentalpractice.net, email This email address is being protected from spambots. You need JavaScript enabled to view it. or call 01604 602491 (option 5).
Follow us on Facebook www.facebook.com/rodericksdental,
Twitter @rodericksdental and LinkedIn
“I first met Dental Elite at BDIA where they were presenting a lecture on practice sales and acquisitions,” reflects Dr Ninan Vettasseri. “Impressed with their experience and knowledge of the market, I decided to give them a call. And I’m glad I did, because not only was Katrina very supportive, but whenever there were hiccups she came up with a solution straightaway.
“If I could go back and do it again, however, I would do two things: Do my homework before putting the practice on the market and spend more time on marketing – the latter of which would have generated a higher completion price if I’d dedicated more time to maximising my practice’s potential.
“My advice to vendors would therefore be to plan well in advance and learn as much as you can about the process – not to mention to keep on track with UDA targets!”
For help planning your exit strategy in advance or selling your practice, get in touch with Dental Elite.
For more information on 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
As a Brit, I was both ashamed and proud of the revelations coming out of Westminster this week - ashamed that a small number of our elected representatives could act in such a grubby and misogynistic manner, but also proud of the way that the whole decades-long business is being exposed and acted on in an open way, even if it has been fuelled and inspired by our free press. There was something typically British and admirable in Sir Michael Fallon’s quick decision to resign from his post as defence minister, as opposed to my disdain for the USA’s Orang-Utan in Chief who has a considerable number of accusations of sexual assault outstanding against him and is a self-confessed and unashamed “pussy-grabber.”
It’s become obvious from the ubiquity of the ‘metoo’ hashtag (#metoo)
this week, that few walks of work life are free from sexual innuendo, threats and frank abuse and I have been wondering at what point the medical and dental professions will stand accused of similar behaviour either in the present or the past. What follows, has bothered me for years. There was nothing I could do about it at the time, and nothing I can do about it now, but I felt it was time to at least illuminate the fact that dentistry is not immune from the abuse of women.
I trained in the eighties in a fairly well-known dental school. There was a reasonably affable relationship between the students and lecturers – there were some lecturers who were frankly, evil bastards and there were some who treated you as sentient adults and although you wouldn’t go out for a pint with them, you would say “Good morning” to them in a corridor without ducking into the nearest toilet facility.
Some lecturers (and yes, it IS males) however, had a closer than affable relationship with female students and it is one that I need to focus on. This married lecturer was a reader in restorative dentistry and was a phantom head instructor. He always seemed to have a pally relationship with the female students and before long it was rumoured that he was having an extra-marital affair with a young student in the year below me. The affair became quite open within the dental school and he would often turn up at finals nights and exam celebration nights at Med Club. I didn’t follow that closely, the ins and outs of the relationship, but since it was so well-known, I assume that the dental school authorities turned a blind eye to it since the female hadn’t protested.
A few months after I qualified and left the dental school, friends of mine who were still at the dental school separately told me that the lecturer and been frequently ‘bothering’ a new and attractive dental student in a sexual manner, to the point where the young woman went to the head of the restorative department to report it.
She was later called to the Professor of the department where she found herself confronted by the Prof and the lecturer in question with the threat that if she were to take her complaint any further, they would ensure that she would fail finals.
I was told a few months later, that the young woman managed to find herself a place at another university and transferred. She apparently took her complaint no further.
I believe the head of the department is long retired (or hopefully dead), but the lecturer in question has risen to the heights, is nationally known, and is in active charge of students.
I didn’t know the victim, or even if she would have wanted to have taken this incident further. The fact that I didn’t? I am ashamed.
Abuse
Dr Andrew Farr talks to The Revu about his recent experience of undertaking the ITI Foundation in Implant Dentistry (FID) course and why, along with the guidance of his mentor, he is now more than ready to place his first implants.
What first motivated you to attend the FID course?
We were already offering implant treatment at our practice, but I was keen to learn for myself how to place and restore implants. I qualified over 10 years ago and received no implant training at all at undergraduate level, so it was a question of looking at the introductory courses out there that could get me confidently started in implant dentistry and the FID course was definitely the one that suited me best.
How did you find the course content?
Because it’s a Foundation course it’s designed to give you a solid theoretical understanding of how and when to use implants and to guide you in implant selection. I believe that the theory is very important when you are starting out in implant dentistry and the FID course definitely gets you off on the right foot.
I was very impressed at the quality of the teaching from some of the most experienced implant dentists in the UK, including Dr Shakeel Shahdad, Prof Nikos Donos and Dr Nikos Mardas. Between them they have a vast amount of experience, and I found them to be very open and honest about real life situations in practice, both good, and occasionally not so good. It would be easy for the experts to just say how good they are at placing implants, but that’s not what the delegates need, nor what they did. It’s just as important to learn about the things that can go wrong as well as the vast majority of cases with highly successful outcomes.
The FID modular course is spread over six months and you successfully completed the course in September. What has been happening in that time?
The most significant thing I’ve done is to partner with my mentor, Michael Betteridge. Michael is a specialist oral surgeon who is very experienced in providing not just oral surgery care in the primary care environment, but also a highly-regarded dental implant service, and is therefore ideally suited to being a mentor.
Are you looking to now move on to an MSc course or similar in implant dentistry or is mentoring giving you everything you currently need?
