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Make It Easy On Yourself | Waterpik

Make It Easy On Yourself  |  Waterpik

A lot of research into the benefits of using Water Flosser as opposed to string floss has been conducted to date. Independent research studies have shown that the Water Flosser was up to 50% more effective at reversing gingivitis, up to 93% more effective for reducing bleeding and can remove 29% more plaque than string floss.[1],[2] It is also significantly more effective for implant and orthodontic patients who are more susceptible to developing gingival inflammation.[3],[4]

 

But, this research would mean nothing without the endorsement of professional hygienists who have a working knowledge of oral irrigation products. Michael Wheeler is a dental hygienist at Bramcote Dental Practice in Castle Cary and an Honorary Senior Lecturer at the University of Kent. When asked about the products available from Waterpik International, Inc. he said:

“I am a firm advocate of the Waterpik® Water Flosser – both for those patients who are having difficulties in maintaining oral hygiene with bridges or crowns, and those who already demonstrate good oral hygiene routines. The Water Flosser is a very effective product and is relatively easy to use, so it’s really beneficial for all. 

“A patient I’d been treating for several years recently highlighted this. She’d had a bridge fitted about 30 years previously and although her oral hygiene was exemplary, she expressed that the bridge caused her some difficulties, especially when it came to maintaining such a high level of oral hygiene. I suggested she incorporate one of the Water Flossers from Waterpik® into her daily cleansing routine, in an attempt to offer her a logical solution to these issues.

“The next time I saw her she was delighted with the results of the oral hygiene adjunct, stating: ‘It’s absolutely life-changing and the best thing I’ve ever used!’ Even I was slightly taken aback by the level of her enthusiasm, but it was great to hear!

“A second patient of mine, a reformed heavy smoker, also noticed an improvement in his oral hygiene with the use of a Water Flosser from Waterpik®.

“It just goes to prove with the right patient, even if their oral hygiene is beyond criticism, you can provide further motivation with the right product.”

Discover the many benefits of clinically proven solutions from Waterpik International, Inc. for yourself, and contact the team today.

 

For more information on Waterpik International, Inc. please visit www.waterpik.co.uk. Waterpik® products are available at Amazon, in

Boots and at Superdrug stores across the UK and Ireland.

 



[1] Barnes CM et al (2005) Comparison of irrigation to floss as an adjunct to tooth brushing: effect on bleeding, gingivitis, and supragingival plaque. J Clin Dent 16(3):71-7

[2] Goyal CR et al. Evaluation of the plaque removal efficacy of a water flosser compared to string floss in adults after a single use. J Clin Dent 2013; 24:37-42.

[3] Magnuson B, Harsono M, Stark PC, et al. Comparison of the effect

of two interdental cleaning devices around implants on the reduction

of bleeding: a 30-day randomized clinical trial. Compend Contin Educ

Dent. 2013;34(spec iss 8):2-7.

[4] Sharma N C, Lyle DM, Qaqish JG, et al. E ffect of a dental water jet with

orthodontic tip on plaque and bleeding in adolescent patients with fixed orthodontic

appliances. Am J Orthod Dentofacial Orthop. 2008;133(4):565-571.

 

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Perspective

I wouldn't recommend him to my worst teecher

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Specialist Lists and the GDC Review

Specialist Lists and the GDC Review

 

The GDC specialist lists were established in 1998; the most recent, Special Care Dentistry, being added in 2008. The UK has more recognised areas of specialism than any other European country.  There are currently 4261 registered specialists across the 13 disciplines. The GDC are not obliged to have specialist lists, but are empowered to do so by various pieces of European and domestic legislation and regulation. If they wanted to dispose of the lists it would not require legislative change, but would need a compelling policy reason and would require a significant amount of regulatory change.

There is no comprehensive data about the total number of patients treated by Specialists each year; although there were 2.7 million outpatient appointments within dental speciality clinics and a further 320,000 consultant episodes in 2012/13 according to NHS data. This of course does not account for private patients.

The GDC recently undertook a review of the way in which the specialist lists are regulated. The aim was to determine what the benefit of regulation was when it comes to patient protection and whether the lists did in fact help patients make a more informed choice about their dental treatment.

The first phase of the review began in January 2014; whereby information was obtained from both the public (with a representative sample of 500 adults) and the profession regarding their experiences (there were 68 responses from the profession, including 25 from individual specialists and 5 from GDPs).

Background

Registration

The most common way to obtain entry onto a specialist list is to undertake a recognised training programme. Approximately 500 students per year attempt this route. Alternatively, candidates can seek to illustrate equivalence in “knowledge and experience gained through academic or research work”; commonly known as mediated entry.

European registrants with qualifications in Oral Surgery or Orthodontics are automatically recognised.

In 2011 there were 175 additions to the list, in 2012 245 and in 2013 231.

Title

Only a registered specialist can use the title. This is also true for the use of the “ist”; endodontist, periodontist etc. It is not permissible to use the phrase “specialising in” if you are not registered on a specialist list. The only permissible terms are “special interest in”, “experienced in” and “practice limited to”. Using an incorrect term can lead to professional disciplinary proceedings and/or a conviction and fine.

Cost

The cost of registering on a specialist list are relatively low; just £345 for initial registration and £72 per year thereafter.  

The GDC have calculated that the cost of regulating the specialist lists in 2014 was £339,000, which income is forecast to exceed by 6%. There does not appear to be any comparison with earlier years, and as such it is not known whether this is a constant figure. However, this cost also includes the cost of the review so is likely to be much higher than previous years.

Conclusions of the Review

Does specialist regulation bring any benefits in terms of patient and public protection?

The reality is that public awareness of the specialisms is extremely low; shockingly more than half of those surveyed did not know ANY specialism existed. Only 1% was aware of periodontists and restorative specialist, only 2% of prosthodontics and only 3% of endodontists. The highest recognised term was “cosmetic dentist” at 22%, closely followed by orthodontist at 19%. Worryingly 10% believed implantologist to be a recognised speciality. However, most people felt that it was important that specialists were properly regulated. Unfortunately, only a third of those questioned had even heard of the GDC (and this was when prompted!).

It is useful for specialists and practice owners to bear in mind that when choosing a specialist most of those who did recognise specialisms relied on their dentist’s referral rather than their own research. What is abundantly clear is that dental specialists are not effectively marketing their existence, and by implication their value.  

Of those in the profession who responded, the general view was that regulation should not be decreased and that deregulation risked those not properly qualified attempting procedures outside their capability. However others pointed out the lack of evidence that regulation does in fact improve patient care. Concern was raised re the lack of regulation of specialists post-entry. At present CPD requirements are the same for both GDPs and Specialists.

Is regulation proportionate to the risks posed by dentists providing complex treatments?

Perhaps understandably specialists were more supportive of the lists than GDPs. Some respondents felt that the fees charged were disproportionate. However this is surprising bearing in mind the amount of administration required in certain cases. £345 may seem a lot for someone who has been awarded the CCST, but is a small reflection of the cost of mediated entrance. It is curious that a more diverse fee structure has not been recommended and that practitioners are not being asked to fund appeal hearings, particularly if unsuccessful.

Many respondents questioned the need for the number of specialist lists. However the review concluded that they were necessary due to the number of complex procedures undertaken.

Are the specialist lists the appropriate mechanism for helping patients make more informed choices about care seen as falling outside the remit of a GDP?

74% of patients who had visited a Specialist had been referred by their GPD. Only 4% of those questioned said that they would check the details of their Specialist with a regulator. Although the majority responded that it was important that the information was there if they did want to check.

GDPs and Specialists generally agreed that the lists do assist in making appropriate referrals.

In reality although specialist lists are available on the GDC website, the public a) doesn’t know about the GDC website and b) doesn’t understand the terminology used and significance of qualifications recorded. It would appear that it is the GDC who are failing in the provision of information to patients.

Should the GDC be the body to regulate the specialities?  

It was generally agreed that the GDC are the appropriate body to regulate, however it was pointed out the GDC was reliant on the Royal Colleges to provide guidance on the skills, knowledge and behaviour of specialists. Nor does it quality assure specialist training or have a separate revalidation process in place.

The review made for possible proposals for the future:

1.       Strengthen the GDC’s approach to regulation. The GDC are developing a “work programme” to achieve this and intends to give a clearer definition as to the meaning of specialist, ensuring the lists are correct, “tightening up” mediated access or removing this route entirely, quality assuring specialist training and providing information to patients.

It appears that the only rational for proposing the removal of mediated entry is to reduce costs. Surely a fairer and more sensible approach would be to charge applicants appropriately.

2.       Explore alternative models of regulation:

If the Council is of the view that the current regulation does not offer significant benefits to either the public or patients; is not proportionate; or that resources could be more properly focussed on key regulatory functions; then there would be no further policy changes and instead possible alternatives to statutory regulation would be explored. This could include investigating the possibility of removing all specialist lists save Oral Surgery and Orthodontics:

3.       Continue to regulate the Specialties, but not make any significant policy changes. Although it is still suggested that the mediated entry route would be reduced.

4.       Further analysis of the evidence of improved patient outcomes.

Overall the review has uncovered the alarming lack of understanding by the public regarding Dental Specialists and the Lists. However, on a more positive note, appears to suggest that those within the profession believe that the lists are both necessary and helpful. Of the proposals, only one thing is clear that dentists can expect an attack on the mediated entry route over the coming years; although there seems little justification for this save on costs grounds.

