JUN
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No Waffle

Sorry. The waffles are off.

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Genius by name, Genius by nature

Genius by name, Genius by nature

 

Last week saw the launch of the latest Oral-B toothbrush at the BDA Conference and I am pleased to see that they have gone even further down the path of the “internet of things” and improved their technology even further with the latest Genius brush.

Previously I wrote a blog in 2014 entitled “Dentistry embraces the Internet of Things”, when Oral-B launched their first brush connected to an app.

So 2 years on, the boffins at Oral-B have taken all the best features of the Bluetooth brush and made a number of considerable improvements.

  • The brush still works alongside the App. The app now tracks brushing habits and shows the user how to brush all zones in the mouth equally and evenly, which is a real game changer. No longer do you have an excuse of missing an area of your mouth.

  • The app has gamification, the user gets challenges to improve brushing habits.

  • Each users can partner with their dental professional through the Professional Guidance feature that provides customised care and a user can share data with their dental professional.

  • The app, also contains in-app entertainment, the app provides news, weather and oral care tips.

  • The brush comes with a stylish case, as well as a smartphone holder that fits to the user's bathroom mirror and lets the user know how they are doing via the app. The app is therefore straight ahead of the user’s eyeline.  

  • The lithium battery offers longer battery life and a lighter toothbrush!

  • The Triple Pressure Sensor technology protects gums from over aggressive brushing.

  • The brushes are now customisable with 12 colours available, except red which is used when the user applies too much pressure.

  • The user tells the app which hand you use to brush your teeth because they will then analyse the data accordingly and the app will understand why certain areas are missed.

 

All these clever features are an exciting way for you to help your patients improve their oral care and with some of the features you can even check what they are doing and which areas are being missed!

Further information about the brush can be found here - http://oralb.com/en-us/GENIUS

It is very exciting to see that dentistry has continued to embrace the internet of things and that toothbrushes are part of the connected home that we will see more and more over the next few years. This new brush is not only easy to use and lighter to hold, it also has a number of benefits that help improve our oral health…. Which is always a good thing.

The brush really is “Genius by name, Genius by nature”.

The Oral-B Genius will be available to the public from July.

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GDC Bull in an FtP China Shop

GDC Bull in an FtP China Shop

 

Is the GDC a sort of Beaurocratic Supertanker, steering a steady, slow path to its chosen destination, slow to change direction and similarly hard to stop?

Or is it akin to a Bull in a China Shop? – breaking everything it touches in an out of control display of unnecessary strength?

 

You decide.

 

There have been a number of recent high profile GDC cases which have caught the eye of any casual observer.

By far the highest profile, in terms of reflective blogging and reporting, is that of Dr Colin Campbell, a colleague who has a practice and training facility which offers implants as a special interest and is generally regarded as being state of the art and second to none. As good as you can get. If you have not read his reflections on his experience at the receiving end of the GDC systems, I have linked them below. It makes painful, perhaps stimulating reading.

You will I am sure be left with one driving question.

 

Why?

 

Why does one case drive such a vindictive, damaging process?

There was another case which was even more worrying: This case of a colleague in the south west went all the way to an FtP hearing before the Panel finally nailed it with ‘No Misconduct Found’.   In this case there was NO patient complaint – it was the Charity, the “Good Thinking Society”, founded and led by journalist Simon Singh, who contacted the GDC based upon a web trawl. Having discovered concerns with some web site material, the Charity chose NOT to contact the practice at all.

But then again, neither did the GDC who took it all the way to a Hearing… at a cost of about £200,000 all in [Registrants costs, GDC costs  etc].  The case revolved around some web site wording which was changed before the process truly got under way, after a request from the GDC!!

You will I am sure be left with one driving question.

 

Why?

How can some contentious wording on a web site, which can be changed overnight, where NO patient has been involved, and where NO attempt at local and direct resolution has been attempted, possibly justify a full hearing?

What is in it for the GDC ? Justification of their work and justification of their ARF Fee?

These are not cases which need ‘the law changing’ to avoid being taken so far. S60 orders have nothing to do with this fiasco.

This is pure vindictive incompetence. 

It is a regime of Regulation by Fear. At a team level, the GDC do engage, and apparently learn, and we must be grateful that the PR teams of the GDC do come out and meet and greet.

But despite all that hard work, we continue hear the dulcet tones of the limp rag of leadership that is Dr Moyes, and still the Bull rages in the FtP China Shop. Still we see NO evidence of proper oversight by the Council. Still we see the Registrant members of the Council taking their expenses.

 

Why?

 

It’s perhaps a reflection perhaps of the mind-set of the GDC in the past, and their reluctance to act in any way which might be regarded as agile or rapidly adaptive, that still we have no specialisation for implantology.

We continue to see quite extraordinary cases heading out to an FtP hearing based on dubious investigative methods and a sense that the charges are trumped up come what may to try and make some mud up, let alone make it stick. There is a sub-genre of course of expert witnesses who have questions to answer in this respect.

The case of a retired Orthodontist and a single patient, with his long spat with the 'establishment'  has become so embroiled that the 5 days of the initial hearing proved insufficient, and an adjournment was taken. For what possible benefit?

But most important you will I am sure be left with one driving question. Why?

 

Dr Colin Campbell of course took an unwittng starring role in Manchester last week

 

It’s a [Conference] Wrap

If you are a member of the BDA you may well have heard from the dentists present at the recent Manchester Conference that Dr Campbell’s presentation pretty much stole the show. It is also fair to suggest that Alistair Burt MP, the Health Minister certainly spoke eloquently the necessary words in respect of the scandal that is Infant Dental Prevention, and the scandal that is GA Admissions.  Finally, of course the FGDP are coming of age, and in particular engaging down in the mud with us wet fingered souls, and re-publishing their guidance on Record Keeping, which will be Open Source. That is a very welcome move, Sirs.  The GDC of course is off limits for a Minister.

 

Which will happen first? NHS Change or GDC change?

 

If one has to speculate, I reckon we will still be talking in 6 years [when the ‘Newish Prototype Contract Version x ’ emerges] about child dental treatment & prevention as funded by the Government because there is no more money to deal with these matters.

Whereas, I suspect that the passionate and motivated colleagues in self-funded dental practice who are feeling the cold hand of the GDC will be effective in their lobbying for significant change.

The GDC will change.  How and when is to be decided.

No one objects to the idea of a regulator for the industry that is dentistry. It is the quite surreal high cost, psychologically, professionally, financially, and in time terms of the blunt instrument that is FtP, allied an unaccountable Interim Orders Committee that is objectionable. 

It is the idea that the GDC are a first line Complaints Handling Agency. 

It is the idea that all dentists are out to harm their patients and lessons must be public, humiliating and disproportionate.

The salt on the professional wounds is, in case after case, Dr Campbell’s being but one, and our colleague in the Southwest who fell victim to the dubious Charity The “Good Thinking Society” being another, where the GDC blankly refuse, or have wilfully chosen not to, force any complainant to seek local resolution first. 

 

That is a choice the GDC make.  Why?

 

Do they do that because they truly believe a £200,000 process cost is a better and more efficient form of justice? Or they do that because they are incompetent and simply have no idea how to be frugal with the resources placed at their disposal by Dentists and DCPs in the form of the ARF?

 

The New Team

 

So… it’s the end of the season, and there is new management in place.  It’s not just in the national game that management is brutally changed!

Mr Brack’s first job as substantive CEO at the GDC is clear – stop feeding the monster. Sedate the Bull.  Perhaps after the events of a US Zoo at the weekend, shoot the beast dead.

 

Perhaps … stop FtP until it is reconfigured?

 

Stop the Bull wrecking the china shop.

So as we head for the ARF setting for 2017, what has changed? We have a new Chief Executive in Mr Brack.  And a new Director of FtP in Mr Green.  And old hand in the shape of Dr Moyes.  These three have the future of dental regulation in their hands. Dr Moyes having proved reluctant to grasp the mettle with his Council team, so it must be Mr Brack, in partnership with Mr Green.

 

That’s it.

 

So no pressure gentlemen. The survival of your organisation and Dental Regulation as we know it depends on you calming this raging beast that is FtP, and it looks doubtful that your Council will be much help.

 

The clock is ticking and many professional eyes are on you.  Indeed, some are still weeping from the whipping that presently is FtP

 

 

 

 

FGDP(UK) The Open Standards Initiative (OSI) 

?BDA: Government still lacking ambition in fight against decay

Dr Colin Campbell My GDC case and more important matters… part 1 – Friday night

Dr Colin Campbell My GDC case and more important matters… part 2

Dr Colin Campbell My GDC case and more important matters… part 3

Dr Colin Campbell My GDC case and more important matters… part 4

Simon Singh’s “Good Thinking Society”

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A tiny glimmer of Hope…

A tiny glimmer of Hope…

I’ve been at the BDA conference in Manchester last week, and as usual have thoroughly enjoyed the networking that this event always brings. I’ve finally met people who have been virtual friends for some time and caught up with those who I’ve known for years. However for me there were two distinct highlights to the whole event.

Firstly, there were two people who I really did not expect to bump into, let alone have a conversation with. We have for so long been under the thumb of an unapproachable and unrealistic regulator that it took me by complete surprise to see that both the new CEO of the GDC Ian Brack, and the Head of Fitness to Practice Jonathan Green were not only present, but actually in the bar of the Hotel where I was staying. Given the previous CEO’s somewhat adversarial attitude towards us lowly insects trying our best despite the ever increasing pressures on us, and her distinct lack of engagement with the profession, to actually see the new CEO of the GDC present at the conference was a positive revelation.

Obviously me being the shrinking violet that I am (and fuelled a little bit by the generous BDA Drinks reception), I felt I had to speak to him. Now, I’m sure many of you would expect me to have launched full tilt with a somewhat barbed attack at the legion failings of the GDC management structure over the past years, but I’m afraid I have to disappoint you all.

I actually thanked him.

I thanked him for taking a step in the right direction and showing his face at the conference, because this is a step that was NEVER been taken by his predecessor (and also not by Moyes to my knowledge) and in my opinion showed that he might just possibly be aware of the damage that has been created by the culture so apparent over the last years.

Its early days I know, (and the jury will be out for some time yet) and I had only a few brief words with him, but in that short conversation I was left with the overriding impression that this might be someone who is prepared to work WITH the profession instead of against it. Since the care of patients is a joint responsibility of both the profession and the regulator, he agreed with the sentiment that therefore we are effectively ‘in it together’. Not only that, but there was an approachability and an authenticity that came across very swiftly in a short time.

Now, before you all start thinking that I’ve been somehow subsumed by the GDC into changing my tune completely, I can categorically assure you I have not. In the week that a FTP over homeopathic dentistry was thrown out after 2 years of stress for the practitioner, when it could have been dealt with by a swift letter saying you’ve got a month to remove your claims, then it shows things still are far from right. But we have a huge backlog of cases some of which are only now surfacing. Like a supertanker, the GDC isn’t going to turn round quickly, and I think there is still more that can be done publically by them to build some bridges. For instance, where was Chairman Moyes? Shouldn’t he do something to try to learn about the profession he regulates, or was he busy learning about washing machines and other consumer products since he thinks dentistry is so closely related?

Perhaps we are approaching the time when the GDC changes from a reactive organisation to one that is proactive (like the GMC). Where does it say that the GDC can’t give us advice in a positive and supportive manner? Rather than building their remit as Bill’s complaints handling super empire, why not give some more vocal and obvious guidance on how we can avoid the wrath of the regulator? Being proactive to prevent problems will be surely less expensive than reactive and shutting the stable door once the horse has bolted? It should also cost us far less in both the ARF and Indemnity. After all, this is what patient safety is all about, and that is their remit as set down in law.

I think that the growth of the FTP Division of the GDC was (and maybe still is albeit more slowly) growing at such a rate that it would be unsustainable within the next 5 years. There would have to be an ARF of such a huge amount that it would result in it being almost as ridiculous as some of the indemnity figures out there (another sore point) and there would be none of us left allowed to practice if we didn’t pay. I suspect there are people at the GDC who know this, and that there might now hopefully be a concerted effort to get back on track. Perhaps a raising of the bar where misconduct is concerned would be a start.

But getting it back on track will need the concerted effort of many people. This brings me to the absolute highlight (for me and I know many others) of the entire weekend. The presentation by Colin Campbell regarding his fitness to practice experience with the GDC.

Such a passionate, humble, ego-less, and at times emotional presentation has not been witnessed at conference for many years, if indeed ever. But it was not a dig and a rant at the GDC. Far from it. It was a clarion call for the profession to unite to change the status quo we find ourselves in. A call to develop a working discourse with the GDC (and NOT behind closed doors or behind the scenes). A suggestion to develop standards of dental care that can be defined in the literature that we can all follow, including the Expert Witnesses, some of whom still seem unaware of their duty of impartiality, and the correct standards to apply. A request for a meeting of the minds of the profession to leave their societies, their egos, and their self-interest behind and to unite for one cause.

To Protect the Patient.

Never has a focus on what is the singular most important thing in our profession been so starkly and beautifully pointed out to an audience.

Using data from a survey of almost 1500 dentists that had been offered to (and declined by) the BDA previously (and correctly statistically analysed so it was robust), in conjunction with live voting from the audience using the latest app technology, it confirmed not only that 90% or so of us felt the GDC wasn’t helping patient safety, but that the majority of dentists practice defensive dentistry. What was probably more embarrassing for the BDA was the fact that the majority of the audience, who were all members of the BDA, felt their trade union was not doing enough.

This blog is too brief to describe the entire lecture. However, the electric atmosphere in the largest hall of the conference must be mentioned, when at the end of what must have been an emotionally draining time for Colin, the entire audience stood and gave a standing ovation. Never in all the years of attending conference have I ever witnessed such a phenomenon. Such was the power of the presentation and how hard it hit home. Never has an audience been so united by one person so humble and considered in what he said.

So the message is simple. We can begin to elicit change now. The smouldering match has been lit, and the kindling has been placed. All that is now needed is for the entire profession (and in this I include those at the GDC who have an appetite for doing the right thing) to unite and fan the flames. Any egos will extinguish the fire, and so will the draft from the closing doors to rooms where traditionally the discussions have taken place. The positions of those straw men and women of the General Dental Council who have been nothing more than puppets to the Guy Fawkes will not survive the gathering heat.

This tiny glimmer of hope can become an inferno of change.

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Risk Assessing your Dental Nurse

Risk Assessment

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Dental Research

Dental Research

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20
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4 reasons why working with an Online Community should compliment your social media strategy.

4 reasons why working with an Online Community should compliment your social media strategy.

 

Social media is now part of all businesses marketing efforts but below you will find 4 reasons why using an online community as part of your marketing plan can also be extremely valuable.

 

Likes don’t automatically translate to more sales, so when using social media for your business you need to start measuring engagement - how often your audience is interacting with posted content and of course each other through your channel.

With Facebook, Twitter and Linkedin you are faced with a number of challenges, how do you get more visits to your page? Once they do visit, will users engage with a status update, or discuss content you have posted.

Online communities on the other hand, don't have an identity problem. Online communities are organised around clear defined goals and values. Imagine what an established online niche community offers to the business trying to reach a clearly defined audience. By engaging with a targeted community you are filtering out all the white noise and interacting directly.

So why can an online community be a valuable marketing tool for a business?

 

  1. You are marketing your business to your actual target audience. Unlike social media, you know that the audience has interest in the content or message you are trying to get across.

  2. When users use a community site, they are doing it for a particular reason, they are interested in the subject and want to learn or share information. There is no distraction of their favourite comedian or band also shouting for their attention. Reaching your audience in a targeted environment, means you can catch them when they are receptive to receiving your message.

  3. Engaging on an online community can be risky but if you are seen to offer good service and advice, it will win you plenty of fans and impress the whole community. Communities dislike being sold to but they like being given good customer service and expertise.

  4. Being seen to interact with a community that contains your potential customers is extremely important, online communities are a form of social media so marketing your business within a community needs to be a part of your marketing strategy. Anywhere your potential customers engage, has to be seen as a potential medium to increase sales.

 

Thanks for reading, please let me know your thoughts or get in touch to discuss things further.

 

Jonny Jacobs

Digital Dentistry Blog on GDPUK.

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Having an Option in the Digital Publishing Era

Having an Option in the Digital Publishing Era

Over the years, I have mentioned that online advertising has a number of advantages. You can read those articles here and here.

 

In 2016, we started using DFP, which is a Google programme that serves ads for our clients on to our main site.

One of the exciting features of this software is the ability to serve more than one ad at a time for our clients, to more than one URL. This is a great way of advertising a number of your services or products at once via one booking of a slot. It also has the added advantage of keeping the ads fresh and distinctive for the audience, who may not have interest in one product but an advert for something else from the same company may catch the eye. So a win/win for both the advertiser and the audience.

Yes it can mean more banner designs are needed but the advantages far outweigh this extra work for your design team.

So as you can see this is an amazing advantage compared to traditional advertising, not only is your advert seen thousands of times a month but when compared to print, you can display more than one advert in one position. Another example of modern technology improving the experience for all.

For further information about working with GDPUK and how we can help you reach thousands of dentists, please This email address is being protected from spambots. You need JavaScript enabled to view it.. We will be glad to help.

GDPUK will also be visiting next week's BDA Conference and Exhibition in our home city of Manchester. Get in touch if you would This email address is being protected from spambots. You need JavaScript enabled to view it..

Cheers

 

Jonny

Digital Dentistry Blog on GDPUK

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Great Expectations

Great Expectations

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4

GDC Watch April 2016

GDC Watch April 2016

April was a busy month in Fitness to Practise.  Unlike March where there was something for everyone, April saw mainly dentists and dental nurses on the proverbial naughty step.  Of these 21 had their favourite things taken away from them, 29 were put into time out, and 2 were sent to their rooms indefinitely.  Drilling down into the outcomes further, the final statistics for April were as follows:

Interim Orders held 20 new hearings and 15 review hearings resulting in:

  • 18 suspensions or suspension extensions;
  • 12 conditions orders or conditions orders extensions;
  • 4 no orders and;
  • 1 adjournment.

14 registrants were not present +/- not represented at their IOC hearing, and were mostly suspended with a couple kept on conditions.


Practice committees held 29 new hearings and 9 review hearings resulting in:

  • 2 erasures;
  • 6 new suspensions, 1 suspension extension and 1 suspension being revoked;
  • 8 new condition orders, 1 extension of conditions orders and 3 conditions orders being revoked;
  • 1 reprimand;
  • 3 postponements and 2 adjournments;
  • 1 case concluded (the incident was historic and there was no current impairment);
  • 1 no impairment;
  • 2 registration appeals (1 granted, 1 refused);
  • 1 restoration hearing (refused);
  • 4 health related hearings with all registrants kept on suspensions and;
  • 1 no case to answer

By registrant type, dentists were the clear sinners with 57, followed by 15 dental nurses and a single dental technician.

Cases of interest in April

The restoration hearing heard in April was refused for the second time due to a lack of insight by the registrant into why note tampering is serious misconduct rather than a silly mistake.  The GDC request to indefinitely suspend any further applications due to the costs involved, was not upheld by the panel who, like a Buddhist monk in meditation, felt that insight might be obtained at some point, and directed the erased registrant towards obtaining representation and taking relevant courses into ethics and personal responsibility before making any future applications.  Said registrant will no doubt benefit from such wisdom and gain mindfulness as a result of the teaching!

Not long after, a dental nurse who was not engaging in her on-going hearing relating to failures in decontamination procedures, was kept on suspension by the panel.   She had not turned up again; perhaps having realised that she could earn as much if not more as a domestic cleaner given the average wage of a dental nurse, with the added bonus of not having to be answerable to a regulator.  I need to do some further reading into whether the Fitness to Practise Rules have any mechanism to bring an on-going cycle of hearings for the above scenario to an end.  Let us not forget there is no statutory limit to the amount of money that can be collected from registrants to be spent on Fitness to Practise hearings.

Interim Orders met to discuss keeping a registrant who was in prison for fraud and false accounting on a suspension.  If this is not a waste of everyone’s time and money I am not sure what is, unless there is scope for him to be employed as a prison dentist without an interim sanction.

My other conundrum this month with Interim Orders is in their role of risk assessment and the concept of innocent until proven guilty.  By putting the allegations against a dental nurse as a statement of fact (‘misappropriation of funds’ into a personal account including the practice name, the exact amount of money and number of patients involved) into the public domain is she going to be able to have a fair hearing?  It rather reads like the IOC have accepted her guilt, yet there is no mention of any admission or criminal conviction for this alleged theft in the public determination.

Experts were on good form throughout April.  When we thought we’d seen the last of them after Dental Protection’s reassurance that there is no legal or regulatory requirement for it, the dreaded failure to record LA batch numbers were back, making it into a charge sheet via GDC expert witness Conor Mulcahy.  Perhaps someone can point him in the direction of this useful position statement for any future cases:  http://www.dentalprotection.org/uk/publications-resources/updates/briefing-documents/2015/11/09/local-anaesthetic-batch-numbers

Aside from the batch numbers of local anaesthetics, sadly there were no other particularly curious or intriguing charges put forward this month.  There were however, some thought-provoking conditions in one case which restricted the registrant from sending abusive or offensive communications.   One of the erased registrants was in jail having been convicted of fraud and deception, and the other was voluntarily not present but faced a raft of serious clinical deficiencies which were found proved, including using a block of bone that had dropped on the floor on a patient.

In the ‘No case to answer’ case, expert witness Robert Bland scored an own goal and had his evidence set aside by providing superficial evidence, changing his mind at a late stage on fundamental matters relating to the case, and most importantly exhibiting a ‘lack of impartiality’ by failing to include ‘evidence that was potentially exculpatory’ to the registrant.  This registrant and his wife are seriously considering leaving the profession despite the no case to answer verdict; this is exactly why the GDC must be taken to task for the style and method of its prosecution of cases over many years, and for the failings in its expert witnesses.  I’d also like to make the point here that pathologist Alan Williams who failed to disclose potentially exculpatory evidence in the Sally Clarke cot deaths case, was later found guilty of serious professional misconduct and banned from court work for 3 years.  The past 12 months have now seen 3 cases slung out because the experts appointed by the GDC have shown a lack of impartiality.  Experts also need to remember they are not immune from a civil lawsuit, and frankly it is probably only a matter of time until one is sued, or sanctioned.

Whilst I am on the subject of bias, it also isn’t appropriate for experts to advertise themselves in a manner that suggests they are employed by, or otherwise working as an expert witness purely on behalf of the GDC.  You cannot be impartial if you only do work for one side and I am amazed that this has not yet been picked up on and challenged by any registrants’ legal teams.

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Recent Comments
Bill Inness

Comment

Vikki I can only thank you for the time and effort you have put into this blog. It is very revealing.
Thursday, 12 May 2016 09:15
Vimal Hathiramani

well done

superb
Thursday, 12 May 2016 11:13
Paul Cole

Comment

"Interim Orders met to discuss keeping a registrant who was in prison for fraud and false accounting on a suspension. If this is ... Read More
Thursday, 12 May 2016 12:48
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Halitosis

Halitosis - Its not to be sniffed at.

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Dealing with Requests for Dental Records

Dealing with Requests for Dental Records

In recent years, Dental Practices have noted a rise in the number of requests for patient records being received, especially from legal services. It is probably no coincidence that this rise has corresponded with an increase in adverts for ‘no win no fee’ solicitors encouraging patients to come forward if they have received what they perceive to be poor dental treatment.

In this blog I set out the legal framework in relation to keeping and disclosing dental records and provide some practical tips on how to respond to requests for the same.

Record Keeping

As you all know, whether you work in a private or NHS practice, the Standards for the Dental Team, Standard 4.1 applies.  It states:

‘You must make and keep contemporaneous, complete and accurate patient records’.

Furthermore, various pieces of legislation also require dentists to keep records, including Regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, which is monitored by the CQC.

Those who work in an NHS practice will know that the NHS contract has a contractual requirement for dentists to keep patient records.

However, there is no hard and fast rule for how long you should keep the records before destroying them.

The NHS contract only requires you to keep patient records for two years. Given that a claim for clinical negligence can be issued within three years of the date of knowledge of the injury, a claim for breach of contract within six years of the breach and a claim for defective products within ten years of the defect, two years will be insufficient should you need to rely on such documents to defend a potential claim. The dental records may be the only evidence of what was discussed during a consultation and what consent was provided by the patient; they are therefore crucial in helping you to prepare a defence.  

The Department of Health’s ‘Record Management’ code recommends community records are kept for a minimum of 11 years after the date of the last entry. For children, it is 11 years or up to their 25th birthday, which ever period is longer. For hospital records the recommendation is a minimum of eight years. The maximum recommended length for retention is 30 years, unless otherwise required by law or some other circumstance.

If you have received any complaints or there has been an adverse incident with a patient, we would recommend keeping the records indefinitely, even if the complaint was resolved satisfactorily. Whilst there are time limits for bringing claims, the courts have the power to extend those limits. This does leave a dark cloud hanging over you; never knowing what might come through the post. However, being prepared with ‘contemporaneous, complete and accurate’ records will help ease the stress of dealing with any complaint or claim.

Please note that if a patient has a disability as a result of an ‘unsound mind’ the normal time limits for record retention do not apply. In these cases, the records should be held indefinitely.

On top of your professional duties, dental practices will also be covered by the Data Protection Act 1998. This requires anyone who holds sensitive personal data about an individual to ensure that the data is accurately created and carefully and securely maintained. Ensuring records are kept securely includes keeping them confidential. The Data Protection Act also states that data should be retained for no longer than necessary. You can find further guidance about your duties under the Data Protection Act in this helpful guide for businesses produced by the Information Commissioner’s Office.

Disclosing Records

Both the Data Protection Act and Access to Health Records Act provide patients with the right to see their dental records.

If you receive a written request from a patient for their dental records, this must be dealt with as quickly as possible but in any event within 40 days. We have set out below under ‘practical tips’ the fees you can charge for providing the documents and what to do if the request is from a third party.

The request must be to the person who controls the data, and it must contain information such that the data controller can be satisfied as to the identity of the person making the request and provide information as to the data sought.

You cannot refuse a patient access to their records unless one of the following applies:

1.       Disclosure would be likely to cause serious harm to mental or physical health of the patient or any other person;

2.    Disclosure would require you to provide information about a third party (other than the dental team providing the treatment) unless the third party consent’s to the disclosure. (Please note that if you can easily redact such information you should do so, rather than refusing the request.)

Once you have received a request you must provide the patient with a copy of all the information you hold about that patient.

If you have destroyed records and a patient subsequently asks to see their record, under the Data Protection Act it is reasonable to say that it was destroyed because it was no longer necessary to be kept.

Breaches of data protection laws can result in criminal as well as civil liability (not to mention adverse publicity, which is increasingly the likely result of non-compliance) so it is not advisable to ignore requests for personal data.

Practical Tips

Identity. You must ensure that the identity of the patient is correct and that you are sending them their patient records. If you are in any doubt ask the patient for more information to help identify them. If you send the wrong records you will be in breach of the Data Protection Act and, as stated above, this could result in criminal or civil action against you.

Consent. If the request is from a solicitor, ensure that the patient has consented to the records being sent to the solicitor and that they understand why the records are being sought. Most solicitors will use a standard form, because it sets out all the relevant information, but there is no requirement to do so.

Fees. The fees that can be charges for copying records are as follows:

Dental Records held electronically

£10

Dental Records held manually

Max. £50

Dental records held electronically and manually

Max. £50

Photocopying charges

You cannot charge an additional amount

Postage charges

You cannot charge an additional amount

X-rays or scans

Should come within £50 unless the patient has a large number. In that case you may be able to justify copying charges onto film.

 

Please note that the fees are the maximum you can charge and you should be able to justify them. They are meant to cover your costs for reproducing the records. For example if the patient only has around 10 pages held manually, charging £50 for administration and copying charges is unlikely to be deemed reasonable.

X-rays and scans can be transferred onto a CD and then disclosed rather than copying them onto film.

Opinions. A legal representative may also seek your opinion on the patient’s treatment and prognosis. Unless you are being asked to provide an expert witness report for court purposes (which you would only be able to do if you had never treated the patient in question) we would recommend that you avoid providing any comments. Any comments could later be used against you in respect of a claim.

If you do provide an opinion, you can seek a separate fee for this, as this is a report and therefore not covered by the Data Protection Act.

Potential Claims. If you receive a request from a legal representative, we would not recommend seeking clarification as to the reasons for the request, simply respond to the request and notify your indemnity insurer or defence union, so they are on notice should anything arise in the future. Providing the medical records may be enough to show there is no claim and nothing further may come of it.

 

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Spring Motivation?

Spring Motivation?

 

Motivation is funny old thing. What is that makes you get up and go to work? In amongst the demands of family life, most of us have to insert some productive hours to generate income to fund the lifestyle of our choice. So be it. But dark winters, both meteorologically and professional with persistent bad news, take their toll.

So as the days lengthen, the earth continuing to tilt on its axis, and the temperatures rise, notwithstanding the unusual nature of May snow !]  you feel the burdens of winter lifting. So let the sun warm your face and raise your spirits. It makes a change from rust and frostbite!

May and its adjacent months are the period of Dental Shows, and Conferences. The Dentistry Show in Birmingham, an acclaimed success, despite the fact that only 5% of the registrant population attend. Then the BDA Conference in Manchester takes place at the end of May and the LDC Conference 2 weeks later, in Manchester too. The Scots LDC Conference took place at the end of April.

These events are a chance to catch up, network with colleagues, and begin to feel good about your profession.  Feel the draw of the latest technologies and equipment, dream, perhaps plan, the next big step in your professional life.

It’s not too late to drop into the BDA Conference and call your Representatives to account. 130 Sessions over 3 days. The link is below.  Manchester in May? Blazing sunshine, darling.  If you have not been, give it some thought. Motivate yourself.

 

Forgiveness is motivating ?

Motivation in its widest sense might mean, for example, that past misdemeanours of our lead regulator fade into a forgiving memory. Sadly recent events mean I cannot avoid mention our old muckers, the "Wimpole Street Stasi".

Spare a thought for the situation of our colleague Dr David Lee, whose wellbeing and reputation have been unnecessarily tested to breaking point by an FtP Hearing at the GDC which was not just thrown out, but was found so wanting that there was NO CASE TO ANSWER. In other words the GDC simply drove an FtP case on a spurious basis.  I urge you to read the hearing while you can, and gasp in anger and sympathy that such events can even be commenced, let alone taken to this £1/4M expensive debacle.

The GDC Chairman, Dr William Moyes, has only last week had the gall to stand up at the Scottish LDCs meeting [linked here to a GDPUK thread] and state that  he is not resigning because, in essence he is part of “The Solution”.  So much for accountability for his Councils distinct lack of proper oversight.

Dr Moyes may be part of some perverse Final Solution but I am not sure that is part of what he has in mind.

For me and my colleagues such as Dr Keith Hayes it is a motivating feeling to think that Dr Moyes is still in post and still does not get it.   Time for a Spring clean? 

So does motivation really increases your capacity to forgive or does it merely allow you to feel justified in moving on in respect of matters about which, in truth, you can do little?

“Whatever, no worries” becomes your daily Gallic shrug.  It’s sunny and the days are long, do I care?

Good job really if you are NHS funded.... Read on ...

 

 

Lost you way? You’re not the only ones…

 

The perils of the all new, singing and dancing Government computerised support in the form of Compass is just ‘one of those things’. Oh for a paper FP17 – oh wait they have changed them, slotted in some extra data collection but failed to print them in time. Online advice on their filling-in is there – but no FP17 other than a sample version!  So use the old ones for now – which Compass of course cannot process properly!

 

The stories of struggles with Compass are now becoming more than irritating – it is beginning to feel like the software has not been properly specified and it may, if the present shambles is anything to go be, be at least one financial year before all the errors and omissions are corrected. Indeed, Compass and its pointed failures  have been a feature a long thread on GDP UK recently if you have not read it.

Meanwhile, if you are spinning your Compass to see which way it points, Good Luck!   You are not alone…  This was a Government Spring Clean which does not appear to have worked well.

 

CQC – Motivating better regulation

On the other hand, compliance is never an easy activity. Let’s face it we are all dragged to the altar screaming. The CQC, in particular now they have Dr John Milne in a leading role, barely a year after his Chair of the BDAs GDPC ceased, are actually evolving fast and well and now leading the future of Regulation in the wider sense.

Not only are their processes actually evolving fast and being targeted where needed, but they are dragging all the regulatory participants to the table to sort out who does what.

They are to be congratulated for their initiative, “The Future of Dental Service Regulation”  a punchy, pleasantly  brief document that has great potential to change dentistry for the better. Read it here.

You can take part – so go to the links and get your say in. It will make you feel better.  The CQC are looking increasingly like an effective strategic ally of the Dental Profession, with scope to act where the Professional Services Authority [PSA] lack the teeth.

Now that feels better!!

 

The weather? Yeah, motivating, isn’t it?

Good job everything else in life is a motivating force for good.

It seems that some of the leading agencies upon which we depend could do with a Spring Clean.

Where shall we start?