For the time being, with the help of Michael, my plan is to first get the basics right in practice before considering moving onto further education and I’m already in the process of planning my first implant cases. It can be a bit daunting when you first start out, but it’s probably more a fear of the unknown and that’s why a mentor is such a good idea to guide you over those first hurdles until you find your feet.
How have you found the support from Straumann - do you plan to place Straumann implants?
Yes, that’s my plan. Straumann are market leaders and when you are starting out you want to place the implant that offers the best chance of long-term success and is backed by a huge amount of research.
The support they offer is terrific and our local Straumann representative Hayley has been a great help in terms of my surgery set-up and making sure I have everything I need to get me started. Everyone at Straumann really knows what they are doing and if I have any problems I know they are there to help. It’s about the whole support package - not just the implant.
What are your plans now going forward?
I want to be doing a lot more than just placing the occasional implant. My aim is to eventually place something in the region of 100 implants a year and be in a position to accept referrals from local colleagues.
Finally, would you recommend the FID course to other GDPs?
Yes, I would definitely recommend this course - it’s ideal for any clinician looking to get the best start in a career in implant dentistry.
In association with Straumann, the next ITI Foundation in Implant Dentistry course begins in February 2018. For further information or to reserve your place, please call the Straumann Education Department on +44 (0) 1293 651270 or visit iti.org/uk
Facebook: Straumann UK
Twitter: @StraumannUK
Broad Street Dental Surgery, Broadway House, 32-35 Broad Street, Hereford HR4 9AR
Andrew Farr BDS(Hons), MJDF RCS Eng
Andrew joined Broad Street Dental Surgery, Hereford in October 2014. Born and raised in Caerphilly, South Wales he studied dentistry at the University of Cardiff, graduating with honours. He completed his vocational training in Plymouth, then spent a year as a Maxillofacial Senior House Officer at Derriford Hospital where his duties included emergencies in A&E, head and neck surgery and wisdom tooth removal. He has developed an interest in orthodontics and is qualified to offer Quick Straight Teeth short-term orthodontics.
In the case of Ivey v Genting Casinos (UK) LTD t/a Crockfords [2017] the Supreme Court effectively re-wrote the test for dishonesty. It removed the second, subjective limb of the current test. This has a significant impact, as it has resulted in one single standard dishonesty test across civil, criminal and regulatory cases.
This decision will have huge implications for anyone facing an allegation of dishonesty by their regulator.
But what does this mean in reality and how will it affect future cases?
Only 4 weeks ago we examined the two stage test for dishonesty as established by R v Ghosh [1982]. Ghosh set the test as follows:
1. Was the conduct complained of dishonest by the lay objective standards of ordinary reasonable and honest people?
2. If yes, whether the defendant must have realised that ordinary honest people would so regard his behaviour as dishonest?
The case of Hussein v GMC [2014] refined this test for professional misconduct cases, confirming the second part should be assessed against a reasonable and honest member of that particular profession.
Mr Ivey was a professional gambler. He enlisted the help of another professional gambler, Ms Sun, to use a technique called ‘edge-sorting’ to increase his chances of success in a card game called ‘Punto/Banco’. Mr Ivey and Ms Sun used this technique at Crockfords casino and over the course of two days managed to win £7.7 million.
Edge-sorting involves using the pattern on the back of the cards to identify if they are ‘good’ or ‘bad’. The technique can only be used on certain cards where the pattern on the back is not completely symmetrical. It also involves turning the cards so that the ‘good’ cards are all one way and the ‘bad’ cards the other. However, in the game of Punto/Banco the gambler cannot touch the cards. Ms Sun therefore persuaded the croupier to turn the cards claiming this was a superstition of hers. Casinos often allow for such superstitions. As Mr Ivey had not touched the cards he felt his actions were akin to simple recognising a pattern and using that to his advantage. The court did not agree. They distinguished this conduct, which would not be dishonest, to his conduct, in which he actively re-arranged the cards.
Due to the high value of the winnings, Crockfords undertook an investigation in to the matter; the investigation discovered the pair had used the edge-sorting technique, a technique the casino had never before heard of. Crockfords therefore refused to pay Mr Ivey his winnings saying his conduct was cheating, instead returning his original stake only of £1 million.
My Ivey disputed that his conduct was cheating. He referred to it as a ‘deployment of a perfectly legitimate advantage’ over the house. The court found that he genuinely believed this to be true but as stated above felt the technique deployed was in fact dishonest. The question therefore, was whether his genuine belief was a factor to be considered when establishing if his actions were dishonest.
At paragraph 57 of the judgment, the Supreme Court highlighted the issues with the two stage Ghosh test, namely that:
1. It has the unintended effect that the more warped the defendant’s standards of honesty are, the less likely it is that he will be convicted of dishonest behaviour.
2. It was based on the premise that it was necessary in order to give proper effect to the principle that dishonesty, and especially criminal responsibility for it, must depend on the actual state of mind of the defendant, whereas the rule is not necessary to preserve this principle.
3. It sets a test which jurors and others often find puzzling and difficult to apply.
4. It has led to an unprincipled divergence between the test for dishonesty in criminal proceedings and the test of the same concept when it arises in the context of a civil action.
5. It represented a significant departure from the pre-Theft Act 1968 law, when there is no indication that such a change had been intended.