 

 

**Blog image from Creative Commons

***This blog has been written for Rumpole of the Surgery by Julia Furley of JFH Law

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Missed the point

The GDC, as usual, have missed the point. Other dentists refer to specialists and the specialist lists help them choose the approp... Read More
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Spiralling Morale …

Spiralling Morale …

Welcome back to the Indian Summer of tropical rain…

There was a time when those of use of a certain age [OK Old if you will, but take that tone out of your voice!] decided to pursue dentistry for many reasons one of which was the life time career of care which happened to be comfortably paid.  Professional life was stable, practice management was an ongoing process. Interestingly by and large we saw all the patients who wanted to be seen and managed their dental needs without any political calls for damage limitation of a crisis of “Access”. Those of us so inclined went home for a celebratory glass of cheap Chateau Rinse de Bouche over an FP17. [For those of our younger colleagues unfamiliar with such things, these were the old claim forms that allowed a course of treatment to be ‘claimed’]

Complaints were rare. The GDC were a body to whom one looked up in awe and respect, and yet who played little part in day to day practice. Indemnity was low cost as was the ARF.  At some point in one’s career one would make the decision to up the standards of ones work and seek to change the way one practiced. It was a cycle of professional life.

Meetings [long before CPD became a fashion statement] were a cacophony of chit chat about practice matters.

Morale I would be so bold as to say was always, broadly, high

So what on earth has happened? How do we find ourselves at the edge of a perfect storm of change for the worse?

The GDC are a runaway train of high cost complaints handling and we are all paying through the nose and other orifices too, I should think.  The persistent arrogance and lack of accountability of the GDC and its leadership remain a real cause for concern.  A worry in part because they affect us but we do seem to be able to affect them, nor can the PSA, it seems.

Just look at Indemnity as an example. On the one hand it is a significant chunk of income on an annual basis, now being compulsory [so the lawyers can REALLY get their teeth into you]. On the other hand, despite reassurances, there is a pervasive sensation that they will dig you out of a shallow pit of excrement, but if you are truly up to your neck they may simply leave you to flounder. A worry in part because they affect us but we cannot affect them.

Now we have news of the falling away of dentist incomes.  In a separate and apposite piece of Government news, even that respected statistical body HSCIC, thinks morale is a worry amongst dentists. Now incomes falling is hardly news because most of us have noticed this in the last 5 years.  How? Well, we run these efficient Micro-Businesses, Minister and produce the annual accounts.

Practice Plan’s latest Confidence Monitor is hardly an advert for happy campers under the Governments clinical cosh that is the UDA.  The vast majority of the NHS dependent sector must be feeling very uneasy.

What has caused this change of circumstance?  Why are all the pointers suddenly running the wrong way?  If morale is a precarious state of mind, all this news must surely cause the spiral of decline to turn more quickly unless something is done?

 

Can morale fall, like the rain, in stair-rods?

Now hold on Dr Prism … Dentists are a resilient bunch – we get by, we generally don’t moan, and we take the rough with the smooth because, let’s face it, there are many worse off than us and despite what the Daily Fail et al may say, we do have a social conscience.

In our day to day work, we [you me and all the other GDPs] take personal responsibility for our situation. It is up to us to be happy … or not as the case may be.  It is up to us to run our businesses. All good so far.

But for the bigger external problems we rely upon an external body to do our work for us.  We reply upon our Academic colleagues to lay out the ground for evidence based clinical practice. Not some random bunch of Red Braces in Wimpole Street who would not know a dental practice if it hit them on the head! We rely upon a representative body to keep the bad news at bay – to fight off the bad guys as it were.

 

Where are the BDA as our ‘Union’?

Perhaps they themselves experiencing a decline in morale as time and again they fail to make an impact against the onslaught of Government regulation and initiative?  Not so long ago there was the change of subscription system and I seem to recall there was a ‘bit of a fuss’.  Even on a professional matter such as obesity and the sugar debate, it was the medical fraternity that snatched the victory, and the BDA were left to issue a “told you so” PR statement which barely caused a public ripple.  

 

Perhaps the lesson of influence here was that we need strategic alliances to amplify our voice and our influence.

 

Why is the BDA so effective on so many levels of “back office” matters and yet on the “Front Line” of headline influence and involvement, it is abjectly falling short. Why is it that as a body of 20000 dentists, they are neither first to be thought of in the media domain nor are they regarded with respect by our political masters?

Incomes … the UDA system …  the Prototypes … the CQC … the GDC and its quisling Dental members …  the GDC and it expansionist ambitions … FtP … more FtP … Professional Morale  … a vision for UK dental care …  Children’s Dental Health … Young dentists and early training...  Planning for Tiers ...   the list goes on where as members [and non-members] we cry out for some serious bloody Bolshiness – and time and again we feel they fall short. Too busy having ‘polite meetings’? You might say that, but I could not possibly comment.

By and large of course those who are in private practice are able to manage their lives and rise above the challenges of NHS practice.  This indeed is reflected in the consistent theme of the HSCIC, Practice Plan and others: their findings relate to NHS practice

 

So if the NHS GDP is the poor bloody infantry, who are their Generals? 

 

Well certainly not the new CDO, ironically Colonel [Retired], who is happy to discuss the present and future problems on the same stage as the very man who was their architect, now relishing his role as a non–exec director for a leading Corporate.

The sign of poor morale in an organisation can be its collective ineffectiveness of leadership.

Perhaps the problem of spiralling morale in GDPs is in part due to a perception of low morale at the BDA?

For sure as profession we need a dose of Feelgood Salts and a good kick where it hurts. 

The season is underway.

 

The BDA need to start scoring some goals.

It’s not like the ball is not in the open, and for sure the net is wide open.  The NHS GDP needs its leaders, its “Generals”, to start doing more than limply waving a PR flag.  I suspect members would prefer one action over the hundred words of a glossy Press Release.

Can it really be a year since we and the BDA all went up in arms over the ARF change?  A fine campaign of action but has 2015 seen it followed through?…  It’s a sad reflection that, as no doubt predicted by Madame Gilvarry and Dr Moyes, the ARF is now seen as small beer – have you looked at your Indemnity bill?

 

Get a grip BDA.

Start earning your members fees.  Before a large part of the profession withers under your watchful gaze. 

The signs are out there. How many more hints do you need?

 

Weblinks:

New report looks at motivation and morale of primary care dentists  http://www.hscic.gov.uk/article/6675/New-report-looks-at-motivation-and-morale-of-primary-care-dentists

Dental Earnings and Expenses - 2013-14  http://www.hscic.gov.uk/catalogue/PUB18376

The first NHS Confidence Monitor  https://www.practiceplan.co.uk/dental-plans/the-nhs-confidence-monitor

 

BDA Current Press Releases  https://www.bda.org/news-centre/press-releases

New CDO to speak at therapists conference  https://www.gdpuk.com/news/latest-news/2004-new-cdo-to-speak-at-therapists-conference

 

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Chris Tavares

Paragraph 6

I presume it's a typo error. Should read: "We don't seem to be able to affect them...+ A good summary of the state of affaires a... Read More
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SUGAR FREE - Let's make dental events and offices free of sucrose

SUGAR FREE - Let's make dental events and offices free of sucrose


Here is a campaign in which GDPUK can be the leader and get the whole profession to change their thinking, and from there spread outwards.

I believe dentists, their teams and dental company offices and dental events must lead the way by being sugar free.

When we visit a dental organisation offices, or we go on a dental course, a conference, an exhibition, any event at all, we must demand that the organisers make the catering sugar free. As well as the granulated white stuff, we must banish the biscuits and the cakes, put out fruit and other snacks. Our chefs can conjure up delicious sugar free creations - let's make dental events the showcase for them.

I have found it weird that for years we would go to dental events and find white sugar, brown sugar, but we cannot find artificial sweeteners.

We need to banish the sugar from OUR events and encourage hotels, venues and offices to do the same. After dentistry, we must campaign for the NHS events to do the same, there must be hundreds of those every day. Minister of Health?

There are multiple alternatives to sugars for drinks, there are many sugar free options amongst soft drinks

In terms of table top sweeteners, there are intense sweeteners such as saccharin, and there are bulk sweeteners such as sorbitol or sucralose.  Some people cope with artificial sweeteners in drinks, some dislike, we can accept that.  At the premises of dental companies, and in our dental practices the law demands no smoking in the workplace, let dentistry take the lead and encourage adoption of sugar-free to trickle down to all food outlets, all hotels, all workplaces, and from there into homes. It does not have to be forced on anyone, no legislation, just a gentle change.

The larger dental organisations need to change their policies, and shout this from the rooftops. It would be good PR. Give journalists packets of sugar free sweets when the story is launched.

Let's do it, colleagues - we can take the lead and start the change to help our nation's health.

 

 

 

 

 

 

 

 

 

 

 

 

Main blog Image credit - Moyan Brenn under CC licence - not modified.

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Sugar free campaign

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Stunning

Stunning

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Walking the Plank - Part 2

Walking the Plank - Part 2

When an oppressive situation arises develops over the years as the one we have with our current regulator, it is natural initially, to think this won’t directly affect me. Gradually, though, it becomes apparent from the people you hear of who are affected, and then those you personally know that becoming involved, you start to think a little differently.  When its people the calibre of Colin Campbell and ‘Microdentist’ (to name a couple whom I know personally) then as I’ve said before in my previous ramblings, there’s no hope for any of us.

So if this happens to us, we need to know we’ve got the support and help of organisations that can back us to the hilt. The backing of our indemnifiers is our lifejacket; they take our money and promise to help us keep afloat.

But it is becoming apparent that the support we need to rely on might not always be a given. An increasing number of colleagues seem to be being told by their indemnifier that they wont be supported, or they are supported up to a point and then dropped. No smoke without fire? In reality I’m sure there is a degree of this in these situations. Social media is often full of discussions involving this subject, with some of the participants almost wearing a badge of pride that they’ve used their indemnifier multiple times. I’m left thinking in those cases that the problem here isn’t the indemnifier, but the way these individuals are practicing dentistry and not learning from what appears obvious to others. After all, if you keep on crashing your car into the same wall every time you drove to work, perhaps its about time you either drove a different route, learnt where the wall was, buy a slower car you can control, or just give up driving. In these cases the indemnifier is probably absolutely right to start loading the costs of representation.