Have great one.

 

 

LINKS IN DETAIL

SPRING MEETINGS

Dentistry Show http://www.thedentistryshow.co.uk/

BDA Conference https://www.bda.org/conference

LDC Conference http://www.ldcuk.org/

GDC

GDC Case – Dr David Lee https://www.gdc-uk.org/Membersofpublic/Hearings/Determinations%202016/LEE%20PCC%20Determination%20-%20April%202016.pdf

LDC Scotland Moyes encounter https://www.gdpuk.com/forum/gdpuk-forum/thoughts-on-an-encounter-with-dr-moyes-22119

Dr Keith Hayes  http://www.rightpath4.com

COMPASS LINKS

GDPUK Compass thread https://www.gdpuk.com/forum/gdpuk-forum/compass-21660

FP17 R9 Guidance http://www.nhsbsa.nhs.uk/Documents/DentalServices/Completion_of_form_guidance_-_FP17_-_England_(V5)_-_11_2015.pdf

FP17 R9  sample form http://www.nhsbsa.nhs.uk/Documents/DentalServices/20160216_FP17_Proof_Sample.pdf

CQC

Consultation on Regulation: http://www.cqc.org.uk/content/future-dental-service-regulation

The Document http://www.cqc.org.uk/sites/default/files/20151207_future_dental_service_regulation.pdf

 

 

 

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Dentists are Pussycats

Dentists are Pussycats

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Do you need the penetration test?

Do you need the penetration test?

Do you need the penetration test?

 

Don’t worry, I’m not about to delve into the wet fingers stuff – this is a different penetration test (no smirking at the back). The idea came to me after hearing a radio programme about cyber crime. They interviewed someone who had been employed as a Penetration Tester. A penetration test (a.k.a. pentest, intrusion detection and red teaming) is, it seems, a well-known and recognised process in the worlds of cyber security and IT governance. Essentially, it is an evaluation of the security of IT systems by trying to exploit vulnerabilities before hackers and criminals can. It goes beyond looking at operating systems and software to include improper configurations and risky operator or end-user actions.

 

A dentest?

My idea is that dental practices should evaluate their governance vulnerabilities by what I’m calling a ‘dentest’. In other words, before CQC inspectors mark you down, the GDC writes a disapproving letter or a patient uses your complaints procedure you should check whether your systems or staff can be faulted. There might be several ways to do this. In the wider world reformed hackers and fraudsters are often employed for such tasks. However, I don’t recommend scouring the GDC’s list of erased dentists. Much more sensible to keep it in-practice.

This is where that irritating team member who is always finding fault and asking endless questions comes into their own. Divide activities in the practice into manageable chunks and set them the task of ‘penetrating’ them one at a time. In theory, they need expertise in an area to be able to exploit any vulnerabilities. Otherwise, how will they know whether, for example, decontamination procedures are being followed correctly?

 

A journalistic trick

Fortunately, such in-depth knowledge is not required. How do you think Jeremy Paxman managed to get politicians to squirm night after night? How does the team on Channel Four News report on a variety of different topics with apparent authority? The answer lies in what journalists and reporters learn on their first day at university – the ‘5 W’s’ – Who? What? When? Where? Why? and How? (yes, I know there’s also an ‘H’). Ask these questions persistently enough and you’re bound to get the answers (or not) on virtually every topic.

 

 

For example

Take decontamination procedures. Your ‘dentester’ needs to be given half an hour during which they ask the 5 W (and 1 H) questions of, initially, virtually anyone in the practice. Anyone? Yes, because they might start by asking the practice manager: “Who is responsible for decontamination?” With that answer, they could ask the person or persons named: “What is the decontamination procedure?” Then follow up with: “Where is it done? Why? How?”

Any “I don’t know”, “I’m not sure”, “I’d have to ask”, “I can’t remember”, replies suggest a vulnerability.

If they began with a receptionist, they might get the answer: “I don’t know”, which they can follow up by asking: “Who will know?”. If the receptionist says the practice manager, the dentester is off and running. If the receptionist doesn’t know, that suggests a vulnerability – each member of the team should know what roles and responsibilities other members, especially senior staff, have.

 

Another example

Now the dentester, or another member of staff with an equally enquiring mind, could play at being a patient. They could ask any team member: “How do I make an appointment?”, “How do I make a complaint?”, “When is the hygienist available?”, “Where is the nearest car park”, “How much do implants cost?” Depending on whether they questioned the part-time Associate or a receptionist, they should be given either the name of the person who will know or the actual answer. The dentester proceeds to ask more questions, as before.

 

The learning points

The dentester’s work is, of course, wasted unless you ensure the vulnerabilities he or she uncovers are shared with the team and corrections discussed and implemented. Also, a dentest is neither a one-off exercise or a standalone one. With new compliance requirements coming on stream all the time, new systems being introduced and new staff joining the team, vulnerabilities may surface again – so regular dentesting is required.

Also, you may wish to enlist a ‘secret shopper’ to check for vulnerabilities. Obviously it needs to be a person your can trust and who will respect confidentiality. Perhaps someone from your plan provider or the dental lab you use or, better still, your favourite dental business management consultant…

 

 

Image credit -Andy Maguire under CC licence -  modified.

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Think Positive

Think Positive

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GDC Watch March 2016

GDC Watch March 2016

 

I have been keeping an eye on the cases emerging from the Fitness to Practice and other committees of the General Dental Council [GDC] for some time, I am sure other GDPUK readers will be interested to know what goes on each month. So, the aim will be to write summary monthly, in what we hope is a short lived blog.

Monthly breakdown of case types and outcomes

The month of March saw 59 hearings scheduled after one was moved back to start in April.  There was 1 registration appeal which was granted.  Of the remaining cases, 18 were new Practice Committee hearings, 6 were Practice Committee review hearings and 2 were health cases.  Interim Orders held 14 new hearings and 18 review hearings.  Broken down by registrant type, there were 48 dentists, 4 dental nurses, 4 dental technicians, 2 hygienists and 1 clinical dental technician involved in hearings.

Interim Orders handed out 8 new suspensions and 8 continuation of suspensions, placed 1 registrant on conditions and kept 7 on conditions.  One suspension was revoked, 1 suspension was downgraded to conditions and 5 cases had no order.  Of the new suspensions 6 of the 8 registrants were not represented and not present.

The Health Committee suspended 1 registrant and placed another on conditions. The Practice Committee erased 1 registrant, issued 2 suspensions, 2 extensions of suspension, and placed 2 registrants on conditions whilst 2 had their conditions extended.  Four suspension orders were revoked, 3 reprimands were given, 3 cases were adjourned, 3 registrants were found not impaired, 1 case was referred back to the Investigating Committee, and in 1 case no misconduct was found. 

March’s cases of interest

The erased registrant was neither present nor represented, but the case mainly related to failing to take appropriate radiographs, failures in treatment planning and record-keeping, lacking indemnity cover whilst treating patients on 4 days, and a failure to cooperate with the GDC.

In the ‘No Misconduct’ case the registrant essentially faced charges which related to not providing an estimate of costs for root canal treatment (although he did not actually invoice the patient for any of the treatment provided), not informing the patient of the risks of the proposed treatment and therefore failing to obtain informed consent. In fact, the registrant had only provided emergency treatment to try to relieve pain and infection.  This was ultimately not successful and the tooth was removed by another dentist. The patient/witness actually complained to the GDC about something else, but this was not worthy of any charges so how this case actually came about is not clear from the determination.  Despite having a confused recollection at times, the patient was still described to be a credible witness. Another matter which is not clear in the determination is why there were 3 experts involved - 1 for each party and a joint expert statement.   The registrant admitted all the charges, but the panel found some aspects not proved and despite both the GDC and defence counsel accepting misconduct and impairment, the panel found neither on the basis that the treatment was emergency in nature rather than a definitive RCT procedure, and the failings not so serious as to be considered deplorable.  A happy outcome here with the lesson of not assuming that because you have not charged a patient they won’t complain about you.   

The case referred back to the Investigating Committee involved fissure sealants on a single patient, which the GDC-appointed expert Professor Deery (who is a paediatric dentistry consultant and Dean of Sheffield School of Clinical Dentistry) had concluded were appropriate after he had examined the patient, and that wear on the patient’s teeth was due to erosion rather than damage caused by the registrant.  It was submitted that this evidence would change the view of the IC and that no realistic prospect of a finding of misconduct existed, begging the question did one exist in the first place?  How the case came about, and on what the basis of the patient complained is not explicit in the determination but it is implied that the registrant may have perhaps been accused of creating damage in which to place fissure sealants or otherwise creating unneeded work for themselves.  This case highlights the inherent issues with the lack of a clinical examination until a late stage, (if at all) in the FtP process and how assessors and experts creating charges purely on clinical records is a flawed concept.  This case will have involved a significant waste of registrants’ money in reaching a Practice Committee that could have perhaps have been avoided with an earlier examination of the patient. Hopefully with the recruitment of dentally-qualified caseworkers cases like this can be avoided in future.

Mr N, who was neither present nor represented, was suspended following his hearing which included 73 individual heads of charge, many of which had several sub-headings.  The GDC-instructed barrister may have missed Jonathan Green’s presentation at the Dental Protection Study Day last October where he stated that no over-drafting of allegations would take place following the embarrassment of the Kirschner case.  In the determination the GDC-appointed expert, Professor Morganstein seems to advise that linings ought to be placed under amalgam restorations.  With no representation there is no means of contesting such a view even though many GDPs would now not line amalgams, nor is there any conclusive evidence that they need to be.  Professor Morganstein is apparently the Dean of the dental school at the University of Buckingham (I know what you are thinking…. and I’ve not heard of it either).  I feel this case nicely highlights the problem with the GDC using experts who are focused on academia or in specialist practice opining on GDPs, and is directly contributing to the stealthy moving of standards in an upwards direction.

 

Finally, the long-running Carew case which I have been watching with interest due to the charge of:

·         you failed to adequately record the clinical reason why a try-in was required……

has left me somewhat disappointed as this charge was withdrawn on day 1 of the hearing. It looks like we will never get to find out why this element of record-keeping was considered to have been essential.  

 

 

 

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Recent Comments
Anthony Kilcoyne

GDC cases monthly comment & an...

This is a great initiative Vicky and actually, in the public interest, I believe the GDC should welcome it too, if it's serious ab... Read More
Wednesday, 20 April 2016 09:41
Victoria Holden

Thank you

Thank you for the positive feedback Tony. I hope the blog is well-received by all parties as I believe there is a lot we can all ... Read More
Wednesday, 20 April 2016 10:47
Ruth Dening

GDC watch blog

Thank you for this, you must have spent a lot of time on it. It is really interesting to see what's happening.
Wednesday, 20 April 2016 17:37
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The Full Marketing Experience

The Full Marketing Experience

 

Our site is free for members of the dental profession to join. Established since 1997, we are proud to have nearly close to 10,000 members of our online community.

Revenue for the site is generated by companies from the dental industry advertising on the site.

Advertising on the site is done in the form of banner ads. These work well on the platform because they are reaching an audience who are interested in what services or products are available and you are offering something the audience is interested in.

We also offer advertising on our daily digest emails, which get sent 3 times a day and on average get opened over 100,000 times a month. These are opened on a frequent basis because they the content changes as the forum posts change.

As part of this advertising experience, we feel we can offer you more than traditional advertising mediums. GDPUK offers a value added experience.

 

  • Exposure on the site or daily digest for a full month or as long as you want. Pricing is on a per month basis. This generates a large number of impressions of your message.

  • Opportunity to post PR or blogs onto the site to accompany your campaign, these are then shared with our thousands of followers on social media. So as well as reaching our community audience, you are reaching another audience through social media.

  • By posting content and information to our blog pages, you can be seen as an opinion leader in your sector.

  • Our ad serving software can display more than one ad at a time, instead of having all your impressions on one message, you can split the exposure between as many messages as you want. This works well for a dental business that has a number of product or service offerings eg. a business that does dental repairs and sells equipment, can advertise both services at once. This is a fabulous way to test what works and experiment with which ads gain the best response.

  • Click throughs can be to a dedicated landing page on our website, where you can collect data or provide further information to the audience.

  • Advert can appear on our front page and our news / blog pages, which get viewed thousands of times in a month.

  • Option to run a forum review of your product or service for a small extra fee.

  • Option to have a sponsored post on the forum for a small extra fee.


So as you can see, we offer banner ads but we also offer a number of extras that we include in the package that makes it a great marketing opportunity. If you would like further information and are interested in reaching your target audience, please get in touch today. Pricing starts from £299 + vat.

 

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

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NHSexit

Should I stay or should I go now?

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Chas Lister

Brexit or Brinnit

Brilliant
Wednesday, 20 April 2016 06:20
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Yes Minister, No Dentistry

Yes Minister, No Dentistry

The new Minister was being briefed by the new Permanent secretary, Lady Arabella Sternchin.

 

“Good morning Minister.”

“Good morning Arabella - it is OK for me to call you Arabella I hope? “

 

“Quite acceptable Minister.”

“Good I didn’t want to get off on the wrong foot. I heard that old Humphrey could be a stickler for protocol.”

 

“I never worked directly with him, Minister, so I was never more than ‘my dear girl’.”

“Well that’s all clear then. Now as we’re both new boys, what are we going to do to get rid of the dentists Arabella?”

 

“Ah yes, I have done some research.”

“Splendid. Burning the midnight oil what?”

 

“No Minister. Burning out interns. It seems that one your predecessors thought they had things sorted out a decade ago.”

“What was the intention?”

 

“Well they imposed a new contract that was so ridiculous, so half baked and so poor for all parties that no-one with any common sense would sign it.”

“What happened?”

 

“The dentists signed it. They ignored advice and signed in their droves. Now the doctors, as Mr Hunt is finding, love a fight, the BMA is a nasty opponent and of course people like doctors. We presumed that as it was so obvious the dentists would lose their clinical freedom and wouldn’t be able to do clever work they would say no and head for private practice. But no such luck.”

“That was 10 years ago though Arabella, haven’t we tried anything since?”

 

“We got this chap Cockcroft to tell everybody that everything was wonderful.”

“Oh yes I met him once - the shifty one who can’t look you in the eye?”

 

“That’s him. Well in spite of the fact that nobody ever believed a word he said, indeed quite the opposite, they all opted for to jam today instead of no bread tomorrow.”

“Didn’t we try anything else?”

 

“Yes we opted for ‘death by acronyms’, the civil servants’ foolproof fallback.”

“What did we use?”

 

“First there was something called HTM01 oh something, it was all to do with cross infection. We put it about that dental practices were death traps and full of all sorts of bugs. We backed it up with lecture tours by a couple of burned out bug counters and some research work by the manufacturers of some extraordinary things called washer disinfectors. They were really souped up dishwashers but had the lifespan of a mayfly. Did no end of good for our German chums who sold them and made the fang farriers pay for servicing. Fact finding trips to the Black Forest all round!”

“I remember that. What else?”

 

“Then we thought we would trial the CQC on them - totally inappropriate for their industry of course but it helped us prepare for the real targets, the GPs. We made them pay for our mistakes too - what a naive bunch these are.”

“Didn’t they smell a rat?”

 

“Sadly not at all, in fact they kept coming back for more. A bit like dental Oliver Twists, “give us more UDAs”, they said.” Then a stroke of genius, they sent Bill Moyes to the GDC.”

“What madman Moyes? He’s not still at large is he?”

 

“Oh yes indeed Minister and he’s on our side now.”

“So let me get this straight, the original plan was to freeze them out of the NHS, into the good old private sector. How would we placate the voters, you know the Daily Mail reading “we support the NHS” brigade? They vote for us you know.”

 

“Privatisation minister.”

“Shhhh! Keep your voice down. How?”

 

“You remember the Carlyle group?”

“What the chaps who sell guns and ammo? They’re so bad even the Yanks don’t like them. How did that work?”

 

“We arranged for lots of little practices to be bought by Carlyle.”

“Goodness that’s cunning - what did the dentists do?”

 

“Some of them especially those growing long in the tooth - if you’ll excuse the pun - hated these “corporates” with a vengeance, but they hated the CQC, GDC and so on even more.”

“That doesn’t sound too good.”

 

“Bear with me Minister.”

“Chance would be a fine thing.”

 

“Cheeky. It seemed that once these upright, responsible members of the profession saw the colour of Carlyle’s cash they couldn’t wait to trouser the money, roll over, mutter “what principles?" and head for the golf course to blow their lump sums on Rory McIlroy clubs and Audi estates”.

“Gosh - I wondered where old Keith the teeth went. He was my constituency’s BDA rep and a right royal pain in the posterior.

So where are we now?”

 

“It has proved such a success that the first thing on your desk - once we get rid of this Brexit thing of course - is to consider the idea that we let the Carlyle conglomerate have the whole dental, err, shooting match. It will stop us having to pretend to deal with that dreadful Armstrong man from the BDA, apparently everyone preferred Martin as he knew how to make a decent G&T but this fellow just drinks pints of real ale and keeps nipping out for fag breaks and, by the look of him, the odd pie or two.”

“Isn’t that a bit drastic?”

 

“Not at all if the Mancs can manage health care, then Dentistry is just nickel and dime stuff as the cousins would say.”

“Just like that?”

 

“Indeed, Brexit may be a fly in the ointment, however.”

“How so?”

 

“Keeping these dental sweat shops, sorry surgeries, manned depends upon foreigners who can’t find work in their own lands. At the moment they can get work here easier than our own graduates.”

“Is that fair?”

 

“What’s fair got to with it? When was a dentist ever fair with you?”

“Sorry Arabella, do continue.”

 

“Our graduates are so in debt, what with £45k of tuition fees and much the same in beer loans that they are starting to undercut Johnny dental foreigner.”

“Maggie would be proud.”

 

“Indeed Minister. But it doesn’t stop there. We have plans for the private dentists too.”

“What now?”

 

“The Dutch control the fees that these cruel b****** can charge so we plan to do that and also to introduce a compulsory insurance plan to match the fees. We started talking to Wesleyan and Simply Health a couple of years ago and they have been very active and are readying themselves.”

“Goodness you have been busy.”

 

“That’s just the start minister. Your next meeting this morning is with Nigel my colleague from education. We intend to liberate the dental schools from University control. It’s something that we have been working on for a decade - it was Blair who originally got the ball rolling.”

“You know Tony was a good man really, a shame he pretended to be a red and a bit too keen to press the button. But ethically one of us.”

 

“Instead of teaching the new dental apprentices in ivory towers they will go to urban silos or, as Peter Mandelson christened them, “outreach centres”. These will be run by Carlyle, using their new branding of “ToothSkool”, and the apprentices will learn on volunteer patients for the new three year course. The volunteers will get rewarded with beer vouchers and the children a sticky bun. We have no end of great people coming on board to sponsor these places. Coca-Cola, Tate & Lyle, Kraft Food, Tesco.”

“What fun….good lord Arabella there’s a seat in the Lords waiting for you if this works out.”

 

Yes Minister.

 

 

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Scandal!

Scandal!

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Get Straight Teeth - An Apology

Get Straight Teeth - An Apology

 

 

It would appear that I have to make an unreserved and wholehearted apology to the entire profession. You might have read my blog of the 1st April, and for those who didn’t realize it, this was an entirely tongue in cheek observation of the profession in general.

However, in my attempt to take a humorous look at dentistry and so e of the characters that inhabit it, it appears that I was closer to the truth than I thought. It appears someone has taken it a little too seriously as only a couple of days later the real life manifestation of ‘Speedy Smiles’ seemed to appear in the guise of http://straightteethdirect.com. I didn’t bother patenting the idea as I thought it was too far fetched, but obviously someone saw more potential in it than I did.

Now many of us felt that this was someone just perpetuating my joke a little longer, but alas, it seems that this is a real defacto business.

I am aghast. I must apologise unreservedly that my joke has become someone’s new business plan.

I’m all for innovation in dentistry and long been a supporter of it, but it has to be in the patients best interests and above all ethical and moral. There are some true innovators out there who combine aspirational patient care with inspirational treatment ideas, and the profession and our patients are all much richer for that. In fact, there has always been a trend for the true innovators in business do something totally ‘disruptive’ to the models that we know. Apple have built an entire lifestyle culture around their products and their innovative ideas of how we do things such as listen to music and purchase software. So much so, many of the old media systems are becoming defunct. And what about the rise of Uber? Having a disruptive view of the taxi service has lead to the inexorable rise of this new service provider, and certainly divided opinion in the sector. Whilst it can be argued that a new way of providing dental care to the masses is precisely one of these types of established market disruptions there is an enormous difference in our market over that of taxis and phones; that of patient safety and our ethical responsibilities.

I’ve long been arguing that we seem to be in a race to the bottom, and it appears to me that we are now plumbing some new depths that I even I thought our profession would never reach. For me to invent a company one week and then find my overactive and warped humour has actually been closer to the truth than I thought has been a shock to me. This new company has very little information on its website, so there are many questions that need answering. I have indeed tried to ask them, but lo and behold, the ‘contact us’ link doesn’t work. How better to avoid having to answer awkward questions than to have a dead link on your website?

A bit of digging reveals that this business venture is actually headed by a UK dental registrant. I can only assume that they have been in some form of suspended animation for the last couple of years whilst the GDC has trundled its way through the profession like a bulldozer in the Amazonian rainforest. Only someone who has been on a retreat to the deeper depths of another planet without any form of contact with the UK dental market could actually think this is sensible move.

This raises so many important questions that I’ve tried asking but had no reply. For instance:

  • How on earth can an entirely remote system of diagnosis and treatment planning meet with any of the GDC standards?
  • Where is the duty of care?
  • Does a specialist diagnose the malocclusion?
  • Are all the technicians GDC registered? (I am lead to understand it is a UK laboratory providing the service)
  • Who will be stupid enough to provide IPR on a patient who you have no relationship with, not knowing the final treatment plan?
  • When some dentists can barely take impressions, how do you expect patients to do this?
  • Who is responsible when (not if) the treatment goes wrong or doesn’t meet expectations?
  • How are the distance selling rules and cool off periods dealt with?
  • How does the legal responsibility to determine the material risks to a patient we now have because of Lanarkshire v Montgomery square with this?
  • Who are the ‘assigned dentists’ who oversee the cases? Are they orthodontists or graduates of the Academy of Seen One Done One Taught One?
  • Is this actually a ploy to drive the patients to affiliated dental practices for the work?

I am sincerely hoping that the indemnifiers for once use their discretionary power to withdraw any support from this venture if it is as ill advised and crass as it appears.  Certainly I hope that none of my money will be used to defend such a venture, so one can only hope the person behind this has enough personal wealth to back it themselves if patients suffer, and not ‘Cameroned’ it all off into an offshore haven.

If I may give a medical analogy, would this company jump on the opportunity to allow one to buy a kidney on line and cut out the middle man? Is that ethical or even legal? Would they offer to deal in controlled medicines direct to the patients without proper prescription? Because this is in reality no different to what is being offered. A set of pictures and models looked at remotely are NO substitution for a full examination, and that should be from an experienced practitioner in the field. The provision of dental care is like any medical specialism and as such is governed by legislation in order to protect the patient. It is just like any other form of treatment, and whilst I’m in full support of marketing and the development of new initiatives to allow patients to seek treatment more easily (so I’m no dinosaur) this is a step into the black hole of dubious ethics and seems driven more by the financial gains than the desire to help patients. And on the subject of Dinosaurs, just because the technology probably exists to recreate one of those genetically, that wouldn’t make it right. Technology needs ethics and a moral compass to be used for patient care, and this venture doesn’t seem to have either from where I sit. I know many people that agree given the chatter on social media.

Whilst it sticks in the throat to admit it, one only has to look at the crass forms of marking that sometimes occurs in dentistry to have to sometimes agree with the GDC that its pursuit of the profession is justified, because there really are some people who should be ejected from our profession forthwith. When you have aggressive tag lines such as ‘Click Convert Sell’, (which is also something to do with the same registrant behind this venture), and things like ‘Best of the Best’ awards for ‘piratical’ dentists,  one only has to recall the mis-selling of PPI in the 90’s to think this is probably going to visit our profession very shortly with this sort of venture. We will all suffer then, but usually the main perpetrators of these things get away with it and it’s the rest of the profession that has to pay.

The Orthodontists and GDP’s have long been at loggerheads, and will probably remain so, but this really is something that they should now get their heads together over. It appears to me that most of the time they seem to argue about the evidence base for this that and the other, and rarely come to any conclusion other than the other side is wrong. But I think they both might be able to pull together on this one, and agree for once that there probably really isn’t much in the way of proper studies that show the success of a self administered orthodontic alignment system that would stand up to peer review of any kind.

Perhaps the BOS can therefore simultaneously build some bridges and produce a press release and advert this time that would be also supportive to GDP’s in their condemnation of what appears to be a dangerous venture. At least if a GDP goes on a weekend course for the latest fad system, the patient has recourse to a real indemnified person (the dentist), and there is a human input for the patient to discuss issues with. A duty of care has been established and the refined law of this land will recompense for any negligence that ensures. With an entirely digital system (and one that doesn’t seem to have the ability for you to contact easily) then where is the necessary communication that patients will need when things go wrong? Who is responsible? Will it all be down to a dodgy impression the patient sent? Will it therefore always be the patient’s fault?

I would like to formally invite the person behind this venture to enter into a public discussion on this forum as to the business plan, the problem solving modalities, the indemnities in place, and the ethics and morals backing this new venture. I’m more than happy to be proved wrong (as I’ve spent my entire marriage being wrong according to the wife!), and it might just be my ignorance that is making me have these concerns. Perhaps we can invite some of the indemnifiers and maybe even borrow one of the attack-dogs of the GDC (once they’ve sated their appetite on a single issue complaint of course) to referee the discussion and give us their input.

So come on. Lets discuss this professionally. Surely we haven’t reached the point where the profession has eaten itself?

Image Credit: Emily Davies

 

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Take Dead Aim

Take Dead Aim

 

With it being Masters week, I thought it would be the perfect excuse to use a golf analogy for my current blog!

 

Little Red Golf Book by Harvey Penick is one of the most influential golf instruction books of all time. The book has a number of short and quick messages for the reader to understand and digest easily which are centred around Harvey’s learning and observations after a lifetime in the golf world. A chapter that I have always remembered can be found on P.45 titled “Take Dead Aim”. Harvey says he tells his students to take dead aim, “Shut out all thoughts other than picking out a target and take dead aim at it.” As an avid golfer, it is a great piece of instruction which is simple and works! I believe it can actually be applied to all walks of life.

In all areas of business we are given targets or we are looking to reach target audiences and we usually need to focus our thoughts or energies on these targets.

Reaching a target audience is now the cornerstone of all successful marketing whether we are using social media, the adverts during Coronation Street or a professional network to get a message across. Whatever area we are looking to reach, we want to reach our target audience and if we can take “dead aim” it works even better.

Reaching work targets also shares similarities, as long as the targets are realistic, you have to take dead aim and focus on reaching those goals. Focussing on the small targets then leads to the bigger prize in the end.

In life we also need to identify our target and then aim for it.  It is good to set specific goals and avoid the distractions. If we are distracted by too many goals or by short term projects and lesser opportunities, we will probably not achieve the important long-term goals that we should all set for ourselves

Are you taking dead aim?

Reach your target audience on GDPUK.com. Get in touch today - This email address is being protected from spambots. You need JavaScript enabled to view it.

 

What else does Harvey do so well to get his message across in this book that has sold millions of copies…… he always shares a story in each chapter! This makes the audience relate to the chapter and remember the piece of wisdom in the book. This shows the immense power of telling a story. That thought can be discussed another day :)

 

Further reading on Harvey can be found here - 

http://www.golf.com/instruction/golf-teacher-hall-fame-harvey-penick

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Gasping, Dying, Convulsions

Gasping, Dying, Convulsions

Welcome back. I think Easter if officially over, just watch the traffic next week!

Your regulator, the GDC, is trying make the news again.  Perhaps in that ironic respect, it is very successful.  I suggest the smell is not good.

However, perhaps not in in the way it might be hoped. The GDC is spinning the facts to serve its own interest. Again.

 

You remember the GDC?

It’s that organisation for whom you pay the best part of £900 per year as a work tax.  If your business also funds your staff registration, you will be paying well over £1000 per year. 

It’s that organisation, paid for by you, that squanders money on frippery and self-serving PR, accountancy consultation and £9M building expenditure.  Prudent management of other people’s money is not part of its remit, it would seem.  Your money is used in part for its role as a World Class Complaints Agency [remember all those outrageous FtP cases? …  they are still coming through!].

 

Seconds away … Round 4  -  Dentistry versus the GDC

It is the latest bleating of the Chairman that should catch your eye and stir your loins with a sense of disbelief and injustice. It certainly has for the BDA [ are you a member - £30 a month for the fighting fund, get on with it!] who have returned to the ring for another fight.  We can but hope that Big Mick is aiming to knock over Chairman Bill and obtain the final ‘fall’.

If you have not taken great interest so far, I am sorry to lean on you again, but please – without YOU taking a simple action, nothing will happen.

As a wet fingered GDP, you CAN make a difference.

The BDA alone cannot clean the stable on your behalf.  The smell and the excrement remain, and it “All hands to the brooms”

 

Why all the fuss?

You will, I hope, have noted the PSA Report before Christmas.

Finally some three months later Dr Moyes, Chairman of the GDC sticks his head over the parapet. Writing in his Blog, you could take a rosy view of the world in Wimpole Street. This Blog is seemingly the first of many. Boy, I look forward to those … the excitement is too great.

I suggest to you that these are the words of a professionally dying man.  If you read the minutes of the 3 March 2016 GDC Meeting, to which Dr Moyes makes reference, it is clear that the Executive Management Team [EMT] of the GDC have been explicitly humiliated so that the Council can remain in post.

 

What's the problem?  This is the problem:

  • The Council of the GDC have completely washed their hands of any responsibility.
     
  • There is no mention anywhere of the failed oversight of the Council
     
  • The Council have abjectly failed and yet remain in complete denial.
     
  • The Council have been explicitly criticised to an unprecedented level by external bodies from the PSA to Parliament, and yet they hold their heads in the air singing “La La La”.

 

The BDA are to be congratulated for shovelling more coal on the fire, but I think more is needed yet.

If you know a Council Member, ask them why they have not resigned? If you know of them, write to them and ask them the question.

 

What "Point of Principle" causes them to stay?

Dr Moyes may think he has got away with it but I think we must all prove him wrong. So very, very wrong.

Until this Council are forced to resign en-masse, nothing will change because it was Dr Moyes and his merry band of Members that oversaw the woeful actions of Ms Gilvarrie, and it is the GDC Council which will design the Job Spec for the new CEO.

If you mix your cake with a poisoned spoon, the cake will always be poisoned.

 

The GDC have fallen  - The political referees should end it now

The Council of the GDC should resign. The Chairman should already have gone. It is an amazing arrogance of unholy magnitude that he and they have not.

 

Whom should be first?

It is clear the Chairman has the skin of a rhino and so it is down to the Council to consider their positions based upon the principle of what is right.

Your profession needs your help. Support the BDA. Write to your MP. Write to the Registrant members of the Council. Phone people.

JUST DO SOMETHING

DO NOT BE SILENT.

 

There is a sense that the BDA have started the final round. You need to shout and holler’ your support.

May all of you have Spring in your steps.

 

 

https://www.bda.org/news-centre/press-releases/Pages/New-era-at-GDC-comes-with-0.5-million-cleaning-bill.aspx
BDA: ‘new era’ at GDC comes with £½ million cleaning bill

 

https://www.bda.org/news-centre/press-releases/Documents/Mick-Armstrong-Bill-Moyes-letter-01-Apr-16.pdf
Mick-Armstrong to Bill Moyes letter 01 Apr 16

 

https://www.bda.org/news-centre/press-releases/Documents/BDA-GDC-FOI-response-18-Mar-16.pdf
GDC response to BDA FOI request

 

http://www.gdc-uk.org/Newsandpublications/Pressreleases/Pages/Bill-Moyes'-Blog;-Learning-the-lessons-of-the-past.aspx
Bill Moyes' Blog; Learning the lessons of the past

 

http://www.gdc-uk.org/Aboutus/Thecouncil/Council%20meeting%20documents%202016/20160303%2005%20-%20PSA%20Investigation%20Report.pdf
GDC Council Meeting 3rd March 2016 Discussion about the PSA

https://www.professionalstandards.org.uk/docs/default-source/psa-library/investigation-report---general-dental-council.pdf?sfvrsn=6
A report on the investigation into the General Dental Council’s handling of a whistleblower’s disclosure about the Investigating Committee
21 December 2015

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Danger - Dentures About by @DentistGoneBadd

Danger - Dentures About

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Dentists Beware - Legal Changes Afoot!

Dentists Beware - Legal Changes Afoot!

Spring is finally here, but with it comes the first wave of new UK legislation for 2016.

So what key changes do you and your practice need to be aware of?