6. Moreover, it was not compelled by authority. Although the pre-Ghosh cases were in a state of some entanglement, the better view is that the preponderance of authority favoured the simpler rule that, once the defendant’s state of knowledge and belief has been established, whether that state of mind was dishonest or not is to be determined by the application of the standards of the ordinary honest person, represented in a criminal case by the collective judgment of jurors or magistrates.
They found that Ghosh had tangled the previous decisions, concluding that there was an objective and subjective test to the question of dishonesty. The court went on to formulate the two stage that has since been relied upon.
The Supreme Court held that whilst there was an objective and subject element to the question, this was all part of the same fact finding exercise to determine if a defendant was dishonest. At paragraph 74 they state:
When dishonesty is in question the fact-finding tribunal must first ascertain (subjectively) the actual state of the individual’s knowledge or belief as to the facts. The reasonableness or otherwise of his belief is a matter of evidence (often in practice determinative) going to whether he held the belief, but it is not an additional requirement that his belief must be reasonable; the question is whether it is genuinely held. When once his actual state of mind as to knowledge or belief as to facts is established, the question whether his conduct was honest or dishonest is to be determined by the fact-finder by applying the (objective) standards of ordinary decent people. There is no requirement that the defendant must appreciate that what he has done is, by those standards, dishonest.
In essence this means that a court can consider a defendant’s state of mind but that ultimately whether he has been dishonest should be assessed against the standards of ordinary decent people.
Given this sudden judgment, we are yet to see what the ramifications are. The question in professional misconduct cases is likely to be whether the refined Hussein test will still apply, namely whether the standards of ordinary decent people will be substituted for a reasonable and honest member of that particular profession.
If you have a professional misconduct case concerning dishonesty and would like advice, contact Laura Pearce on 0207 388 1658 or by email at This email address is being protected from spambots. You need JavaScript enabled to view it..
Laura Pearce, Senior Solicitor
24th November 2017
The Mecure, St Pauls Hotel & Spa, Sheffield
Now in its third year, Sheffield’s 2017 Dental Charity Ball is nearly upon us!
With much fun to be had, including a magician, an obligatory photobooth, and games to be played, this year see’s the ball support a fantastic charity that promotes dental health both here in the UK, and across the globe. Working to provide access to safe and affordable dental care for those in the poorest communities, Dentaid provides equipment, volunteers and training. Every penny raised from the ball goes directly to Dentaid, who will also be attending to help educate those attending of the great works that they and their volunteers do.
A video from the 2016 ball below!
With tickets costing £45 per person, or just £400 for a table of ten, it is a great event for all to attend, whether as your Christmas party or simple as a festive, charitable knees up!
Set up and supported by S4S Dental Laboratory, 4Health, one80 Dental, and John Holland, you can book your tickets at s4sdental.com/charityball2017. For more information on the charity, visit dentaid.org.
The Faculty of General Dental Practice UK (FGDP(UK)) says further action is needed to tackle the nation’s sugar habit.
The Faculty is supporting Sugar Awareness Week (30th October – 3rd November 2017), organised by the Action on Sugar campaign group, which aims to build public pressure to persuade the government and the food and drink industry to implement stronger sugar reduction policies.
Action on Sugar also aims to raise public awareness of the adverse health effects of consuming too much sugar and the costs to the NHS of treating sugar-related illnesses. The campaign has produced two free, downloadable posters, highlighting the differing types and amounts of sugar in everyday foods and drinks.
Sugar Awareness Week runs from 30th October to 3rd November 2017, and the focus of the national campaign this year is on the large amounts of sugar available on price promotions. Local areas across the country are also running their own Sugar Awareness Week events.
Dr Mick Horton, Dean of FGDP(UK), says:
“This is an important campaign. Dentists and dental practice teams spend a lot of time educating patients about the importance of diet to oral health, but this can be quickly undone by the lure of discounts and adverts for sugary food and drinks. The average person in the UK eats three times the recommended maximum intake of sugar, and our bad habits start early. A quarter of primary school children, rising to a third in secondary school, have tooth decay, an almost entirely preventable disease, and action to further restrict marketing of high sugar items would help encourage people to make healthier choices.”
Jenny Rosborough, Registered Nutritionist and Campaign Manager at Action on Sugar says:
“We currently consume 2–3 times more free sugars than is recommended and the biggest source in the diets of children and teenagers are sugar-sweetened drinks. Excess consumption of free sugars (i.e. those that are found naturally in fruit juices, honey and syrups, plus sugars added to foods and drinks ) is associated with a greater risk of tooth decay and leads to increased energy intake (compared to other energy sources). What’s more, sugar-sweetened drinks are associated with an increased risk of type 2 diabetes. Whilst we urge both the government and food manufacturers to act now, our message to dental practitioners is to help educate their patients about the impact of sugar consumption on their teeth.”
For more information on Sugar Awareness Week visit Action on Sugar online here.
Simplyhealth Professionals and the University of Birmingham spinout Oral Health Innovations Ltd have announced today that 100,000 assessments have been carried out by the highly regarded Denplan PreViser Patient Assessment oral health assessment tool (DEPPA).