Is this always the case though? There seem to be so many rumours flying around that suggest if you ring for advice this counts against you, or that if you settle a certain number of times you’ll see your premiums loaded or even cover withdrawn. There is a definite lack of public clarification from the indemnifiers about the decision processes involved in these situations. One of the indemnifiers has said that ringing for advice does NOT load the premium or count towards a risk analysis. But what about a letter that immediately closes a case or offers a refund (which is usually out of the pocket of the practitioner and not the indemnifier). We don’t know what their process of risk assessment is. We need to.

I’ve been aware for a long time of the discretionary nature of much of the indemnity, and the fact it can be withdrawn, and I’m surprised more dentists aren’t. But I’ve never heard of so much of this discretionary withdrawal actually happening as recently. A good part of this is probably due to the unprecedented increase in complaints, but is this the only reason? There isn’t any public explanation usually as to what discretionary cover is, because it’s at their discretion, which is a fantastic catch all, but that doesn’t help us. We don’t actually know what the criteria are, so we don’t actually know if we are going to be helped when we need to be. Some practitioners will be higher risk that others, but that is not necessarily their fault either. Some of those will work in environments that are naturally more hostile than others, such as prisons, and it is not their practicing style that brings the risk to them or the indemnifier but the nature of the patients they treat. I would also strongly argue that there are certain demographics of patients and even geographic hotspots that increase the risk of complaint and claims, and perhaps we should be made more aware of that in order to mitigate the risk to us. We need to know.

I can see the point that if we don’t know what the reasoning is we wont construct our practice around it. A sort of Indemnity Gaming if you like; if you know the criteria that are used then you know what you can get away with and just stay within the margins (if you are a dodgy practitioner that is). But this is what risk assessment should be about. I’m talking about the risk to our livelihood and careers here. We can lose our home due to a regulator that we accept is not fit for purpose, so we need the security that our indemnifier is going to be transparent and fair with us.

I don’t see any profits warning or indications that their membership reserves are running terminally low from any of the indemnifiers which suggests that they are in reasonable financial health. Given the beautiful offices that many of then operate out of confirms that indemnity is big business. Which leads me to where I think part of the problem lies.

The bigger a business, the more it loses its personal touch. There is a immediate personal contact with the advisors who do so much valued work, but they are not going to be the party that decides if support is withdrawn or not. That is likely to be made at a higher level, lacking in the emotive connection with the dentist. There is so much litigation going on now that the indemnifiers have to be large, and have to have the resources necessary to run such organisations. The costs of the support network in order to run the core business are huge. The cost of the legal representation for its clients is also huge, and shows no apparent sign of getting any less. As more patients complain via the medium of ‘No Win No fee’, or direct through the GDC, then the need for the indemnifier grows symbiotically as does the drain on its resources. With the demand to stay in business, then the indemnifier needs to ensure it is financially solid enough to survive to protect its clients. Its survival then becomes the prime reason for its existence, and it becomes even more risk averse. Thus affecting the very clients it is there to protect. Is this why some dentists are finding themselves without a lifejacket? Will there eventually be a multi million pound business protecting the one or two clients who are so risk averse themselves they will never need the indemnifier as they never see a patient?

This symbiosis is no different to any other supply and demand industry. The more the GDC presses ahead with what appears to be the UK’s largest complaints handling business, the more the indemnifiers will grow on the back of the legislative need for us to protect ourselves. The more they need to protect the finances of the business it becomes.

But we need to know they will be there for us when we are walking the plank. Perhaps the indemnifiers should publically reconnect with us, be more transparent, and show us their human side once more. After all, it’s not all about the money….

It’s about saving lives.

 

 

Did you read Part 1 of this blog? If not, click here

 

Image credit -Ian Armstrong under CC licence - not modified.

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Walking the Plank - Part 1

Walking the Plank - Part 1

Readers may or may not have experienced the delights of going on a cruise. So how does a voyage on a Dental Cruise sound?

You join your ship with lots of other passengers and set sail. What is vitally important though is that you’ve been told before you sail you have to provide your own lifejacket. You notice that there are quite a few different sorts and colours. Some are ones that only inflate whilst you have them with you, and some are inflated all the time, even when you get off the ship at the end of your journey. Some passengers even have special coloured expensive ones that some of the lifejacket manufacturers don’t even supply. We’ll come back to those later. The industry is getting bigger and bigger, so more and more life belts have to be made for all those going cruising.

Initially it’s all really nice, the food’s ok, and the accommodation is too. However, there’s something not quite right. The crew seem to be openly hostile to you, and the officers never seem to speak. The captain of the ship and the 1st officer never come down to speak to the passengers. You’re actually suspicious that the direction the ship is headed isn’t the one you signed up for. Not all the islands you visit are as welcoming as others. After a couple of ports you also start to see the numbers of passengers dwindling a bit and you hear a lot of splashes at night.

You do a little research and you find out that the crew is in better quarters than you are, and your money has gone to pay for that. You have to tip the crew more and more even though the service is rubbish, and then you find out the way they worked out the tips was illegal. More worryingly you hear that the captain orders the crew to round up passengers who might be a danger to those who live on the islands the ship has visited or might visit yet. The captain orders the islanders to report anything they don’t like about the passengers to the bridge. The captain also allows spies to be put ashore to trap some passengers if the locals themselves don’t report the things that are done ashore. Passengers who have committed some sort of infraction are invited to visit the Bridge for a tour. Its not an option. You hear rumours that some of the officers don’t speak as the 1st officer has ordered their tongues cut out, possibly to prevent mutiny. You laugh at this, but you start to get a bit worried. You realize the crew doesn’t trust the passengers at all. Some of the passengers even report other passengers, or get the islanders to report them, or even join the crew.

Then you see why the passenger numbers are dwindling. Every night, the crew makes those passengers who’ve had the bridge visit walk the plank. They are allowed to take their lifejackets though. Sometimes the crew let the passengers off before they get to the plank, although there isn’t always consistency as to who will be let off or not. Some even get halfway down the plank before they are allowed to come back. Usually that’s because the lifejacket manufacturers send their best machinists and repairers to make sure of the buoyancy of the jacket whilst its owner is on the plank. This costs the manufacturers lots of money, so it’s better if the lifebelts never get used in the first place. But you’ve already paid for the service when you bought the lifejacket.

Most of those that do fall off the plank therefore obviously have their lifejackets to help them. These keep them afloat until the rescue boat picks them up and puts them back on the ship. Sometimes some are thrown overboard before the captain has heard the case and they might be allowed back on board, or they might be put ashore until the case has been heard, then they get to walk the plank all over again.

However, there’s a problem with some of the lifejackets. Not all of them are going to work. Most do, but not all. Any you might be wearing one that isn’t going to work when you need it.

Now some of this is because the passenger has done something so bad that Mercenaries employed by the crew are allowed to puncture the lifebelt. Some of these passengers drown or swim to shore, but either way they never get back on board. Occasionally the crew or even a mercenary punctures a lifebelt through their own incompetence and hope they don’t get found out. The lifejacket repairers sometimes throw a spare lifejacket to them. But sometimes the sharks get them first.

But sometimes its because the maker of the lifebelt has decided not to put the flotation device in a lifebelt because of something you’ve told them or you’ve walked the plank before. It looks the same, and you certainly paid the same for it, but its only when you try to use it that you realize its not working. Remember those with the special coloured expensive lifebelts? They’re really expensive because the normal lifejacket makers wont supply normal ones to these passengers because they keep being made to walk the plank, or just keep jumping overboard because they do stupid things and don’t seem to learn from it. In fact, some of the lifejacket makers wont supply them at all but don’t always say why. Strangely, some of these passengers seem to arrive at the ship in fast cars and occupy the biggest and best passenger suites.

Occasionally there are times when a passenger is walking the plank and the manufacturer of the lifebelt actually takes it off them, either just before they walk, when they’re in the water, or when they get back on board having survived the ordeal. The rules say passengers can’t stay on the ship without a lifejacket, but they now can’t get one to fit, the manufacturer wont sell them another, or they don’t have enough holiday cash left to buy another one. They either have to stowaway for which the penalty is immediate plank walking, or they have to get off at the next port.

The captain no longer answers to the ships owners, but they don’t seem bothered, and the captain and 1st officer decide they’re going to expand their little seafaring enterprise as a result. There’s a ship right behind with loads of passengers that go ashore and always paint the islands white and harm the natives, and occasionally the captain makes one of them walk a plank, but doesn’t seem that bothered by the harm they’re doing. They don’t have any lifebelts on that ship either.

The passengers frequently get together and talk to one another, but no-one ever has the bravery to arrange a passenger mutiny even though they keep having the cost of the planks added to their tips. Most of the passengers are too busy trying to protect themselves to look out for the others. The senior officers of the crew don’t talk to one another as they haven’t any tongues, and those passengers that become part of the crew and can still talk don’t want to resign as they say they’re the ones that keep the bridge visits and plank walking fair. The happiest are the mercenaries that get to puncture the lifebelts as they get a bonus especially if they can make it take longer. The manufacturers seem to want to really only give the lifebelts to those that will never use them as they don’t have to spend money readying them for plank walking or repairing the punctures. But their top repairers are happy because they get paid more when they have a puncture to repair.

What a silly story…. No one in their right mind would get on that ship if they read that, or stay on it a moment longer than they possibly could once they found out what was happening.

 

 

Read Part 2 of this blog by clicking here.

 

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Agony Aunt

Agony Aunt

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Delivering Better Oral Health

Delivering better dental health

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Revolution - the Dental World according to Corbyn

The Dental Revolution (Dentistry in 2020)

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Institutional Arrogance

Institutional Arrogance

Institutional Arrogance

Many of you will be reading this from the sneaky preview of your ‘mobile device’ while on holiday so I will keep my mumblings brief. Don’t want the present Partners or Spouses to my dear readers getting a holiday stress on!

Holidays are of course the time when you re bond with the family, and past troubles diminish in their significance such that when you return, the sun still shines and the daises are growing. Holidays allow a new focus on the real issues such as the performance of the many Premier League teams.