National Living Wage. From 1st April 2016 any worker who is 25 years old or above will be entitled to the National Living Wage, which is initially set at £7.20 per hour. The National Minimum Wage will continue to apply to workers under the age of 25. In addition, the penalty for employers who fail to pay the minimum amounts to workers has doubled from 100% of the underpayment to 200%. This, along with the introduction of Pension Auto Enrolment (which for many practices is due to take effect this year), will mean further increases in the cost of running your business. There is therefore little comfort in the 1% pay rise announced by the DDRB (for more on this see below).

Apprenticeships. As part of the Government’s drive to create more apprenticeships for young people, they have abolished the requirement on employers to pay NIC for apprentices under 25. This comes into effect from 6th April 2016. In addition, although not yet in force, the Government wants to ban organisations from using the term ‘apprenticeship’ unless it is a statutory apprenticeship. In order to be a statutory apprenticeship, there are certain legal requirements that must be met.

Zero Hour Contracts. It is unlikely that these contracts are common within in the dental community. However, if you do employ staff on a zero hours contract, for example bank nurses, if those contracts contain an exclusivity clause, stating the employee can only work for you, the employee can now seek redress against unfair dismissal and detrimental treatment following a breach of such a clause. 

Hazadous Waste. From 1st April 2016 dentists in England, who produce or store waste of 500kg or more per year, will no longer have to register with the Environment Agency. Dentists in Wales still need to register with Natural Resources Wales. This will mean slighlty less adminsitrative paperwork for dentists in England. 

Immigration. From April 2016 tier 2 skilled workers from outside the EU who have been in the UK for 5 years or more must be earning £35,000 or above to remain in the UK. This will not affect workers on the Shortage Occupation List, such as nurses, but could affect teachers and IT workers. 

Pension. From April 2016 there will be a new flat rate pension; as opposed to the lower basic rate pension and secondary and additional payments. 

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In a Parallel Universe - - - SpeedyGrins

In a Parallel Universe  - - - SpeedyGrins

In a parallel universe….

We have recently learnt of a new entry into the burgeoning short term orthodontic market in the UK. Due to launch on the 1st April 2016, this news comes as a GDPUK exclusive.

Speedy Grins is a system designed to fit as seamlessly in to a practitioners armoury in the same way as 12lb lump hammer would in a florists. Based on a revolutionary bracket design, where the individual brackets are made from papier mache and dissolve after 3 months whether the teeth are straight or not, the system is backed by 12 hours of extensive research from the Baywatch University Lifelong Learning Self Help Institute of Technology. The unique selling point is that it is the first system to guarantee no extractions will ever be needed for treatment to work. As a result they claim this will make GDP’s ‘experience the same joy as orthodontists do at never having to take out teeth anymore’.

There is a sister product called Slanted Smile which is exactly the same as Speedy Grins, and only comes into being at the end of treatment when the analysis of the smile is done; if the teeth are straight then the patient had the Speedy Grin treatment, and if the teeth still look they were thrown at the face and stayed where they landed then the patient bought the Slanted Smile Product. The company claim this is the first example of a “Patient Responsive’ system. Dentists upload a drawing of the patients teeth, and using their patented treatment planning system called the ‘Central Responsive Analysis Program’ which is designed to give the patient an indication of what someone else’s teeth would look like in their mouth, a treatment plan is formulated by the company, and then the components are sent back for fitting. The company obviously take full responsibility for the treatment planning result, making this ideal for the beginner to ‘orthomadontification’, as the company have called the technique.

The company is headed up by entrepreneur Rolf Pialo who realized there currently aren’t quite enough orthodontists angry with GDP’s at the moment and he saw a hole in the market which he swiftly stepped in to fill. Claiming the system will move teeth ‘faster than a speeding hedgehog’, the brackets come pre-glued with a revolutionary 76th generation cement which only has to be held next to the mouth for the bracket to automatically find and attach itself to the correct tooth. A bond strength ‘stronger than wet tissue’ is also claimed.

The training is a 22 minute FacetwitTube video which is presented by the celebrity dentist and system endorsee,  Dr Sean One-Dunnwan, who was recently voted the 945th most influential person in Ovine Dentistry in the Falkland Islands after qualifying last week. Apparently there are only 11,782 places left on the next course so people need to hurry before it sells out completely. In an exclusive interview recorded from behind the wheel of his new rented 701 ½ bhp Porshabentlighini, the celebrity toothsmith explained why he got involved with the new system. “It’s basically the best thing since the last best thing before the previous best thing I was involved with so that’s good enough for me.” Unfortunately he had to cut the interview short as his tea was ready according to his mum.

There has been some controversy (as there always is when these new systems come out) that this will affect the business models of the specialist orthodontists, but the company behind Speedy Grins are adamant that given their experience in the Oral Surgery Sector with their MegaSupaImplant system and the huge increase in workload for Oral Surgeons now taking out simple retained roots and mobile teeth so the delegates on their Advanced Implant technique 1hr course can start placing their products means that the Orthodontists should have nothing to worry about. So much so that they have also added a free refresher course to their portfolio to enable orthodontists to fill the gaps in their books with premolar extractions instead.

As part of the package, delegates will also get free marketing materials endorsed by Marketing ‘Guru’ and failed Seal trainer Billy Bull consisting of a badger suit, 3 stuffed gerbils, a tin of lilac paint and a pink biro. There is also a version with a costume of a Parus Major as well for those who want to make a great tit of themselves.

The system is already accredited by a new regulatory body, the General Expert Specialist & Technical Amalgamated Professional Organisation who have already started recruiting case handlers from Costa and Starbucks in anticipation of the increase in patient complaints arising from the use of such an advanced system. We understand they think the patient is unlikely to be able to consent to the treatment without a 17 year cooling off period and explanation of the procedure in Andalusian interpretive mime with Gaelic Subtitles. Work is well underway to ensure the ‘Organisation’ meet their new targets. As a result, their new gallows facility will be constructed from a variety of materials, including the finest aged mahogany and oak (although pine would have been sufficient). There will also be one made from Meccano for the implantologists so they feel at home before their final drop. Any registrant caught gaming will be hung in the same way as anyone else, but they will now have to pay for their own rope as that is only available privately. Their new Head of Corrective Discipline Mme Prila Olof was said to be most excited at the news of the Speedy Grins announcement as there were still some registrants who had not been ‘disciplined’ yet and she was described as being ‘positively moist’ at the thought of more business for the ‘Organisation’.

The announcement has also been broadly welcomed by a new professional association for dentists, the Association Somehow Leading Everyone Everywhere Professionally, the spokesperson for which was quoted as saying ‘Baaaaaaaa’ and making a sound like a wet fart in a colander before flouncing off in a puff of talcum powder.

All persons depicted in this article are entirely the product of the author’s imagination and bear no resemblance to any person living or dead. Any similarities are therefore entirely coincidental. Any organisation or company is also entirely the product of fiction and again is not intended to represent any current or past organisation or business. Any similarities are entirely coincidental. This article is for the reader’s entertainment and is not intended to be representative of any situation real or otherwise in any way shape or form.

[This blog was first published on the morning of 1st April 2016]
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Paul Isaacs

Speedy Grins

Even for April 1st, it was all very credible, until I read the disclaimer at the end. "Any similarities..." , well that bit is cl... Read More
Friday, 01 April 2016 19:58
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Dental Innovations

Dental Innovations that didn't quite make it

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Sugar Tax

Sugar tax

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Anthony Kilcoyne

Sugar Tax + work in progress.....

Yes it was disappointing that Teeth weren't mentioned as a health/prevention benefit too. It's time to put the Mouth back in the ... Read More
Thursday, 24 March 2016 00:40
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Fight or Flight

Fight or Flight

We all know what fight or flight means. We all know the situations where you feel the rush of tension before you panic and go one way or the other.

The third response, freeze, is often overlooked. But freeze is exactly what I did, day in, day out, for years.

I froze. Standing, at the counter in my local big name coffee shop, for what felt like an hour. In reality it was only a second. What had caused this rush of fright?

The barista repeated. “Do you have a busy day?”.

That was it.

This wasn’t in my mentally rehearsed plan. I was ordering a cappuccino, the same as I did every Thursday in the morning, part of my weekly coping strategy. Going out of the house, doing SOMETHING, was better than sitting at home, waiting for the afternoon shift to start. I had become accustomed to going to the coffee shop, ordering the same thing every week, and gradually became more and more comfortable with my surroundings. And then this happened. I couldn’t go back. Well, at least not for a long time. I was comfortable, and she had ruined it by asking a straightforward question that any reasonable person would have answered without hesitation.

Social anxiety is a problem I’ve had since I was 8. I don’t remember exactly how it happened, but I was never really comfortable around people. Having someone who was obviously uncomfortable around other children drew the bullies out like flies to a turd. So I was a very obvious target of bullying. I froze, all the time. I couldn’t do anything. It got worse and worse, every time I was asked anything by an authority figure, I ground to a mental halt, unable to answer and unable to move. Rabbit in the headlights.

I was pushed into social events by my parents, who were clearly at their wits end and thought that forcing me to go to interact with other people would help. It didn’t. It made things worse.

As a teenager I got great solace in music. The louder the better. By putting earphones in, I could block out the cacophony of the outside world, and if anybody tried to talk to me, the brief time it took to take the earphones out gave me a fraction of a second to steady my nerves.

And then I discovered alcohol. I went to university, unable to feel comfortable when surrounded by anybody, and I found that at first beer took the edge off, then it became whisky. At the same time, I started smoking cannabis. Cannabis was wonderful. My anxiety was gone, I could be much more “myself” and it even allowed me to sit in a room and have no nerves at all.

But illicit drugs and alcohol soon took their toll and were starting to take over my life, as I descended down the path of alcoholism, and being so anxious of normal life that I couldn’t function without the instant and total relief brought on by cannabis.

I decided to stop everything. I stopped drinking, I stopped smoking cannabis. I was left (briefly) with the one drug that provided any form of relief, nicotine, although I stopped that fairly soon after.

Meeting new people was always very tough after that. It went back to how it was when I had been at school. I completely froze. When you freeze and struggle with conversation, people make all kinds of assumptions, with the stories sometimes making their way back to me through friends. If only they had known the truth, I don’t think people would have been so judgemental. The worst experiences were when people talked ABOUT me, to a third party, when I was right in front of them, on one occasion telling the third party that I was “the weirdest person I’ve ever met”, and the other, that I had “zero personality”. That was a trigger for a complete meltdown, and when it happened I struggled to leave my flat for a couple of weeks afterwards on each occasion.

And so on to the world of work. Eye contact became increasingly difficult. I somehow managed to develop a different persona for dealing with patients, and could blag my way through. I was able to talk to patients with comparative ease, but I always kept it very informal. Staff, however, were almost impossible to deal with. The more people tried to assert themselves as an “authority figure”, the worse it became. I once again got labelled as “weird”, got left out of social events, and then told that I made no effort to socialise. I do wonder if they knew how much effort it was to smile and say “Hi” to somebody in the morning, whether the same judgement would be made.

I recently decided to get treatment for this as I was incapable of living a normal life. It’s a lonely existence, plodding through life without any real social interaction. Social media has equally helped and hindered me at the same time, in that while providing an outlet for at least some socialising, it has also acted as a crutch, and got in the way of normal social interaction.

I had 8 sessions with a psychotherapist to try to overcome the social anxiety, and while progress is slow, the realisation that nobody looks or cares about me or what I say, was actually a huge relief. My GMP prescribed some antidepressants that unfortunately made my anxiety worse. However, after nearly a year of pushing myself into more and more uncomfortable situations, I’m much better. I can finally look somebody in the eye, and I don’t freeze when the conversation goes “off script”. I don’t take any medicines and I am no longer receiving any psychotherapy.

 

My only regret is that I hadn’t been able to access the treatment earlier. 

 

Image credit -PracticalCures under CC licence - not modified.

 

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Anthony Kilcoyne

Anxiety syndrome?

A very insightful and informative blog. We are too quick to judge others sometimes, yet too slow to consider and appreciate how o... Read More
Wednesday, 23 March 2016 23:08
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Tooth decay in children – why don’t parents care?

Tooth decay in children – why don’t parents care?

Walk down any high street and you’ll likely witness a cornucopia of contrasts and contradictions. Overweight people, painfully thin people. Healthy looking pensioners, teenagers who couldn’t run for a bus. Naturally wrinkly old people, unnaturally smooth-skinned middle-aged people. Adults with bright shining teeth, children with a mouth full of decay.

It’s deeply ironic that in an age when many of us could live to a 100 and all but the most serious diseases can be treated, some people are clearly missing out. As a mother of two and former practice manager it particularly disturbs me to see children with bad teeth. The numbers are staggering. According to the Health & Social Care Information Centre recent report NHS Outcomes Framework for England, tooth extractions due to decay in children admitted as inpatients to hospital, aged 10 years and under were at the rate of 462.2 per 100,000 population in 2014/15. That’s about one in every 216 children.

That’s an average for England, in Yorkshire and The Humber the figure was about one in every 112. The report also showed that: ‘Nationally, there is a strong correlation between area deprivation and the rate of tooth extraction. As deprivation increases so does the rate of tooth extraction. The rate of tooth extraction in the most deprived decile is almost 5 times that in the least deprived decile (808.7 compared to 167.5 per 100,000 population).’

 

What does Google say?

To attempt to answer the question posed in the title of this blog I decided to post it into Google. The result was many references to information on children’s oral health and an article in the Daily Mail with the headline: ‘The lazy middle-class parents who don’t teach children to brush their teeth: By a teacher who’s seen the horrific consequences’.

The article claimed that parents were too busy to show the children how to brush their teeth and when the teacher opened a pack of tiny toothbrushes and tubes of toothpaste in her class of four-year-olds ‘the children were saucer-eyed with curiosity.’

An article on parents.com claims: ‘Many parents are surprised to learn that kids need help brushing their teeth until at least age 6. Young children simply don't have the manual dexterity to do the job well.’

In October 2014, in guidance aimed at local authorities, NICE said: “Schools and nurseries should run tooth brushing schemes to help standardise the oral health of younger children.”

In an article about this guidance in The Telegraph, Joyce Robins from Patient Concern was quoted as saying: “Nice has often been accused of pushing nanny state measures but this is more like a ‘supernanny state’.

“What will they suggest next, that parents can drop their children off at school naked and unwashed, and leave the state to step in and do the rest?”

Oh dear.

 

There is an answer

So if parents are too lazy, too ignorant, too impoverished, living in area of deprivation or are combination of some of these factors, what is to be done? The answer comes from the USA. Tegwyn H Brickhouse D.D.S., Ph.D. Department chair, research director and associate professor in Pediatric Dentistry at the Virginia Commonwealth University was the lead author of a paper presented to the IADR/AADR/CADR conference in March 2013. In it she wrote about a study into a scheme to decrease the number of low-income children in the Roanoke Valley with long term dental disease. The Child Health Investment Partnership of Roanoke Valley (CHIP) provides in-home preventive oral health services designated as the Begin with a Grin Program. The paper states: ‘In the context of a home visit, Community Health Nurses (CHNs) and Pediatric Nurse Practitioner (PNP) apply fluoride dental varnish (FV) to the teeth of CHIP-enrolled children from tooth eruption to 36 months. They educate the caregiver in preventing tooth decay and the importance of a dental home.’

The study found that: ‘Two applications of FV to the child’s teeth significantly reduced the likelihood of having any decay.’ The conclusions were: ‘Home visiting programs such as CHIP’s Begin with a Grin serves as a model to improve the oral health of high-risk children. The CHIP program provides an innovative solution for providing oral health care to the nation’s medically underserved populations.’

NHS Choices states: ‘From the age of three, children should be offered fluoride varnish application at least twice a year. Younger children may also be offered this treatment if your dentist thinks they need it.’

That presupposes a parent takes their child to a dentist. The CHIP Begin with a Grin programme avoids that requirement. However, dental practices would need to be informed when children are born in their area.

Is this something the GDC and NMC (Nursing & Midwifery Council) should be liaising about? Another question seeking an answer…

 

 

Image credit -Tiffany Terry under CC licence - not modified.

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CDO - Decision Time?

CDO - Decision Time?

In my last blog, I noted a developing Critical Mass for change in how we address infant caries and its consequences. And barely a month later, the steam pressure has been increased once again.

The Chief Dental Officer Dr Sarah Hurley, is starting to make public inroads into her role, and recently delivered the 2016 Pendlebury Lecture. It was in stark contrast to the one delivered in 2014, demonstrating a wide understanding of the playing field that is dental health.

 

Critical Mass 2

 

It comes at the end of a week in which the state of children’s teeth once again was publicly pilloried, on the back of the General Anaesthetic numbers.

While it remains a problem in England, just look at Scotland. After many decades when Scotland has been spiritual home of the UKs dental problems, it suddenly produces numbers through its Child Smile initiative that suggests significant inroads are being made to improve the health of children’s teeth and prevent dental caries [and thereby reduce the costs and morbidity of unrestricted dental breakdown]. It is not really rocket science, they have just been investing in infant dental health.

So we in England [and Wales and Northern Ireland to a similar extent, but out with the CDO[NHSE]’s remit] have a problem.

We know the target population for any changes must now be parents and infants in equal measure.  There seems to be ample evidence that parking the dental professionals in discrete buildings, called Dental Surgeries, is simply not working, and it is evidence that Dr Hurley seeks.

We know that the medical stakeholders are now on board, as obesity and diabetes rear their heads with all the long term cost implications. Indeed it is the medical drive for a sugar tax to discourage the dietary shortcomings that is also driving the publicity that emerged in the Daily Telegraph over the weekend of the 26th February, and was subsequently widely discussed on broadcast and printed media.

 

Follow the money

 

So increasingly the priority is being defined. But the thorny issue will arise of funding.

Which Departments will pay?   How will we [the public] pay for the inevitable targeted measures that are due to follow, as day follows night?  A sugar tax undoubtedly could easily raise the funds but the political will in the chaos pre-Referendum is clearly not there.

There is a serious danger in the current fiscal period of restraint that the HM Treasury will insist on a cost neutral option.  Maybe not, but we must for now assume that.

Could it be that the GDP Budget is being eyeballed [at £3.4Bn] as the low hanging fruit of funding that could or perhaps should be used to address the issue of infant dental health?

The Chief Dental Officer is clearly leading dental health to a better place – but who will pay for this Piper’s plans?

The role must soon change it seems to that of Chief Decision Officer.  

Interesting times, but the sooner we address the issue of Dental Health for the young child, the sooner we can restore some pride to our profession.
 

As a GDP you would do well to plan for big changes. Not sure what but for sure very significant.
 

Have great Easter, assuming the snow has eased back!

 

 

 

2016 letter to Telegraph http://www.telegraph.co.uk/comment/letters/12077501/Letter-The-NHS-dental-health-system-is-unfit-for-purpose.html

Dentistry response http://www.dentistry.co.uk/2016/01/11/nhs-dentistry-letter-published-in-the-telegraph-unhelpful/

Feb 26 article DTel  http://www.telegraph.co.uk/news/health/news/12174796/Thousands-of-children-have-decayed-teeth-out-in-hospital.html

BDAs Press release  https://www.bda.org/news-centre/press-releases/tooth-decay-stats-should-offer-wake-up-call-on-prevention

GDPUK News https://www.gdpuk.com/news/latest-news/2151-gas-for-dental-extractions-in-children-on-increase

GDPUK CDOs response https://www.gdpuk.com/news/latest-news/2152-strong-response-to-child-ga-figures

GDPUK Scan of other media [Dr Tony Kilcoyne]  https://www.gdpuk.com/forum/gdpuk-forum/telegraph-third-world-dentistry-crisis-in-engand-21379?start=130#p239340

Scottish example  http://www.child-smile.org.uk/professionals/childsmile-core/toothbrushing-programme-national-standards.aspx

·         Since 2011, all elements have been delivered in all Health Board areas throughout Scotland.

·         "As a result of our efforts, dental health in Scotland is improving, particularly in deprived communities. In the Primary 7 age group dental health has never been better and on a Scotland level the target of 60 per cent of this age group having no obvious decay has been met. This is a fantastic success story."

Summary of 2016 Pendlebury lecture http://www.fgdp.org.uk/content/news/synopsis-of-the-2016-malcolm-pendlebury-memorial-l.ashx

 

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Recent comment in this post
Anthony Kilcoyne

Child Dental Health tragedy = ...

Great Blog and it just goes to show SUSTAINED public exposure and pressure, has helped HMG in the latest March Budget go from 'No ... Read More
Sunday, 20 March 2016 13:12
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Three Years of Exceptional Growth

Three Years of Exceptional Growth

 

As an online publisher we like to keep an eye on the stats on the site, how the banner ads are performing and also hope to increase the number of visitors and users of the site.

We publish a number of news and blog pieces a week, which all help to bring a steady stream of the target audience to our website.

The daily email digests, which get sent three times a day also keep our members engaged with what is happening on the forum and ensures the community spirit is maintained.

Since our mailing list was turned into a website and forum in 2008, we have seen the site evolve and grow. In early Jan we went past 20,000 threads created since mid-2008. Screenshot below of the most recent threads created and forum posts received.

 

 

The 20247 topics have received 229387 replies, which is around 11 replies to each topic, an amazing amount of input from the members of the site.

Below we can also see the amazing growth of the site in numbers since 2013, by using the month of February as a comparison, the growth in unique visitors and total visits made in each month demonstrates the popularity of the community.

 

 

February

Unique visitors

Total visits made in month

2013

17409

60418

2014

25477

81513

2015

30287

110502

2016

38038

132966

 

As the site continues to grow year on year we have now also moved the serving of our banner ads to Google Doubleclick for Advertisers which we have found improves the serving of the banners and isn’t as susceptible to click fraud as other software. It has a number of advantages, with the main one being that an advertiser can book a certain space for a month and then advertise more than one thing in that space, with each banner getting an equal share of the impressions. Useful for a dental business that wants to advertise a new product as well as an existing service. You can promote both!

There are many ways we can work together to use differing formats for banners, HTML 5, video ads, and we have space ready for a new size banner, the Super Leaderboard.

Advertising is also available on our email daily digests which is sent three times a day to thousands of dentists, who have voluntarily subscribed to the list and use the digests to look at the latest news and forum posts on the forum.

For further information about GDPUK and what we can offer companies looking to reach dentists, please This email address is being protected from spambots. You need JavaScript enabled to view it. or give Jonny a call on 07786571547.

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Advertise your Course or Conference on GDPUK.com

Advertise your Course or Conference on GDPUK.com

 

Thanks for clicking through to find out more about advertising your course, conference or website on GDPUK.com.

 

Get noticed by the thousands of Dentists on GDPUK every month.

 

Below we have put some excellent pricing for advertising on the site from April 16 onwards. We believe the site is an exceptional place to attract dentists who are interested in learning on your course or conference in 2016.

 

Advertise your course one month at a time, improved pricing offered for 2 or more months booked. Please get in touch for more information.

 

All advertising includes 2 PR pieces per month published on the site, which we share on social media to our 5,000 + followers.

 

Advertising Options start from £250+vat for the month

 

All banners appear in rotation with other banner ads throughout the month you book.

 

Email banner - appears on our daily digest emails - 468x60px

Usual Price …. £395 + vat  …….Special offer - £250 + vat

 

Forum banner Spot 2 - appears on forum pages on left hand side of page - approx 30,000 impressions per month - 300x250px

Usual Price - £475 + vat ……. Special offer - £325 + vat

 

Forum banner Spot 1 - appears on forum pages on left hand side of page, above Spot 2 - approx 30,000 impressions per month - 300x250px

Usual Price - £550 + vat ……. Special offer - £395 + vat

 

Leaderboard Banner - available from May onwards, appears on all pages of the site at the top, 728x90px

Usual Price - £950 + vat ……. Special offer - £750 + vat

 

This email address is being protected from spambots. You need JavaScript enabled to view it. to book your space on the site and

get your course advertised in front of your target audience.

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Dental Stuff of the past

Dental Stuff

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8 amazing reasons that you should embrace Digital: The benefits of digital over traditional print media.

8 amazing reasons that you should embrace Digital: The benefits of digital over traditional print media.

 

Trade media has been slow to embrace digital but below you will find 8 compelling reasons why now is the time to embrace digital media. The way we all use and share content has totally changed, with the large majority of people under 40, using only digital mediums when looking for news, information or opinion. Dental publishing is no different.

 

This change is now picking up speed, with the number of dentists reading and joining GDPUK growing all the time. The start of 2016 saw the site go over 20,000 threads created on the forum, which has produced an impressive library of content and knowledge. As dentists spend the majority of their time online, the companies looking to reach dentists will also do so.

Below are our 8 reasons that you should start embracing digital media.

 

  1. Lead generation / Data

For years advertising in magazines has been based on brand recognition but now with digital you can gather data from who visits your site, or who is interested in your product. The opportunities are endless. We are currently helping with a product trial in conjunction with a leading dental manufacturer who are offering products to our users on a trial basis, in return for feedback on the product. 10 dental practices were successful with their application and have now received the product. By encouraging engagement with our community, the manufacturer is also gathering data and generating potential leads as well as increasing brand awareness.

 

  1. Back Catalogue

Online publishers are constantly publishing content, whether it's blogs, daily news or the 20,000 + threads created by our community. A monthly or weekly magazine, are very rarely stored by anyone for more than a few months and it’s not straightforward to search for a particular article or opinion piece. All our content can be found online.

 

  1. Gain extra exposure

With over 4000 visitors a day to the site, we have a large number of eyeballs looking at our content. Online publishers receive a large number of readers on a daily basis, some of our news articles will receive thousands of views in a week. Instead of a banner being seen once, your ad will get seen numerous times in a month by one user!

 

  1. Visit an exhibition every day of the week!

In the dental industry there are a number of events cropping up on a weekly basis which unfortunately crowd the market for the established shows. Sites like our own often have thousands of visitors a day which is like an exhibition every day of the week, so the value of advertising when compared to exhibiting is exceptional because you are getting thousands of eyeballs on your product or service a day.

 

  1. Measure what works

The ability to be able to measure how many impressions your ad has received or which content is engaging users is an incredible advantage. Digital methods provide real-time results.

 

  1. Experiment with content - Flexibility

Another amazing advantage of digital is the ability to experiment with your ad or content. With our software you can even run more than one ad at a time and advertise two products or services at once. Ads can be tweaked or amended at any time giving tremendous flexibility. Make changes quickly based on real-time metrics and performance. There is no need to wait 12 months to identify what is and what is not working.

 

  1. Community

With a digital community content can be shared instantly. Obviously not everything is going to go viral but when your marketing efforts get shared, it is a great way of increasing engagement and exposure.

 

  1. Control your Sales Funnel

With a well functioning landing page you have extra control in your customer's journey. When an ad appears in a magazine you hope they remember the brand or remember to call you, but with a well designed landing page, you can capture information in a much quicker and less random manner. I have written previously on the importance of a good landing page, read more here.

Thanks for reading, get in This email address is being protected from spambots. You need JavaScript enabled to view it. for further information about GDPUK.com.

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Spot the Talent in the Dental Team

Dental Staff

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Ascent of Dentistry

The Ascent of Dentistry

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Pressure - what pressure?

Pressure - what pressure?

The news that the BDA is putting together a Research Project Advisory Group supporting research into the mental health and wellbeing of UK dentists might be greeted with suspicion in some quarters. Not in this one, anything that can look seriously at the causes of frustration, despair and burnout in dentistry must be supported.

Several years ago my accountant, who was married to a dentist’s daughter and had a dozen or so dental clients said to me, “I don’t know how you guys do it. If I have a problem I can close the file, go for a walk round the block and come back to it later in the day. Or I can go down the corridor and talk it through with someone. If you have one it’s right in front of you, living, breathing and, possibly, bleeding. You’ve probably got two more sitting waiting outside as well.”

I remember spending ages formulating this statement when I wrote my first report for a client:

“I need to make a couple of points about Dental Practice ownership. Firstly it can be a solitary place; being a medical professional has pressures upon it, having to make immediate decisions with patients that are awake and where you have a finite time to complete procedures produces even more pressure. Being the owner and main producer of a small business is lonely too.

Next; dentists, in common with a lot of “solopreneurs”, are notoriously poor leaders; they have problems separating management from leadership. They have difficulty in keeping themselves in a position where they are able to make decisions about their businesses in a dispassionate way.”

Mike Wise had taught me that it was OK to repeat the same stock phrases in different treatment plans so, as this applied to most of the reports, I have written it again and again. Firstly composed nearly a decade ago, the pressures have not diminished, indeed quite the opposite.

I accept that many of those obligations are by no means unique to dentistry, everyone who makes a living has to do it in a finite time to turn a profit. Even the biggest movie star, musician or sportsman has deadlines to hit. We all have to please someone at sometime. Human nature says you are a special case and begrudge anyone else’s right to be treated as such.

Dentistry is unique. Of course, in some ways, the business model may be similar to others. The need for systems, HR, financial controls, time management and dedication can be found in many other walks of life.

There’s one big exception. Dental clinicians have the use of sharp instruments with the potential to cause pain and inflict lasting damage. This carries a huge responsibility. It’s this last point, a major cause of stress, that the bean counters don’t grasp - and how could they? You have to be there to know that peculiar feeling of dread before exploring a hot pulp, the uncertainty of trying a perfect veneer or the sinking despair of fracturing a root in a phobic patient with limited opening.

Too many dentists don’t share their experiences, their uncertainties and concerns. Across the country attendances at many courses and BDA section meetings are down. One reason for this is the intrusion of “higher powers” to make CPD yet another exercise in box ticking of having turned up and fed the time in the approved core subjects. By extension, non-core subjects are seen to be less important.

Another reason is the courses, lectures and seminars are accessible on-line so that you can be solitary and get information at a time that suits you.

Often dentists view each other as competitors and are suspicious of others’ motives. I was recently given two separate opinions, “there’s no point in going to our local meetings because they are dominated by 1) the willie-waving early adopters who boast and lie about what they are doing and earning or 2) the patched elbow brigade who only moan about the CQC, GDC, BDA and are hanging on for their pensions.” Take your choice.

What is missed is the sharing of experiences, of being part of a community with mutual support. There’s nothing better than finding out that someone has had an even worse day than you.

Without that where does the frustration go? A fast drive home? Difficult on this crowded island. A fast cycle home? Good. Via the gym? Now you’re talking. What is all too frequent is a stop at the off licence and an evening shared between TV, laptop, iPad, smart phone and paperwork. Or goodnights made to children on the phone after your last patient and before you get on with the next bout of compliance.

Some people grow an outer skin so that the day to day doesn’t get to them, but in many this carapace resists any change and when it finally cracks the result can be catastrophic. The consequences of the pressure are physical and mental ill health, and a poorer quality of life than might have expected. So perhaps those expectations should be tempered or better still there should be training in how to handle the pressures. That has to start at undergraduate level.

Resilience is a word that is often bandied about but not properly understood, applied or taught and I’ll continue with it next month.

 

Image credit - Kevin Dooley under CC licence - not modified.

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Can a bit of stress be healthy?

Can a bit of stress be healthy?

My previous post about stress was posted here on 28 January. This time, I’m attacking (more accurately, sneaking up on) stress from a different angle. And I’m starting by going back in time. Way, way back to pre-CQC. It seems prehistoric man suffered stress, would you believe? And guess what – we know it from their teeth! In 2010, George Armelagos, an anthropologist from Emory University in the USA, discovered enamel defects in teeth dating back one million years indicating that, ‘During prehistory, the stresses of infectious disease, poor nutrition and psychological trauma were likely extreme.’ This stress reduced life expectancy – remains from Dickson Mounds, Illinois, showed that individuals with teeth marked by early life stress lived 15.4 years less than those without the defects.

So is stress bad then?

Not necessarily; read on. According to the Mental Health Foundation: ‘Some stress can be positive. Research shows that a moderate level of stress makes us perform better. It also makes us more alert and can help us perform better in situations such as job interviews or public speaking. Stressful situations can also be exhilarating and some people actually thrive on the excitement that comes with dangerous sports or other high-risk activities.’ The Foundation does point out that stress is only healthy if it is short-lived.

Stress causes a surge of hormones to better help you deal with ‘fight or flight’ situations. According to NHS Choices: ‘Once the pressure or threat has passed, your stress hormone levels will usually return to normal. However, if you're constantly under stress, these hormones will remain in your body, leading to the symptoms of stress.’

How much stress is normal?

Now we come to the science – specifically the Depression, Anxiety and Stress Scale (DASS). This is a self-report questionnaire whereby you answer questions, add up the score and convert these to severity ratings for depression, anxiety and stress. There are two versions – DASS and DASS 21. The former has 42 questions, the latter 21 (so you multiply the scores by two). Ignoring depression and anxiety for the purposes of this article, the severity scores for stress are:

·        Normal 0-14

·        Mild 15-18

·        Moderate 19-25

·        Severe 26-33

·        Extremely severe 34+

DASS is not a diagnostic tool. If you are feeling anxious, depressed or stressed, you should see your GP – even if you get low DASS scores. However, if you wish to get some idea of how stressed you are and so gauge whether it could be considered healthy, go to https://www.cesphn.org.au/images/mental_health/Frequently_Used/Outcome_Tools/Dass21.pdf for DASS 21 (remember to double your scores for the full DASS severity ratings.