DEPPA is an evidence-based online individual risk assessment tool which helps patients understand their current oral health and future disease risk. It assesses an individual patient's medical history, dental history, lifestyle and their clinical status and provides feedback on current health and future disease risk directly to patients via a personalised report.
In May 2017, Simplyhealth Professionals also announced the addition of Young DEPPA (YDEPPA) to bring the benefits of comprehensive online patient assessment to young patients and their parents or carers for the first time. The primary benefit of YDEPPA, like its adult counterpart, is to support communication with young patients about their oral health.
The system was developed for the UK by Oral Health Innovations Ltd to help patients understand their oral health needs and to support decision making by dental professionals.
The reports use a traffic light colour-code system of red, amber and green to indicate what is going well and what the patient needs to improve on with the help of their dental care provider.
Henry Clover, Director of Dental Policy at Simplyhealth Professionals said: “There is evidence to support that personalised biofeedback, delivered using reports such as DEPPA for patients, is more likely to trigger the emotional response required in order that behaviour change can occur than traditional methods. Improved oral health can only be achieved through a strong partnership between dentist and patient.”
Recent research has shown that patients who receive an individualised communication about risk as part of a routine dental consultation took advice on periodontal disease more seriously, and felt better able to follow it, than those who receiving a routine consultation alone (p<0.05). 1
Moreover, research presented earlier this year at the International Association for Dental Research conference showed that sharing the report with patients resulted in reduced levels of bacteria in their mouths and gum inflammation, and better daily oral hygiene routines.2
Iain Chapple, Professor of Periodontology and Consultant in Restorative Dentistry at the University of Birmingham, commented: “As routine dental consultations incorporate risk assessments for future disease, it is vital that we understand how to communicate this risk to patients, so they can distinguish between generalised advice and individual risk.”
DEPPA and Young DEPPA are available free of charge to all Denplan Excel certified member dentists. Non-Excel certified member dentists can also benefit for just £100 per month (inc VAT) for up to two dentists in a practice or for £150 per month for three or four dentists. For more information visit www.simplyhealthprofessionals.
A few basic things are always needed in a banner ad to ultimately give you an excellent click through rate. (CTR) We have collected our experiences and thoughts together to produce a short blog on what makes a successful banner advert.
A clear call to action (CTA), has to make sense for your product or service. Such as “Shop Now”, “Learn More” etc. A call to action always has to be included.
Secondly the banner ad can be compared to the billboard in the street, the consumer has a split second to decide if they are interested in the product or service. So you need to decide what you want the consumer to see and take away in those few seconds you have to grab attention to your product or service. This can be a catchy headline, an aspirational image or a hybrid of the two!
Basic animation is also always recommended. Animated GIF is therefore recommended over a static image. Keep it simple and to the point, telling a story rarely works. But the advantage of the animated GIF is that you can put together a series of frames then combine them in such an order that will eventually form some sort of animation and attract attention.
A theme I always go back to when talking to customers is the landing page. The clickthrough needs to land on a landing page that delivers what the banner ad promises. So that when you do secure the click from the consumer, you make sure they get the information the consumer desires. So basically you need to ensure you promote a product or service and not a website / homepage!
This blog - http://www.boxofads.com/blog/always-fine-tune-your-landing-page/ sums up the value of a landing page quite nicely. While designing a campaign think about it as a whole, an ad makes the first impression, and a landing page is a continuation of this impression.
We also recommend that our clients don’t just have one version of the their banner ad. We always say to test the colours, the CTA or the headline and see what works in line with the branding of your business. The software we use (DFP) can handle more than one ad in the space you book, so it's always worth testing a few banners and seeing what performs best. The same can also be said of landing pages as well.
Thanks for reading, hope this short guide to what makes a successful banner is useful.
The British Dental Industry Association (BDIA) and Federation of the European Dental Industry (FIDE), as the trade associations representing the dental industry in the United Kingdom and Europe, have today issued a joint letter outlining their priorities for the ongoing Brexit negotiations.
The initiative, proposed by the BDIA, saw a letter addressed to the European Chief Negotiator for Brexit, Michel Barnier and the Secretary of State for Exiting the European Union, David Davis, highlighting the important economic and public health role played by the dental technology and devices sector, and calling for action to be taken to safeguard it.
BDIA Chief Executive, Edmund Proffitt, comments, “The measures outlined by our associations would ensure that our industry is able to continue to provide access to innovative dental technology in the UK and throughout the EU, to the benefit of patient oral health and the economy, beyond the UK’s exit from the EU in March 2019”.
Chief amongst these measures is a commitment to parity of UK and EU legislation after Brexit. The UK’s decision to leave the European Union came at a critical point for the dental industry, coinciding with the publication of the EU Medical Device Regulations (MDR), and future divergence in legislation would risk disadvantaging both patients and businesses across Europe.
Other priorities to ensure a successful outcome to the negotiations include the maintenance of the Medicines and Healthcare products Regulatory Agency’s involvement in ongoing discussions concerning medical device regulation, the continued adoption of the CE marking process for medical devices and allowing UK Notified Bodies to operate under the MDR.
Over 9,000 dental professionals attended BDIA Dental Showcase 2017, which took place at the NEC in Birmingham on the 19-21 October.
This year marked the first time in which this prestigious event has been organised by its new owners MA Exhibitions, in collaboration with George Warman Publications. The result of the partnership between a professional show organiser and the dental publisher has been a tremendous success, seeing an 11.29% rise in visitor numbers to 9,080.