If you are single of course holidays can be a “fun” time, strangely challenging in some respects. The STO or Short Term One-nighter relationship can lead to some interesting morning conversations.  Matters of Validity of Consent can raise their head.

And so it is, in your professional area of work.  

I do, I do I do …

You will return from holiday to a focus on your note taking and records like never before. For some time this has been defensive, and a recent case [1] now confirms that it is not enough to record what treatment you undertook. You must now have a discussion with your patient about the risks or proposed treatment, and you must know your patient sufficiently well to apply context to those risks, and the end result will be that the patient should be able to agree to a course of action of their own free will.

GDC Standards for the Dental Team was of course ahead of the consent game by stating in 2013

3.1.2 You should document the discussions you have with patients in the process of gaining consent. Although a signature on a form is important in verifying that a patient has given consent, it is the discussions that take place with the patient that determine whether the consent is valid.

3.2.2 You must tailor the way you obtain consent to each patient’s needs. You should help them to make informed decisions about their care by giving them information in a format they can easily understand.

This of course all takes time. As busy GDPs in mixed practice, that is the one thing that most of you will lack. The threat of an FtP case against you however focusses your mind.

Welcome back to the Autumn of un-squareable circles, as the GDC in their lofty arrogance see no reason why you should have a problem, that body being out of touch with reality.

 

OK …  Talking of that body the GDC  …

If you have not heard, the problems have officially been fixed. Hurrah!

The Professional Standards Authority issued a report [2] being most unfair & critical of the GDC. The GDC Press release [3] in response was beautifully dismissive – a masterpiece in Institutional Arrogance. Taking arrogance to a new level. Real Premier League stuff

We have already instigated a significant programme of change within the GDC which will help us to support dental professionals to deliver high standards of care and maintain public confidence in the profession.  

You would never guess that the PSA were critical in the extreme, the GDC being a long way below the standards of other regulators. Someone has to come bottom of the class but the GDC take that ‘achievement’ to a new level. You hear the PSA sighing in frustration.

Constantly we hear the mantra from the Executive Suite in Wimpole Street that a new Parliamentary Section 60 order is needed. And yet we read in Fitness to Practice rules [4] as follows:

Initial consideration by the registrar.

The registrar shall consider a complaint or other information in relation to a registered dentist or a registered dental care professional, including a dentist or dental care professional whose registration is suspended, and shall determine whether a complaint or information amounts to an allegation

 

So the reality of the GDC’s crisis is that it is entirely in the hands of the Registrar to create a system to sort out the wheat from be chaff in letters of allegation received.  Instead of picking true FtP cases, the Registrar operates a set of rules in which it seems that any allegation is considered seriously.  Good grief, the Caseworkers are in some cases a contracted company. 

The GDC has descended to the role of a commercial Complaints Handling body.

Standards is being used as stick to beat the profession and not as a level of practice to which to aspire.

Fitness to Practice is not a Regulatory function in hands of Ms Gilvarry, it has become a commercial operation of immense cost, be that financial to the wider profession through the ARF, the financial cost to a dentist under investigation, or of course  the emotional cost to dentists.

The way that Ms Gilvarry operates demonstrates that she has mastered the delivery of Institutional Arrogance. In the Chairman, Dr Moyes,  she has a willing partner who has revoked his role of oversight.

Who will rid us of this rotten leadership? The summer may be over but the need remains.

 

Coalescence

It is time for the six registrant members of the GDC to seriously consider their positions. I assume even they were shocked at the GDC’s Press Release.  The BDA and FGDP, perhaps with DPL, & DDU, and perhaps with Denplan, Practice Plan et al, have a massive role here through the BDJs editor’s concept of Coalescence[5]. Action is needed to grab the attention of both the Minister and the Council.

Unless of course they have all caught the Institutional Arrogance disease

 

 

 

 [1]The Montgomery case - Montomery -v-  Lanarkshire health Board Scotland 2015

[2] PSA link

[3] http://www.gdc-uk.org/Newsandpublications/Pressreleases/Pages/General-Dental-Council-response-to-the-PSA%E2%80%99s-report-%E2%80%9CRethinking-Regulation%E2%80%9D.aspx

[4]  http://www.gdc-uk.org/Aboutus/Thecouncil/Meetings%202006/Items%208%20and%209%20FtP%20Rules.pdf

[5]  BDJ leader Vol 219  No 2 July 24th  “Coalescence”  Stephen Hancocks OBE

 

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If patients wrote dental information leaflets

Listen carefully - We'll be asking questions later

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Comfortably Numb?

Comfortably Numb?

Is there anybody out there?

These words introduce the beginning of my favourite song, Pink Floyd’s ‘Comfortably Numb’, the title of which has always struck me as a particularly apt song for dentists.

Several times in my career different parts of the song have resonated with me for various reasons, but this is perhaps the first time the whole song in its entirety relates to dentistry at the moment. For those that don’t know the song, it’s about a reluctant performer who is made to keep going on stage by the various influences and promises of those who seek to benefit most from him, without any consideration as to how the performer is actually feeling inside. Sound familiar? Give a performer a new drug (the continued promise of a new contract??) and that’ll keep you going through the show….(despite the eventual catastrophic effects).

However, I’m not going to muse about the wider issues of dentistry that are analogous to the lyrical musings of Roger Waters otherwise this will be a very long blog.

So, in particular given the recent Professional Standards Authority paper looking into the rethinking of regulation, one has to ask if there is indeed anyone out there who is actually listening to what this paper suggests.

Here we have what is effectively a toothless organization in the PSA (show me precisely what it has actually done to rein in the GDC given its publicized failings over the last few years?) that is suggesting a completely new way of thinking with regard to the regulation of the professions. Its worth a read as there are many things that have been mentioned within the pages of GDPUK.

However, it’s one thing suggesting this radical rethink, but who with the power to actually instigate change is listening to what the PSA have to say? The Health Select Committee still seem to be getting their diaries in order after the election, and with no apparent repeat hearing for the GDC in the offing one has to wonder if other more pressing health matters will take priority over our issues. There appears to be no pending Government Bill in the offing to set up a super regulator (which is what I personally think will happen eventually) or rewrite the outdated legislation of the current regulators. It is obvious that the PSA sees radical failings in the current scheme of regulation, and we all know the opinion it has of the GDC in particular. However, we need to be careful about thinking the PSA is our knight in shining armour riding to the rescue; one of its remits is to review all the decisions of the GDC FtP process and if it feels they are insufficiently protective of the public (i.e. not a harsh enough punishment) then it can order further action against the registrant via a re-hearing. So they are no particular friend of the regulated, but I would counter that by suggesting they are at least an organization with the ability to actually understand what modern regulation requires. They, after all, they keep referring to the paper written by them for the Council for Healthcare Regulatory Excellence on what ‘Right Touch’ regulation means, and it doesn’t appear to always be the touch of the executioner’s sword.

There was a suitably robust call from the BDA for the government to take action as a result of the PSA paper, and whilst this is the sort of thing we need to see and hear from the BDA, once again I have to ask if there is anybody out there to listen? We are unlikely to ever get any press sympathy like the GP’s do; when the Daily Mail is happy to run a story asking if we are all Natural Born Killers as a result of the recent Lion hunting episode then we really are going to lose that battle before we begin. As a profession we already know the issues, so really the BDA is only going to be preaching to converted. How they get the message out to the wider public is the key to getting the regulatory change we so desperately need. That is going to require an awful lot of positive PR and I don’t see much evidence of that. Even the fact we have been harping on about the perils of refined sugar for years seems to have fallen on deaf ears until our medical colleagues woke up to it.

The PSA paper recognizes that over-regulation costing more offers no additional benefit to the patients, or the fact that healthcare has inherent risks that cannot be regulated out without a disproportionate amount of money and time, and that attempting to do so only serves to not only stifle the beneficial innovation that can help the patient, but also the general benefit to the patient overall. None of this will be news to any ethical practitioner reading this; but it’s not us that needs to take heed of this, we need to be listened to by the people who can instigate change and actually have a desire to do so.

The PSA also admit that one of the problems with the current outdated regulation mechanisms is that the action or words of a registrant last lasts only a mere moment or so but can result in serious damage to not only their careers and lives, but the lives of their families too; often having a serious and lasting effect. Again, not news to us particularly, but at least it is being recognized by the PSA. The disproportionate effect of a minor, spurious, or downright vexatious complaint should not be able to carry this threat, and indeed never used to; but more recently seems to be something that we must all be prepared to bear as an occupational risk no matter how diligent we are in our care and dealings with patients.

More interestingly for the GDC though is that the PSA warn against the expanding of the boundaries of regulators and the lack of clarity and tensions this then produces. It’s no secret that Mr. Moyes has said he would like to develop the role of the GDC and broaden its remit. It is already apparent that this seems to have begun, as the GDC is no longer just the upholder of Standards within the profession but has become the de-facto complaints service which will happily look into every single issue it is made aware of. A stop to this ‘mission creep’ as the PSA call it must come sooner rather than later, but again, the PSA has little power to prevent it at the moment.

Yet the GDC in its latest press release once again refuses to acknowledge that responsibility for regulatory failings are in any way its responsibility, choosing to blame once again the legislation that constrains it, and actually indicating it doesn’t go far enough currently. I think most registrants would be of the opinion that when a single complaint can have you in front of a committee that can end your career, then there isn’t actually an issue with the legislation not going far enough. The GDC is also apparently putting in place a series of ‘measures’ to help support the profession in delivering high standards of care and maintain public confidence in the profession. What these measures are we don’t know yet, but of course one way of doing this would be to make sure there are less people able to meet the standards they enforce, either my repositioning the interpretation of standards to make them virtually unattainable, and then ‘help’ by removing the registrants who fall short via the FtP process or by just driving them out of the profession by fear. Maybe this is too cynical a view but it’s hard not to have such thoughts in the current environment.