No added stress

In my previous post, I urged you to stop putting stress on others – particularly colleagues and staff in your practice. Now we see that some stress is normal and may well be beneficial. So does that contradict what I wrote before? Not at all. Yes, some stress is normal and healthy but so very few of us lead completely stress-free lives that we need added stress at work. Relationships, health, family obligations, household maintenance, cars, money worries all cause stress. Many of us are also good at getting stressed about things that haven’t even happened yet! So who are you to add to the stress of your colleagues or staff and maybe move them from normal to mild, moderate or severe on DASS?

Stress as a management tool?

Excuse me? Think twice (or more) before you decided to ‘push’ members of your team to make a greater effort. It is far more effective to motivate people to work more effectively or efficiently. People work best through their lunch hour when they don’t hold a grudge at you demanding it but because they genuinely want to get the patient records up to date.

As a manager you should be familiar with the theory of psychological type as introduced by Jung and the Myers-Briggs Type Indicator – so you know how to get the best out of each member of your staff.

This is a topic covered on my courses – come and find out.

 

Image credit -Bottled_Void under CC licence - not modified.

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Capacity; Your Duties as a Healthcare Professional

Capacity; Your Duties as a Healthcare Professional

Capacity

In our last blog we considered the importance of patient consent. One of the key elements of valid consent is the patient’s capacity to give that consent and the Mental Health Act 2005, which came into force in October 2007, deals with all issues surrounding mental capacity.

First and foremost the Act imposes a duty on all healthcare professionals to have regard to the Mental Capacity Code of Conduct. It is therefore important to read and understand this document when considering whether a patient has capacity to provide consent.

Capacity  
 
A person lacks capacity if:

  1. They have an impairment or disturbance (for example a disability, condition or trauma or the effect of drugs or alcohol) that affects the way their mind or brain works; and
  2. That impairment or disturbance means that they are unable to make a specific decision at the time it needs to be made.

It is very important to note that capacity is to be assessed at the time the specific decision is required. Therefore, a patient may have capacity to consent to some treatment but not to others, or may have capacity at some times but not others.

Under the Act you must assume the patient has capacity unless you can establish that they do not. And simply because a patient’s decision to refuse treatment is unreasonable does not mean they lack capacity.

Assisting Those Who May Lack Capacity

If you are unsure whether a patient does lack capacity, all practical and appropriate steps should be taken to assist the patient in making the decision before you determine they actually do lack capacity. This will mean changing the way you provide information to the patient; giving the patient all alternatives to treatment; considering whether there is a time in the day they have more understanding to make the decision.

Best Interests of the Patient

Under English Law no one is able to give consent to the examination or treatment of an adult who lacks the capacity to give consent, even parents, relatives and healthcare professionals. The exceptions to this are where there is a Lasting Power of Attorney or a court appointed deputy.

However, the Act protects healthcare professionals from civil and criminal legal liability if treatment is provided in the patient’s best interests. The Act states that you must take the following steps before acting in the patient's best interests:

  1. Consider whether the person is likely to regain capacity and if so whether the decision can wait:
  2. Involve the person as fully as possible in the decision that is being made on their behalf;
  3. As far as possible, consider:
  • the person’s past and present wishes and feelings (in particular if they have been written down).
  • any beliefs and values (eg religious, cultural or moral) that would be likely to influence the decision in question, and any other relevant factors.
  • the other factors that the person would be likely to consider if they were able to do so.

         4. As far as possible, consult other people if it is appropriate to do so and take into account their views as to what would be in the best                         interests of the person lacking capacity, especially:

  • anyone previously named by the person lacking capacity as someone to be consulted.
  • anyone engaging in caring for or interested in the person’s welfare.
  • any attorney appointed under a Lasting Power of Attorney.
  • any deputy appointed by the Court of Protection to make decisions for the person.

      5. For decisions about serious medical treatment, where there is no one appropriate other than paid staff, healthcare professionals have to              instruct an Independent Mental Capacity Adviser

      6. If the decision concerns the provision or withdrawal of life-sustaining treatment, the person making the best interests decision must not be            motivated by a desire to bring about the person’s death.

Assessing whether a patient has capacity will be a balancing act. You will also need to bear in mind your duties to treat patients with dignity. This may therefore lead to difficult situations; remember to take notes of any decisions made as this will later assist if any queries are raised.   

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I Spy a Dentist

Types of Dentist

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Have you embraced Native Advertising?

Have you embraced Native Advertising?

 

So what is Native Advertising?

Native advertising is a type of advertising, primarily found online, that matches the form and function of the platform upon which it appears. Most of the time is is produced as an article or a video, created  by an advertiser with the specific intent to promote a product, while matching the form and style which would otherwise be seen in the work of the platform's editorial staff.

Native advertising is the next stage of content marketing. It is a great way to promote the content that brands are creating and an innovative way to reach their target audience where they congregate but in a way that is not seen as being overly intrusive.

 

Why does Native Advertising work?

  • It works for businesses whether small or large in their market.

  • Brands always have content to share and native advertising provides them a way to do this, while also monitoring the results of what works and what doesn’t.

  • Native advertising works very well in a mobile format. Whether it's a text link, hosted editorial or promoted video, because native content sits in the main part of the site, it is often seen as the same as any other content viewed via mobile.

  • Leads to greater innovations, brands don’t have as many limitations as traditional advertising. Anything that is innovative and different is sure to attract your target audience.

  • Native ads work best when placed on social media platforms and news focused websites. Site like these (like gdpuk) are built around content, so exciting native ads will attract attention.

 

Where can we see examples of Native Advertising?

Below are a few examples of native advertising, I have found by utilising google. I have included examples from buzzfeed because it turns out a lot of their content is actually native advertising! From $4 million of revenue in 2011, they were expected to reach close to $100 million of revenue by the end of 2015, primarily from native advertising articles!

  1. Netflix on Wired.com - http://www.wired.com/partners/netflix/

  2. Nike on SB Nation - http://www.sbnation.com/sponsored/nike-pep-talks/

  3. Cancer Research UK on Buzzfeed - http://www.buzzfeed.com/cancerresearchuk/sunbathing-expectation-versus-reality#.vbGDX25oKe

  4. Spotify on Buzzfeed - http://www.buzzfeed.com/h2/osmo/spotify/bands-that-wouldnt-exist-without-led-zeppelin?b=1#.mc7Rp2zNQP

  5. Call of Duty on Buzzfeed - http://www.buzzfeed.com/callofduty/jokes-only-call-of-duty-fans-will-get?b=1#.ffoNOKPeoj

 

 

As we can see in the examples I have randomly chosen, brands have been thinking of some great ways to interact with consumers without appearing overly intrusive. What do you think? Do you spot native ads?

Can this form of advertising be applied to the dental market? GDPUK has recently launched an option available to all potential clients, to do product reviews which gets you interacting with the dental community and getting your brand sampled or tested by our users.

Native advertising could be implemented into GDPUK in a number of ways such as a news story, a regular blog or even a forum post that gets the users engaged. Please get in touch if you have any ideas or methods you would like to try. We are open to suggestions and want to help you get the best experience you can from GDPUK.

Look forward to hearing from you. Contact details below.

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Race to the bottom

Race to the bottom

Ever since humans started to trade with themselves there has always been the need for them to feel that have got a bargain in some way. It’s human nature to actually feel like you got something worth more for less than you needed or intended to pay, and as such that drives many businesses in a constant battle to attract customers by offering bargains.

There’s a simple explanation for value in any transaction.

  • If you pay a lot for something that’s poor quality it then it’s a rip off.
  • If you pay a lot for something that is high quality then that is acceptable (and even possibly exclusive)
  • If you get something that is poor quality for a low price then that’s called cheap.
  • If you get something that is high quality for a low price then that’s a bargain.

Everybody loves a bargain. That’s why sales are so popular all the time, trying to get people to spend money they don’t have on products they don’t need. You only have to look at Groupon and Wowcher to see the type of offers that are touted on there. This is not necessarily a problem in the consumer driven world that supermarkets and retail stores operate in, but caveat emptor is the mantra that we should all employ when looking at this type of trading. Its also the way that our Beloved Chairman would probably like to see in his Red Book of ‘How the Dental market should evolve’, at least according to his now infamous Pendlebury Lecture.

The problem with this of course is that there isn’t a particular need to have ethics in those kind of industries that can price cut and offer heavy loss leading deals in order to get people through the doors and then upsell. It also usually involves already cheap products, or those with artificially hiked prices then given a huge discount, to con the buying into thinking they are getting a bargain.  

The reason for this is if it appears too good to be true, then it probably is (for someone). There stories galore of businesses that have almost or actually imploded due to a demand that they didn’t foresee when offering a ‘too good to be true’ deal. One of the most famous was the Hoover free flights promotion in 1992. Due to a huge surplus of electrical products they needed to sell, they came up with the offer of 2 free round trip tickets to destinations such as America. Somehow they failed to realize that offering tickets that were worth well in excess of the product they were trying to sell (the qualifying purchase only needed to be over £100) would result in an overwhelming demand for their products and hence the tickets. The court cases took until 1998 to settle, and cost Hoover an estimated £50million pounds. It would probably have been less costly for Hoover to scrap the products they needed to sell rather than to retain their market share. They were big enough to survive, but not everyone would be so lucky in a similar situation.

So what has this got to do with dentistry? Well, there has been an increasing trend to offer these kind of deals to entice patients into practices which are probably too good to be true. It’s a matter of contention that this is how some mixed practices operate, by offering certain NHS items to patients and then upselling the options that ‘aren’t available’ on the NHS. Even after 10 years of the new contract I am still struggling to understand the concept of how offering an NHS exam but having to see the hygienist privately works within the contract, and no one at all has yet presented an argument to me that convinces me this isn’t just a form of upselling by getting the patient in on the pretext of NHS treatment and then providing a private upgrade. Whilst business survival is paramount in dentistry in the same way as any other business, some often seem to forget there is a higher ethical plane that dentistry must lie on when running our businesses.

People outside dentistry don’t often get this, and one of those appears to be Mr Moyes, but also there is an increasing amount of people within the profession itself who have, shall we say, ‘flexible’ ethics when it comes to the upselling game and marketing in general, and who seem to forget what it means to be part of a caring profession. Is it any wonder that some GDC cases have an accusation that the financial motivation of the registrant one of the reasons the case is being heard?

Marketing is vital to the survival of dental business, but not at the expense of our professionalism, which is inextricably linked to our ethical compass. Something those who sit on the outside of our profession seem to forget. With the increase in non-registrant owned corporate practices, we have some people who see dentistry as just another business and apply the same rules to it as would be more appropriate for a supermarket. They however don’t run the same risks as those who are regulated do. 

A recent example would be that of the clinics in Manchester and London offering deals on limited outcome orthodontics through Groupon. These clinics now appear to have gone to the wall leaving patients who have paid for treatment up front out of pocket and a significant number of them now facing the prospect of paying more for the completion of their treatment. What their perception of the profession will now be can only be guessed, but it isn’t likely to be good.

And then we wonder why as a profession we get bad press, and are labelled greedy dentists. Even the GDC have got something right recently in the warnings about the use of things like Groupon to promote dentistry. That does actually seem at odds with the beliefs of their consumer-rights driven Chairman. It will be interesting to see how this situation develops, since there is likely to be little or no regulatory comeback against the owner of these clinics, but the full weight of the GDC may be felt by the registrants who were involved with the treatment of those affected.

Selling a product for a price far less than it costs elsewhere will attract people who are after a bargain. Restored implants for £795? Orthodontics for £995? Is it all part of a mechanism to draw people in and then upsell using crass pseudo ‘ethical’ selling (that potentially doesn’t even meet with the requirements of Montgomery let alone those of the GDC) to actually get the purchaser to buy something that actually profitable rather than the offer? But this isn’t a pocket money purchase, and these patients are likely to be attracted by the ability to have something they thought they couldn’t afford. So the business model of upselling is not necessarily going to work, as these patients might not be able to afford a bigger investment. There is then an exceptionally fine line between your bargain purchase becoming a rip off because it doesn’t turn out to be what it was promised to be. Anecdotally, purchasers like these are often the ones who have no particular loyalty to a practice and are shopping on price alone. The same ones who are usually well aware of how to use social media to destroy a reputation, and then take further legal action….

It doesn’t matter that these people will now maybe only end up paying roughly the same as it would have cost to have the treatment provided by a different practitioner in the first place; they have been misled into thinking they could afford something that they wouldn’t normally be able to and their bargain has now become a rip-off. The point is these people have suffered at the hands of our profession and we will all pay the price for that eventually. The owner of the clinic involved appears not to be a registrant, and the business model used to draw people in means that both the clinic and Groupon are likely to have been paid up front which improves their cashflow. But surely the ethics of this type of business are not those of a caring professional? Pile ‘em high and sell them cheap whilst upselling to a customer might work in some industries, but dentistry has the subtle difference of being driven by a core ethical requirement to do the right thing FOR THE PATIENT. With the change in the rules that allowed the increase in corporate dentistry and non-registrant ownership that had been restricted since the 1920’s, one could argue that the good old days were actually better for both the patients and the profession. Were ethics and professionalism more in the forefront of the profession those days?

Whilst all this is an example of what has happened in a case where a non-registrant is involved, I think there are probably registrants who should be taking a long hard look at themselves, possibly both individually and as members of corporate organisations.

I’m afraid that I for once agree with the GDC over their warnings of involvement with this kind of marketing practice.

This is a race for the bottom financially, but more importantly ethically, that I for one am not going to compete in.

 

 

Image credit -Gordon Joly under CC licence

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You're not the boss of me!

You're not the boss of me!

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Critical Mass

Critical Mass

There is a concept in nuclear chemistry which many will be familiar with. Critical Mass has been adapted to apply almost any situation nowadays.   When a process of change is beginning, Critical Mass is used to refer to that point when change becomes inevitable.

What starts as a mood that change is needed becomes a minority activity with early adopters, eventually tipping over the edge for widespread general change for the better.

The bigger the system, the more one can see change with necessary Critical Mass at work on a daily basis

 

 

Early Years - has General Dental Practice failed?

 

Is “Early Years” dentistry about to undergo a change of massive significance? Is the state of children’s teeth [as it relates to caries and GA Admissions] about to trigger a political Critical Mass change

The problem of course is this:

£3billion of funding, give or take, by the Government, aims at funding dentists to sit there waiting for patients to wheel their little rug-rats in for a ‘check-up’.

Sadly, two facts suggest this time-honoured approach is a fail.

Firstly only 50% of the population actually go to the dentist, and that is without weighting the numbers towards any problems with new migrant or ethnic groups.

Secondly, by the time the child appears for their check-up age 3-4, the caries is already established, the dietary patterns are embedded and the Prevention horse has, by and large, well and truly bolted.

http://www.hscic.gov.uk/catalogue/PUB17794/prov-mont-hes-admi-outp-ae-April 2014 to March 2015-toi-rep.xlsx  is a spreadsheet of child hospital treatment number suggesting in England alone some 110000 admissions for dental caries at about £670 per admission .

My back-of-my-vape-packet estimate is that some £73Million is spent [in England alone] with hospitals sorting out the fact that community prevention of dental disease in children has failed.  The medics have now woken up to the fact that this same diet is leading to an epidemic of child obesity and diabetes.

 

This pressure for change, smouldering for some time,  arguably gathered pace with the excellent planning document, Delivering better oral health: an evidence-based toolkit for prevention at

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/367563/DBOHv32014OCTMainDocument_3.pdf

Then we have the January 2015 Faculty of Dental Surgery issuing this report:

The state of children’s oral health in England at

https://www.rcseng.ac.uk/fds/policy/documents/fds-report-on-the-state-of-childrens-oral-health

 

 

GDPs do their best - but what is needed?

Patently dental teams who care for caries affected early-years-children do their best, often with imaginative and innovative outreach, but the numbers for GA Admissions suggest the problems fires are still raging despite the attempts to limit the spread by the profession from the GDP model.

 

Is the demand for planning of a different dental intervention for the first three years beginning to gather momentum? Are we indeed reaching a point where the energy and desire for change to be planned means that significant change will indeed become a priority?

Just look at the last year of public domain comment and criticism of the present status.

 

 

The Sugar-Obesity-Diabetes-Caries complex

 

Sugar is now being discussed in a widespread public debate about obesity [be it child or adult] and diabetes but led his time our medical colleagues. Caries is being discussed too.

Dentistry was the subject of an adjournment debate in the House of Commons this last week

Various media events [including the 3rd Daily Telegraph Letter] have taken place in which members of the profession have presented the view that the present system of delivery of dental care is simply failing to deliver any effective prevention to the early-years child.

It is also unclear if the new GDP Pilots will change much in the context of a developing problem and reducing financial resources in Government spending plan. It is clear the new CDO [NHSE] has sensed this and is trying to wind the initial changes back and see where the true problem lies an th evidence takes her.

 

Evidence?

Sadly, there is no real evidence, because we have a problem which requires action for which an integrated approach has never been trialled, let alone undertaken.

One example of the media attention is a recent BBC Look North slot with Dr Tony Kilcoyne.  The BDA it is reported are meeting with the Chief Medical Officer’s team.

Dentistry on its own is a small backwater of medical provision.

But when we start to get frequent interventions by the medical profession, increasing interest by the broadcast media, and an increasing public desire to understand and discuss the situation as it relates to THEIR dental health and that of their children,  … well anything can happen.

Now what happens to the GDP’s element of the  NHS Budget on the back of such changes is, of course, a separate discussion.

But can all this really happen? Will we really witness 2016 as the year that Critical Mass for real change will be reached.

 

 

Dentistry and Medicine united?

 

I suggest the need for a “National Early Years Preventive Strategy” will be crafted which integrates medicine and dental care into a program targeted at mothers and their children and wider families that will aim to influence the diet and dental care of the under 3’s.

We as a profession have arguing this case for years and the Department of Heath have merely sat by.

I sense the medical profession are not going to sit idly by and watch the sugar/obesity/diabetes/caries scanal  wreak further havoc, be it to personal heath or their budgets.

 

We can but hope. 

We can hope that as a profession we are included in the delivery of a  solution.

We can but hope that something better comes out of it for the wider work of Geneal Dental Practice.

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Importance of Consent

Importance of Consent

Every dentist knows how important it is to obtain consent from a patient before conducting any physical examination or undertaking treatment on a patient. In this blog we look at the legal issues surrounding consent, namely the definition and the consequences of not obtaining it.

Valid Consent

There is no statute setting out the definition of consent; the principles for consent have developed through case law.

For consent to be valid it must:

1.       Be given voluntarily and freely; 

2.       By an informed person; and

3.       By a person who has the capacity to give consent.

Voluntarily and freely means the person giving consent must not be put under any undue pressure or influence to either accept or reject treatment. Such pressure may come from partners or family members. If you have concerns about this, you should see the patient alone in order to obtain valid consent.
 
A dentist must provide the patient with all the necessary information about the treatment so the patient understands the nature and purpose of it. If it is alleged by a patient that proper informed consent was not obtained, the Courts will consider whether the dentist has taken reasonable care to ensure the patient is aware of the material risks of the treatment and of the reasonable alternatives to the treatment. The Courts look at what a reasonable person in the patient’s position would consider was a material risk, by looking at whether a reasonable person in the patient’s position would attach significance to it. The Courts will also consider whether the dentist had knowledge, or should reasonably be aware that their patient would be likely to attach significance to the risk.

This test follows the decision handed down by the Supreme Court on 11th March 2015 in the case of Montgomery v Lanarkshire Health Board, which has been a feature in a recent forum discussion on GDPUK.com. As pointed out by many of you, the discussion in Montgomery simply re-iterates what best practice is, as advised by the GDC.

Prior to this the leading case on consent was Sidaway v Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital or, as it is referred to, the Bolam test. The decision said it was a matter for clinicians to judge how much information was to be disclosed to a patient. Provided the doctor explained the risks of a given treatment, to the extent that it accorded with a responsible body of medical opinion, liability would not attach.

However, Judges had been moving away from the Bolam test in any event, but these cases had not reached the highest court in England, so they did not overturn the Sideway’s decision.  

Given the decision in Montgomery, it is now advisable for dentists to give information to patients about all possible outcomes and make a record of the information given. Furthermore to engage in an open dialogue with their patients regarding any treatment offered.

Other Issues Surrounding Consent

Consent obviously needs to be obtained before treatment is performed. When the treatment is intrusive the consent should be obtained well in advance to give the patient time to ask questions and you to provide the information.

There is no set form in which consent must be obtained, but it is always advisable to have the consent confirmed in writing, usually by signing a consent form, as this can be used as evidence should any questions arise.

Consent will normally last indefinitely, unless new information comes to light that could affect the patient’s decision or the patient’s health has changed such that the risks have changed. A patient can withdraw consent at any time, even part way through treatment. In these circumstances, the dentist should stop treatment to see what concerns the patient has and should only continue if consent is re-established. Unless to stop the treatment would cause the patient greater harm.

Legal Consequences

There are two potential legal avenues a patient could take if consent is not obtained or not obtained properly.

Firstly, touching a patient without consent can constitute both the civil and criminal offence of battery, namely unlawful physical contact.

Secondly, if a healthcare professional fails to obtain proper consent and the patient later suffers harm as a result of any treatment, the patient may have a claim for negligence.

It should be noted that informing people of the nature and purpose of treatment is likely to be sufficient to defend a claim of battery. However, a failure to provide all necessary information about the treatment could lead to a claim for negligence.

Remember, alongside these legal principles, there are also ethical principles surrounding consent. Whilst there will be some overlap between the two, you should refer to the GDC guidance highlighted above for more information. As you all know, failing to follow the Standards for Dental Professionals may result in an investigation by the GDC in relation to fitness to practice.

 

 

Image credit -Quinn Dombrowski under CC licence - not modified. 

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How Dentists Turn Bad

Dirty Rotten Scoundrels

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Me, STRESSED? Nah!

Me, STRESSED? Nah!

What a day! Traffic jams, a flat battery in my mobile, a parents’ meeting tonight and I’ve still got to write this blog about being stressed.

Ah, that’s better. It’s another day and instead of writing the blog when I was tired and grumpy, I wisely left it until now. If only all stress would dissipate so easily.

This is not an examination of stress in dental practice. For that, I recommend an excellent study on the Yorks and Humber Deanery website.

And this is not about managing stress because I agree with dentist and communication coach, Brid Hendron, who says we need to be eliminating stress.

This is also not a guide to stress relief. There are plenty of those available and the Stress Management How to Reduce, Prevent, and Cope with Stress article here is better than many.

So what is this blog about?

Oh dear, I can sense you’re become a bit stressed reading this, so I need to get to the point. Which is to ask: are you the source of stress in your practice?

Can you honestly say you don’t ever put stress on your subordinates/superiors/equals? Think carefully, do you bang on endlessly about problems that cannot be solved within the practice (government policy, for example)? Do you set your staff unnecessarily tight deadlines to complete work? Are you careless about returning equipment so that colleagues can’t find it? Do you leave an empty loo roll in the toilet and a dirty mug in the sink?

#LoveYourImperfections (not)

Such behavior may, according to the online dating service TV advertisement, result in you finding true love but that won’t be in your practice. Instead, it will result in stress, which will have consequences. According to the HSE, 9.9 million working days were lost to work-related stress, depression or anxiety in Great Britain in 2014/15.

Just stop

Like ceasing smoking or the consumption of alcohol in too large quantities or (as in my case) pigging out on cream buns, stopping causing stress is easier written than acted upon. Here’s what you should do. Suffers of stress are advised to keep a stress journal. Do likewise but instead of recording stressors on a daily basis, you should identify ‘stressees’ (the colleagues to whom you’ve caused stress). This won’t be easy. Not everybody reacts to stress by pigging out on cream buns or bursting into tears. Quite probably, you won’t witness the effects of your stressful action within the practice. So here comes the clever bit.

Stress balls

At a team meeting, explain you’ve read an article about stress in the workplace and want to learn how many people in the practice feel it. Now place a bowl of marbles, walnuts or (if you are in an upmarket practice) Ferro Rocher chocolates in the tea room (staff lounge) with a mug (porcelain cup) beside them. Ask your staff to place one of the items in the mug (cup) at the end of each week if they’ve felt stressed.

Self-regulating stress reduction

Once this has been done for a few weeks (so that staff have become comfortable with it), explain that you’re keeping a stress journal and would like others to do likewise (anonymously, of course). While there is no direct correlation between what people note in their stress journals and the weekly marbles/walnuts/chocolates ‘score’, it is in everybody’s interest to reduce the stress they place on colleagues in order to decrease how many ‘stress balls’ are in the mug (cup) at the end of the week.

Let me know how you get on with this exercise (and perhaps you can come up with a name for it).

 

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20,000 Forum Topics!

20,000 Forum Topics!

 

Today we are proud to have reached 20,000 topics created on the GDPUK Forum since mid-2008. An incredible achievement from all involved. Thanks everyone for all the contributions to the forum pages over the years and the many interesting topics created. The site continues to foster a special atmosphere and relationship between dentists throughtout the UK. The forum exists because of the community, the many different contributors to the site (979 different ones last year) plus of course the thousands of dentists who read the site on a daily basis.

As you can see from the image above, there has also been 226,000 posts on the 20,000 topics created, which means on average there are just over 11 replies to each thread, which again demonstates how much everyone cares about dentistry in the UK and how it is natural for colleagues to want to help or guide each other. We hope all this help over the years has improved the level of dental care and professionalism and that the forum continues to be an incredibly useful resource for many years to come. 

Thanks to all the moderators of the site for keeping on eye on any controversial threads, thanks also to our webmaster Steve, who keeps all the forum software ticking along. A huge thanks, to the site owner Tony Jacobs whose vision and passion for dentistry in the UK, has kept the GDPUK community together and reaching amazing landmarks like today!

Bring on the next 20,000 topics :)

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Twenty Questions

Twenty Questions

Rather than my usual look at what’s going on at the Schloss Moyes on Wimpole Street, I just thought I’d just ask a few questions this month, and leave the reader to think a bit about the possible answers.

I’ve become aware recently about the sheer scale of the money spent by the GDC on the whole PSA situation. The chances of getting answers from our arrogant and out of touch regulator are about the same as getting to watch the Titanic arriving in New York next week, carrying Lord Lucan, with Glenn Miller playing mood music in the bar whilst Elvis sings to Shergar on the top deck, but we can live in hope. Surely all that has now happened over the last few years with the GDC must start to bring some change.

  1. How is it possible for the GDC to spend £735,000 of registrants money on the legal fallout of the Whistleblower affair and not have to answer to the profession or parliament for this?
  1. Since this includes the GDC having to respond to ‘Letters of Claim’ involving members of the GDC, exactly how many of them are being sued and why are registrants picking up the bill for the actions of individuals?
  1. Since the BDA know of this why have they not told the profession of the sheer scale of this use of registrants money?
  1. Does this figure appear publically in the accounts of the GDC? If not, why not?
  1. Why did the GDC spend £230,000 on the recruitment or ‘refreshing’ of the Investigating Committee in 2014 when it was likely the section 60 order would result in the recruitment of Case Examiners within a short period of time? Why couldn’t the existing members just carry on a bit longer and this money be saved?
  1. As the Council members are aware of the inordinate amount of money being spent on what is basically incompetence and a lack of the correct procedures being followed or being in place, why has there been no public criticism by them of this?
  1. Do all regulators spend a million pounds with such lack of transparency?
  1. Given the ‘Objectionable Practice’ being run by the Investigating Committee Secretariat that lead to this whistleblowing, how many registrants have had the incorrect sanctions applied to them that shouldn’t have been?
  1. How many of them have had their careers and personal lives affected by this?
  1. Have these registrants been contacted and informed there may have been a breach in the natural justice they have a right to expect? If not why not?
  1. Where is the duty of candour from the GDC to tell the truth about this situation involving registrants? Its not even mentioned in the latest Pravda press release or email from Moyes Towers.
  1. Has anyone at the GDC been made aware we actually have a Human Rights Act in the UK and this applies to registrants since they are actually Human Beings?
  1. Now Lord Hunt has been highly critical of the GDC in the Lords, and it has also been raised in the Commons during the recent Section 60 debate, why have there been no immediate resignations of the Council Members?
  1. Does anyone think the Council Members have held the executive to account properly at any point in the last 3 years?
  1. If not, why do we actually have a Council?
  1. Should the present Chair and Council have anything to do at all with the recruitment of the new Chief Executive?
  1. How much has Ms. Gilvarry’s departure cost registrants?
  1. Why should her incompetent leadership be rewarded financially at the registrant’s expense with a termination package?
  1. When are the BDA, DPL, DDU, FGDP, and all the other groups directly involved actually going to sit down together and PROPERLY talk to one another formally and lead the profession from the front?
  1. Have the Executive, the Chair, and the Council actually been guilty of malfeasance in public office?

 

And your bonus question….

  1. Should Bill pay for his own taxi when he leaves for the last time or should we let him have one last final trip on expenses?

 

 

 

Image credit - Colin Kinner under CC licence - not modified.    

 

 

 

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Andrew Adey

Taxi fare

Heck Simon, I`LL pay for his last taxi fare, as long as a) it`s no more than £25 and b) it really is when he leaves dentistry, hea... Read More
Monday, 08 February 2016 17:31
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The 4 Advantages of Using a Targeted Landing Page

The 4 Advantages of Using a Targeted Landing Page
 
A landing page is a single web page that exists or is created for the sole purpose of getting your user to take action. 
 
In the past I have looked at landing pages and why they are an important part of any marketing strategy. I thought this was something that was definitely worth revisiting. So much of our marketing is now online we have to look at how we attract and keep any leads we attract. 
 
  1. Landing pages are the key to converting the leads that click on your facebook or banner ad. So whether you are asking for contact details in exchange for a white paper, offering a demo piece of dental equipment, a targeted landing page is going to help you convert those visitors.
  2. Using one specific landing page for your campaign also gives you a clear idea if the marketing campaign is working or not. If you are still getting a high bounce rate on your targeted landing page, the page may need tweaking or reworking slightly. If traffic goes to your homepage, it is impossible to see why the leads aren’t taking the next step. The landing page can always be tweaked and then you can see if your results improve.
  3. Having one page also lets you narrow your focus and remove the clutter you would expect on a homepage. The page should enable the visitor to find the information a lot quicker. This keeps the visitor focused on the product or service you want them to look at. 
  4. Landing pages need to be seen as part of your sales team. Can the page sell your service or product to the level you would expect? You obviously wouldn’t expect your salesperson to convert every single lead they receive but you would expect a certain proportion. You need to look at your landing page in the same way. The page needs to be converting the clicks.
 
Therefore the landing page always needs a clear call to action and hopefully you will start seeing some positive results.
 
So when should you be using landing pages?
 
  • As destinations for your banner ads.
  • To create anticipation for a new product or service you are offering the dental community.
  • To promote a special offer that you don’t normally offer. The landing page can expire after one week or a month, it is upto you. 
  • To segment your audience. You may want a landing page that is aimed just at endodontists for example. 
 
If you have a target audience in mind, you need to start thinking about how you are going to reach that audience. Once you reach them, how will you keep them engaged? Designing a targeted and focused landing page is a great step to getting a return on your marketing budget. 
 
Get in touch if you would like further information on GDPUK and where our site can fit into your marketing plans.
 
Have a great week
 
Jonny
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Complacency or Conspiracy?

Complacency or Conspiracy?

Welcome back to the start of what promises to be an interesting year

There appears to be a consistent theme however running through the early events, which seem to me to be somehow all related. Perhaps not in a complimentary way.

 

That Letter

Firstly we have the Daily Telegraph Letter, discussed widely on here, as well as a supporting article in the newspaper itself.

 

http://www.telegraph.co.uk/news/health/news/12079233/Third-World-dentistry-crisis-in-England.html

http://www.telegraph.co.uk/comment/letters/12077501/Letter-The-NHS-dental-health-system-is-unfit-for-purpose.html

 

This is of course the third year that such a letter has been published by, this time, some 400 signatories including this writer.  Critically, a small nugget of self-opinionated idealism say some.  By contrast its supporters suggest it is merely a further reasoned cry for a sensible strategy to use the limited Government money for the groups in need. For example, those such as children who finish up in theatre under a GA, or other high needs groups, often postcode affected. 

Just where is the Clarity of the Deal for the rest of us for example?

However, is there a Conspiracy of Silence? Perhaps a mood of disdain? For as we speak some 3 weeks later, the BDA have not mentioned its publication. At all. Anywhere.  You may search their News Releases at https://www.bda.org/news-centre/.

 

Would you care to wonder WHY the BDA feel so reluctant to even acknowledge the letter let along jump on the brief media bandwagon?  Complacency or Conspiracy? You choose.

 

The PSA-GDC relationship

It is certainly a case of no love lost. Before Christmas, you will recall,  the GDC were aligned in the crosshairs of the PSA and their hyper critical report.

https://www.professionalstandards.org.uk/footer-pages/news-and-media/latest-news/news-article?id=91bb5b9e-2ce2-6f4b-9ceb-ff0000b2236b

Comment made again on GDP UK and elsewhere has been withering.  It is clear that there is a mood that the Chair of the GDC must go, not just because of these events, but also BEFORE any process to identify a new Chief Executive takes place.