From MA Exhibitions, event director Ed Wyre said “The response from the dental community has been incredible. Not only have visitor numbers seen a substantial increase, we’ve seen a significant increase in the percentage of dentists (41%, up from 33% in 2016) and practice managers (11%, up from 5.5% in 2016) attending. It’s fantastic to see so many decision makers leaving the practice to attend the show. Other dental groups also saw a rise in numbers, highlighting the event’s importance to the whole dental team”.
In addition to the bustling show floor of 300+ exhibitors, three brand new features were a major draw for visitors to this year’s event.
The impressive Dental Practice of the Future was the flagship feature at the show and gave visitors access to a fully functioning reception, patient lounge, surgery and decontamination room brimming with state-of-the-art equipment in a purpose-built practice setting. The surgery itself housed a 150-seat lecture theatre where packed out keynote presentations on topics such as medical emergencies, radiation protection and the future of dentistry took place.
The CDO Zone proved to be extremely popular, as it provided the unique opportunity for visitors to meet with the highest level of the dental profession. Chief Dental Officer England Sara Hurley and her team were on hand each day ready to discuss and answer any questions visitors had on NHS dentistry. This was a fantastic chance for GDP’s and DCP’s to engage face to face with the CDO and her team, who have never been so easily accessible to the profession.
Sara Hurley, chief dental officer England said “The show was a tremendous success for us. Having a platform in which we could directly engage with so many dental professionals face-to-face and facilitate discussion around our initiatives and their experiences in practice was invaluable. This is the perfect example of industry coming together for the good of oral health, and we’re delighted to be a part of it. We are already looking forward to 2018”.
The 150-seater Dental Update Theatre offered a balanced variety of clinical CPD and business orientated sessions led by leading experts, providing advice and guidance in each of their topics. On Thursday 19th October, the Dental Update Theatre hosted the annual Dental Update Study Day, organised by Professor Trevor Burke. Visitors also had another chance to increase their dental knowledge and top up their CPD in the Mini Lecture Theatre, which proved extremely popular over the three days.
Ed Tranter, managing director of MA Exhibitions said “We are delighted with the show. We always strive for quality in our events, and this was no exception. We had a significant rise in visitor numbers, and the quality of those visitors was outstanding – testament to the partnership with George Warman and the diverse range of exhibiting companies and CPD sessions. In addition, exhibitors put in a huge amount of effort into their stand builds all of which looked incredible. BDIA Dental Showcase is a show that has such a strong community of companies behind it and we look forward to being a part of that in the coming years and taking the show from strength to strength”.
Stuart Thompson, managing director of George Warman Publications and BDIA council member, said “The response has been encouraging. Feedback from exhibitors and sponsors has been very positive and we are pleased with how the show went. We are delighted to be taking the show to the level the association aspired to achieve and we’re looking forward to progressing it further in the years to come”.
BDIA Dental Showcase 2018 will take place at London ExCeL, 4-6 October 2018.
The show was opened with a ribbon cutting ceremony involving the show’s new owners and its headline sponsor, Oral-B. (L-R): Stuart Thompson, managing director, George Warman Publications; Jane Kidson, UK professional oral health country manager, Oral-B; Razi Hyder, professional oral health associate director, EMEA, Oral-B; Ed Tranter, managing director, MA Exhibitions; Ben Pegram, UK market strategy and planning manager, Oral-B; Mark Allen, chairman, Mark Allen Group. Pictured above.
Friday 3 November 2017
National Motorcycle Museum
To celebrate their 25th anniversary, the Faculty of General Dental Practitioners, in partnership with Simplyhealth Professionals, will host a conference, on Friday 3rd November, bringing together six of the UK’s leading oral health experts.
Designed for clinicians, the conference will provide an overview of the latest research that provides the foundation for the contemporary management of common dental diseases, insight into complex inter-relationships between oral diseases and general health of patients of all ages, and reveal evidence that demonstrates the long-term impact of traditional treatments on oral and general health.
The programme will provide dental professionals in general practice and other clinical settings with the knowledge to help them deliver extended oral health care. The lectures will also describe the skill-sets that will help delegates select biologically respectful, minimally invasive techniques and future-proof their practices by integrating general health care with everyday clinical dentistry.
Professor Nairn Wilson, one of the UK’s most International respected academics, and former Dean of Kings College London Dental Institute, will open the conference and introduce each of the presenters.
Finally, Chief dental officer Dr Sara Hurley will discuss the conference themes and join the lecture team in answering delegate questions on the exciting future for oral care and holistic dentistry in the UK.
The conference will be held from 9am-5.30pm at the National Motorcycle Museum, Solihull, West Midlands, B92 0EJ. Tickets are £205 for members and £290 for non-members.
To purchase your ticket, go to www.holisticdentistry.eventbrite.com
Masters of ergonomics, A-dec, have recently started working with Curran Dental. A-dec are well known for their high-quality dental chairs which offer the utmost comfort for both patient and practitioner. Curran Dental offer technical support and project management to dental practices, and pride themselves on providing a high-quality service.
Pleased to be bringing a new partner on board, A-dec’s Nick Olive says: “I am very excited to be working with Curran Dental, whose reputation for exceptional service fits really well with the A-dec ethos.”