More and more I hear of dentists leaving the profession due to the immense pressure placed on them every day. Despite their best efforts to remain positive, it is increasingly difficult to not think that the next patient could be the one that ends their career, despite not having done something bad enough to justify such a draconian result. That makes the risk of practicing dentistry increasingly difficult to justify. It would be interesting to see if you are likely to have a longer career these days in the field of professional bungee jumping or crocodile wrestling than clinical dentistry. In what way does this help patients when good practitioners decide to leave our profession?

I remember a satirical comment a few years ago that eventually there would be 100% employment in the UK. Only one person would actually have a job doing something, but all the others would be employed to regulate them. I can see the dental profession going this way if someone in power doesn’t start to listen soon, as there will be less and less people electing to remain in or join our profession. We as individuals therefore need to unite and show the public that the pressures on our profession will directly affect them. Only when the voting public is affected will the situation come to the attention of those in power and change can be made. Although how this will pan out if the supposedly unelectable Jeremy Corbyn takes control of the Labour party and renders the opposition as toothless as the PSA remains to be seen.

Getting back to the title of the song then, the problem is that too many of us are (un)Comfortably Numb with inactivity. So we are reaping the rewards of our complacency and intransigence and will continue to do so unless we unite to do something positive. If we were as vociferous and active as dairy farmers have been recently when things finally got too much to tolerate we would have arranged some form of peaceful and professional group action. Perhaps we should round up a few hundred small cats (lions would be too difficult to risk assess and probably attract the wrong type of dentist) and release them into the General Dental Council chamber at the next meeting. Trying to herd said bunch of cats into Wimpole Street is likely to be simpler than getting dentists to do anything en masse. We could then say not all dentists have a desire to hunt cats (including small ones), and given that social media these days seems to be obsessed with the antics of cute kittens then surely this is guaranteed to get positive press interest. A flock of sheep might be easier to manage, but we don’t really want them in the Council Chamber do we? Tongue in cheek maybe, but food for thought nonetheless.

In all seriousness though, whilst it appears the public at large don’t appear to have a clue what damage over-regulation and the current litigious and complaining environment is doing to the ability for dental professionals to care for them appropriately, these are the same people who in their chosen fields are also likely to be suffering from similar threats. Speak to many of your working adult patients and you’ll find we are not alone in suffering the pressures we are currently under. Admittedly there might not be the same degree of threat to their career and livelihood, but certainly anyone in one of the professions and the emergency services have very similar issues as we do. ‘Guilty until proven Innocent’ is not unique to dentistry.

This is the message that needs to be conveyed in no uncertain terms to the public by both our professional leaders and us as individuals. Only when the public has empathy with us will we have their support. If nothing changes then the profession will dwindle more and more as a lack of morale grows.

For it is they the public as patients who will then suffer most when there are no longer any of us out there.

 

 

Image credit -Samuel Rodgers under CC licence - not modified.

 

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GDPUK Forum Facebook page - give us a Like!

GDPUK Forum Facebook page - give us a Like!

 

We have recently created a Facebook page for GDPUK, where we aim to publish news, blogs, articles and forum posts which are focused on UK Dentistry. We realise the creation of this page is a number of years late but it is better late than never!

 

Like all digital publishers, we use social media extensively to share articles and blogs. The GDPUK Forum facebook page will be another medium we will use to share our opinion and information on all things Dental.

 

You will find the Facebook page here - www.facebook.com/GDPUKforum

If you are interested in having the latest dental news from GDPUK appear on your Facebook newsfeed please “like” the page.

We will continue to update and improve the page as much as we can.

Please share this page with friends and dental colleagues. Basically anyone you believe would be interested in reading dental news....

The GDPUK forum remains free to join, you can register here.

Thanks for your help and sharing the message with the whole UK dental community.


Cheers :)

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The Worst

Preparing for the worst

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Advertising

Dental Advertising - Seeing through the gloss

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Sugar

Sugar - the bitter truth

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Read All About It!

Description goes here

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Pain - pass the analgesics

Pain - Nothing hits it harder than @dentistgonebadd

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09
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Accountability Holiday

Accountability Holiday

Well the summer looms, indeed some may argue we have had it !!

 

Radiant heat from our nearest star warming the cockles of our hearts is a rare treat in these temperate climes.  Some things never change though, and the weather is one of those. I am sure by the time your read this, moaning about the heat will have rapidly become the usual philosophic whinge about the rain and wind!  Maybe we should talk to our patients about the GDC instead … 

 

And so, it seems, the GDC are to be placed in the same weather related category of criticism. Always something to moan about.  

 

But there is an unavoidable truth:

 

The Executive simply do not get it.

 

The problem, they imply is us moaning dentists  - we just do so always go on about them.  Get a life and move on, you hear, mainly from an anonymous adviser in Wimpole Street somewhere. 

 

 

 

 

Exactly where are we? 

 

 

They are castigated by the Panel Chairman in the Singh case – and we are not talking a “could do better” comment as per my old school report.  We are talking having a “Door Closed, Hat on” interview [Those of a miltary background will recognise that as being as bad as it can get] in which the conversation was very much one way. I think we can imagine the Chairman was using a raised voice when he dictated that little lot!  This of course , suggests the GDC in its imaginative defence, was all down to a one-off with a rogue GDC lawyer who has ‘moved on’.   Funny that.

 

Not satisfied with that there has been a Professional Standards Authority Report. To suggest it is hardly complimentary would be an understatement.  Bottom of the Class. Absolutely useless.   You decide!  The tone of the recent GDC Newsletter for us all suggested they had passed with flying colours. 

 

 

Do they really think we are that stupid? 

 

Many members of the profession have written vociferous, well-argued letters of complaint to their MPs. Although duly acknowledged and in some cases passed on it seems to the Secretary of State for Health, Rt Hon Jeremy Hunt MP, little action or redress seems to be being planned.  That said, the MPs and Ministers would be unlikely to signal the intention of Parliament. 

 

 

 

The Damp Sqib of the Health Committee

 

 

It's not about you. It's about not rocking the boats of politics.

 

The Health Select Committee of the House of Commons Accountability Hearing has turned into a damp squib simply because an Election intervened. The HSC committee has only just had a Chair voted in, and the committee has yet to be elected, at the time of writing, in secret ballot of MPs.  Replies from Dr Wollaston MP suggest that the Health Committee might reserve a right to recall the GDC but it is hardly stirring stuff. 

 

 

You would have to be very naïve to image the GDC and its woes are likely to be sliding off the top of the Minister’s full in-tray.  Political agendas are notoriously hard to influence. 

 

 

 

But what weapons do we have to drive change at the GDC? 

  • We could continue to write to our MPs and let the heat of correspondence volume light the fires of scrutiny. 
  • We can continue to write to the PSA but they do not have the powers required. 
  • We could as a profession, call an Emergency Conference – perhaps jointly led by the FGPD, the BDA and perhaps an Indemnifier. As well as a Vote of No Confidence, we could request the resignation, in the name of the wider profession, of the dental members of the GDC.  There are only 6!! 

 

 

 

Peep Peeeeep?

 

We could ask that the Council registrant members use their Whistle-Blowing policy.  Now ironically, they have to go the Chief Executive, or The Chairman [I think not ...]  or the PSA … who have just issued their terrible report, and whom, of course,   … have no authority to do anything! 
 
The PIDA [The Public Interest Disclosure Act] list at the GDC Governance Document written for Council members states 
 
The specified matters should be issues that are in the public interest, for example, under the PIDA these are:  

  •  a criminal offence that has been committed, is being committed, or is likely to be committed; including actual or suspected fraud or misuse of funds;  
  • failure, or likely failure, to comply with a legal obligation;  
  • a miscarriage of justice has occurred or is likely to occur;  
  • an act causing or likely to damage to the environment  
  • actual damage or risk of damage to the health and safety of any individual;  
  • deliberately concealing or attempting to conceal information relating to any of the above 

 

 

 

Well it strikes me based on the cases reported on the GDPUK forum that the GDC are certainly open to accusation on at least three of that list - I will let you adjudge which!


 
GDC Standing Orders for the Council permit either an Emergency Motion [SO 3.7] [requires at least 4 Members to sponsor it]  or a Routine Motion for discussion [ SO 4.3]. 

 

If anything such as a Council Vote of No Confidence were to occur it would need a pretty unanimous vote by the Council and would patently be resisted by the Chairman, Dr Moyes since these items are perversely at his discretion. 

 

 

 

 

So where are we ? 

 

 

 

You have to give the Chairman and his Chief Executive due credit – their hides must be sun baked to a hardness not previously seen. 

 

For Accountability Hearing at Parliament, it looks more like an Accountability Holiday! 

 

The Registrant members by their silence speak volumes and it would appear that  they are happy to take the GDC Shilling. 

 

The BDA are trying, as are the FGDP but are it would seem simply bouncing off the armour plated skins of the Executive. 

 

That leaves us – you know, that’s you, me and the others - to make a public gesture of some sort.

 

A Conference it has to be Ladies and gentlemen to offer a vote of no confidence and to request the honour-bound resignation of dental members of the GDC

 

 

 

 

Who will rid us of this corrupt and disgraced body? 

 

 

It has to be us, everyone else has sadly left town on the Accountability Holiday Omnibus 

 

 

 

 

 

 

 

 

 

GDC Whistle Blowing Policy for Council Members  Page 27/28  http://www.gdc-uk.org/Aboutus/Thecouncil/manual/Governance%20Manual%20for%20COUNCIL%20MEMBERS.pdf 

 

 

 

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Gums - are they pink?

Gums - are they pink?

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9 Rules for Designing Effective Banner Ads

9 Rules for Designing Effective Banner Ads

GDPUK remains free to join and to post on the forum. We have close to 9000 members and they love using the resource to keep upto date with all things dental and keep engaged with the dental community. Revenue for the site is generated from banner advertising. Our clients who advertise are predominantly from the dental trade.