It is therefore very interesting that the GDC have seen it unnecessary to mention in their public media releases anything about this report, let alone any sort of “It’s all good here” spun response.

Complacency or Conspiracy? You choose.

 

Peter Ward, CEO at the BDA has placed a damning Leader “Whistling in the Dark” in a recent BDJ about the GDC at http://www.nature.com/bdj/journal/v220/n1/full/sj.bdj.2016.1.html

I have stated it before. Others have stated it.  And so we all say, again:

The Chairman must go, and the Council, in particular the Dental Registrant Members of the GDC, should seriously consider their position.

 

The BDA

Shortly before Christmas , before the letter in the D Tel, the BDA seniors figures and the LDCs met with the new CDO of NHS England, Dr Sarah Hurley and you may read the reports here courtesy of Yorkshire’s East Riding LDC

http://www.eryldc.co.uk/download/i/mark_dl/u/4012071383/4625508579/LDC%20Officials%20Day%20Notes%20Friday%204th%20December%202015.pdf

 

Is it me? It is similarly interesting to think that since then  the BDA have kept a very tightly sealed pair of public lips on matters pertaining to the disgraced UDA system of Contracting and its Prototype successor

Not a mention, not a dicky bird.

Complacency or Conspiracy? You choose.

 

There is it might be argued a fine line between complacency and conspiracy as to why each of these bodies [The BDA and the GDC] have chosen to ignore these two unrelated and yet significant events.

 

In the case of the GDC, I think we can speculate that the present Council are in their final days, especially after the unprecedented mauling by the House of Lords in the debate this week.  I will put that down to complacency therefore.  Please view the debate here http://parliamentlive.tv/Event/Index/2a3f3b86-7d34-448d-ab91-52e134879e49

 

The GDPC - CDO[NHSE] Relationship

Which leaves me to ponder the conspiratorial nature of the relationship between the GDPC of the BDA [representing all you dentists at the negotiating table for the New 2020 Contracts] and NHS England’s Chief Dental Officer. 

It seems like the old days, for those of you old enough to recall that great old wise owl, Labour leader and Prime Minister Harold Wilson.  Beer and sandwiches at No 10.  In this case, filter coffee and homemade biscuits with a fine group of colleagues.

 

Transparency is dead.  

Complacency is the food of conspiracy

The outcome is the same.  It appears any chance of truly driving change with the wider interests of the public and profession at heart, in a transparent manner, at the highest level of our Profession, is to be denied.

Instead agreements will be cobbled together in secrecy and behind closed doors by the privileged few.  You will told when you need to know

As was stated recently: we are a  Profession that suffers Group Mural Dyslexia ! Failure to see the writing on the wall.
 

A little more energy is required if we are to see the Profession make progress against the political headwinds this year.

Perhaps a little less complacency and a little more Conspiring to rebel?  We can but hope!

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Recent Comments
Eddie Crouch

Not accurate

Not accurate BDA issued the following press summary on 5th January Dentist who billed clients and NHS for same work pleads guilty... Read More
Thursday, 21 January 2016 19:25
Anthony Kilcoyne

BDA website online NO mention ...

Dear Eddie, As a BDA member I looked upon the BDA website bda.org, home page, news and press releases tabs every single day for a... Read More
Friday, 22 January 2016 21:54
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Challenging a Decision of the GDC Committees

Challenging a Decision of the GDC Committees

There is a genuine concern amongst the dental community, including within the GDPUK forum, that the Practice Committees are not acting fairly or with common sense when conducting disciplinary proceedings. In December 2015 of the 46 cases heard, 4 dentists were erased, 17 were suspended, 4 were reprimanded and 15 were issued with conditions.

I am sure you all remember the Professional Conduct Committee’s damning comments of the GDC’s conduct during the Fitness to Practice investigation of Dr Singh on 11th May 2015. If not, you can read about it here. Because of the appalling conduct of the GDC in that case, the hearing was abandoned as a result of an application by Dr Singh’s legal representative. The purpose of the legal application made was to stop the unfair process, and to allow a fairer more transparent hearing to follow. However, the case is still yet to be re-listed for hearing.  

Although a positive result for Dr Singh in the short term, it did not bring an end to the matter for him. The question now is has he just delayed the inevitable?

So what steps can you take if you disagree with the decision of the Fitness to Practice committee?

Appeals

Any appeal against a decision of the Practice Committee must be made within 28 days of the original decision to the High Court. The grounds on which you can appeal the decision are:

1.       That the decision was wrong;

2.       That there was a procedural or other irregularity.

You can also appeal decisions of the Interim Orders Committee on one of the above grounds; again any appeal must be within 28 days.

The High Court is completely independent of the GDC; it is therefore not afraid to overturn the Practice Committee’s decisions.

The High Court has made it clear in a number of judgments that the purpose of Fitness to Practice hearings is not to punish the practitioner for past misgivings but to protect the public. In the decision of the High Court in the case of Cohen v. General Medical Council (2008), the judge stated it was not inherent that every case of misconduct must automatically mean the practitioner’s fitness to practice is impaired. However, it appears from recent decisions that perhaps the Practice Committees are losing sight of this principle.

In the recent case of Professional Standards Authority (PSA) v (1) General Medical Council (2) Uppal [2015], the GMC decided not to impose a sanction on Dr Uppal even though she had accepted the allegation of dishonesty. The PSA appealed the decision on the basis it was too lenient. They argued that dishonesty must automatically amount to impairment. The court disagreed and accepted the GMC’s findings that this was an isolated incident and therefore there was no impairment of Dr Uppal’s fitness to practice.

If you think you have been treated unfairly at a hearing, or that the punishment laid down by the Practice Committee far outweighs the “crime” that has been committed, then it is well worth seeking to appeal.

However, it is essential that you act promptly, as although the High Court does have the power to extend the 28 day time limit, this will only be done in exceptional circumstances.

Judicial Review

A practitioner could also consider seeking a judicial review of the Practice Committee’s decision or an order from the Interim Orders Committee. A judicial review is where a Judge reviews the decision or action of a Public Body.  Any application for judicial review must be made within three months of the decision. The grounds on which a judicial review can be made are:

1.       Illegality;

2.       Irrationality;

3.       Procedural unfairness;

4.       Legitimate expectation.

There is some overlap in the above with the grounds on which a decision can be appealed. However, the court will not consider an application for judicial review until all other avenues have been exhausted.   

Bear in mind that irrationality means that the decision of the GDC was so unreasonable that no reasonable public body would have come to it; an extremely difficult test to overcome. Legitimate expectation is where the public body, by its own acts or statements, is required to act in a certain way.

You cannot appeal an Investigating Committee’s decision to refer a complaint to the Practice Committees. However, you can seek a judicial review of that decision if one of the above applies. This may be a better course of action if you can satisfy the relevant test, as it could prevent the matter progressing to the Practice Committees entirely.

So in conclusion there is some light at the end of the tunnel. Whilst it is clearly a stressful and daunting experience having a complaint raised against you, the decisions of the GDC can be challenged in the courts.

Indemnity and insurance companies should fund an appeal subject to meeting the terms of the policy and some may provide funding for an application for judicial review. Remember you do not need to use the ‘panel’ solicitor appointed for you; you have freedom of choice as to your representative.

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CPD The Easy Way

CPD The Easy Way

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You don’t have to do this - letter to a wavering dentist.

You don’t have to do this - letter to a wavering dentist.

You don’t have to do this - a letter to a wavering dentist.

Is this really what you want to do? You don’t have to.

Many students have made their decisions to study dentistry at university in their mid-teens, an age when they are neither mature nor in possession of great insight.

Parents, family and teachers see dentistry as a well-remunerated, successful profession with a secure future. Well positioned on any socially acceptable list that makes it traditionally attractive to the children of immigrants. My mother, a migrant from Ireland was determined that both her children would have professions, her background, in nursing, favoured the medical. I became a dentist, my brother a doctor.

How many of us have the nerve to say that it’s not what they want? Many dentists are ill suited to a profession that makes extensive physical, mental and emotional demands on its members. I am not convinced that the undergraduate course prepares students for the rigours of general practice.

After 5 undergraduate years and now carrying a large student debt it takes a brave new graduate to dare admit to parents and family that they have studied the wrong subject. If you have a degree in humanities or pure sciences you are fortunate to be able to continue with your subject. Only with a “vocational” degree is the graduate able, and expected, to follow a career pathway.

Socially, turning away is akin to failing to show up at your own wedding. An individual might be secretly admired for admitting that they don’t feel the commitment needed for a happy marriage but it’s a brave dentist who says that they have done the wrong thing.

Turn things on their head, if you know in your heart of hearts that you are going to be unfulfilled and unhappy being a dentist isn’t it better to say so sooner rather than later? How many more miserable years can you tolerate? How much stress and heartache can you endure once you have admitted to yourself that you’re in the wrong place?

Far too many dentists have plodded on through degree, foundation training, associateship, partnership, marriage and children all carrying with them increasing financial pressures.

They thinking that this is the way that it has to be, that it will get better, easier, less of trial to get out of bed in the morning - next year. They live from holiday to holiday and get absolutely no fulfilment or satisfaction from the clinical work that they do or the people for whom they are supposed to care.

Often they succumb to the stressors. One of my contemporaries only accepted that he had a problem when he needed a quarter bottle of vodka to start work in the morning and was facing his third drink driving conviction.

I have attended funerals of successful and apparently happy dentists who have taken their own lives because they could only see one way out.

These problems are not unique to dentists and many people “live lives of quiet desperation” so I would encourage them to change also, if they can.

What else is possible?

The answer is anything that you want to be. There are ex-dentists who are successful architects, writers, lawyers, musicians and businessmen. I know of one former specialist orthodontist who now builds dry-stone walls (and will also teach you how to build them). The discipline of your training means that you are suited to re-train in many disciplines.

Let’s not forget those people who are stuck in a rut. NHS dentistry has never embraced excellence, though lots of good work is done in spite of the system. You will never perform at the highest level on the conveyor belt of UDAs or whatever imposed system of production is in vogue this year.

If you are having second thoughts then I suggest that you examine your reasons. If you feel that you aren’t right for a job that demands a high standard of manual dexterity in order to practice at its best then you should explore your options.

Darwin says that empathy is instinctive not learned, so if you are not a person-person will you be happy going against the grain and attempting to gain the trust of your patients day in day out for the next 30 years?

If you are doing it just for the money, you will probably be disappointed at the amount of further training, dedication to a career pathway and sheer hard work that it will take. You might get a better return on the invested time in some other field.

On the other hand if you stay and you choose to dedicate yourself to a unique discipline, then every day will give a new challenge. You have the opportunity to grow as the leader of a team in a niche where you help your patients not only to achieve and maintain an important element of their general health but also to have an enhanced sense of confidence, comfort and function.

If you want to be happier then say so, and do something. This isn’t a rehearsal, there is no second chance, no re-run, no “it’ll be all right on the night”. If you want to be better nobody can do it for you. If you need help ask those who have already done it, study excellence and embrace it.

Polonius said to his son:

“This above all: to thine own self be true,
And it must follow, as the night the day,
Thou canst not then be false to any man.”

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© Alun Rees, GDPUK Ltd 2016

Recent comment in this post
Gaurav Vij

Great post....

Great post and sums it up succinctly. My experience is very few are cut out to be dentists. You are basically a surgeon in the cla... Read More
Saturday, 16 January 2016 07:20
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9 ways GDPUK can help you in 2016.

9 ways GDPUK can help you in 2016.

 

How can we help you?

 

First week back in the office has flown by and like everyone else involved in the world of sales, we have all been working hard on following up leads, arranging meetings and even closing some deals! (always be closing)

There has been a recurring theme this week in my small dental related bubble and that is clients or prospects asking how we can help them in 2016?

We see GDPUK as an integral part of a dental companies opportunity to market themselves to dentists in the UK. We believe we have a large, active and engaged audience on the site, which we are very proud of. This is important because dental professionals in the UK are using social media more than ever and GDPUK is at the centre of that. For example many of the signatures for the letter published in the Daily Telegraph came from GDPUK. NHS unfit for purpose.

So we have put together a short list of the ways in which we can help our clients engage with potential customers.

 

  1. Banner Ads - We offer a range of banner ads on the site and our daily digest emails. Further info can be found in our media pack here

  2. Product Spotlights - New for 2016, the product spotlight will appear on the frontpage of the site, with a promotion of your new service / product or special offer.

  3. Product / Service Launches - We can help launch a new product into the market, with blogs, news articles and banner ads.

  4. Special Offers - Entice new or old customers with a special offer / or sample offer

  5. Case Studies - We can publish case studies for you of products that are working for patients in dental practices. A case study can be a great way of demonstrating how your product works and how it will help the dentist improve his or her skills.

  6. Forum Reviews / Tests - Put your product to the test, use members of the GDPUK forum to test your product and receive honest reviews that can be shared on the forum and published as a blog post.

  7. Surveys - Run a survey, which can be hosted by our site or your site. Use it to do product research etc

  8. Social Media Competitions - Combining promotion on GDPUK and other social media channels, we can run a competition that helps collect data and potential new users of your product.

  9. Promotion of Courses / Events - There are a large number of events, meetings, courses that are scheduled in the UK dental calendar on an annual basis, we can help with promotion and even the sale of the tickets.


We hope everyone out there has also had an insightful start to the year and like ourselves are always thinking about how they can improve what they offer to their customers. If you would like to try any other marketing ideas on our site, we are always interested in new methods and always looking to learn. Look forward to hearing from you soon.

Thanks for reading. 

 

Our latest media pack can be found by clicking on this link

Look at some of our amazing numbers that GDPUK produces - GDPUK in Numbers

 

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The Telegraph

The Daily Telegraph

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Caring and Cosseting

Caring & Cosseting

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Dental Desires 2016

Dental Desires 2016

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GDC hearings: The imbalance of probabilities

GDC hearings: The imbalance of probabilities

GDC hearings: The imbalance of probabilities

Can we make the Regulators serve the Public and the Profession in foro conscientiae (the court of the conscience), rather than just a notion of what the regulations might say?

I have attended and been asked to make some input into a variety of cases recently involving several different Regulators.

It has become clear that there is a real danger that rules and regulations which may have been drafted for the protection of the Public and the guidance of the Profession are sometimes widely misinterpreted at best and occasionally deliberately corrupted and applied at worst.

How does this occur?

Whilst it might be considered that most regulation has been drafted to improve standards and reduce the risk of poor practice continuing; it is quite obvious that it can be applied in a manner to exert control or ‘manage’ the Profession. Sometimes this may occur deliberately and because it broadly serves the purpose of a government administration, it is allowed to continue at least as long as it serves a purpose. Sometimes it occurs at a much lower level and whilst not serving any particular purpose, it is allowed to continue because there is nobody at that level who is prepared to question it.

I’ve got nothing against shop assistants, however I wouldn’t be wanting them to draft the GDC Charge Sheet which might end a Professional career. There is a high turnover of staff at the GDC which I suggest leads to a poor understanding and there appears to be a low level of dental knowledge.

What this might mean if you are in the dock

One of the cases to which I refer involved a young colleague, and for whom funds were raised at very short notice thanks to the excellent GDPUK membership.

If you read the Charge Sheet, you would be forgiven in believing this dentist was a real danger to the Public. However I’m sure that you will all remember me reminding you to read between the lines whenever you are dealing with a Regulator. That is certainly necessary in this case.

Example appearing on a Charge Sheet

(i)            The use of a double cantilever (the bridge was fixed-fixed)

(ii)           Not adequately assess that a RCT was required (the tooth was root treated and had been a symptom free bridge abutment for 20 years)

(iii)          Fitted an inadequate post which was a) short of the apex, b) not extending to the apical third and c) was inadequate in width. (The post was temporary and deemed too wide).

If the Charge sheet is a nonsense, the solution is simple. The Panel changes it, strikes it out or substitutes different wording. In other words, it moves the goalposts. The Panel, which is independent by hearing both parties then asks its own questions of the witnesses. It is advised by experts and can choose which expert it ‘prefers’. The expert appearing on behalf of a registrant might then be warned by the Prosecution barrister that the GDC may take action against them. The prosecuting barrister is instructed by the GDC and regularly prompted by their expert witness.

In one of the cases to which I refer, four patient witnesses who had made a complaint were called. One of the witnesses was travelling to London and it was found that she intended to speak in favour of the Defendant and it was agreed therefore that this patient would not be heard.  

The Panel seemed to have some ability to read between the lines, but in the end ‘prefers’ the testimony of two patients. One of these patients produces a hand annotated diary of the treatment dates containing some dates that the defendant was actually not in the practice (a screen shot of practice diary was produced as evidence). The patient was receiving treatment from more than one dentist at two different practices simultaneously, but on the ‘balance of probability’ is to be believed. This patient was heard to say that she was seeking ‘redress’ on at least four occasions.

Our young colleague describes how he always uses rubber dam for RCT and yet on his last day in the practice he finds there is no rubber dam available. He admits that on this single solitary occasion, rubber dam was not used. The patient has pleaded that a temporary post crown be placed (the same inadequate temporary post that was short of the apex) and he accedes to the request of RCT and temporary post, since the broken tooth was within the patients smile. He uses rotary RCT instrumentation, floss on hand instruments and high volume aspiration. The patient is the same one who was not given the opportunity to give further evidence in support or denial of the registrant. Our young colleague is guilty therefore of serious clinical failures and therefore misconduct.       

Another patient gives evidence about never having received treatment he has paid for, but the Panel agrees that this evidence is just not credible, which it isn’t.

A fourth patient was having a long and complex treatment plan part of which had been incomplete and following a tooth fracture needed to be modified. The patient didn’t clearly understand the new treatment plan and for that our colleague was criticised.

It’s worth mentioning that there were NO PATIENT RECORDS available because there had been a burglary declared immediately following the practice change of ownership. This was highlighted to the Panel. 

Communication was a big word in this Hearing. Other significant words are ‘insight’ and whether or not the Panel consider that this is ‘embedded’ sufficiently. Our young colleague was supported by Sir Peter Bottomley in person who made a statement and also by the testimonials of 47 patients.

The GDC however do not need to give weight to the above in making their determination, although I noted that the prosecution barrister frequently returned to the GDC to ask for further instructions. I think it worthy of note that the Panel describe our young colleague within the Determination as follows ‘It is clear from all of this evidence that you are viewed as a competent and caring dentist, who will go out of his way to assist his patients.’

Do the GDC therefore need to apply Conditions, because that’s what they did? 

Please read the GDC Determination when it is published.

So what?

If you recognise any of the issues above, you are guilty of misconduct and your standards will be deemed serious failings. Approximately 1 in 7 dentists in the UK currently face some form of investigation which could result in imposition of sanctions either through the GDC, CQC or NHS and this number is growing constantly. This might mean that we have the worst performing Dental Profession in the World bar none or that we have the most disproportionate Regulators.

You may consider yourself lucky and are happy to cross the bridge with your indemnity organisation when your time comes; or you may be sufficiently confident to wade across the raging torrent alone when your indemnity organisation makes an unexpected discretionary decision against you.  

What type of indemnity organisation are you currently paying for?

How can it be legal?

You are required to have professional indemnity and it is considered a serious failure if you have ANY gaps in your cover period. Indemnity providers however do not guarantee to provide legal representation to you and if they exercise their discretion in favour of their balance sheet (or dressed up as other members interests) you will find yourself alone or facing a huge legal bill.

A recent Hearing which I attended over 7 days starts at £32,000 and it’s uphill from there.

Does anything need to be done about this?

You read the PSA report published 21st Dec, I hope.  https://www.professionalstandards.org.uk/docs/default-source/psa-library/investigation-report---general-dental-council.pdf?sfvrsn=6

What exactly have we learned about whistleblowing from the Sir Robert Francis Report (Mid Staffs)?

And you can see how the whistleblower was treated, you can see what the PSA thinks about it and you have seen how the GDC are going to be dealing with your ‘serious failings.’

You tell me, do you need to do something about this?

So where are we now?

From a variety of recent cases we can conclude:

·         The GDC consider failure to use a rubber dam in endodontics to fall seriously below the required standards and therefore to represent IMPAIRMENT and worthy of sanctions.

·         In my view neither the CQC nor the GDC have a currently correct understanding of CONSENT which conforms with the recent Supreme Court judgement of Montgomery – v Lanarkshire Health Board. This needs to be challenged in the High Court.

·         The GDC will always use the ‘balance of probability’ in forming an opinion on which evidence it prefers. 

So where are we going in 2016?

The Profession must for once in its life join together. The issues regarding Consent and use of rubber dam will need to be challenged and this requires more than a well-intentioned individual or some crowd funding. It requires a strongly actioned move being taken by the BDA and the indemnity providers.

 

 

Image credit -Michael Coghlan under CC licence - not modified.   

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Moyes Out

Moyes Out

I could basically repeat this mantra for the whole of this blog and I don’t think many would disagree with it (except of course Bill himself). However, I think my readers are more used to having a bit more to get their teeth into, so I’ll pad this out a little more. It won’t run to the 306 pages of the Professional Standards Authority report (here) into the GDC, but the sentiment is the same…

As well as reading my ramblings, I would strongly urge you read two blogs by a couple of fellow colleagues whom I have the utmost respect for. This blog was not originally going to be about Ghosts of Christmases Past, Present, and Future, but it is quite an appropriate analogy.

These are our perspectives on what has gone before, what is still happening, and what we need to do. Three views for the price of one.

http://dominicohooley.svbtle.com/a-christmas-tale

http://campbellacademy.co.uk/blog/short-gdc-update/

I am very aware of the warnings by Dental Protection not to be too critical of the GDC in public. However, I think the publication of the recent report allows me to point out some factual issues in that report, and exercise my right to free speech about a public body without too much fear.

The PSA’s whistleblower report makes fascinating, and at times unbelievable reading. What is clear from it is that the GDC at both Executive and Council level is not only a failed organisation, but a completely and utterly incompetent, insensitive, and dare I say it, corrupt (in the ethical and moral sense) edifice that now needs to be put out of OUR misery.

The report is probably the reason that Ms. Gilvarry has decided the time is right to move on. We can only hope that other regulators do not suffer in the same way as we have in the recent past; I would certainly hope any organisation thinking of engaging her in a similar position is made aware of this damning report and the role she quite obviously played. It’s really not something I’d want on my CV.

From the writing of policies by untrained and unknowledgeable staff who then went on to train more untrained and unknowledgeable staff in the process of discipline (via the Investigating Committee), the lack of scrutiny of the IC’s work, the failure to correct the problems outlined in the previous PSA report, having an ineffectual whistleblowing policy, rewriting it and it still being useless, to the utter lack of oversight by the very Council whose duty it is to ensure the Executive do not go off on a tangent, there can be no doubt the GDC has become a derided regulator both by the profession and the PSA.

So how on earth then can the Chair feel he can remain in post too? Not only that, are the other members of the Council so isolated from the real world situation everyone else can clearly see, that they somehow feel they have no responsibility for this disaster of an organisation that they are at the head of?

Having a regulator that uses untrained staff, described by their own director as just ‘bums on seats’ and ‘clones’, to be responsible for an entire section of a professional disciplinary process is nothing short of negligent. It is admitted in the PSA report that they were under pressure from the Executive to ‘Get the Job Done’, which implies the rulebook went out of the window. When people’s careers, livelihoods, wellbeing and indeed their personal lives are being held in the hands of people quite obviously out of their depth and unaware of their duty, then that attitude by the Executive is utterly reprehensible. Not only that, there still has to be the accountability that is sadly lacking. These members of staff are not specifically blamed by the PSA for the problems, as it was recognized the responsibility was entirely that of those in overall charge of the systems (and some of them are no longer in post thankfully), but one would hope that the moral compass of anybody involved would direct them to make the right decision and now leave.

Whilst the influence of these people was seemingly only on the members of the Investigating Committee, one would hope that the integrity of those on that committee was such as to not be influenced by them. However, by a simple process of extrapolation it makes one worry that other committees were under pressure of being influenced in the same way. The evidence for this isn’t in the PSA report because they didn’t specifically look for it, but we all know the GDC have acted unlawfully before in setting the ARF, which isn’t exactly a great track record. Not only that, but the findings suggest that the situation the PSA investigated with the Investigating Committee leaves the GDC open to further legal challenges via Judicial Review over the decisions it made. I would therefore suggest that EVERY SINGLE case that falls within the dates the report encompasses is reviewed and looked at independently, at the GDC’s own cost. If that bankrupts it, good. Perhaps the Government might take notice when it has to bail out the GDC.

It’s a bit like a parent dealing with a delinquent child; it tends to ignore it hoping things will get better, then gives it a stern talking too, but when it finally has to go down to the police station and bail it out for a serious offence the realisation that there is probably something perhaps seriously wrong with its offspring begins to dawn.

It’s one thing Ms. Gilvarry falling on her sword (or was she pushed?), but the supervisory role of the council during this period was non-existent. In addition, the judgment of the chair has also been called into question over decisions that he made. The sort of important decisions we take for granted will be made correctly by someone in his position. The sort of decisions that if we made incorrectly would see us in front of the regulators fearing for our careers….

There is NO way that Dr Moyes has the respect of the profession as a result. He has shown his lack of understanding of the profession on so many occasions, starting with the infamous Pendebury lecture where he likened us to the supermarket sector. That’s all well and good in this increasingly consumerist world, but you don’t get people losing their careers if they give you the wrong shape carrot or your tin of beans is past the sell by date.

So I address the final part of this blog to those people involved in the whole sorry affair.

To the Investigating Committee Secretariat, you must ensure nothing like this is ever allowed to happen again. The overwhelming majority of people in dentistry are good people, and they are not numbers that need processing despite your instructions to ‘get the job done’ by what appears to be a bunch of Dentist Haters. There is no defence to the excuse of ‘we were just following orders’; Nuremberg in 1947 saw to that. Whilst the GDC whistleblowing policy has been shown to be pretty useless, please bear in mind the need to do the right thing if there are things you are not comfortable with. Please remember, you are not the judge and jury.

To the members of the council; you might have thought that being part of the GDC would be altruistic and for the greater benefit of our profession. It should be. You might even have thought it looked good on the CV. At one time it would have conveyed respect and deference. But given the utter failings and lack of detailed, focussed, professional management that has occurred, you might be better admitting you were unwittingly coerced by the members of a ruling Politburo, which might go some way to rescuing both your CV and your own professional reputation. The Council’s oversight has been so lacking, not even Specsavers could help it.

Finally, wake up and smell the coffee Dr. Moyes. You seem to have absolutely no idea what being part of a profession is, and the members of the council have obviously not educated you properly (or been allowed to). The insight that you rightly demand of your registrants has been sadly lacking by your entire organisation, and given the tone of your emails to us particularly by yourself. I’m just waiting the email from you saying what a resounding endorsement of the GDC the PSA report is, since that’s the usual spin that is put on things at Wimpole Street. Your oversight of the Executive has been completely ineffectual. Your part in this whole debacle cannot be brushed under the table; it happened on your watch so you must bear responsibility at least in part. It’s quite ironic that some of your previous posts have been with the Office of Fair Trading and Monitor. Because there has been absolutely nothing fair about this organisation whilst you have been at the head, and your monitoring of what was going on around you appears to have been non-existent. Dentists might be in the minority of whom you regulate; but believe me without us the profession couldn’t exist. Ignore us at your peril.

For that reason your fitness to regulate has been found impaired and you must face the sanctions.

Dr. Moyes, you must resign.

You must all resign.

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Ruth Dening

Dentist

Thank you. A good resume of the facts thus far, as indeed are the links given. In fact we might be considered to be failing in ou... Read More
Monday, 28 December 2015 14:22
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Hope got me through . . Terry Waite CBE

Hope got me through  . .  Terry Waite CBE

‘Hope got me through…..’ Terry Waite CBE

A warming Xmas story to boost practice manager’s morale

 

I have been to many a Christmas carol concert over the years but this festive season I attended one that I will never forget! The concert was held in aid of Emmaus, a UK charity that helps homeless people off the streets and of which Terry Waite CBE is president. For those young readers who may not know, Terry was an envoy for the Church of England in the late 1980’s. He travelled to Lebanon to try to secure the release of four hostages but was kidnapped himself and held captive from 1987 to 1991. Terry spent almost five years, including four Christmases, in solitary confinement without any news of his family, his friends or the outside world. Torture and mock executions were a regular occurrence.

Terry was invited to be a guest reader at the concert and he relayed a story to us of his fourth Christmas in solitary confinement……the room was dark, damp and cold. There was no source of heating and only a single blanket to keep him warm. Terry was forced to sit on the floor in the tailor’s position whilst shackled to a radiator which for a very tall man must have been torture in itself. His only source of light was a single candle; his only company, a bible. One day, after many attempts, Terry managed to encourage his guard to tell him the time and date. He was surprised to find that it was late afternoon on Christmas Eve. Terry decided to celebrate Christmas by holding his own, personal Holy Communion so saved a small piece of bread and drop of water from his meagre rations. His candle was burning low but he wanted to wait as long as possible to be sure that his celebration was as near to Christmas Day as possible. In the dying light of his candle, Terry took the morsel of bread and water, blessed it and savoured it whilst reading a passage from his bible. The moment passed as the light finally died.

When asked how he survived these lonely, unbearable years, Terry’s answer was ‘hope’!

I think in the world of the practice manager there is much hope that can be taken from this message and many synergies too. I work with many practice managers who feel lonely and isolated incarcerated in their cold offices in the rafters of their practices. Communication with busy staff can be scarce increasing the sense of segregation. On the rare occasion that a staff meeting is held, everyone wants a ‘piece of flesh’ or demands answers about something. The practice principal is generally focused on the clinical workload leaving the burden of renewed CQC inspections, financial management and human resource issues to the overloaded practice manager. The pressure to perform is sometimes torturous. On top of the internal workload scrutiny is increasing from the outside world. A week rarely goes by without dentistry featuring in media headlines and public observation of the dental profession being heavily influenced by this bad press. The weight of complaints handling and demands from patients also falls on a practice manager’s shoulders and sometimes ‘giving blood’ is still not enough in some cases!

So, where can a practice manager find ‘hope’ in such difficult circumstances? How can they release the burden, shake off the shackles and find freedom and enlightenment as Terry did? One definition of hope is ‘a feeling of expectation and desire for a particular thing to happen’. This is all well and good, but in business, hope sometimes needs to be accompanied by a ‘mental shift’ to allow change and escapism to happen.

Here are my ten top tips for seeing your hopes come to fruition:-

1.      Define your purpose – be clear as to what kind of manager you wish to be. Take responsibility for shaping the future.

2.      Embrace change – be proud of what you have achieved to date but embrace change and make improvements.

3.      Keep moving forward – view failures and disappointments as an opportunity to improve, evolve and succeed.

4.      Communicate – plan, organise and review communications with your team and patients to be effective.

5.      Lead authentically - be sensitive, open, firm and fair. Learn to listen. Be you!

6.      Believe in yourself – be prepared, have faith in yourself and be true to your inner beliefs.

7.      Make everyday count – give 100% to everything you do.

8.      Act now – deal with situations as they arise. Don’t leave things to fester.

9.      Keep a positive attitude – do not tolerate negativity or poor attitudes. Stay focused on steering a buoyant ship!

10.  Stay healthy – sleep, eat and exercise well. It has a direct impact on your mental wellbeing as well as your body.

 

Happy Christmas everyone and here’s to a New Year full of hope!

 

Image credit Mararie under CC licence - not modified.

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'Tis the season ...

'Tis the season ...

...to be Jolly, fah-la-la-la-la,la-lah-lah-lahhh

 

It is the season of Goodwill to all Men [and Women of course]. Too much food, a touch too much liquid spirit, and comfy armchair beckon for many, while Granny sups the sherry.

It is a time of year to reconnect with family, and let loose the strings of attachment with dentistry.

It has been quite a year.  If anyone has recently been affected by the extreme weather and flooding, you will have our deepest sympathy and best wishes.

 

TWTYTW

 

We have a new CDO[NHS England]  who seems to have big dreams. While her grip on reality is yet to be proven, her grip on mission creep is patently in doubt too as the New NHS Contract slides back another year.  When does evidence seeking become procrastination I wonder? 

 

Let’s not forget to toast the former CDO [NHS England] spinning the revolving door of Corporate employment. A nice little earner, some might cynically say; I could not possibly comment.  For sure, the numbers-merchants all seem in agreement.  Corporate Dentistry is a House of Cards just waiting for the crutches to be kicked away.

 

What about our soon-to-be ex-Chief Executive Officer of that great body in Wimpole Street.  I wonder how many cards of goodwill she really will receive? Goodwill to Dental Colleagues has been the byword on her watch… NOT!

 

And then of course our congratulations to the newly elected members of the BDAs Principal Executive Committee.  Is it me or is a vote of 1900 on a membership of 18000 a 10% turnout?  Is a 10% turnout the sign of a well engaged campaign and a profession with fire in their belly?  Hmmm, thought as much. 