Sue Curran, director of Curran Dental is also very happy about the development, she says: “We chose to work with A-dec because we know they are a company with integrity, that puts patient and practitioner comfort first. We are excited to be working with a quality conscious company such as A-dec and are honoured to bring their products to our customers – we can’t wait to see what the future brings.”
For more information about A-dec Dental UK Ltd, visit
www.a-dec.co.uk or call on 0800 2332 85
Dental professionals have one last chance this year to experience the high-quality educational experience of a Nobel Biocare symposium when the final event of the 2017 series takes place in in London, UK, November 10–11.
A limited number of places are still available for the event, which will be held at the Millennium Gloucester Hotel. The symposium will offer lectures and master classes from both globally renowned experts and the leading local names in implantology.
Speakers include Dr. Rubén Davó from Alicante, Spain, who will present the new Trefoil system for the first time in the UK. Launched on October 5, the Trefoil system is a breakthrough in efficiency for treating the edentulous mandible, enabling a fixed and definitive prosthesis on the day of surgery.1
As a principal investigator in an international multi-center study of the Trefoil system conducted prior to launch, Dr. Davó is one of very few clinicians in the world already experienced in treating patients with this latest Nobel Biocare innovation.
The latest techniques for the treatment of edentulous patients and those with a failing dentition will also be addressed on stage by Prof. Paulo Malo, from Lisbon, Portugal–the pioneer of the original, proven All-on-4® treatment concept–and London-based Dr. Andrew Dawood, who will present the management of the atrophic maxilla using zygomatic implants.
Other highlights include a comprehensive program covering the integrated digital workflow. Nobel Biocare’s collaborative workflow has been developed to significantly increase treatment efficiency and patient acceptance with the latest digital innovations.2,3 International speakers on the topic include Switzerland’s Dr. Roland Glauser and Drs. Leon Pariente and Karim Dada of Paris, France, who will discuss these latest digital trends shaping implantology and their benefits.
Over 6,000 dental professionals have attended the 10 Nobel Biocare symposia held already this year, with hundreds more expected in London.
Those looking to view the full program, or to register for the Nobel Biocare symposium in London, should visit nobelbiocare.com/London
“Nobel Biocare doesn’t present products, but solutions. Once again they surprised us with the new solutions that are now available. These will continue to help us in our daily practice, making things easy and simple, with better solutions for the clinic and, naturally, for our patients.” Dr. Pedro Santos Silva, Portugal
“The Next Generation session was a wonderful surprise, it’s good to see young speakers with such good presentations, they are our future. Congratulations to Nobel Biocare on the event!” Dr. Alexandre Rovisco, Portugal
"I would like to thank Nobel Biocare for the perfect organization of the Dubai Symposium. The scientific program was outstanding, as the renowned clinicians lecturing succeeded in relating how Nobel Biocare has always joined science and innovative technologies in the constant evolution of their products to better serve the dentists and their patients." Prof. Nabil Barakat, Lebanon
“We enjoyed a top-level scientific program. Highlights were the interdisciplinary approach, the live surgeries and also an excellent program for the laboratory technicians who play a very important role in treatment – this is crucial for the benefit of the patients.” Dr. Beatriz Aranguena, Spain
“Nobel Biocare events are always interesting – lecturers from all over the world providing different concepts and approaches are widely represented here. They help to follow trends in the contemporary dental market and to be at the cutting edge, both clinically and scientifically.” Dr. Ivan Kondratiev, Russia
“The Nobel Biocare symposium in China has been well organized with fantastic academic topics. It provides dentists with a good chance to be exposed to the latest ideas and technologies of the dental implant industry.” Prof. Ye Lin, China
1. Depending on clinician preference and close cooperation with the laboratory.
2. Imburgia M. Patient and team communication in the iPad era – a practical appraisal. Int J Esthet Dent 2014,9(1): 26-29
3. Imburgia M, Coachman C. Using digital devices to improve communications between clinicians and patients during implant- prosthetic treatment: a clinical study [#519]. 23rd Annual Scientific Meeting of the European Association for Osseointegration. Rome, Italy: Wiley; 2014. p.538
Disclaimer: Some products may not be regulatory cleared/released for sale in all markets. Dental professionals should contact the local Nobel Biocare representative for current product assortment and availability.
Nobel Biocare is a world leader in the field of innovative implant-based dental restorations. The company’s portfolio offers solutions from single tooth to fully edentulous indications with dental implant systems (including key brands NobelActive®, Brånemark System® and NobelReplace®), a comprehensive range of high-precision individualized prosthetics and CAD/CAM systems (NobelProcera®), diagnostics, treatment planning and guided surgery solutions (NobelClinician® and NobelGuide®) and biomaterials (creos™). Nobel Biocare supports its customers through all phases of professional development, offering world-class training and education along with practice support and patient information materials. The company is headquartered in Zurich, Switzerland. Production takes place at five sites located in the United States, Sweden, Japan and Israel. Products and services are available in over 80 countries through subsidiaries and distributors.
The Faculty of General Dental Practice UK (FGDP(UK)) held an anniversary dinner on Friday 13th October to commemorate 25 years since it was established. Hosted at Drapers Hall in London, the dinner included three very special awards to reflect the everyday commitment of General Dental Practitioners to their practice and their patients.