 

Clients of GDPUK often ask us about designing banner ads for the site, so we thought we would put together this simple guide and let you know our thoughts on what makes up an effective banner ad. Obviously when creating a web banner ad, it is important to always look at it from the perspective of the viewers (or your potential customers).

 

  1. Make sure it is correct size. If you are given details of a certain specification or size needed, you should follow the requirements, otherwise the banner ad won’t work.

 

  1. Keep the file sizes to a minimum. Smaller files load faster and it increases the chance of being seen by visitors.

 

  1. Good copy (like all advertising) is very important. Use of graphical elements is good, however, it's the copy that triggers people to find out more about your product. Banners that are effective are kept short and simple. Further info below

 

  1. You want your potential customers to look at your ad, get interested, and click on it, then find out more info about your product on your website (preferably on a relevant landing page on your site). Don’t try to fit all the benefits of your product into that small space, it never looks rights and is ineffective. Simple and clear is the best method.

 

  1. Over the years, the banners that have been the most effective, use an eye-catching hook. Headlines are what trigger people to read the story. Emphasising the benefits of your products more than the features of your products is the way to go.

 

  1. By using a call to action graphic or text you make it very clear to the visitor what you want them to do. For example: For More Information; Download Info Now; Click Here to Purchase. This works with the earlier advice of being simple, clear and direct.

 

  1. Animated GIFs work brilliantly on GDPUK but graphic designers always tell us that you need to avoid using photos and photo-like images on animated GIFs. Because of how GIFs work, the photos won’t look as nice and it will just make the file size huge. It is most likely you will be limited to having just one or two frames for the banner given the file size limits, plus as mentioned before, banners are more effective as a smaller file.

 

  1. If you want to use photos in your ad (for websites only; not on our daily digest emails), consider creating it in Flash or HTML5. It will give you better return in terms of quality and file size.

 

  1. Effective landing pages. We have mentioned this a number of times over the years! When people click on the banner, they should be presented with the relevant campaign or information immediately. They do not want to go to your homepage and be forced to hunt for the information that may exist on another page of your site. An effective landing page produces a great experience for your customer but also better results from your advertising campaigns.

 

Thanks for reading this guide to creating effective banner ads. We hope you find it useful and a simple blueprint to follow when looking to advertise online.

 

If you need further information or want to ask a question about this blog. Please get in touch.

Thanks

Jonny

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Stats, Glorious Stats

Stats, Glorious Stats

At GDPUK towers we love to keep an eye on the statistics that the site creates. We want to make sure we are still doing all the right things to attract an audience that stays engaged with the site and of course interacting on the forum.

Below are a few stats we would like to share, we are very proud of these and they show that GDPUK is constantly used for news, views, opinion and information.

These stats are up to date, as of 30th June 2015.

  • In June 2015 alone, we have had over 100,000 opens of our daily digest emails (sent 3 times a day)

  • We published a news story on Friday 26th June called “GDC labelled worst of all regulators”. As of Monday afternoon we have had over 4500 readers. This shows the reach of GDPUK news by using various social media platforms and our daily digest email.

  • This year, the site averages 32,000 unique visitors a month

  • Users continue to join the site, membership is now getting close to 9000 people, who are all members of the dental community.

  • The forum attracts just over 1000 different contributors a year.

  • Whilst on the topic of the forum, it continues to attract readers and plenty of engagement. Since our present site went live (late 2008), there have been 18653 topics created and 209771 posts. An average of 11 replies a post. This definitely demonstrates the amazing amount of discussion and activity that takes place on the forum.

By sharing these stats we want to demonstrate the reach of GDPUK and how we feel we get important dental news in front of thousands of readers daily. Thanks for sharing, engaging and reading the site, we appreciate the great dental community that continues to support us.

If you would like to join the forum (it’s free) and get a feel for what is happening in UK dentistry in 2015, please follow this link. If you are already a member, keep spreading the word and telling your colleagues about the site :)

Thanks for reading, please get in This email address is being protected from spambots. You need JavaScript enabled to view it. with me if you would like further information on GDPUK.

Jonny

 
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The GDC - they got this right

The GDC - is it ALL bad?

  9821 Hits

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© DentistGoneBadd, GDPUK Ltd 2015

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JUN
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GDC: Hired Gun with a Smoking Gun

GDC: Hired Gun with a Smoking Gun

The Hired Gun with a smoking gun….

We all know the GDC has spent the last few years on its own little self-righteous planet, and even given its recent pitiful showing in front of the Health Select Committee there appears to be no sign they are planning to return to normality in the near future.

Indeed, this week, what can only really be described as damning evidence of the GDC’s utter and complete contempt for the process of Justice in its most fundamental form has been revealed.

A case in front of the Professional Conduct Committee this week has revealed that it is not only the initial stages of the disciplinary process that are woefully inadequate which resulted in their huge backlog of cases; but that the basic legal requirement of full disclosure of the case against a registrant may be riddled with horrific inefficiency and contempt for the fundamental tenets of justice. Not only that, the GDC is not following the rules set out for its registrants and flagrantly flouting them in order to pursue its own agenda of what now appears to be a persecution of the profession via its individual registrants. The PCC themselves described it as an ‘Offence to Justice’.

In this particular case, amongst other things, the GDC had 9 different versions of its expert witness report, and failed to submit many of them in a timely manner for the defence case to be prepared. It was still submitting them to the defence on the day of the scheduled hearing. Not only that, but it would appear that evidence the GDC held was not submitted to the defence at all, which may have helped the defence case. Thankfully the outcome has been for justice and propriety to be upheld by the members of the PCC. (who have for some reason remained anonymous)

With the facts that have come out about the way this case has been handled, the GDC has now plumbed new depths it seems. I didn’t think we could be treated with any more contempt that we already were; but this is jaw-droppingly bad. By what definition do the GDC expect us to have fair trial if they don’t submit the evidence as per the rules? They fail by their own standards throughout this case. Where is their duty of candour? Where is their transparency in their dealings with the registrant?  Have they actually read the Human Rights act? I refer them particularly to Article 6, the right to a fair hearing, which quite obviously would not have occurred in this case had it not been for the integrity and the strength of the members of the PCC.

For the PCC to accuse the GDC of being egregious (or outstandingly bad) is an extremely strong and unusual stance for them to take. Whilst this occasionally happens in the criminal and civil courts when a judge or jury might take exception to the conduct of one of the sides, for a committee funded by one of the sides to effectively take a swipe at its paymaster is highly unusual. I know the PCC is made up of independent members, but don’t forget, despite this independence, they are funded by the prosecuting side, the GDC. I am not for one minute casting any doubt on the integrity of any of the members of these panels, and in this particular case nothing could be further from the truth. But one has to wonder how much of a culture of fear is being instilled that pervades throughout any process the GDC is remotely associated with including these committees. How many other cases have been similarly dealt with by the GDC and the PCC not spoken up in the same way? We know now that this is an organization that doesn’t seem to apply the rules of law and justice properly to those it pursues, and even think these rules don’t apply to itself, and then show no insight whatsoever into its failings. Even the GDC solicitor involved in the case appeared to have had an inappropriate contact (not contemporaneously noted incidentally!) with the patient witness in order to ask leading questions and to coach them which also a big no-no.

Just as strident but more worryingly to my eye is the criticism the GDC’s expert witness comes in for at the hands of the committee. I have not seen this amount of criticism of the expert in any case before. It almost seems like he has gone out of his way to act as some sort of private investigator in order to help the GDC secure its desired conviction. There have been a couple of cases recently where the GDC’s expert witness has come in for criticism, but not to this degree.

Expert Witnesses are required to be independent and objective. It is an enormously privileged position to be in as they alone are allowed to give opinion-based evidence to a court and not just statements of fact. They are not and should never be seen as a Hired Gun to destroy the defendant. For whatever reason it would appear that in this case the expert has gone beyond his remit in such a way that one could seriously question that if this were a civil or criminal case whether serious charges against him would be the result of such a deviation from the accepted role. All the expert witness training I’ve done (and I’ve done a lot) has stressed the importance of never being a Hired Gun. I’ve had solicitors request I change parts of my reports to better serve their cases; and the answer has always been an immediate refusal. An expert witness has a duty to the court and to no-one else. We are not Magnum PI no matter how much we might want to be.

But by acting as a hired gun, this expert has now turned this case into a smoking gun.

Experts are no longer immune from prosecution, and given the evidence in this case, one has to wonder if the abuse of process by the GDC and its expert means that this should now be taken further by the defence team in order to recoup their costs. Ironically, the expert could well be professionally covered by the same indemnifier involved in the defence, but then I’d have thought that might be an appropriate time for any discretionary support for the expert to be withdrawn since it appears he acted in such an unusual manner. Its also rather hypocritical of an expert who appears to be acting far outside his remit to feel he can stand in judgment of a practitioner who may or may not be acting outside his sphere of expertise. Unfortunately Expert Witnesses are not regulated in any way other than by their profession; but this behavior has to be close to bringing the ‘profession’ of expert witnesses into disrepute. I know a good many experts who are aghast at the revelations in this case.

I’m sure the acquitted practitioner will probably now want the whole thing to go away, but I really hope that he doesn’t take this lying down; the GDC should be massively on the back foot with this revelation, and the profession’s moral (and legal) advantage should be well and truly rammed home now.

The BDA should also now get very vocally involved again, and if they don’t they are going to miss a huge opportunity. If they approach it through lobbying MP’s they should broadcast this loudly to the profession so we can hear their voice.  Some have said they should call for a complete halt to the GDC investigating process; but this would leave the public open to the risk of any truly dangerous individual being left free to practice. However, in my opinion they should press for every case both this expert and this particular GDC team been involved in to now be independently reopened, re-examined and all at the cost of the GDC. The costs of this should then be made exceptional from the annual GDC budget so they cannot then charge the profession for this. I’m sure they’ve got some indemnity insurance kicking around somewhere they can use. In addition, every pending case that involves just a single patient complaint should be now be suspended until a full independent inquiry (and I don’t mean by some equally flawed organisation like KPMG) into the above cases has been completed. There should be full and complete disclosure, and compensation paid to any registrants if the GDC are found to be in the wrong. Any employees of the GDC found to be in breach should feel the full weight of any legal process, and not be allowed to hide behind the corporate protection of Wimpole Street.