 

So there is much to be done and as ever so little time to do it. 

 

Crystal balls, anyone?

 

Maybe 2016 will be the year that as a profession of 100,000 like-minded souls we unite into one influential body, instead of Nurses here, Therapists there, Dental Technicians under the table, Dentists arguing and never agreeing, LDCs bangin’ on to no avail, the BDA in constant denial and the FGDP worrying about ‘stuff’.  No wonder the Government can run rings around us all.

 

To you all, I bid you a Happy Christmas and an Utterly-Butterly Joyful New Year.

 

In the South, we Sassenachs favour the early celebration. North of the border of course, our Scots colleagues will be awaiting the excesses of Hogmanay.  To our non-Christian colleagues, we know you will join us in celebration in whatever way suits.

 

But wait:

 

What is this with Santa’s paw prints all over it? A PSA Report I see? Now this is a Festive card of gargantuan size.

 

Ladies and gentlemen of the Dental Profession, now you know why the Chief Executive Officer and Registrar of the GDC has pulled the Ejection Seat firing handle and is departing.

 

A report on the investigation into the General Dental Council’s handling of a whistleblower’s disclosure about the Investigating Committee 21 December 2015

 

This is a 270 Page report on the investigation into the General Dental Council’s handling of a whistleblower’s disclosure about the Investigating Committee dated 21 December 2015, but from events through the previous 3 years.

My goodness me. I take it all back.  The PSA do have teeth, they are most certainly sharp and their Regulatory jaws have closed around the neck of the GDC.

 

Close typed pages of absolute dynamite. Evidence based critical analysis of what the GDC did with your ARF that led to it having to be increased...A pantomime with an unbelievable plot by any other description.

 

Please do go read it Ladies and Gentlemen.  2016 may indeed be “The Year”

 

I also urge you to read it in the context of Dr Alyson Lockyer's brave attempt to drive this agenda in 2011 with the PSA in their report entitled An investigation into concerns raised by the former Chair of the General Dental Council Advice to the Department of Health February 2013

Many would say  she was right all along. How sad it has taken this long to prove it

 

Broadsword calling Billy Boy  …  Broadsword calling Billy Boy

 

Dr Moyes? Are you reading this…  You know what you should do.  Prove to us that you are the honourable and ethical Gentleman we believe you to be.

As should the whole Council, given the implications of poor oversight.

 

Pull up the table, You get the mulled wine, I’ll get the nibbles. Just feast on these nuggets of you will.

 

  • 6. Overall conclusions
  • What was the outcome of the failings in the Investigating Committee processes and support during 2013?
  • 6.1 The outcome was that the independence (and perceptions about the independence) of the GDC’s Investigating Committee were jeopardised by various practices that were designed to improve the quality and consistency of the Investigating Committee’s decision making, but which at the same time sought to restrict the Committee’s autonomy to an extent that infringed upon the appropriate separation of powers within a regulator. This could have had very serious implications for the GDC in terms of the robustness of decision making, potential judicial review actions and the consequent reputational damage. Those practices also had serious implications for the culture that developed in the Investigating Committee Secretariat, which in turn affected the working relationships between some Investigating Committee members and the Secretariat team.
  • 6.2  “   Changes had been made to the reasoning of Investigating Committee decision documents after the event and without appropriate authorisation … “
  • 6.14 …”The Chief Executive is ultimately accountable for the decisions taken about the level of information disclosed to the GDC’s committees and the Council, staff and GDC associates. The Chief Executive also had several opportunities to identify the seriousness of the problems emerging, even if they were not properly brought to their attention.”

 

And finally

Sub note 257, with my highlighting of the PSA final words in the Report. Hah!  Pass that English Sparkling Wine, dear - the one that knocks spots off Champagne ...

 

Here's to 2016 dear colleagues.

 

  • 257 We note that the Chief Executive has responded to our conclusion by stating that they believe that they acted appropriately and quickly in response to each risk as soon as it became apparent, and that they reported fairly and fully to the Audit/Audit and Risk Committee and the Council. The Chief Executive has stated to us that their view is that they have responded to each of the “shocks” that have occurred to the GDC with honesty and transparency and by taking appropriate action. In response to seeing a draft of this report the GDC has said that the Chief Executive’s reliance upon the former Director of Regulation was reasonable, has noted that the Authority’s 2012/13 performance review of the GDC did not identify problems relating to the Investigating Committee, and has referred to the fact that no complaints had been made by the Investigating Committee members, and has drawn the conclusion that the Chief Executive could not have had visibility of the problems emerging in these circumstances.
  • We [The PSA] do not agree

 

 

 

Try this by the way

http://www.englishorganicwine.co.uk/products/pinot-noir-chardonnay-2013-organic

 

Happy Christmas to one and all, and especially all our colleagues trying to level the GDC Playing Field.

 

 

 

 

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Merry Christmas Everybody

Merry Christmas Everybody

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GDPUK in Numbers

At GDPUK.com we love to share stats and numbers. We have created an infographic to show some of the amazing stats produced by the users of our site, we believe the infograph demonstrates how busy and active our community is. Something we are very proud of. Thanks to all the users of the site and to all the advertisers who support and engage with our community. 

 

 

 

If you would like to join GDPUK and participate and engage in the GDPUK forum please follow this link 

If you are looking to reach dentists in the UK and would be interested in advertising on our site in 2016, please This email address is being protected from spambots. You need JavaScript enabled to view it., we look forward to hearing from you. 

Merry Christmas and a Happy New Year from all the GDPUK team. 

 

 

 

 

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Davids and Goliaths of Dentistry

Davids and Goliaths of Dentistry

This post was stimulated by my re-reading Malcolm Gladwell’s book “David & Goliath”. In it he examines the underdog in several circumstances and how they have managed to overcome the odds to become victorious.

Initially I was looking to draw analogies between the “corporate” large and chain practices and the small, independent practice. My idea was to show that a good little ‘un can beat a big ‘un every time. The idea grew on me so I have expanded the remit.

Quite often when I listen to owners of small dental practices I am reminded of the children’s ‘swing song’ that starts, “Nobody loves us, everybody hates us, think I’ll go and eat worms”. Certainly when one looks at the plethora of legislation, political interference and change in consumer expectations one can understand this attitude. Yet it is those changes or rather the practices’ response to them that can make success more likely.

Let’s look at the David and Goliath of the title. David was smaller, poorly equipped and had no experience of battle. Goliath on the other hand was battle hardened and massive in terms of both physical size and equipment. But we know the result, one slingshot brought the giant to defeat.

Perhaps with these two protagonists we saw a hint of the first guerrilla war. History shows that a larger organisation doesn’t approve of small groups. Michael Collins and his flying columns had learned lessons from TE Lawrence (of Arabia) whose methods, although successful, were frowned upon by the British authorities.

The Davids of Dentistry are used to being the smaller person, indeed one of the reasons for successful small practices is that the owner will put in hours outside the “9 to 5” for repairs, maintenance and upkeep. These hours are never allocated in year end accounts. The successful Davids are light on their feet, flexible and adaptable, they know their terrain and where they can operate to best advantage.

The Goliaths have capital, resources and are “business savvy”, whatever that means. They can absorb wasted efforts, tolerate inefficiencies of staff and materials and, above all, can take a long view.

The negative for the Davids is that they can get stuck in a rut of reacting to circumstances and their campaigns are short term. Financial survival is usually at the top of their agenda meaning that they tend not to consider a long term strategy. In order to survive they need, in the words of Alastor Moody, constant vigilance, this becomes wearisome with time and contributes to their eventual burn out.

On the downside for Goliaths is their rigidity and lack of conventionality as their bean counter driven businesses seek to impose an external model onto a personal service. A surfeit of management levels and often unsympathetic HR practices mean that their teams operate at less than optimum efficiency.

The important thing for Davids has been to avoid the  temptation to take on the Goliaths at their own game and terrain because they will surely lose. With market changes it becomes more and more difficult in the post Shipman world for David to remain profitable. The battlefield has morphed too, the big armies of Goliath have taken a lot of the easy low ground of the NHS contracts and can use their clout and experience to bid for more.

Davids must choose their battles, battlegrounds and to time their campaigns with care. They need to learn not only from Goliaths’ mistakes but also from their successes and ensure that they are strong where their opponents are weak. In addition they must look at all the Davids in other professions and industries for inspiration.

Can Goliath learn? Of course he can. To my knowledge nobody has devised a franchise operation in Dentistry that reflects the unique elements of the profession, rewards the franchisee and gives them a sense of freedom. Not yet but with imagination it could work if done properly.

The pattern of post-war Britain has been about smaller companies being absorbed by larger ones. Is it possible for the independents to stay small and free of involvement? Perhaps the model for freedom is one of small managed groups of practices? Here much of the tiresome “grunt” work is centralised. It is this work that, in my experience, ultimately leads to owners losing their resilience, their final fatigue and despair. This sees with them reluctantly selling to a Goliath or to another increasingly cash-strapped David to perpetuate the battle. This group model leaves the clinicians and customer facing team members to do what they are good at with support coming from dedicated and probably off site back office.

All wars eventually end with talks and compromise. The challenge for the different Davids is to find someone with whom you can share a philosophy of business and agree a way forward to keep your places on the battlefield of dentistry. This way the strengths, efficiencies and independence of you Davids can be continued.

 

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Pension Auto-Enrolment; 'We're All In'

Pension Auto-Enrolment; 'We're All In'

In October 2012 a positive duty was placed on all employers to automatically enrol ‘eligible job holders’ in to a qualifying pension scheme. For most Dental Practices the relevant date for complying is likely to be early next year. If your Practice has not been given the relevant date yet, then you should expect notification imminently. A failure to comply with this duty can result in a penalty notice with a fine or enforcement action being taken against you. Enforcement action can consist of inspections being carried out on premises, which is yet another layer of bureaucracy for Dental Practices to comply with.

In this Blog we take a look at who is eligible for auto enrolment; what is a qualifying pension scheme; and what you must do to comply with the auto enrolment requirements. We also explain the continuing duty placed on employers to re-enrol eligible job holders.

Who must comply?

All UK employers must comply with the auto enrolment requirements, even if you employ just one eligible job holder. The only exception to this is if the eligible job holder is already in a qualifying pension scheme.

If you currently do not employ anyone but offer an eligible job holder a position following your relevant date, you will have an obligation to enrol them into a qualifying pension scheme from the start of their contract.  

Who is an Eligible Job Holder?

An eligible job holder is a worker who:

•       Is working under a contract;

•       Aged at least 22 and under State Retirement Age;

•       Earns at least £10,000 (in 2015/2016);

Therefore it’s not just employees who must be enrolled; it is workers, agency staff, apprentices, and could even extend to some self-employed contractors. It will also cover permanent and temporary staff and those on fixed term contracts.

Given this is a relatively new scheme, there is limited legal guidance as to what an eligible job holder, or worker, will be for the purposes of the Pensions Act 2008. However, the definition is similar to that found within the Employment Rights Act 1996. As such, we can look to existing case law to assist with the definition of a ‘worker’ under the new act.

Interestingly, in the case of The Hospital Medical Group Limited v Westwood [2012] EWCA Civ 1005 the Court of Appeal held that a GP working as a self-employed independent contractor for a private clinic was a worker.

Dr Westwood held three positions. He was contracted by the Hospital Medical Group Ltd to perform hair loss surgery for its clients; he was referred to in marketing material as ‘one of our surgeons’. He also had his own medical practice which he worked at, and finally, he had a contract to provide advice on transgender issues with another separate clinic.

When asked to determine whether he was a ‘worker’ at the HMG Ltd, the Court of Appeal held that there is a distinction between those who market their services independently to the world in general and those who are recruited by the principal to work as an integral part of the principal's operations. Whilst there was no requirement for the clinic to provide work and for Dr Westwood to accept it, the HMG Ltd had engaged Dr Westwood because of his skills. The patients were clients of the clinic not Dr Westwood. He was therefore recruited by the principal as an integral part of the principal’s operations. He was therefore considered to be a worker despite the flexibility of his role and the terms of his written contract stating he was a self-employed independent contractor.

The parallels between Dr Westwood’s position and that of most self-employed Associate dentists are clear. As such it seems extremely likely that for the purposes of pension enrolment legislation, Associate dentists will be considered an eligible job holder working under a contract. As such they will need to be included in Practice’s qualifying pension scheme, unless of course they choose to opt out. 

Practices will also need to consider their company structure when considering who is eligible for auto-enrolment. In the case of Clyde & Co LLP and another v van Winklehof [2014] UKSC 32 the Supreme Court held that a member of a Limited Liability Partnership was a ‘worker’ for the purposes of whistleblowing legislation. In this case Ms Bates van Winklehof was an equity partner receiving a profit-related element of remuneration and a guaranteed level of remuneration. Ms Bates van Winklehof made a complaint that a managing director had accepted brides. She was subsequently removed as a partner of Clyde & Co. Ms Bates Van Winklehof alleged this removal was due to a protected disclosure, a claim a worker is entitled to bring.

The Court’s reasoning for finding that Ms Bates van Winklehof was a worker was because she could not market her services for anyone other than Clyde & Co and she was an integral part of their business. 

The result of this judgment means Limited Liability Partnerships will need to enrol their members into a qualifying pension scheme if they meet the other requirements, including the minimum qualifying earnings. If the member received drawings based on the company’s profits there is a question as to whether these would be classed as ‘earnings’. Although the definition of earnings is wide and we would recommend automatically enrolling members in any event to avoid litigation.

The position would be different for partners in a traditional Partnership Agreement, as a partner cannot employ themselves and would therefore not been deemed a worker.

As most Dental Practices are Limited companies, it is worth bearing in mind that a Director of a company is a worker only if he is also employed by the company under a contract of employment and there is at least one other person employed by the same company under a contract of employment.

Exceptions

There are some exceptions to the requirement to auto enrolling eligible job holders and these are:

•       Job holders in their notice period within six weeks of the enrolment date;

•       Job holders who have cancelled their membership after being contractually enrolled;

•       Job holders who are receiving a benefit from a lifetime allowance;

•       Job holders who have received a winding up lump sum.

What is a Qualifying Pension Scheme?

A qualifying pension scheme is an occupational or personal pension scheme or a registered pension scheme that satisfies the quality requirements. You should talk to your current or proposed pension provider to get advice on this or you can find out further information here.

The Government’s ‘NEST’ scheme is an automatic enrolment scheme, as is the NHS pension scheme. However, if the eligible job holder is not able to register in the NHS pension scheme then employers are under an obligation to find another qualifying pension scheme for them. An example of this would be someone who has retired, but later decides to return to work. If they are an eligible job holder still they will need to be enrolled into a qualifying pension scheme.  

Non-Eligible Job Holders and Entitled Workers

A non-eligible job holder is:

•       Aged between 16 and 21 or State Retirement Age and 74 and earnings in excess of £10,000; OR

•       Aged between 16 and 74 with earnings between £5,824 and £10,000

Although they are not eligible for auto-enrolment, they must be made aware of the scheme and have the right to opt-in. If a non-eligible job holder opts into a qualify pension scheme the employer must make the minimum pension contribution, which at present is 2% of which the employer pays 1%.

Finally, there are entitled workers who are:

•          Aged between 16  and 74 and has earnings under £5,824

Similarly, these workers must be made aware of the pension scheme and their right to join. However, there is no obligation for an employer to make the minimum contributions for this class of worker.

What Next?

Once a practice owner is informed of their relevant staging date they will need to:

·         Find an appropriate qualifying pension scheme;

·         Provide workers with information about the pension auto enrolment before it takes place; and

·         Enrol any eligible job holder into a qualifying pension scheme if they do not opt out.

To find your relevant staging date, click on this link.

It has been suggested that the process can take up to 12 months to complete so we recommend preparing early.

You need to write to employees within 6 weeks of the staging date. For an example letter to send to eligible job holders and an opt out form, click on this link.

Ongoing Duty

There is an ongoing duty to auto enrol. Even after your staging date has passed you will need to be aware of the following re-enrolment dates:

  • As soon as a job holder becomes eligible the employer must auto enrol. You have one month to make the necessary arrangements;
  • After three years the employer must auto enrol any job holders who previously opted out;
  • If a scheme no longer qualifies as a relevant scheme the employer must enrol the job holder into a relevant scheme.

Employment Protection Safeguards

The Pensions Act contains specific duties for employers to safeguard their workers’ rights in connection with auto-enrolment. It should be noted that these safeguards apply regardless of whether you have reached your staging date yet, and will apply to current and potential job holders. Below is a brief outline of the employment protection safeguards currently in place; a more detailed look at these can be found here.

Prohibited Recruitment Conduct. Employers must not ask questions or make statements as part of the recruitment process that indicate that an individual's application may depend on whether or not they opt out of auto-enrolment. This is enforced by the Pensions Regulator; it does not give rise to a separate claim in the Employment Tribunal by the individual.

Inducements. This is any action which has the sole or main purpose of inducing a job holder to either opt out or leave a pension scheme, or inducing an entitled worker to leave a pension scheme. An example of this would be re-negotiating contractual terms at a lesser rate if the sole or main purpose is to take into account the cost of implementing pension auto-enrolment for that individual. Again this is enforced by the Pensions Regulator; it does not give rise to a separate claim by the individual.

Right not to Suffer a Detriment.  A worker has the right not to suffer a detriment by their employer on the grounds that:

  • any action was taken, or was proposed to be taken, with a view to enforcing a requirement under the auto-enrolment regime in favour of the worker; or
  • the employer was prosecuted for an offence under section 45 of the PA 2008 as a result of action taken for the purpose of enforcing a requirement of the auto-enrolment regime in favour of the worker; or
  • any requirement of the auto-enrolment regime applies to the worker, or will or might apply.

If a worker does suffer a detriment then this will give rise to a claim that can be pursued in the Employment Tribunal. As above, re-negotiating terms could be seen as detrimental treatment. Alternatively, offering new workers lower rates to take into account the direct cost of pension auto-enrolment for that individual could be seen as a detriment.

The situation may be different if pension auto enrolment causes your Practice financial hardship; this could potentially be seen as a valid reason to re-negotiate contracts. However, this will be fact sensitive depending on the circumstances of your business, so if you are planning to take direct action then you should seek specific legal advice.  

Automatic Unfair Dismissal. If you dismiss an employee and the main or principal reason for that dismissal is one of the three points highlighted above under ‘right not to suffer a detriment’ then that dismissal will be deemed automatically unfair and the employee can pursue an Employment Tribunal claim. This right only applies to employees; not workers.

Whistleblowing. Workers are already protected from detrimental treatment as a result of blowing the whistle on their employer. If a worker makes a complaint to the Pensions Regulator and suffers a detriment as a result of such a complaint, then they will have protection under whistleblowing legislation. In the case of a worker this could include their contract being terminated; so whilst they may not have a right to claim unfair dismissal they may have a claim for whistleblowing.

This is yet another financial burden being placed on small businesses. However, given the consequences of not complying with the law, it is important to know what you must do and when; ensuring you are prepared in advance will help take the stress out of implementing pension auto enrolment and help you plan for the future.

Pension Auto Enrolment is a vast area of law and as such this Blog gives an overview of your duties. For more detailed information you can visit the Pensions Regulator website here

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Dentists-vs-Nurses

Dentists vs Nurses

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NHS Chooses - Dental Reviews

If Stephen King wrote dental reviews

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9117 Hits
DEC
04
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Enter the Dentists' Provident Survey and win a Speaker!

 
 
 
 
 
 
 
At Dentists’ Provident they protect dentists in the UK and Ireland with income protection cover when a dentist can’t work because they are ill or injured. As a mutual, members are at the heart of our organisation.
 
They would like to learn more about your daily habits so they would be grateful if you could spend a few moments completing this survey, for your chance to win one of two Bluetooth® speakers.
 
 
 
Click here for the survey - Dentists' Provident Survey
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9474 Hits
NOV
30
0

True Confessions

True Confessions by @DentistGoneBadd

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© DentistGoneBadd, GDPUK Ltd 2015

12252 Hits
NOV
29
1

Acccountability - A level playing field?

Acccountability - A level playing field?

All through my life I have had to account for my actions and omissions to somebody. Parents, teachers, the wife (sometimes J ), and obviously now to my patients and regulators. This is no different to any of you reading this. Accountability for our actions keeps us on the correct path (hopefully) and having a regulatory mechanism and a legal system that should be just and proportionate helps to define what that path is. Whether our spouses are just and proportionate in keeping us on that path is another matter entirely!

But we work in a system where there appears to be very little or even a complete absence of accountability for the actions of those who influence us in some way.

The departure of Ms Gilvarry from the GDC is a case in point; I’m sure there will be rather nice pay off from the ever expanding coffers of the Wimpole Street Complaints Enforcement Company that she currently runs. Following this will presumably be a move into another similar role where her unique skills and qualities will be valued just as much as they were on Wimpole Street. She departs not a moment too soon for the profession in my opinion, but what should stick in the minds of each and every one of us is that there will be absolutely no accountability for the debacle that has occurred during her tenure at the GDC once she has left her post. Had any one of us dental registrants been at the head of our individual organisations and found to be lacking to the degree the GDC has, then our regulators (both GDC and CQC) would have had no hesitation in making us accountable for our inabilities to manage and provide our patients with an appropriate and safe service. I’m absolutely sure if we had been found to be acting in an unlawful manner then the full weight of accountability would have come crashing down on us very rapidly.

Surely rather than a pay off there should be some form of public accountability that executives in positions like this should answer too. The money from any pay off could be placed in a fund to support those practitioners who have suffered injustice at the hands of the GDC in the period of her tenure. It won’t be anywhere near enough, but it would a start and an acknowledgement by the GDC that they have often got it wrong and need to make reparations. And yes, I still believe in the tooth fairy.

The recent report into the HBOS crash in the recession has ruled that about 10 of the executives were culpable in some way for the mismanagement of the company. It has been recommended that they never work in banking again. Whilst I’m sure they will still get lucrative posts in industry (and some indeed have already), at least there is an accountability for their actions in some way and a degree of public shaming. The Iceland banking crash resulted in jail sentences for those found to be culpable which many feel was an appropriate redress.

In addition, we still have a Council that appears to be run similarly to the politics of Zimbabwe. Where is the mechanism to address this? The registrant members of the Council do not seem to be making any difference whatsoever to the decisions made. Are they there just to keep the numbers up? Aren’t they supposed to be part of the accountability system the Executive answers to? And why is there no public mention to the stance Council members are taking? Is every vote unanimous these days? Such questions need a mechanism of accountability to be in place to answer them.

A chief executive is no different to the captain of a ship. There might be various members of crew responsible for various aspects of the running of it; but it is the captain who is in ultimate charge and therefore has the final responsibility. Captain Smith went down with the RMS Titanic, in effect accounting for his responsibility with the ultimate sacrifice of his life. The tragedy of the Costa Concordia has resulted in criminal accountability for the captain who unbelievably left the sinking ship before all the passengers had. Anyone who leaves a ship prematurely that is sinking due to their poor leadership and navigational skills is thinking only of themselves; no consideration to the effect of the disaster on other people’s lives can be at the forefront of their minds, and saving their own skin is paramount. The Council is effectively equivalent to the Directors of a shipping line, and they too can be found liable for policy errors that lead to disaster. The difference is maritime law has robust legislation and accountability for these people, and justice is usually swift, fair, and effective.

Unfortunately we never seem to see this in our profession. From the Commissioners who continued to allow ludicrous amounts of UDA’s over the years in the D’Mello situation, to the lack of appropriate measures taken against the corporate mismanagement in the Stafford fiasco, there is always a scapegoat found in the medical, nursing or dental profession to take the fall. Until we have some form of register for people in the higher echelons of regulation and management of our healthcare in the UK, we will always have this lack of accountability and problems will continue. For instance, if I forgo my registration with the GDC and go off to run a hospital incompetently then there isn’t really any likelihood of a significant punishment that will end my career, ill probably just get moved laterally or get a consultancy position somewhere. There seems to be a reluctance to press for corporate manslaughter charges, and vicarious liability seems to be rarely found. Yet if I forget to write down a medical history or fail to justify my reasons for placing LA whilst simultaneously allowing my child to sit behind reception doing some colouring-in then potentially its career over. Our accountability has gone too far, yet for many others it doesn’t go anywhere near far enough.

We have regulatory bodies and members of those bodies that are accountable to no-one. We have non-dental registrants at the head of dental corporates, companies and organisations who are accountable to no-one, yet are setting policies or advertising services that could affect the care of patients adversely. We have dental registrants at the head of businesses that blame the individuals at the tooth-face for problems, whilst chasing profit in preference to supporting the clinicians appropriately. We have an Ex CDO who has supported the flawed UDA’s system passionately despite all the obvious problems with it. We’ll have another contract from the DoH eventually that will only be designed to further cut the budget and get us to provide more for less. We have expert witnesses who appear to be unable or unwilling to use the correct standards without any redress. And we have Commissioners and Management who in many cases are promoted far beyond their abilities and understanding of healthcare. I can’t recall reading anything of the accountability of any of these groups recently, but please correct me if I am wrong.

Hopefully the new CEO at Complaints Enforcement Plc will have a more proportional idea of how the Dentists Act should be enforced. Because enforced it has to be; but please, not with a zeal verging on fanaticism; it has to be with the right touch and a realisation that this profession is generally very, very good at what it does for the patients and that true misconduct and dishonesty is actually quite rare. But until all those tainted by the problems at Wimpole Street have accepted their responsibilities and left then nothing will change. The shipping line will get to choose a new captain, but we still can’t get off the ship. Bill Moyes expects our patients to have choices and make us accountable, but is impregnable from such actions himself. We need an entirely new crew who are not used to piloting a battleship with its guns constantly trained on the profession whilst getting it to pay for the ammunition used in the barrage.

Until we have accountability for all those currently immune against the effects of the mistakes that humans naturally make then they will never be able to empathise with what we go through on a daily basis in our professional life. Only by respecting the responsibility we have because of the accountability we have, firstly to our patients and then to our regulators, will they finally appreciate what we do and the problems we encounter. The old Council with its primarily registrant make up had this, and the profession wasn’t any more unsafe then than it is now. In fact, in my opinion it is actually far more unsafe for patients now when practitioners are working defensively, and when you can get a single complaint ending a career, without accounting for the thousands of patients who were being cared for (probably) appropriately by that practitioner. Just who is going to be made accountable for this damage to patient care long term?

Because without full accountability for all those involved in providing, regulating and commissioning healthcare, nothing will ever change.

  11301 Hits

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© Simon Thackeray, GDPUK Ltd 2015

Recent comment in this post
Vimal Hathiramani

Great article.

Couldn't have put it any better. ..Now, who is going to solve our problems. .... Read More
Saturday, 12 December 2015 08:50
11301 Hits
NOV
26
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Do you have a story to tell?

Do you have a story to tell?

I saw this advert on Youtube the other day when it appeared before a Youtube video that I subscribe to. I was waiting to watch the latest Vlog from Casey Neistat, when this advert really caught my attention. It caught the attention because of one simple theme, a theme that has been used for centuries. The advert told a story, something humans have been doing for ever. Watch the story about LeeFest below. Further information about LeeFest can be found below the video.

http://leefest.org.uk/holding/index.htm

 

Brands using storytelling is far from a new concept and obviously just telling a story doesn’t make you a fascinating brand but if a story is presented in the right way, it adds something different to what you are offering and makes you stand out from the crowd.

 

Thinking deeper about the LeeFest advert which as you have hopefully seen is actually for Android devices, I wasn't thinking I want an Android phone or I must get on Google but that the advert managed to catch my attention and pull me into a awesome story and that was why I liked it. Yes it makes my mind aware of the Android brand but I didn't feel like I was being sold to, I just got taken in by a simple tale and I think that is something we all get attracted by. Examples crop up in our everyday life all the time. This could be a Facebook post someone shares, an advert like I am sharing in this blog or a great story shared between friends down the pub (old skool!). The perfect example was from a few weeks ago when the John Lewis Xmas advert was released, it was eagerly anticipated and everyone quickly had an opinion on it. I am sure the advert has been shared an amazing amount over social networks. Read more here. The advert told a story, which got people talking and exchanging views, whether they liked the advert or not!

 

I have never followed anyone's vlogs before on a consistent basis until I started watching the earlier mentioned Casey Neistat on Youtube and I think the reason I have found them so enjoyable and addictive is because each vlog follows his daily life in NYC as a businessman and filmmaker and it always involves a story or an adventure. He has a fantastic ability to tell a story within a few minutes, with his unique personality shinning through. This skill to tell stories through Youtube has made his channel gain 1.5 million subscribers and has led to many opportunities that I am sure he uses to his advantage to improve his brand (which is him), as well as setting up the video based social network Beme, which also has the theme of storytelling as the main aim!

 

 

So what is our story? GDPUK was established in 1997 by Tony Jacobs when he realised that dentists in the USA were talking to each other over email on a regular basis but there was nothing similar in the UK. Tony wrote a letter to the BDJ to see if other like minded dentists wanted to network and discuss dentistry over email, he supplied his email address and colleagues started emailing him! As simple as that. GDPUK was born. These emails then evolved into a Yahoo mailing list which eventually carried text advertising and then in 2008 our current site was born and we haven’t looked back since. As we approach 9500 members and over 220,000 posts on our forum, we would like to think that we still have a community spirit and that all members feel part of something that has made a positive impact on UK Dentistry. Colleagues have been brought closer together and have made friends for life. Plus they get to help their fellow dentists and offer plenty of advice! The GDPUK story is still evolving and we can’t wait for what the next chapter will bring.

 

Do you or your brand have a story to tell? How can you get your message across in a different way that attracts the audience you are looking for? What story can you share with your potential or current clients?

 

  5769 Hits
5769 Hits
NOV
25
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Wimpole St PECking Order

Wimpole St PECking Order

PECking at the BDA

 

The BDA claims to be your representative body and the Principal Executive Committee is its leadership board. It is elected by you, if you are a member.

Are you one of the 18000 odd BDA members who have heard the distant thud of voting papers landing on your mat?  Have you read the Candidates Statements? You may read them here https://www.bda.org/pecelections

If you have waded through them, you may be forgiven for wondering if the candidates have been reading the dental news!

If you are not a member of the BDA then you may read the list at https://www.bda.org/news-centre/press-releases/Pages/The-candidates-bidding-to-lead-the-profession.aspx

While I admire the concept of leading the profession, and for sure Mick Lad is slapping few heads, I do worry that this reflects an assumed position of strength that is perhaps not wholly justified.

 

For starters, who will lead the 22000 other odd dentists [a greater number, no less] and who will lead the DCP’s – some 60000?  So representing 18000 to “lead” a profession of 100,000 is in my book, bordering on spin of political magnitude. Never mind, move on.

 

Are the candidates REALLY in touch at your level, at my level?  Do they really understand the wet fingered challenges we face?

The news I referred to of course is regarding our old muckers, Cruella and Billy Boy. If their divorce is well signalled in advance, the ARF announcement must be their parting gift to all their friends.  How sweet.

 

BARF

 

I cannot refer to our annual Practice Tax without using an expletive as the first word. Many years ago, in student days, such a word would suggest advanced post alcoholic nausea.  Sadly, I can see a startling similarity nowadays!

In case you missed it. it was serenely announced that the relentless march of arrogant loftiness continued as the GDC, without hint or irony or guilt, agreed to maintain its role as the most expensive [and arguably useless] Regulator in the UK. Proud and passionate, Premier League stuff – indeed with the ARF at this level they should be able to afford a truly gifted player soon, so swollen will be their Reserves.

“Dr William” has become curmudgeonly friendly “Bill” again as he seeks to avoid the need to spend more time with his family.

There is talk about the insanity of it all [see Michael Watson’s excellent analysis at Dentistry http://www.dentistry.co.uk/2015/11/24/the-insanity-of-the-gdc/ ]

The BDA have issued a strongly worded response at https://www.bda.org/news-centre/press-releases/Pages/ARF-freeze-a-choice-not-a-necessity.aspx speaking of the GDC making a choice to simply rob dentists of excessive ARF fees.

The FGDP have also come down in utter contempt for the GDC Leadership at http://www.fgdp.org.uk/content/news/fgdpuk-reaction-to-general-dental-councils-decisio.ashx

Saying  “it may be patients who suffer as a result of the GDC’s actions”

 

PECking Elections

So it is an opportune time [voting closes 14th December 2015] to see if the mood of the BDA Leadership will truly reflect the outside mood of anger.

I am struck that of the 22 candidates, many have issued look-back statements of their achievements, and simply assumed that will be good enough.

Indeed, what a fine profession we have and the contribution that these colleagues have made over the years to the profession of dentistry and the wider community simply cannot be overstated.  Please take note Mr Hunt.

They are truly amazing and we should salute them.

 

But I was also struck by the fact that of the 22 National Candidates to lead the profession, only 8 made any real mention of the GDC.

 

We can but hope that Dr Armstrong welcomes some proactive colleagues to the Principal Executive Committee if his lead of the fight against the GDC is to carry any momentum in 2016

 

Your vote counts

 

At the moment, in the proper voting sense, the Jury is very definitely out.