Dr Mick Horton, Dean of FGDP(UK), opened the evening by reflecting on the role of the Faculty now and into the future:
“Our anniversary celebration is a great occasion for us to look forward to our new future. We are now laying the foundations for forming a new chartered medical college after 25 successful years at RCS.
“It’s a bold step: one that we believe will inspire our members and open a gateway to new partnerships that promote professionalism in dentistry. For the public and for patients, a clearly identifiable, confident and active standard-setting body will help us to cultivate greater confidence in dentistry overall. We want to focus on developing the appeal of a modern medical college for new generations entering practice.
“We are delighted to award our Anniversary prizes to three extremely worthy winners. Their own personal achievements mirror the quality of standards and the diversity within the general dental profession, and we congratulate them on their awards.”
Award Winners
Foundation Dentist of the Year – Claire Culverwell
Claire works as a Dental Associate at Crook Log Dental Practice in South East London. Her career began as a Dental Nurse, before studying Dental Hygiene and Therapy at the University of Liverpool. She then decided to study Dental Surgery at King’s College London and was nominated by her Foundation trainer, Baber Khan.
Claire commented: “I went the long way around to my career in dentistry, but I am glad I did, because I’ve been in contact with patients from the very beginning, allowing me to develop a range of skills. This award means a lot to me, because getting to this point in my life has taken great effort and commitment. I wasn’t sure I would ever get there, but I know that all the effort has paid off. I’m surrounded by people who push me to be my best every day, and I’m loving every minute.”
Community Dentist of the Year – Jason Wong
This prize recognises GDPs and DCPs who have made a significant contribution to improving oral care in their local community, and was awarded through a process of open nomination by peers within the profession.
Jason commented: “I am honoured that a colleague had the thought and put in the effort to nominate me and delighted that the FGDP(UK) panel chose me for the award. I believe that we are all part of a great profession and that all of us who benefit from being part of it need to put something back in for the benefit of the whole profession.”
Dean’s Award – Dentaid
The Dean’s Award, sponsored by Simplyhealth, was presented to Dentaid for their support of the The Real Junk Tooth Project in the UK.
Andy Evans, CEO of Dentaid, said:
“Everyone at Dentaid is delighted and honoured to win the Dean’s Award. In recent years, we have become increasingly aware that many people in the UK struggle to access dental treatment for a wide variety of reasons and this has a negative impact on their general wellbeing. Thanks to an incredible team of volunteers, many vulnerable people and those who could not register with an NHS dentist in Dewsbury were able to visit a dental surgery in the evening, without an appointment, and receive pain relieving dental care. They only paid if they could afford to. Over seven months 150 people received emergency treatment thanks to the Real Junk Tooth Project. Dentaid’s next step was to purchase a mobile dental unit so we could bring a similar service to other parts of the country. This unit also went back to Dewsbury in September when we treated almost 200 people in two weeks at clinics held outside schools, community centres and public buildings. We are very grateful to all our volunteers and supporters for enabling this project to be such a success.”
As part of the 25-year celebration the FGDP(UK) will also host a conference on Holistic Dentistry on 3rd November in Solihull.
Sirona Connect has always stood for comfortable, digital intraoral impressions in the dental practice and the quick and secure transfer of data to the dental laboratory. And with growing success, up to 2016, more than a million dental restorations were made using Sirona Connect. Dentsply Sirona has now enhanced the no. 1 in digital lab connections with the latest Sirona Connect software 4.5 update. Additional software services and new portal functions offer advantages for dentists and dental technicians.
Bensheim/Salzburg, October 10, 2017. The number of digital intraoral impressions completed in dental practices is steadily growing. Sirona Connect is increasingly used in practices and labs for transferring the impression data to the dental lab, allowing dentists to provide their patients a modern practice concept, take impressions quickly and comfortably thanks to intraoral scanning, and ensure faster overall treatment. Sirona Connect benefits the dental lab with direct connection to the practice, and quick and secure transfer of digital impression and order data. In addition, Sirona Connect saves the practice and lab valuable time by enabling the immediate exchange of information during the patient's visit.
Sirona Connect SW 4.5 with enhanced features
With the new Shade Detection tool for the CEREC Omnicam, the latest Sirona Connect software analyzes the scan and indicates the tooth color as a VITA* Classic or VITA* 3D Master shade. This function supports dentists in selecting the suitable shade for the restoration.
For even more flexibility, digital intraoral impressions can be made for Dentsply Sirona or third party implant systems and different scan bodies can be used.
Sirona Connect SW 4.5 also allows the practice to make an open scan export of the model data in STL format for direct transfer to the lab's CAD software.
There is another interesting enhancement for Sirona Connect labs. For the first time, they can create a customized lab profile on the Sirona Connect portal and show offers for appointments, materials, degrees of refinement, special services, and much more for the individual lab. This gives Sirona Connect dentists an optimum, customer-friendly overview of the range of services and saves them time when ordering from a lab.
The new Sirona Connect SW 4.5 is available to Sirona Connect users with CEREC Omnicam, CEREC Bluecam, and APOLLO DI as a free auto-update or as a download at www.dentsplysirona.com.
Due to various certification and registration periods, not all products are immediately available in all countries.