The GDC are quite obviously in breach of the Human Rights Act. There was no way this registrant was going to get a fair trial, and the GDC were quite obviously unconcerned by that. How many times they have done this before now needs to be made public. If we persistently did the same to our patients we would lose our careers, our livelihood, and our professional integrity. They should pay the same price and their executive should now be held vicariously liable if the law has been found to be broken (again…)

Resignations of individuals at the GDC are no longer enough for confidence to be restored in our regulator. The profession should demand the highest powers possible now decide their fate. Whether this should be up to individuals crowd sourcing an opinion from a barrister as to whether the GDC are breaching our human rights; or our indemnifiers taking their own legal action to seek redress for the expenses incurred in cases like the above;  and whether the Health Select Committee recall the GDC Executive to be given the coup de grace; or the BDA continue their lobbying of MPs whilst we keep filling those same MP’s mail sacks with letters. It needs to be all of the above and simultaneously. We need to unleash a veritable storm that cannot be ignored.

Enough is enough. We need to keep taking firm action.  Is the entire profession listening? It’s time to hit back again.

 

 

 

 

  17333 Hits

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© Simon Thackeray, GDPUK.com 2015

17333 Hits
JUN
20
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The Forgotten Victims

Teeth - the forgotten victims

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9510 Hits
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Email Marketing is still alive and more popular than ever!

 

One of my early posts to my digital dentistry blog was entitled 4 A * Reasons Email Marketing is still Alive! and I looked at the reasons behind why email marketing was still so important.

Nearly 2 years later, this is still seems to be the case. One could argue it is more important than ever. In the recent eConsultancy Census, it was found that revenue from email marketing increased proportionately by 28% in 2014, and was ranked as the number 1 channel in terms of return on investment, with 68% of companies rating the channel as ‘good’ or ‘excellent’.

Email has become part of mobile marketing, it is estimated that mobile can account for up to 70% of all email opens. The banner ads or message on these emails still need to be clear and well positioned, although it’s not just the creative that is important, the sales funnel must also be fully mobile-optimised, with every page working so that they are mobile optimised and keep your customer engaged. A well designed landing page is still always an important part of the process.

We forget that with emails you are often reaching an audience that already knows you, if you have them on your list, they want to hear from you. Email requires a deeper level of engagement and trust. That is the reasons our daily digest emails remain popular. Our members are expecting them.

Therefore advertising on the GDPUK daily digest emails (sent 3 times a day) remains incredibly popular because so many people receive these daily emails to their inboxes and thousands of eyes look at the animated banners on the emails. We use these daily digest emails ourselves as an accidental marketing tool. What started as a way of communicating the latest posts on the forum to our members, has instead become a way for our members to be constantly engaged with the site and what is happening within UK dentistry. We know that not every member reads every thread or email but there is always a subject that appeals to a number of our members and that keeps our site busy and the banners receiving impressions. This means email remains incredibly important for GDPUK plus of course every big business that is online and looking for customers.

So two years after I wrote the blog piece linked above, email marketing remains an important tool for businesses of all sizes and needs to be treated as an integral part of your marketing plans, whether you are looking to reach dentists or members of the public for your practice.

We are all looking to generate leads and gain new customers, is email marketing still something you use to reach these goals or do you find other methods more effective? We look forward to hearing your thoughts, on what works for your business and what doesn’t.

Hope you enjoyed this follow up blog. Thanks!

  6363 Hits
6363 Hits
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15
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The Dental Directory - A popular stop at Scottish Dental Show

The Dental Directory - A popular stop at Scottish Dental Show

The Dental Directory had a busy stand at the Scottish Dental Show. Thousands of practices already use The Dental Directory, for everything from consumables to cabinetry and delegates were able to discover just why people keep coming back: fantastic deals, unbeatable customer service and a huge selection of products.
 

The Dental Directory also stocks specialist ranges for facial aesthetics, oral hygiene and orthodontics. With dedicated, knowledgeable reps who want to make dentists’ lives easier and save them money, The Dental Directory offers innovative solutions to common problems such as stock control and how to reduce the time spent ordering.
 

Quality is second-to-none and free next-day delivery is available on most items. If you missed meeting The Dental Directory at the Scottish Dental Show, contact the team today and see how your practice can benefit.

 

For more information, contact The Dental Directory on

0800 585 585, or visit www.dental-directory.co.uk.

  3599 Hits
3599 Hits
JUN
14
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'No Nonsense' Endo

A no-nonsense guide to Endodontics

  8219 Hits

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© DentistGoneBadd, GDPUK Ltd 2015

8219 Hits
JUN
11
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What’s in a “C” , Oh GDC

That third letter has a lot to answer for. What DOES it stand for I wonder?

 

Competent?

Well, the GDC are adamant. In their role as a “Council” They are improving immensely, and have refuted the FGDP’s assertion [1] that they have not "learnt any lessons" after their 2014 ‘Annus Horribilus” [2]

Given that when you are bumping along the bottom, the only way is up, I guess we should on the one hand be grateful for small changes and perhaps acknowledge that internally , the GDC are attempting to re-configure the disaster that is FtP.

Speaking with the Dento-Legal teams, there is a sense that the peak, the height of the tide of FtP, if you will, has either passed is passing.

 

Complacent?

The GDC in their latest report state [3]

  • 9. The triage KPI has improved and is being met in almost all instances. 99% of cases were triaged within 14 days in Q1. This has now been 97% or above for three quarters in a row.
  • 10. The Hearings KPI was met in a smaller number of cases in this period. 61% of cases were heard in Q1 within 9 months of referral from IC. This has reduced from 67% in the previous quarter. However, a much larger number of hearings were held in Q1 than Q4 (66 v 37).

Add to that the pilot schemes to require that the NHS get its own house in order with matters of performance and one can see that the steam pressure in Wimpole Street is indeed reducing.

Perhaps it is wrong to regard the GDC as a Great Day for Complacency?  Internally, it appears we have an organisation finally “getting it!”

On an annual basis, it appears that FtP cases may reduce by some 300 to 350.

  • 756 cases were received in Q1, when as many as 825 may have been expected.  

So we can expect at the very least a static ARF in December … can’t we?  Too much to hope that the GDC’s success might result in an ARF reduction!!

Talking of which, I wonder what the HoC Health Select Committee report will state. It all seems so long ago now.  In fact, I can even see the GDC Press release batting it away like an annoying fly in an arrogant, even corrupt sort of way. The FGDP pulled no punches for sure. [4]

 

Corrupt?

We could discuss whether the GDC are a corrupt body [5] – not in the fiscal sense, but in the aggressive occupation of the moral high ground. The FGDP have a point really – the GDC have utterly lost the confidence of the profession.  It is a measure of their arrogance that they fail to see this.  It is a measure of their insularity that they see dentists as a minority Registrant group.

I wonder what it will take for all those dentists and DCPs who partake in the FtP Process and indeed sit on the Council to withdraw their support.

Well, they might wish to consider their position on the matter of the GDC being in discussions with the Dept of Health to see how to amend the regulations to allow the new Oral Health Assessment to be undertaken by Therapists.

The well-worn phrase of Lord Acton suggests that while all power corrupts, absolute power corrupts absolutely.

I put it to you that the GDC is indeed corrupt, by throwing away its independence in its dealings with Government.

It is not acting in the best interest of the patient, it is acting in the best interest of the Minister of the day.

 

Correct, Competent, Campaigning

The FGDP and BDA are suddenly standing up; their heads are above the political parapets and dentists, as a profession are starting to demand to be heard, to be counted. Join one, join both, but do sit idly by.

 

What’s in the letter “C”?  Quite a lot as you can see

Enjoy flaming June, the Cricket looks as if it could be exciting  .

Ciao!!

 

[1]   http://www.fgdp.org.uk/content/news/fgdpuk-statement-care-standards-and-fitness-to-pra.ashx

[2]  http://www.gdc-uk.org/Newsandpublications/Pressreleases/Pages/General-Dental-Council-challenges-FGDP(UK)-stance.aspx

[3]  http://www.gdc-uk.org/Aboutus/Thecouncil/Council%20Meeting%20Documents%202014/Review%20of%20Direct%20Access.pdf

[4] http://www.fgdp.org.uk/_assets/pdf/consultation%20responses/hsc%20accountability%20hearing_gdc_fgdp%20submission_feb15.pdf

[5]  http://en.wikipedia.org/wiki/Corruption

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© Enamel Prism, GDPUK Ltd 2015

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Recording the Non-Verifiable

Recording the Non-Verifiable

Acronyms should be catchy in dentistry, shouldn't they? Surely that's a rule? GDC, BDA, DPL, CQC, NVQ, CPD . . . It also seems to be a rule that they have to be three letter acronyms but maybe the exception proves the point!

I have been puzzled by the newer demand to note non-verifiable education. GDC call it "General CPD".

In my mind non verified means it cannot be defined nor denoted as a specified event in time.

I feel if written down, this act of noting the time spent means it is verified. Expressing this the other way, the act of writing, noting the activity, makes it no longer non-verifiable, to my mind. I therefore offer you 2 minutes of recorded general CPD for reading this article on a dental website, and of course, closing your eyes and reflecting on it.. There you go. Only 174 hours 58 minutes to go and RECORD!

I propose, if the GDC insist we must continue to note this time spent, and they do, this part of recorded CPD has now become not-non-verified and must be renamed as "self verified personal study time".

I'm off to do some SVPST!

Now that's bound to catch on.

 

 

 

Image credit - Moyan Brenn  under CC licence - not modified.

 
  14565 Hits

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© Tony Jacobs, GDPUK Ltd, 2015

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30
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Patients - You have to laugh

Patients - You've got to laugh.