If the BDA and its PEC are to be an effective representative body, I think the second year of a near £900 ARF suggests that they need to play harder, and kick more accurately. They are 2-0 down and this election suggests that members had better vote carefully if the match is not to be a whitewash.

 

A wise BDA with its eye on the ball would aim its actions at the other 80000 non members as well, that being the biggest investment in future membership and the wellbeing of the profession that can be achieved.

 

Here is hoping for better results in 2016.

  7752 Hits

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© Enamel Prism, GDPUK Ltd 2015

7752 Hits
NOV
23
0

Clickbait

Press here to begin

  8806 Hits

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© DentistGoneBadd, GDPUK Ltd 2015

8806 Hits
NOV
20
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Social Engagement Proves Powerful

Social Engagement Proves Powerful
Last month I wrote a short blog on Denplan's new TV advert which was and is exciting for the dental profession. The early results of the advert show some really positive engagement stats and suggests that Denplan's strategy of using a hashtag and encouraging social engagement has really paid off. It is great to see a positive reaction from this campaign and shows the importance of an all around marketing plan that uses a range of mediums to engage with the target audience.
 
Denplan’s high profile national TV advertising campaign ran throughout October and received a fantastic response from the public, dental profession and Denplan members. Below are a few stats that have been shared by Denplan. Although these obviously have their promotional slant on them, it is obvious that the impact of the advert was huge and has been great for the profession and Denplan. Not only will Denplan members have benefited from the advert but I also think that other plan providers will have also seen a boost in their numbers after the advertising campaign.
 
A few interesting stats have been shared and listed below but two really caught my eye. Firstly its shows the amazing reach of TV adverts, in that it is estimated the advert has reached 20 million consumers and secondly the increase in visitors to the Denplan website is really impressive, with a 158% increase from previous months.  
 
Web
  • Nearly 60,000 online searches on the ‘Find a Dentist’ page - a 223% increase*
  • More than 150,000 visitors to the Denplan Website - 158% increase**
  • Over 26,000 visits to the #Doitforyourselfie microsite in October
* compared to average monthly searches in 2015
** compared to average monthly new and returning visitors in July 2015
 
Social
  • 1 million people reached on social media, using #doitforyourselfie
  • The advert was viewed over 200,000 times on social media
  • The advert was viewed for 123 hours on Twitter
 
TV Coverage
  • The advert reached over 20 million consumers across the UK
  • On average people saw the advert four times
Dentist Feedback
  • 90% of Denplan’s member dentists agreed with the statement: “I am proud that Denplan are encouraging people to love their teeth”

 

Thanks for reading as always, let me know your thoughts on this campaign and how it was received by your patients?

 

  5554 Hits
5554 Hits
NOV
17
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The Nation’s Oral Health

The Nation’s Oral Health

This month is Mouth Cancer Action Month, a charity campaign set up by the British Dental Health Foundation (BDHF) to raise public awareness of mouth cancer. The campaign has been long running; spearheaded by the late Richard Horner, founder of Scope Group and well known among the dental media and trade, in 1998. He retired in 2003 and handed over the project to the BDHF, who have done much work to raise awareness of mouth cancer;  pushing through changes in legislation in relation to the tobacco industry, including a direct marketing ban and the smoking ban.

Over the last year concerns over the Nation’s oral health have hit the headlines; from concerns over children’s oral hygiene, the effect of sugar and proposals for a ‘sugar tax’, and more recently revelations regarding the poor state of professional footballers’ teeth. This article will consider the nations awakening interest in all things oral health, and what impact this has on the fight against mouth cancer.

Children’s Oral Hygiene

In 2013 the Health and Social Care Information Centre commissioned a survey in relation to Children’s Dental Health. This survey has taken place every 10 years since 1973 to track changes in the oral hygiene of children.  The results were published in early 2015 and found the following:

·         The nearly a half (46%) of 15 year olds and a third (34%) of 12 year olds had “obvious decay experience” in their permanent teeth. This was a reduction from 2003, when the comparable figures were 56% and 43% respectively.

·         The proportions of children with some untreated decay into dentine5 in permanent teeth have also reduced, from 32% to 21% of 15 year olds and from 29% to 19% of 12 year olds.

·         In 2013, nearly a third (31%) of 5 year olds and nearly a half (46%) of 8 year olds had obvious decay experience in their primary teeth6. Untreated decay into dentine in primary teeth was found in 28% of 5 year olds and 39% of 8 year olds.

·         In 5 year olds, the average number of primary teeth with obvious decay experience (dmft) was 0.9. Among 5 year olds with such decay, the average number of teeth affected was 3.0.

·         In 12 year olds, the mean (average) number of permanent teeth affected by obvious decay experience (DMFT) was 0.8. Among 12 year olds with any such decay, the mean number of teeth affected was 2.5.

The survey also looked at lower income families by assessing the oral health of children who had free school meals. The findings for this group were as follows:

·         A fifth (21%) of the 5 year olds who were eligible for free school meals had severe or extensive tooth decay, compared to 11% of 5 year olds who were not eligible for free school meals.

·         A quarter (26%) of the 15 year olds who were eligible for free school meals had severe or extensive tooth decay, compared to 12% of 15 year olds who were not eligible for free school meals

Around this time the Faculty of Dental Surgery at the Royal College of Surgeons of England (RCS) also published a report in relation to the state of children’s oral health. The RCS was seriously concerned about the state of oral hygiene in children and noted the regional inequalities in the results. The report confirmed that in 2013-14 approximately 46,500 children under the age of 19 were admitted to hospital with a primary diagnosis of dental caries.  The RCS estimated that 90% of dental caries are preventable.

Sugary drinks have been blamed for the poor oral hygiene in children, with many seeing sugar as the new tobacco. We reported on this in Issue 4 of our Dental Bulletin, at which time Tesco had banned sugary drinks from its shelves and Coca-Cola had funded research which down-played the effect of sugary drinks on teeth.

 

Since that Dental Bulletin the Government has come under increasing pressure to implement a sugar tax and for the food industry to have clearer packaging as to the amount of sugar in their products.

Jamie Oliver has been a campaigner for the sugar tax for a while, even implementing the tax in his own restaurants. He has a ‘five point sugar manifesto’, which includes the sugar tax and banning advertisements for junk food before 9pm. On 19th October 2015 he also appeared before a committee of MPs to discuss the sugar tax, in which he asked David Cameron to ‘frankly, act like a parent’ with the food industry.

Meanwhile, Jeremy Hunt was accused of delaying Public Health England’s (PHE) report on the subject, which was meant to be published in July 2015. The report was finally published on the Government website on 22nd October 2015; it appears his hand was forced after Dr Alison Tedstone, director of diet and obesity at PHE, went public with details of the report.

The highlights from the report are:

·         Treating obesity and its consequences alone currently costs the NHS £5.1bn every year;

·         Reducing the Nation’s sugar intake in the next 10 years to the recommended 5% (or 30g per day) could save the NHS £484m a year;

·         The influencers to buying sugary products include:

o   Advertising:

o   Food retail price promotions. Foods with higher sugar content are among the highest food retail price promotions on offer in stores:

o   Taxation on products:

·         Evidence shows lowering sugar in foods will help reduce consumption. This has a proven track record in relation to the reduction of salt in foods;

·         The report recognises that one single action will not be effective and a combination of changes will be needed to reduce the sugar intake of the Nation. Eight changes are recommended and these include:

o   A price increase of  a minimum of 10-20% on high sugar foods:

o   Reduce and rebalance price promotions;

o   Reduce opportunities to market and advertise.

What is evident from reading all the reports above is that children from lower income families are amongst the worst affected. Yet the Government is still reluctant to take action against the food industry. This is surprising as greater public awareness of the risks of sugar will surely help increase calls for change, hopefully resulting in similar action being taken against the food industry as has been achieved with the tobacco industry. 

Professional Footballers

On the opposite end of the spectrum, recent research has shown that wealthy professional footballers are amongst the worst culprits for bad oral hygiene.

Research carried out by University College London and published in the British Journal of Sports Medicine, found that nearly 4 out of 10 professional footballers have ongoing tooth decay; 57% have tooth erosion; and 8 out of 10 have gum disease, which in some cases was irreversible. Compare this with the national average, where 3 out of 10 adults suffer from tooth decay.

So why is it that professional footballers have such bad oral hygiene? Again, sugary drinks may be to blame, with the footballers drinking sports drinks during training sessions and games to help maintain energy levels. However, with appropriate oral hygiene, it has not been proven that drinking such drinks would harm teeth.

 

Similar research was carried out by the same study author, Professor Ian Needleman, on professional athletes during the London Olympics in 2012 and this report had similar findings in relation to the state of the athletes’ oral health.

Many people may be surprised at how oral hygiene can have an impact on one’s health and well-being in general. 7% of professional footballers and 18% of professional athletes said bad oral health had affected their training.

Dr Claudio Peru is a specialist endodontist and the principle at Chiswell Green Dental Centre.  CGDC have been working with Watford FC for the last two years, during their rise to the football Premier League. Dr Peru is responsible for the dental health for the players. His view on the importance of dental health in elite sports people is as follows:

“The importance of ensuring optimal dental health for professional athletes, including footballers, cannot be understated. By ensuring the dental health of players, they are able to train and perform during matches without being impaired by acute or chronic dental problems. There is an obvious economic advantage to the club. In particular we find that by addressing occlusal imbalances we are able to optimize neuro-muscular coordination and the postural balances. This is particularly important for the competitive performance of athletes.”

The studies did not give any conclusions as to why these professionals had such poor oral hygiene; many saying they visited a dentist regularly. With access to the best dentists and products surely there is no excuse for this.

Mouth Cancer Action Month

Mouth cancer is one of the few remaining cancers that is likely to increase in numbers in the coming years; the disease has already increased by a third in the last decade. In the UK last year 6,767 people were diagnosed with mouth cancer.

Mouth Cancer Action Month hopes to raise awareness of the symptoms of mouth cancer and the benefits of taking action early on.  The key message from this campaign is that early detection is key and it encourages the public to regularly visit their dentist.

The British Dental Association (BDA) has published an article highlighting the vital work dentists and their teams have in making the public aware of mouth cancer and early detection. It confirms that if detected early there is a 90% survival rate; compared with 50% where diagnosis is delayed. 

The BDA is also supporting HVP Action’s campaign for the HVP vaccination given to girls to be extended to adolescent boys (rather than just those between 16 and 40 who are having sex with men as recommended by the Joint Committee on Vaccination and Immunisation). It is thought that the HVP virus is likely to rival tobacco as the number one cause for mouth cancer in the coming years; the rate of mouth cancer is expected to double between 1995 and 2025.

If you want to get involved in Mouth Cancer Action Month you can visit their website here. We will be doing our part to raise awareness; look out for JFH Law’s #bluelipselfie.

Laura Pearce, Senior Solicitor

  17864 Hits
17864 Hits
NOV
16
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Poetry of Complaint Handling

The Poetry of Complaint Handling

  9326 Hits

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© DentistGoneBadd, GDPUK Ltd 2015

9326 Hits
NOV
16
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What our members say about GDPUK

What our members say about GDPUK

Hello everyone, 

Below you will find a video of some testimonials we collected at the BDIA Showcase in October. As you can gather from the short video, our members love using the site, finding it very useful and interesting. Our users find the site becomes a part of their daily routine. Have a watch and please share with anyone that hasn't discovered the site yet! Thanks to all the members featured. 

Tapatalk

Mobile has been the biggest thing in the digital world for a number of years, all of us love to use our smartphones and apps on an increasingly frequent basis. Over the years GDPUK have explored the ways in which we can embrace the move to mobile but unfortuntely have never quite found anything satisfactory. But we are pleased to annouce that the forum and our dental news is now available on an app called tapatalk. Our members will be able to use their exisiting logins for the site and within the app you will receive instant updates to the latest articles published and forum threads created. We hope this is an extra convenient way of accessing GDPUK in a mobile format. You may also find one or two other interesting forums to subscibe too! The app is available to download on Apple, Android and Microsoft devices.

Over the next few weeks we will also integrate advertising on Tapatalk. Advertisers will need to supply some extra copy, so their ads can work with the  different options that Tapatalk offers but we think it will supplement our traditional advertising avenues perfectly and ensure our clients adverts are getting impressions and clicks!

https://tapatalk.com/

Bloggers

As the site continues to evolve and grow (eg tapatalk, nearly 9,500 users) we are always looking to offer a bit features on the site, especially as we are known for our original content, news and information when it comes to UK Dentistry. Over the last few months we have added a few new writers to our blogging lineup, which we hope offer plenty of insight, expertise and original thinking around dental matters. We are pleased to say that Alun Rees has recently joined the lineup and his first blog can be found here. Alun is an experienced dental practice owner who changed career and now works as a coach, consultant, troubleshooter, analyst, speaker, writer & broadcaster.

Our latest blogs can be found on this link and our daily dental news can be found here. We are proud to say that we continue to reach and engage with thousands of readers through our news and blogs. Please keep sharing our content and encouraging colleagues to join the site. Thanks :)

 

 

  5426 Hits
5426 Hits
NOV
16
2

Why isnt perio sexy?

Why isnt perio sexy?

Why isn’t Perio sexy?

My undergraduate years were spent in the old Dental School in Newcastle-upon-Tyne. During my five years I learned about dentures, amalgam, gold, porcelain and of course the use of forceps of all shapes and sizes.

I know there was a periodontology department, my tutor was a senior lecturer. The staff were perceived as a bit wet, uninspiring and dominated by the rest of the “cons” floor. Our restorative treatment plans always ended with the phrase “S&P”. There was a hygienist training school but our paths only crossed socially and the idea of integration was years away.

We had to do a “perio" case as a final year project, and mine was to be shared with another student. The patient was wore a chrome partial denture and “needed” a full mouth gingivectomy. My colleague did his half of the mouth, using whatever technique was fashionable then, reviewed her and re-appointed for my ministrations in a month. With gingivectomy knives all set I looked in her mouth, looked at the notes, looked back again and realised that I couldn’t tell the difference between the treated and untreated sides. Patient discharged and my case written up with the patient described as “non-compliant”. I passed - so that’s OK then.

Three years of oral surgery only added to my ignorance. Then the move into general practice, an NHS amalgam factory with a hygienist. One serving five dentists. The mystery deepened, what were these things called PGTs and why did they have to be booked at 11.45am? The answer, the appointment straddled midday so covered two sessions. My introduction to gaming.

I moved from practice to practice, some scale and polishes were bloodier than others, sometimes the blood oozing around the matrix band or the acetate strip was a nuisance. In 1985 I joined a practice where there was a newly qualified hygienist whose company I enjoyed, she explained that her role was primarily as a communicator. There was a glimmer of light at the end of the tunnel.

But then the practice was sold. The new regime sacked the two hygienists as being unprofitable and told the associates that they should be looking to do at least four crowns on every patient. I jumped ship - again. It seemed that everywhere I worked patients were treated as mouths on legs whose teeth were there for the benefit of the dental profession.

In December 1987, disillusioned by dentistry but searching for something, I rolled up at the Grand Hotel in Leicester for an evening course given by Phillip Greene. I met the WHO/CPITN probe.

A revelation! First move, order half a dozen CPITN probes. Second, explain to each and every patient what was going on, why it was important and what would happen next. Then a setback, the hygienist was sacked for having the temerity to tell the practice owner’s patients that they had gum disease. He explained it to me by saying that, “hygienists were mostly cosmetic really, a bit like hairdressers”.

For a decade I had drifted but was now a man possessed. I had a dream and a plan. I had been reactive, patients brought their diseases for me to treat. Time for a paradigm change, let’s make a presumption that people want to be healthy and to stay healthy.

The only solution was to start my own practice, so I did. It went well, so I started another 12 months later. In those days I used nurses to inform, to educate, to explain what the diseases were and how they could be controlled. No scaling until plaque control was good. I persuaded “the hygienist” to move to Gloucestershire to join me and for the next fifteen years we worked in adjacent surgeries sharing our patients.

I did the first BUOLD course in perio, I joined the BSP, I bought and read Jan Lindhe’s textbook.

The patients who had good plaque control had fewer problems, their endo treatments worked, they didn’t get recurrent caries, working on them was easier win/win.

We became a practice that listened and talked to our patients. When the time came to leave the NHS most understood why and stayed with us. When treatment options were explored the patients got it, there was already a relationship so we never had to worry about “selling”. Choices were offered, benefits outlined, costs explored and commitment gained, either then or further down the line.

All because everything was done on a basis of health.

Nearly 30 years on from my epiphany I talk to clients and find that many dentists are still driven by what they can do to patients rather than for them. Perio (along with paediatrics, prevention, pathology and public health) is still a Cinderella subject. Hygienists still work in cupboards.

Yet those practices that embrace health thrive, are profitable and happy.

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Recent Comments
Bruce Mayhew

Reply following your perio art...

Dear Alan I see your posting from time to time and often wonder if Dave Bridges was your hygienist,(because he was right up the sh... Read More
Tuesday, 17 November 2015 18:03
Alun Rees

Thanks Bruce

Hi Bruce Thanks for taking the time to comment. Although Dave Bridges and I practiced in the same city (Gloucester) we were not i... Read More
Tuesday, 17 November 2015 18:48
11460 Hits
NOV
10
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One Small Step

One Small Step

So…  we learnt today that the Chief Executive and Registrar of the GDC is to step aside.  What is it you hear said? The longer the name of the job …  Hmmm.

By all means have fun deciding whether she jumped or was pushed.   Enjoy heating the invisible ink in order to read between the lines of the Press Releases.  Savour if you will the exchange of pleasantries between the Chairman, Dr Moyes and Ms Gilvarry which suggest that there may have been little love lost. 

Is it me or was there an undertone of glorious victory from the Chairman?  A bijou hint of “OK that’s over, let’s move on”.

 

What now?

 

The problems with the GDC remain three fold

 

The financial aspect.

 

The GDC seem to assume that the funding of the ARF can be an unlimited remit, a bottomless pit of registrant’s cash.  Nowhere in the Strategic Plan, for example [being celebrated rather rudely by Dr Moyes in almost the same sentence as his “goodbye wave” to the CEO] is the concept raised of budget cuts, or reduction of budget.

Indeed at the Dental Complaints Service, a reduction in complaints is seen as a crisis needing management to bring the numbers back up by advertising.  Only an arrogant Quango could possibly see things this way.

This of course is in the context of department cuts and harsh realities of reducing public funds.

The sense of aloofness and insulation from the realities of the world mark the GDC out.  They arrogantly march on ignoring the realities of day to day financial life for the dentists.

Unless the new CEO comes in with a wholly different attitude I see little chance of change.  It is the Council and the Chairman who will design the ‘essential skills’ matrix.  It is they who will determine the job requirement.

The Council and The Chairman must now, of necessity, come under immediate and decisive pressure from the profession.

 

The regulatory aspect.

 

The problems of the GDC are in simple terms their reluctance to recognise and classify complaints properly at the early stages. FtP and the appalling costs are driven by too many single patient complaints, in which over-zealous Expert Witnesses [colleagues by any other name] encourage the GDC legal teams to generate charge lists which if they were not so serious for the Registrant, would read like a copy of the Beano.  Lets remember: the present CEO has been in cahoots with the Chairman to create a Complaints Handling Agency - a far cry from an efficient regulator with its eye on patient safety.

Proper classification of incoming complaints does not need a Section 60 order – this needs a CEO to understand Dentistry. Only if our new CEO understands Dentistry will we stand a chance of having a CEO who understands a Dental Complaint.  Only then can a CEO classify at the early stage complaints which should be managed out of the GDC and those which are truly FtP matters.

Unless the new CEO brings a wholly different level of dental knowledge I see little chance of change.  The Council and the Chairman will design the ‘essential skills’ matrix.

I say again: The Council and The Chairman must now, of necessity, come under immediate and decisive pressure from the profession.

 

The unresolved business.

 

Can we expect a new CEO to take a different view on the matter of publication of addresses?  Can we expect true transparency and full public domain records for Interim Orders?  Can we expect a reduction in ARF?  Can we expect it to be become permissible to employ nurses out with the over-priced and over burdensome system of registration?

 

A skirmish, maybe, but there is more

 

It seems to me that the resignation of the Ms Gilvarry may be regarded as a decisive moment.

But the problem remains the Council and their Chairman. Six of those are Registrants.

Now is the time for them to consider their true loyalties as they write up the Job Specification for the new CEO.

Wow, imagine of the six registrant members were now to tender their own resignations in order to effect complete change at the GDC?

I think our representative bodies – the BDA, FGDP, and DPL / MDU / MDDUS – have their goal now.

 

 

The only effective change for the GDC will involve the departure of the poisoned and ineffective Chairman.  Anything else will look very watered down and leave too many questions unanswered.

 

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10758 Hits
NOV
09
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The Snu [well known newspaper]

Shock dental horror probe shock

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NOV
03
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Are you giving your patients what they want this Mouth Cancer Action Month?

Are you giving your patients what they want this Mouth Cancer Action Month?

Are you giving your patients what they want this Mouth Cancer Action Month?

 

A recent survey highlighted by the British Dental Health Foundation (www.dentalhealth.org) found that 9 out of 10 dental patients want to be screened for oral cancer but only 14% of those surveyed were aware that they had been whilst visiting the dentist. An estimated 90% of dentists are screening for oral cancer during a dental examination but do not talk to the patient about what they are doing!

Why is the dental profession so reluctant to talk about the ‘C’ word when patients want to hear it? Is this due to our fear of litigious activity if patients know too much or is it because dentists lack knowledge, confidence and experience in dealing with oral cancer management? It seems irrational when we hear about skin, cervical, breast and testicular cancer all the time. The public is exposed to messages about these types of cancer on the television, through other media and even in GP’s waiting rooms. At certain ages we are invited to be screened for a variety of cancers and given advice about screening ourselves regularly too. People are generally well informed about prevalent cancers and aware of Government initiatives to tackle the problems.

Why is oral cancer any different? Why is our profession so fearful of talking to our public about this developing epidemic? Why is there no Government initiative to combat this hidden killer? Why are girls not informed that the HPV vaccine will safeguard them against oral cancer as well as cervical cancer? Oral cancer is not just a hidden killer but also a silent one as nobody seems to be talking about it!

So, this Mouth Cancer Action Month (https://www.dentalhealth.org/our-work/mouth-cancer-action-month) give your patients what they want! Train your team to talk to patients in a confident, knowledgeable and appropriate way particularly during screening. Teach patients to self-screen on a monthly basis and arm them with the information that they need to look out for the early signs of the disease. Self-screening is particularly important as NHS recall intervals continue to be unreasonably stretched. The way I see it, if patients are given joint responsibility to screen themselves for oral cancer, this may help to counteract the barrage of litigation we are experiencing. As a profession, if we screen for, talk to and educate our patients about oral cancer, we will be meeting our professional obligation to do so as well as keeping the CQC happy when they come knocking at our door.

Talking to patients about oral cancer not only raises their awareness but it also helps to spread the word about the disease. Give people what they want and they will also tell their friends and family about the fantastic job that you are doing. ‘Word of mouth’ is the most effective marketing tool at your fingertips, so go ahead and use it!

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8465 Hits
NOV
03
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Care Quality Commission - A New Era?

Care Quality Commission - A New Era?

The Care Quality Commission (CQC) began operating on the 1st April 2009 and was created to regulate and inspect health and social care services. Since its inception a number of additional services have come under its umbrella, including Primary Dental Care Services as of 1st April 2011.

In recent months the CQC has come under fire from the Medical Profession, with reports such as:

Delegates at the British Medical Association (BMA) conference in June 2015 voting in favour of a motion stating the current CQC regime was "unfit for purpose". After the conference GPC chairman Dr Chaand Nagpaul said it was ‘clear that the CQC has lost the confidence of the profession’ and that it needs to ‘urgently address the fundamental problems within its inspections regime’.

This was shortly followed by the Royal College of GPs (RCGP) calling for an immediate suspension on the process of routine inspections. Research by the RCGP found a GP could gain an additional 120 hours a year in practice, if the Government slashed the administration burden of the CQC inspections.

The British Dental Association (BDA) has been relatively quiet about the CQC inspection regime. In October 2015 the BDA posted on its website that it welcomed the report from the CQC that Dental Practices were ‘low risk’ to patient safety.

However, the BDA’s silence on the matter does not reflect the feeling amongst the dental community generally. On forums such as GDPUK.com, the old CQC inspection regime is viewed as over cumbersome and bureaucratic, time consuming, expensive and inflexible.

In addition to the lack of confidence in the CQC inspection regime, is the dental community’s frustration and mistrust of their regulating body, the General Dental Council (GDC). This year alone we have seen the Professional Conduct Committee make some damning criticisms of those who investigate fitness to practice on behalf of the GDC. The Professional Standards Authority reported that the GDC was the worst regulatory body, with only two of the ten ‘Standards of Good Regulation’ being met. Finally the BDA asked ‘Will the GDC ever learn?’ in their article on the 24th June 2015 in response to the Professional Conduct Committee’s comments and MPs querying the GDCs hike in the Annual Retention Fee.

However, unlike the GDC, the CQC has recognised its failures and has accepted that the old inspection regime was not fit for purpose. As such, from 1st April 2015 the CQC has implemented a new format for inspections. Are we now entering a new era for the CQC inspection process?

Life before CQC

Prior to the CQC taking over the regulation of Primary Care Dental Services, NHS Dental Practices would be assessed by Dental Reference Officers (DRO). This often involved the DROs observing a dentist at work. The advantage of this system was that as DROs were qualified dentists, they had a good understanding of the required standards to be met in terms of treatment.

In addition to the above, all Dental Practices were governed by the GDC and were expected to meet the standards set by them. There was no on-site inspection process by the GDC; dentists, as professionals, were left to ensure they maintained those standards and the majority did in order to maintain their business and reputation.

There was no obvious need for overhauling the system. There was no public outcry regarding the quality of dental practices, and no high profile cases of errant dental practices. However, as with many areas of life, the Government took the view that this additional layer of regulation would benefit the public, in principle creating a more effective and standardised regulation of Primary Care Dental Services. 

CQC - The Beginning

From 1St April 2011 the CQC was tasked with the regulation of Primary Care Dental Services.

The first hurdle of the old regime was for Providers of Primary Care Dental Services to register with the CQC.  Each Provider had to show from the outset in the application form that it was meeting the ‘essential standards’. The application form ran to 42 pages, setting out each Regulation and asking the Practice to state whether or not they were compliant and, if they were not, how they would become compliant. Guidance was provided on how to meet the essential standards, which comprised 174 pages. On top of the registration form each Provider had to have a ‘Statement of Purpose’. Needless to say the registration process alone was both complex and time consuming.

After the registration process, nearly all Providers underwent an inspection. This involved further preparation and time to ensure the ‘essential standards’ were being met. The plan was that follow up inspections would then take place every two years thereafter to ensure continued compliance. However, the CQC grossly underestimated its workload and it took up to April 2015 just to carry out the initial inspections and even then the task was still incomplete!

The concern with this inspection regime was that it was a ‘tick box’ exercise, undertaken by non-professionals. Whilst on the face of it a few underperforming practices may have improved, questions were raised as to whether it improved the overall quality of care; for example did it prevent injury and were patients safer? The general feeling amongst dentists is that no, overall it did not and instead placed huge administrative burdens on them, that took them away from the practice of dentistry.

Whether a mark of successful regulation or not, the GDC and NHS England have reported an increase in the number of complaints about dental professionals. Given that the aim of the CQC inspection process was to focus on a patient’s experiences and ensure they were being treated fairly, it suggests a change was indeed needed.

A New Era?

In its report, a fresh start for the regulation of primary care dental services, the CQC acknowledges that when it started regulating dentists it did not get the model right. The report confirmed that the CQC had inspected nearly all of the 10,102 dental practices registered. One in eight was not meeting the regulations compared with one in five in adult social care. Furthermore, in the majority of cases where inspectors re-visited practices, the concerns raised had been addressed. The CQC therefore identified that the dental profession presented a lower risk to patient safety compared with other areas inspected by the CQC.

Following a review of the inspection regime, on 1st April 2015 two Regulations came into force which created new ‘fundamental standards’. These fundamental standards are applicable to all regulated activity; not just Primary Care Dental Services. You can find guidance on the new standards at this link.

As a result of the new standards and the review of the existing inspection process, on 5th April 2015 the CQC implemented a new system for regulating Primary Care Dental Services.

The key changes are:

·         The removal of the rating system for Primary Care Dental Services;

·         The introduction of five questions about the service. Are they safe? Effective? Caring? Responsive to people’s needs? Well-led? These will be used to ensure the fundamental standards are being met;

·         In order to answer these five questions, inspectors will use ‘key lines of enquiry’ (KLOE) and prompts. These KLOE and prompts, along with examples of how they can be met, can be found in the Provider Handbook;

·         As before, there are two types of inspection, but these have been re-labelled ‘Comprehensive’ and ‘Focused’ inspections. A Comprehensive inspection will be carried out at 10% of registered Providers in 2015/2016 and will usually look at the Practice as a whole. A Focused inspection will either be a follow up or be responding to a particular concern or issue;

·         Clinicians will be involved where necessary with the inspection process.

In addition to the Provider Handbook, you can download our CQC Inspection Guidance here, which gives examples of the documents that may help you meet the five questions and fundamental standards.

The new regime has only been in place for six months. Having reviewed the Provider Handbook, there does appear to be more flexibility in the process. Under the section ‘Making judgements’ it states:

These examples of what we would expect to see in demonstration that the characteristics of each key question, and fundamental standards, are being met. The KLOE’s and examples of evidence are not an exhaustive list, or a ‘checklist’. We will take into account the context of the Practice when we look for evidence.

Therefore, the KLOEs and prompts do not need to be followed to the letter. It seems as long as the registered Provider can show the five questions and fundamental standards are being met, they should be free to run their Practice as they see fit.

The Handbook is much more user friendly; the five questions each have the relevant KLOEs set out and examples of how to demonstrate these have been met. The relevant Regulations are referred to under each question, but the document does not set out the Regulation and avoids legal jargon. Having in place good Practice policies and procedures, having regard to patient satisfaction,  ensuring legal documentation is completed and training and managing staff effectively will greatly assist when preparing for a CQC inspection; all the elements needed to run a successful business in any event.

If you have prepared in line with the old inspection regime, then the reality is that you should meet the requirements of the new regime. The Regulations are very similar; they both focus on patient safety, legal requirements and managing staff/the business.

The new Regulations add a ‘duty of candour’, which requires a Provider to notify a patient if something unexpected happens, so this will need to be considered when preparing for your next inspection. 

Only time will tell if this new system does in fact ease the bureaucratic burden on Registered Providers, freeing up your time to concentrate on dentistry.   

Fees

In addition to the changes made to the inspection regime, in October 2014 the CQC began consultation on a proposed increase to registration fees. The proposal was to raise fees for all registered Providers, except Dental Services. The rationale for this was that the CQC did not envisage the cost of regulating dentists would increase. The proposed increase for other registered Providers was 9%. This came into effect on 1st April 2015 and, as proposed, registration fees for dentists this year remained the same.

On 2nd November 2015 the CQC announced a further consultation on increases to registration fees. The good news for dentists is that it is proposed registration fees for 2016/17 should again remain the same and for 2017/18 they should be decreased and then frozen until 2019/2020.

Unfortunately for GP practices, they will see registration fees nearly double year on year for the next four years.

To find out what your annual registration fee is you can use this handy calculator from the CQC website:

http://www.cqc.org.uk/content/fees-calculator

 

Laura Pearce, Senior Solicitor

 

 

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7480 Hits
NOV
01
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Diary Of A Wimpy GDP

Diary of a Wimpy GDP

  8738 Hits
8738 Hits
OCT
26
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1984

1984

It was not until recently that I have thought of the significance of the year 1984. The year that the Dentist’s Act was put on the statute books is also the year George Orwell wrote about in his 1949 Novel. What a coincidence.

I was never one for this sort of literary masterpiece in my youth, preferring more escapism than that provided by the rather dark writings of George Orwell. After all, how would a fictional writing about a society that records what its members say in order to use against those same members be relevant to my future career? A story about a society that encourages members to report one another to the authorities in order to punish them for minor transgressions was not really going to be hugely useful when human biology and chemistry was going to be the entry requirements for dentistry in a couple of years….

How wrong was I. It would appear that in fact 1984 is a highly relevant textbook on how the regulation of dentistry is currently modelled.  Just like in Orwell’s Tome we have individuals who are all too happy to report colleagues directly to the authorities; multiple omnipresent organisations taking the role of the morally correct ready to report us immediately to Big Brother for everything and anything, and now, with the information that appears to be coming to light from the numerous Subject Access Requests (SAR), the actual holding of data on some (if not all) of us by the GDC.

Despite the assurances recently at the Dental Protection study day by the Head of FtP, Jonathan Green, that the only reason a watch is kept on GDPUK is to report to the executive about what the profession think of the GDC, I find myself just a little uncomfortable that this is not entirely the whole reason why. If the GDC want to know what we think of them then fine;

BUT WHY KEEP IT ON THE REGISTRANT’S FILE?