Whether you already run a dental payment plan at your practice or you’re considering launching a plan for the first time, award winning Patient Plan Direct invites you along to its Cost Saving Clinic at this year’s BDIA Showcase @ The NEC, Birmingham – 19th to 21st October.
This 15-20 minute investment of your time, could prove to save your practice thousands over the coming years.
Why visit the cost saving clinic?
If you already offer a payment plan…
If you work with a plan provider other than Patient Plan Direct that supports and administers your existing payment plans, we’re confident we can demonstrate how your practice could significantly cut the costs of running your plan and increase your practice profits, even if you opt to continue working with your existing provider.
Irrespective of the type of plans you offer patients (Full care, Maintenance, Membership, Hygiene only) or which provider you currently work with, we can share with you a range of options and methods to help you cut your plan administration costs!
If you’re thinking about launching a payment plan…
You may be looking to launch a payment plan simply to nurture patient loyalty or offer patients a convenient means of accessing their regular care, or you may be looking to launch plan as a means of transitioning to practice privately, stepping away from the NHS.
During your clinic appointment we’ll share with you the important considerations when selecting which plan provider to work with and tops tips on ensuring you maximise the profitability of your payment plan, whilst building a successful base of plan patients and offering the right range of plans to suit your patient demographics and oral health requirements.
Where and when is the cost saving clinic?
We’ll be hosting our cost saving clinic at stand E16 on all three days of the BDIA showcase exhibition.
You can pop along to our stand at any time, where one of our business development team will be more than happy to conduct our cost saving clinic exercise, which won’t take any longer than 15-20 mins.
If you would rather chat through the exercise in a little more privacy or away from the hustle and bustle of the show, one of our team will be more than happy to take you for a coffee (or something a little stronger) outside of the exhibition hall.
Whilst you’re welcome to simply ‘roll-up’ to our clinic at any time, to avoid disappointment we recommend you pre-book an appointment before the show. To do so, simply drop our team an email or give us a call to let us know which day and time works best for you and we’ll reply to confirm your appointment.
Email: This email address is being protected from spambots. You need JavaScript enabled to view it. Tel: 08448486888
What do you need to bring along?
If you already offer a payment plan, please bring along your latest monthly plan schedule / report provided by your existing provider, or at the very least a note of the administration fees you’re currently charged and details of the plans you offer patients.
If you’re considering launching a dental plan for the first-time, you don’t need to bring along anything other than an appetite to understand how to launch a successful and profitable payment plan
See you soon!
We look forward to seeing you soon. In the mean time you can discover more about Patient Plan Direct and how we’ve helped other practices on our website http://patientplandirect.com/case-studies/
Have you recently qualified and seeking to enhance your knowledge and skills in implant dentistry?
In partnership with Straumann, the ITI is proud to present the highly regarded ITI Foundation in Implant Dentistry course. Now in its tenth year, the FID is a comprehensive programme specifically designed to assist delegates towards meeting the requirements of both the GDC and the FGDP Training Standards in Implant Dentistry for a safe and predictable start in implant dentistry.
This modular course, divided into six modules of two days each, covers all the essential materials needed for assessment, diagnosis and treatment planning, plus the opportunity to gain one-to-one practice mentoring in the clinical environment. Taught by some of the most experienced implant dentists in the UK, including Prof Nikos Donos, Dr Shakeel Shahdad and Dr Nikos Mardas, it delivers a wealth of implant experience combined with the ITI philosophy to deliver an evidence-based curriculum in a continuously peer-reviewed format.
Delegates have full access to the renowned ITI Online Academy – a ground-breaking e-learning platform that meets the needs of implant dentistry professionals by complementing and backing up the modular course’s didactic teaching. FID has its own dedicated Campus on the ITI Online Academy with learning modules, lectures and treatment examples all part of the FID curriculum.
There are a number of options for further training after the delegates have completed the FID course. Delegates can choose to continue on the ITI Training Pathway: the UK & Ireland Education Programme, offering a wide range of Straightforward and Advanced level courses. Beyond the ITI many UK Universities also offer formal certificates, diplomas and MScs in Implant Dentistry. The FID is recognised by the University of Bristol as Approved Prior Learning (APL) for their MSc in Implant Dentistry and on completion of the FID, delegates have the option to apply for entry directly into the second year of the MSc. There is also the option of self-guided preparation for the Royal College of Surgeons of Edinburgh Diploma in Implant Dentistry (Dip Imp Dent RCSEd).
Don’t miss out on your chance to take a significant first step on the ITI Pathway!
Early Bird Discount - Book before 31st October and save £900!
All delegates who book before 31st October 2017 will benefit from a £900 discount off the full course fee of £6,000 +VAT (£5,100 +VAT).
Book a free place for one of your practice staff on either a Dental Nurse or Treatment Coordinator course when you book your place on the ITI Foundation in Implant Dentistry course!
Calling all past FID delegates – If you refer a friend on to the FID 2018 course and they enrol and pay the deposit, you will receive a £50 John Lewis voucher!
Places are limited to a maximum of 24 delegates so to reserve your place or for further information please call the Straumann Education Department on +44 (0) 1293 651270 or visit iti.org/uk.
Start date: 20th February 2018 with modules running through to 19th September 2018
Venue: ITI Education Centre, Crawley
CPD: 78 hours of verifiable CPD
Materials, lunch and refreshments are provided
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