There can be NO reason whatsoever to keep this information logged against an individual. None. Feeding back to the executive the opinion of the profession is one thing, and probably sensible. However, it seems they don’t want to do anything particularly to improve our perception of them; possibly they are just making sure they’ve got the level of fear just right in the profession so we keep toeing the line. But storing that information in the registrant’s data file is not necessary. Unless they are going to use it against us at a later date there can be no reason for that.

Now it might just be entirely innocent and that it is just an administrative mistake why this potential breach of the Data Protection Act is occurring; and lets face it, the GDC have got history in this area as the Information Commissioner has just recently ordered undertakings to be made by the GDC for a previous breach. It might even be that the head of FtP wasn’t actually aware of what was going on in another department. But it is none the less worrying as to why the right to freedom of speech (Article 10 of the Human Rights Act) is being is being threatened in this way. Surely if individuals think their comments made on a private professional forum are somehow being noted and stored this will make them think twice about contributing in the first place. A Public Body such as the GDC has responsibility to uphold the Human Rights of those it is responsible for, not to make them feel threatened.

All this is before we get onto the subject of using Private Investigators in order to further challenge the Human Rights of its registrants. It would appear that this is down to the Professional Standards Authority wanting the GDC to be more proactive in ensuring registrants are kept on the straight and narrow. Perhaps the BDA should engage the services of a PI company and then send them to check on members of the FtP panels or the GDC executive themselves. I can imagine the outcry at 37 Wimpole Street if this were to happen, but surely they too are all innocent until proven guilty just as the registrants are? I am also intrigued as to why the use of Private Investigators is allowed, since neither the GDC nor the PSA appear on the list of the 40 types of authority sanctioned to use them under the Regulation of Investigatory Powers Act 2000. Perhaps someone more legally trained can enlighten me as to the mechanism under which they can use them legitimately, because all I can see is the infringement of Article 8 of the Human Rights Act, the right to privacy.

I have been writing for GDPUK for just over a year now, and whilst I am still awaiting my SAR, I am pretty sure there will be references to these blogs made. Why? They are on the public facing side of GDPUK for a start and accessible to all. They are also my individual views, which I am entitled to hold, about a regulator that has been shown to be acting in a draconian, inefficient, illegal (remember the ARF consultation?) and now it appears an Orwellian manner. Now as far as I am concerned, I have never knowingly written one word that isn’t true. It is not unprofessional to tell the truth; indeed we have a professional duty to do so. It is not misconduct to tell the truth, and it is not bringing the profession into disrepute to tell the truth. It is also not illegal and it is not dishonest to tell the truth (obviously!). But I am worried that a regulator that is still so out of touch will try to deprive me of my livelihood and professional standing just because I have spoken up about its failings. Why else would it probably be keeping references to things I’ve said? Given some of the strange heads of charges still found on FtP hearings (do ANY of us justify the ‘reason for a try in’ in our notes?) it wouldn’t be too hard to come up with something suitably fitting for my literary forays. Perhaps when I get my SAR there will now be absolutely nothing about my views in there. Especially if they read this article…..

Literary analogies seem to abound in the way 37 Wimpole Street appears to do its business, from the McCarthyism of Miller’s Crucible and its tales of the Salem Witch Hunt to the totalitarianism power of the Communist era in Orwell’s 1984. A combination of these two literary masterpieces seems to be the current operations manual for the GDC in how it polices its registrants.

In that case I think it’s time for the profession to bring the works of J K Rowling to life…..

 

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9776 Hits
OCT
25
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Antibiotics

Antibiotics - a quick guide

  9664 Hits

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© DentistGoneBadd, GDPUK Ltd 2015

9664 Hits
OCT
21
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The Fall?

The Fall?

The early autumn is a period of wind  and rain, perhaps storms and even the back end of the Atlantic hurricanes.  All in all it is often a period of wild weather.

I wonder if dentistry is entering its own Autumn of storms and wild and windy conditions.

Can we hope even for a “fall” of sorts, in Wimpole Street; you know, a “Fall from Grace?” Perhaps near that newly refurbished office block at No 37?

I dream.  It’s too much to hope.

Let’s look at the facts.

 

West Side Story

The BDA [at No 64, being on the West side of the street] are suddenly in a ballot kind of frame of mind, openly calling for such a move. [1] OK it is only the hospital based colleagues but they have tagged along with the BMA on the proposed changing of the working week to include the weekend.

Now if the Government, broadly, get away with this, anyone fancy betting it will trickle into GDP in the new contract?

Meanwhile the GDC have attracted Dr Mick’s ire – again - as they feel the need to start examining how to measure the quality of YOUR dental care.  The GDC ? Yes, you heard right. [2]

 

GDC Metrication is on the way to YOUR practice

In the GDC’s Big Plan for the Next 3 Years  they suggest: [3]

  • Patients:
    • Objective 3:
      • To increase the information we provide to help patients make better informed judgments about their treatment
    • Over the next three years we will do the following to meet this objective:
      • improve our online register and website so that patients can find out more information about their dental professional, including how to locate a specialist.
      • explore the development of quality metrics in dentistry so that patients are clear about the quality of the care that they can expect to receive.
      • produce a range of guidance for patients and their carers about what they can expect from a visit to a dental professional and what questions they could ask. We will tailor this guidance to the type of treatment and the setting where care is provided.

 

Now if you thought the CQC slid under the radar of professional alertness, or that the GDC being reorganised to emaciate the dental involvement by having a Lay majority and non dental ‘appointed ‘ Chairman was one you really should have seen coming, I urge the assembled throng to finally take this one seriously

 

The GDC are expanding into the quality of YOUR care

It’s not the only area the GDC plan to expand.  They even plan to expand the role of the Dental Complaints Service.  [3]

They are on record as wanting to advertise again because the numbers of complaints are dropping!!

Yes, you heard right.  Oh, and they see the NHS as a major partner, not as the creator of the UDA nightmare that drives people to the GDC in the first place! [3]

 

The awakening of the sleeping… Giant?

However, there is a faint sense that the BDA might, possibly, finally, be awakening to the possibility of a long and hard fight against Government sponsored attacks on the profession. We are of course in good company with our medical colleagues.

If Press Releases are the tip of the “what’s going on behind the scenes” iceberg, perhaps all is better that we had thought?

 

If you are a BDA Member – phone them and find out what their plans are.

If you are an FGDP member, phone them too!

 

You, on your own, can do little. Only as a united front can we even remotely stand our ground.

Or are we going to sleepwalk into yet another costly restriction upon our activity ?

 

 

Search And Rescue? [SAR]

As if all that is not enough, in a separate move reminiscent of Cold War Eastern Europe, the GDC are under fire for retaining data on all public discussion about its efficiencies, filing such data against the name of the registrant. [4] 

There has been an eye opening thread on GDPUK [no doubt all carefully annotated and filed by the GDCs very own MI5 trained clerks].

If you have not made your Subject Access Request to the GDC you are most definitely urged so to do. 

Do you know what data they hold about YOU?  
Do you know the justification? 
Give it some thought.

 

 

How Snoopy laughed!  ARF ARF!

It's that time of the year again. The GDC are now consulting on next year’s ARF.  After 37 pages of "transparency", it was hard to remember that they were proposing ‘no change’. Still, I always like to see out money being used wisely.[5] [6] [7]

 

The new NHS Contract is dragging on [as predicted] and there is a sense that the current financial crisis surrounding NHS Trusts generally must at some point trickle down into the provision of dental care. Cuts have to be in the shadows, even if they are not overt.

 

 

So all in all, a delightful Indian Summer of calm?  I rather think not!

 

No Sir.  The storms are brewing and I suggest that you had better batten down the hatches.

 

Far from clipping its wings, the GDC is very much in an expansionist frame of mind and YOU ARE PAYING FOR IT.

 

And when the Government pay you LESS through the new contract to do MORE, we will all pay, sadly, in so many ways.

And who will be the ultimate loser? The poor patient. Your patient. My patient. And perhaps all those who are not patients.

 

Perhaps now is the time for the profession to start uniting in some way? 

 

I mean, properly uniting

What shall we call this association of like-minded professionals?

 

 

[1] https://www.bda.org/news-centre/press-releases/Pages/Junior-dentists-balloted-on-industrial-action.aspx

[2] https://www.bda.org/news-centre/press-releases/Pages/GDC-attempting-to-extend-remit-at-expense-of-registrants.aspx

[3] http://gdc-uk.org/GDCcalendar/Consultations/Documents/Draft%20Corporate%20Strategy%202016-2019.pdf

 

[4] https://www.gdpuk.com/forum/gdpuk-forum/what-does-the-gdc-know-about-you-time-to-find-out-20365#p223009

 

[5] http://www.gdc-uk.org/GDCcalendar/Consultations/Documents/ARF%20level%20consultation%202016.pdf

[6] http://www.gdc-uk.org/GDCcalendar/Consultations/Documents/ARF%20level%20consultation%202016%20-%20supplementary%20forecasting%20information.pdf

[7] http://www.gdc-uk.org/GDCcalendar/Consultations/Documents/2016%20ARF%20consultation%20FAQS.pdf

 

 

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Equality in 2015: Can dentistry hold its head high?

Equality in 2015: Can dentistry hold its head high?

This Blog is by Julia Furley, Barrister, at JFH Law.  

 

In 2015 the debate over the inequality of the sexes has raged. Ironically it hasn’t taken an earth shattering event to incite anger, instead it is the existence of what has been labelled “everyday sexism” that has tipped the balance; tolerance of inequality, particularly in the workplace, has finally run out.

Protests against perceived sexism have punctuated the news this year:

In June Sir Tim Hunt, the Nobel Award winning biochemist, was lambasted across the press and social media for his ill-conceived jokes about the pitfalls of women working in laboratories, made during a speech to the World Conference of Science Journalists in Seoul, South Korea. His comments caused international uproar, although the reaction to his comments divided both the scientific community and many commentators. Nevertheless they resulted in his resignation from UCL, the European Research Council and the Royal Society’s Biological Sciences Awards Committee.

The fire was stoked again on the 7th September when barrister Charlotte Proudman publicly shamed a senior male solicitor, Alexander Carter-Silk, for complimenting her physical appearance following their connection on a business networking site. She was offended that Mr Carter-Silk felt it appropriate to comment on her “stunning profile picture”. Again, the reaction to the story divided opinion, with some suggesting that Ms Proudman should not have gone public and should learn to take a compliment with good grace, whereas many questioned why any woman should be subject to a physical appraisal on a site dedicated to business networking.

Just days later, a relatively unknown figure outside the legal profession made national headlines with his comments about equal representation of women in the upper echelons of the legal profession. Lord Sumption, a Supreme Court Judge, told the Evening Standard that rushing to achieve gender equality in the judiciary could have “appalling consequences” if achieved through positive discrimination, and suggested that society should wait a further 50 years for gender equality to be achieved naturally. Most controversially he blamed the lack of equal representation on “life style choices” made by women, who are “unwilling to tolerate long hours and poor working conditions”. At present just one of the twelve justices of the Supreme Court is a woman, there are no ethnic minorities, and just twenty one of the one hundred and six members of the Court of Appeal are women.

One can only assume that by lifestyle choices, he meant the inconvenience of giving birth. It should be born in mind that Lord Sumption’s rise to the top did not require years sitting as a judge in the lower courts like most, but instead direct promotion from the practicing bar. An honour never before afforded to a woman.

The outrage from women and men in the legal profession has been palpable, and unintentionally it seems, Lord Sumption has fuelled the debate regarding equality in the 21st Century.

But sexism is not the sole domain of the scientific and legal communities; But sexism is not the sole domain of the scientific and legal communities; on the 1st October The Telegraph published an article, quoting Jyoti Shah, a consultant urological surgeon at Burton Hospitals NHS Foundation Trust, who had blogged about the sexist “gang culture” prevailing in operating theatres across the UK. She claims that the operating room was male dominated, and was often hostile to females; she cited incidents of being asked to make the tea for her male colleagues and, even more extreme, an incident of a female colleague being subjected to a sexual assault.   Figures revealed that women make up only 11% of the total number of surgical consultants in the UK.

And thus came, with perfect timing, the film Suffragette. The film received its UK premier on the 7thOctober, telling the story of the militant campaign in support of women’s voting rights in the UK one hundred years ago.

The film’s ensemble female cast, including Meryl Streep and Carey Mulligan, later highlighted the high levels of inequality in the arts, entertainment, sports and media industry, in the US, where in 2014 women working full time in the industry earned on average 85% of their male counterparts pay (although one should bear in mind this is quite good when compared with the average across all sectors in the US, where women earn on average 82.5%  of their male counterparts).

It seems that regardless of legislation designed to ensure equality in the work place, and numerous legal cases ensuring that women are paid the same as their male counterparts, there is still a mountain to climb for women in the workplace; particularly in their fight to reach the top of the Professions.

However, notable in the absence of any complaint was the dental profession.

What about equality in 2015: can dentistry hold its head high?  There have been no audible complaints from female dentists, and no exposés in the press of horribly sexist behaviour by senior dentists. Does this mean there is no underlying problem, or just that no one is yet willing to put their head above the parapet?

Since 2007 the GDC have published figures regarding registration in the UK of dental professionals.

In 2007, 35,419 dentists were registered with the GDC. There was quite a significant gender gap; with 61% (21,596) of those registered male and 39% (13,823) female. However, of the 2359 dentists added to the register that year, slightly more than 50% were women.

When looking at dental care professionals (nurses, therapists, hygienists and technicians), an even more significant gender divide opens up. In 2007, 20,219 of all registrants were women, with just 1,508 men registering.

Unfortunately, the GDC do not provide the gender breakdown of those registered on the specialist lists for 2007.

Fast forward to the latest 2015 figures, and how are the numbers looking?

In October 2015, 40,953 dentists were registered with the GDC, and a massive 66,009 dental care professionals.

The good news is that the numbers of female dentists are catching up with men; 53% (21,775) being men and 47% (19,177) being women.

Dental care professionals have however gone even further the other way, with 91% (60,388) women and just 9% (5,711) men.

What does this tell us? In accordance with the numbers of women currently studying for their BDS degrees, the balance of male/female registered dentists is likely to be equal, if not tipping marginally in favour of women over the next 10 years.

What it does not assist us with is how well those women perform in the profession overall, how many achieve senior roles in hospitals and how many become NHS contract holders or practice owners.

Anecdotal evidence tends to suggest that women are quite positive about the profession, finding that the flexibility of associate positions can work well with child care responsibilities; which still tend to fall to women to resolve.

Perhaps more worrying is the male/female ratio of dental care professionals. The vast majority of dental nurses in the UK are women; reflecting the general breakdown for the “caring” occupations such as medical nursing, carers and nursery education. The reason it is worrying is that dental nursing remains relatively low paid and insecure, with many nurses being employed on the now notorious “zero-hour contracts”. The upshot is that women find themselves undertaking work that men would traditionally not be willing to do, largely due to the pay and conditions associated with it. Again anecdotally, there also appears to be reluctance on the behalf of dentists to employ male nurses, as there is an expectation from the patient that nurses will be women.

For dentists, things take a negative turn when one considers the gender of specialists. The GDC have provided statistics in relation to the specialist lists for October 2015, which show that the divide opens up quite dramatically.

Looking at the most “popular” specialisms; orthodontics, endodontics, periodontics, restorative dentistry, oral surgery and prosthodontics there is a significant gender divide:

Of 1373 orthodontists, 52% (720) are men and 48% (653) are women.

Of 277 endodontists, 77% (212) were men and 23% (65) are women.

Of 368 periodontists, 67% (247) are men and 33% (121) are women.

Of 317 restorative dentists, 76% (240) are men and 24% (77) are women.

Of 754 oral surgeons, 72% (544) are men and 28% (210) (are women.

Of 450 prosthodontists 78% (349) are men 22% (101) are women.

Of the 13 specialities, only in dental public health (55 v 62 registrants), oral microbiology (3 v 5 registrants), paediatric dentistry (62 v 182 registrants) and special care dentistry (104 v 218 registrants) did women outnumber the men. All, dare I say it, the more typically “caring” side of the profession.

So why are women so woefully underrepresented in the specialities? One argument again relates to “lifestyle choices”. At a stage in their profession where postgraduate training may appeal to some, many women will also be considering starting a family and will not have either the time or resources available to pursue a speciality. However there is also the question of the decision makers at the competitive entry stage of postgraduate training. Very few “heads of department” positions are currently held by women; could this be affecting the way in which recruitment is undertaken?

Whatever the reason, dentistry like all other professions must give careful consideration as to how we can ensure true equality within our professions. It can no longer be acceptable to suggest that any woman must choose between having children and fulfilling her career potential. More should be done by the Universities, the GDC and the RCS to ensure that women are actively encouraged to undertaken postgraduate training, and that facilities, such as funded crèches on site,  are made available to all those, men and women, who have child care responsibilities.

The author, Julia Furley, is a barrister and partner at JFH Law. Julia has a special interest in dentistry, and currently advises both dental practices and individual dentists on both legal and regulatory obligations.

JFH Law LLP

Tel: 020 7388 1658

7b Bayham Street, London, NW1 0EY

DX 57064 Camden Town

www.jfhlaw.co.uk

Follow us on Twitter: @jfhlaw

 

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20
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What produces a successful advertising campaign?

In my role as Sales Manager at GDPUK, I often get asked what kind of campaign works well on the website and I am always happy to give a few suggestions which I hope helps the client and gives them a few ideas to take away and ponder.

Below are a few bullet points of the suggestions that have come to mind in recent times. Please feel free to add to the suggestions.

The idea behind the list below is that it hopefully gets the client creating an interesting campaign that then gets them a return on their investment and builds a long-term business relationship with our publication.

Our users do notice the adverts but it is upto the advertiser to catch their attention enough that they become fully engaged with the message. The fact that a banner gets shown thousands of times in a month is an obvious advantage of advertising online, your brand has an extra chance of getting noticed on a popular blog or forum thread.

So what are some simple, straightforward methods of getting noticed? A few brief ideas below.

 

  • A good, simple, well designed landing page, that matches the campaign / campaigns. I have blogged about the importance of landing pages before. Read more on this link.

  • Experiment with different designs / styles for the banner ads, see what is successful and look to implement banners in different colours and fonts.

  • A competition or prize draw to get data for your business, as well as create some buzz around a new product or service.

  • Supplement all advertising campaigns with PR that matches the advertising and is shared on social media. Run the same advertising / PR on your social media pages, so it increases brand awareness.

  • A successful campaign has been with a company who have used client testimonials "I love using this xxx dental software because...." So showing that fellow dentists use the product and it works for them, creates a positive message.

  • A social media campaign that includes advertising on dental websites but run in tandem with social media. For example an equipment manufacturer could collate photos of dentists using the handpieces in their surgeries etc. Create a pinterest style collage.


If you would like to discuss any of the brief suggestions above, we will be attending the BDIA Showcase at the NEC in Birmingham. We can be found on stand F215. All my contact details are below.

 

Our new media pack for 2016 is also now available for download. It is available here and if you click the image below.

 


Thanks for reading and hopefully see you in a few days. Cheers.

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5748 Hits
OCT
18
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CRB or not CRB?

CRB or not CRB? THAT is the question.

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8826 Hits
OCT
15
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Dental Equipment Needed!

Dental Equipment Needed!
 
The “Jungle” refugee camp in Calais, is inhabited by refugees and migrants from across Africa and the Middle East. The population is currently 4,000+, with approximately 40 new arrivals each day. Until recently, this was almost entirely male, but over the last couple of weeks there has been a huge influx of families. There are now approximately 500 women and at least 100 children in the Jungle.
 
Conditions in the camp are truly appalling. MSF (Medecins Sans Frontieres) have recently engaged and this has made some impact, as have a number of volunteer organisations (many from the UK), but it remains a terrible humanitarian crisis. Winter is rapidly approaching; there is already frost at night, and the Jungle is prone to flooding.
 
We need to get these people out of the mud. "Caravans for Calais” is providing caravans and trailer tents to the “Jungle". The organisation was conceived in early September 2015; to date we have 20 caravans deployed in the Jungle, with another 20 procured in the UK, awaiting shipment, and four in France, also awaiting volunteer drivers to tow them.
 
The caravans are being donated by their owners, or bought by members of the public, or purchased by Caravans for Calais using funds raised from campaigning. The organisation is steadfastly apolitical. This is an extremely complicated issue, but our position is simple. Whilst we debate a solution, people should not be abandoned to live in these conditions. We are deploying initially as humanitarian infrastructure. Later, we will provide them as housing for refugees. So far, we have doctors’ and dentists’ surgeries, nursing stations, a secure distribution staging centre, homes for the vulnerable and family reception centres. We have also allocated some to families with young children.
 
We are looking to equip a dentist’s surgery, in a caravan, in the Jungle. We can gut and sterilise the interior, we can even supply some power…but we need the specialist equipment. A chair, instruments…all the equipment required to provide basic dental care is needed. Initially, most of the work will be extractions, but as we progress, the procedures will become more complex.
So, we’re looking for donations of the relevant equipment.
 
Can anybody help us, please? 
 
Caravans for Calais can be contacted via This email address is being protected from spambots. You need JavaScript enabled to view it. or 0208 824 9314.
 
Thank you - this is changing lives.
 
Dave King
 
 
 
 
 
 
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6025 Hits
OCT
14
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HPV Vaccinations - Make Some Noise for the Boys!

 

 

Squamous papilloma -- very low mag.jpg
"Squamous papilloma -- very low mag" by Nephron - Own work. Licensed under CC BY-SA 3.0 via Commons.

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8047 Hits
OCT
12
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Dentists Beware – Legal Changes A Foot!

b2ap3_thumbnail_beware.png

In this blog we summarise some important changes in UK legislation, which may have an impact on you and your Practice.

From 1st October 2015 the following legal changes have come into force:

·         The National Minimum Wage: this will increase from £6.50 to £6.70 for those over 21 years of age; for employees who are aged 18 to 21 the rate will increase from £5.13 to £5.50; Employees under 18 will see an increase in their hourly rate from £3.79 to £3.87; and finally the apprentice rate will increase from £2.73 to £3.30. In relation to apprentices, please note that this rate only applies if the apprentice is under 19 years of age or in their first year of apprenticeship. This means that salaries and all other associated benefits, such as holiday and sick pay must be amended from this date. Failure to do so could result in a claim by an employee for unauthorised deduction from wages;

 

·         The Consumer Rights Act 2015: the Act aims to consolidate existing UK consumer legislation but will also introduce new provisions relating to statutory remedies for defective goods and services. See below for our full analysis on how the changes will effect dentists;

 

·         Businesses, including Partnerships, with a turnover of £36 million will be required to publish a slavery and human trafficking statement every year. Whilst this will not directly affect small to medium sizes businesses, we consider there may be an indirect effect on them. Our detailed analysis of the requirements can be found in JFH Law's September 2015 E-Alert;

 

·         The right for Sikhs to wear a turban instead of a safety helmet will be extended to all work places, with some exceptions applying in relation to military and emergency services. Prior to these changes, Sikhs were exempt from wearing head protection in the construction industry but, because of legal loophole, they were not in less dangerous occupations such as factories. This meant Sikhs could face disciplinary action or dismissal for refusing to wear a safety helmet. In terms of medical treatments, there is no reason why a turban cannot be worn, if covered by a surgical head cover in the normal way it poses no health and safety risk.

 

Consumer Rights Act 2015

The Consumer Rights Act 2015 (CRA) aims to consolidate existing legislation in relation to consumer rights, whilst introducing new provisions which will come into force from 1st October 2015. The key reforms are to improve consumer rights and remedies in respect of goods, services and consumer notices, but also to stop the inclusion of unfair terms in consumer contracts.

Under new consumer rights legislation a “trader” is defined as a person acting for purposes relating to their trade, business or profession; whether personally or through others acting in their name. This will include dentists, and their support staff, who provide treatments to a patient. Patients will therefore be deemed “consumers”. As such, patients have ‘consumer rights’ when they enter into an agreement with their dentist.

The following terms are implied into that contract:

  1. That the services will be provided with reasonable skill and care;
  2. The services will be performed in line with the information provided about the service and in line with information provided about the dentist;
  3. That a reasonable price will be paid for the service.
  4. That the services will be performed in a reasonable time.

This is broadly similar to the position on consumer rights prior to the CRA.

However, important changes relate to the provision of information to consumers.   Any information said to or written down for the patient, and which the patient relies on when entering into the contract, will be contractually binding; even if it is not in any contract signed by the parties.

Dentists will therefore need to be increasingly careful when a) agreeing timescales to provide treatment, and b) in how they express the likely outcomes of any treatment. Of course it is always advisable to prepare a clear written treatment plan for all patients, but dentists also now need to ensure that conversations had between reception staff, practice managers and treatment coordinators are all properly recorded and documented. If in doubt, make a note and follow up sales consultations with an email or letter summarising what has been said as these discussions are likely to form part of any contract if patients rely upon them.

JFH Law will keep these changes under review and will endeavour to advice on how these changes will work in practice in both the dental and medical professions.

The CRA also has a number of controls on excluding and restricting liability. Perhaps unsurprisingly, a term that excludes the trader’s liability for failure to perform a service with reasonable care and skill will not be binding. But also it will not be possible to attempt to restrict liability when timeframes are not met. Indeed the CRA makes provision for a reduction in price where work is not done within a reasonable time.

The CRA also provides new statutory remedies, namely the right to repeat performance and the right to a reduced price where work is not done to the correct standard or the agreed timeframe. The patient may also have remedies for breach of contract in the normal way, such as damages or specific performance.

Much of these changes will not dramatically alter the way in which dentists operate, as most already have in place excellent record keeping and performance levels in accordance with the requirements of their professional regulations. This is however another level of bureaucracy that dentists and their teams should be aware to avoid unnecessary litigation.

The Trading Standards Institute has produced this very helpful guide for traders in relation to contracts for the supply of services:

http://www.businesscompanion.info/en/quick-guides/services/the-supply-of-services-from-1-october-2015

 

picture from Creative Commons

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OCT
10
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Tooth Fairy Story by @DentistGoneBadd

A true tooth Fairy Story

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OCT
08
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Is a Dental themed hashtag about to go viral?

Is a Dental themed hashtag about to go viral?

 

 

 

On Wednesday the 7th of October, GDPUK were invited to the launch of Denplan’s new TV advert which will air on our screens from Saturday night (10th Oct) and will run for approximately 3 weeks.

The campaign demonstrates Denplan’s huge investment and commitment to dentistry and the dental practices that they work with. An impressive £1.2 million has been spent on this campaign.

After a short consultation period, Denplan have used the advertising agency “brothers and sisters” to design the advert. Established since 2008, they have a number of famous campaigns in their portfolio including the Thierry Henry advert that aired this year which can be viewed below. Great advert, especially the part when he joins Alex Ferguson and Brian Kidd on the Old Trafford turf!

 

The Denplan advert

So what does the advert entail? It shows a young man taking a selfie on a day out but everytime he smiles, he snaps his horrendous teeth. These teeth are obviously quite extreme to get the message across and were created by the special effects team at Fangs Fx. (If you click on the link, it gives you a great idea of what they are capable of!) So the bloke starts coming up with ways to cover his teeth, eg putting his cat in front of his mouth or putting his hand in front of his teeth. The producers behind the advert have gone for something that will make the viewers smile and also gets people interacting, which seems to be the current trend for TV adverts, as exposure is limited with the way we all watch TV these days. Let us know what you think, when the advert airs over the weekend? Does it make you smile?

The aim

Denplan would like to increase brand awareness, plus of course help Denplan’s member practices stand out in the competitive market of attracting / retaining patients. Practices have been sent a large amount of marketing material that will be used to engage with patients, so in conjunction with the advert, it will provide excellent opportunities to talk to their patients and forms a part of their practice marketing.

Denplan conducted some selfie research which gives further credence to the campaign. A YouGov survey revealed that a staggering 5.6 million selfies are taken in an average day by adults online which equates to an incredible 2 billion plus per year!  Three quarters (74%) of adults have worried about how their teeth look in photographs and a third of adults (33%) have smiled but purposely not shown their teeth due to being embarrassed by them, so selfies and smiles was an easy place for Denplan to focus their efforts. 

 

The Impact

 

So from a dental perspective, what impact will this bring on UK Dentistry? A few thoughts to consider:-

 

  1. Obviously there will be a huge impact for Denplan dental practices but will other dental plan providers also receive a boost? I believe it gets people thinking about their teeth and their dentist, so its a positive piece of marketing for all dental practices.

  2. It is fantastic to move away from traditional tv dental advertising and instead Denplan have embraced a modern and fresh approach…. Everyone at the event agreed that this was a brave move and the small crowd were certainly positive about the message that Denplan are hoping to achieve.

  3. The use of social media and a hashtag #doitforyourselfie taps nicely into a younger, celebrity obsessed crowd but if it gets the public visiting the dentist on a more frequent basis and talking about dentistry in a positive light, then surely this is a good thing? Dr Roger Matthews (Chief Dental Officer) of Denplan mentioned that motivation is key with patients and he believes that running this campaign could be a great way of motivating patients to visit their dentist on a regular basis and that is obviously the overall aim of the campaign.

  4. Dentists are often negatively portrayed in the media but I believe it is refreshing to see a slightly humorous take on the Dental world but with a positive message that people in Britain our proud of their smiles and possibly the work dentists have done on their teeth? This will hopefully be demonstrated over the next few days, as the public share their selfies on www.doitforyourselfie.co.uk. Already a number of selfies have been uploaded!


 

Unfortunately I can't provide a copy of the advert just yet but I will update this blog with the advert once it has had its premiere. Over the next few days we will be keeping a close eye on the microsite, to see whether it captures the public imagination and the general reaction from the dental community on social media. We certainly hope it does capture the imagination and as stated previously, it achieves the positive message that Denplan are striving for. Please let us know what you think and how the advert will be received?

 

** Blog now updated**

 


The advert is due to be shown at 15:28 on ITV1 on Saturday afternoon.

 

 

#doitforyourselfie

www.doitforyourselfie.co.uk

 

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OCT
06
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The Mystical World of Dentistry

Mystical World of Dentistry

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Terminology - Dental jargon to bamboozle

Dental Terminology

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7808 Hits
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The FCA is more than just the OFT with a new name . . .

The FCA is more than just the OFT with a new name . . .

The FCA is more than just the OFT with a new name . . .

 

by Martin Gilbert 

Offering credit to your patients used to be so simple. All you needed was a Consumer Credit Licence and that was it. When a patient wanted to spread the cost of the treatment, you forwarded an application to the lender, they sorted out the paperwork, you did the work and you got paid.

Then the credit crunch came along, and in the aftermath it was decreed that the Office of Fair Trading wasn’t the best organisation to supervise consumer credit (think about the unfettered antics of payday lenders and home reversion scheme providers) and responsibility was transferred to the Financial Conduct Authority.

And they are a different animal altogether. They started gently enough, by writing to all CCL holders and telling them that if they wanted to continue to be credit brokers, they just needed to register for Interim Permission.

Then all IP holders were notified of the Allocation Period in which they have to apply for Authorisation. The last ones finish in February 2016. Applying for authorisation (which for most dentists, who just need to act as Secondary Credit Brokers, will be for Limited Permission) is not too difficult, as long as you have the time and understand the terminology (who knew that ‘agreeing to carry on a regulated activity’ was itself a regulated activity, and one which you have to have).

So you complete the online application and pay the fee. The letter arrives (within their 6 month’s SLA) with your Authorisation, your Firm Reference Number and information about your ongoing obligations. You skim through it, and then file it.

But this is only the start of your relationship with the FCA.

Next you get an email telling you that a Return is due. So you phone the FCA Helpline, who tell you that you should have registered for GABRIEL. Which you didn’t bother with, because you hadn’t really read the letter, and the OFT never used to ask you for any returns, so it hadn’t occurred to you that the FCA would. (CCR008 is required quarterly, CCR007 is annual, and there are fines if you miss the deadlines).

Then you get an email telling you that your Periodic Fee is due. So you phone the FCA Helpline, who tell you that you should have registered for online invoicing. And when you do so, and find the invoice, you’ll see that you also have to pay a Money Service Advice Fee and a Financial Service Ombudsman Levy.

So then you think, I can’t be bothered with this, I’m going to cancel my authorisation. So you phone the FCA Helpline, who tell you that you should have registered for CONNECT (not the one you used for your original application, but the one that was mentioned in that letter) to enable you to make any changes to your standing data. And when you do eventually manage to login, you have to find your way through ‘Start a new application’ to get to the cancellation option.

If you’ve got more money than time, there are plenty of firms out there who’ve made a business out of managing the authorisation for you – typically charging £600 to submit your application and £25 a month for ongoing compliance.

Or you could become an Appointed Representative of a specialist such as Chrysalis Finance, who look after the compliance and the reporting, and provide you with a state of the art online portal to process applications simply and easily. So you can not only get on with giving your patients the best treatments, but you also make them affordable for them. 

 

Martin Gilbert, a chartered accountant,  is a Director of Chrysalis Finance.

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