  8602 Hits

Copyright

© DentistGoneBadd, GDPUK Ltd 2015

8602 Hits
MAY
28
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GDPUK Q&A with Simon Reynolds of Patient Plan Direct

GDPUK took the time to interview Simon Reynolds – Commercial Director of Patient Plan Direct, one of the UK’s fastest growing and most cost effective plan providers, as well as a GDPUK partner.

In the past six months more practices than ever before have opted to work with Patient Plan Direct, either launching a new plan for the first time or transferring an existing base of plan patients from another plan provider. Jonny Jacobs of GDPUK took the time to find out more about Patient Plan Direct’s success:

Jonny GDPUK: Please give us a brief background to how you ended up working in the dental industry?

Simon: “Following my studies in the North West I stuck around the Manchester area and joined Patient Plan Direct’s parent company, First Capital Cashflow, as a business development associate working with both the sales and marketing teams.

“I eventually focused on the marketing side of things and after undertaking a diploma in digital marketing, took up the role of marketing manager at Patient Plan Direct, going on to progress through to my current role as commercial director – managing the business development and marketing teams. I have been involved with Patient Plan Direct for almost five years now, in which time the company has significantly evolved and grown year on year.”

Jonny GDPUK: For those that don’t know of Patient Plan Direct, can you give us a brief potted history?

Simon: “Patient Plan Direct is a dental plan provider similar to the likes of Denplan, Practice Plan and DPAS. The company was formed in 2008 as a subsidiary of our parent company First Capital Cashflow – a long established payments bureau providing payments related services and technology.

“We have embraced technology, cut out a lot of unnecessary paper based administration and benefited from the economies of scale and efficiencies nurtured from our parent company, thus cutting a lot of our own cost bases – resulting in lower fees for our clients!

“Since our inception we’ve sustained our low cost, flat and transparent fee structure of £1 per patient per month (inclusive of VAT and patient Worldwide A&E cover underwritten by Hiscox) whilst other plan providers have marginally increased their administration fees each year.

“Since the company formed, our team has grown and our service delivery and support has evolved in line with market demands. We now work with over 300 practices across the breadth of the UK, helping them to develop, grow and retain a solid base of plan patients.”

Jonny GDPUK: How does Patient Plan Direct differ to other plan providers?

Simon: “Our core proposition is our low cost fee structure, enabling a dental practice to maximise the income and profitability a dental plan generates. It is our ethos to maintain this position in the market, at the same time ensuring we provide first-class training alongside business and marketing support to ensure we can help a practice reach its objectives.

“Our fee structure can easily prove to be 2-3 times more cost effective than other plan providers, enabling a practice with even a modest base of plan patients to easily make significant cost savings year on year in comparison to working with other plan providers. Moreover, we’re very focused on flexibility and branding, offering a fully practice branded solution with the freedom for a practice to determine their own plan offering, structure and price point.

There may be some misconceptions that our service is a no frills / vanilla option when it comes to dental plan administration. However, on the contrary, whilst we don’t offer support in other areas such as CQC guidance, hold annual golf days, invite ‘key’ clients to trips abroad, or hand out ice creams at dental shows, we do invest in our team, processes, technology and support whilst keeping our costs to a minimum and passing these savings on to the many happy practices that work with us."

Jonny GDPUK: What trends are you seeing in the payment plans market?

Simon: “The biggest trend I have noticed for some time now is the lack of appetite from practitioners to either introduce or continue to grow an existing capitation based plan such as Denplan Care. There are so many reasons this is the case, which I could talk about separately for hours on end.  We have worked with many practices that have transferred from another plan provider and opted to put a cap on their capitation plans (only keeping existing capitation patients on this type of plan), opting to only promote and grow a maintenance based plan moving forward.

“The other noticeable trend is the increase in principal dentists making the switch to private dentistry and using a dental plan as a vehicle to make the transition, enabling their patients to budget with a monthly payment to see their preferred dentist. Of course this is all in line with not keeping all their eggs in one basket in light of the uncertainty around the future of the NHS. My team and I relish the opportunity to get involved in this type of plan launch, delving into the viability analysis and financial modelling to identify and recommend the best strategy for the principal, practice and patients.

“Finally, we’ve worked with a number of practices recently that have decided not to take on a plan provider transfer for a number of reasons, but instead have opted to run a new plan administered by Patient Plan Direct alongside their existing plan, taking advantage of cost savings in admin fees  for new patients joining the practice’s plan.”

Jonny GDPUK: How long have you been aware of GDPUK? Why do you think it works so well?

Simon: “I have been aware of GDPUK for as long as I’ve been involved in dentistry. It’s the place I usually hear about the latest news and opinion. As such, I visit the site daily to keep up to speed on what’s new in the world of dentistry.  With all the challenges that the dental profession faces these days (many of which are well documented and discussed within GDPUK), it’s so important there is a place where dental professionals can freely express opinion, discuss ideas and offer each other advice, feedback and moral support.

“Every credit to yourself and Tony for keeping the forum running for what is now coming up to 20 years! Long may it continue.”

Jonny GDPUK: As an advertiser on the site, have you found the site a good place to gain business?

Simon: “Without doubt the site has helped raise our brand awareness and helped us extend our message to market, educating the industry on our service proposition. We have had plenty of new enquiries and new clients that initially explained “we saw you on GDPUK”.

“I see the forum as very well respected and trusted amongst the industry; as such it’s a fantastic site to attach our brand to.”

As a private plan provider, how do you see the future of NHS dentistry panning out?

Simon: “Now we have the general election out of the way and details of the prototype dental contracts are becoming a hot topic of discussion, I think it’s safe to say that irrespective of what the new contract eventually looks like, employment under the NHS is not likely to provide greater income for less graft and a stress free life. As such, I’m pretty certain the NHS won't be for everyone and as there was in 2006 there will be a noticeable shift in the number making the move to practicing privately – a process which has already begun.

“Clearly if a dentist or practice is considering the switch from NHS to private, the introduction of a dental plan is a very obvious and proven strategy to achieve the move successfully and retain happy patients.”

 

Contact Details for Simon:

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

Tel: 08448486888

Mob: 075407063232

Web: www.patientplandirect.co.uk

Web: www.firstcapitalcashflow.com

Twitter: @PatientPlan

  9559 Hits
9559 Hits
MAY
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An Open letter to the New Chief Dental Officer

Dear Colonel Hurley,

The profession would like to congratulate you on your appointment to the post of Chief Dental Officer. As someone with a reputation for professional change management, then your appointment is seen as a welcome one by many.

The profession has not recently been blessed with a CDO who it can feel it truly relates to, and many may feel that the last few years have been detrimental to the quality of dental care available in the United Kingdom. Whilst the position of CDO will always be to do the will of its paymaster, Her Majesty’s Government, I am sure you will continually keep your professional responsibility to the profession at the forefront of your mind.

At a time of unprecedented change and pressure within the profession, you will have the opportunity to rebuild the bridges that have been lost over the years. One of the ways of doing this would be to listen very closely to the concerns of the profession, and most importantly do not be afraid to tell the truth of the problems we are experiencing. After all, you are a member of our profession first and foremost, and what is bad for the profession is bad for patient care.

A New NHS contract will no doubt be a priority; but in whatever incarnation this takes, it needs complete and total clarity as to what treatment is available for patients under the rules. There should be no room for abuse by those who use a lack of definition to perpetuate the problems of the current system. Contract negotiations based on honesty are a must; and if the government cannot afford what it wants, then it should be told in no uncertain terms that this is impossible to achieve. Not only do our representatives the BDA have this responsibility, but so do you. Only by listening to and working with the profession in a fully engaged and mutually respectful manner can this be secured. If this means a core service for the NHS, or a new way of thinking that benefits both patients and teams alike then it should be piloted properly and not forced on the profession in the manner it has before; please don’t forget that the success of dental care depends on those delivering it. You have a track record in delivering high quality change within a budget; but do not underestimate the suspicion of the profession as to how government will treat them.

The inequities of dental care must be addressed; and the continued lack of a joined up policy on dental health in the nation is still something that makes dentistry a poor cousin to other health issues. When dental problems are the number one cause of admission to hospital for children, can nobody actually see it would be cheaper to fight the problem at source rather than wait until the problem occurs? There would be no better long term legacy for a CDO than to have truly changed the face of dental health in the UK for the better. A public face of the profession that is prepared to stand up for the patient and not hide behind government spin and empty promises is what the profession requires if faith in the position of CDO is to be renewed. A clear message is what the public need.

The situation with our young practitioners having to play some kind of bizarre lottery to gain a job on graduation is another aspect of the profession that you must turn your attention to. At the very beginning of their careers, we have an increasing number of them considering whether or not they have made the right choice for their futures; and by association this is the future of the profession too. Whilst part of this lack of morale lies at the door of our failing regulator, to then heap on the uncertainty of a tiering system will eventually result in the profession being devoid of is youngest talent, without which it will wither.

So, as you approach the start of your tenure as CDO, the profession can only really ask one thing of you.

After years of obfuscation, spin, and confusion;

We need clarity.

Yours Sincerely,

 

The Profession.

 

Image credit - Jason Dean  under CC licence - not modified.

 
  11474 Hits

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© Simon Thackeray, GDPUK.com 2015

11474 Hits
MAY
25
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Crowns - Avoiding the Pitfalls

Crowns by @DentistGoneBadd

  10193 Hits

Copyright

© DentistGoneBadd, GDPUK Ltd 2015

Recent comment in this post
David Chong Kwan

mis-click

Sorry, dentist gone bad. That was really funny, then I clicked one star due to being a bit clumsy.
Sunday, 31 May 2015 12:23
10193 Hits
MAY
20
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Dental Governance on a Human Scale?

Dental Governance on a Human Scale?

I have been reading coverage and watching interviews about the latest book by Steve Hilton. Apparently, he is the favourite political guru of David Cameron and therefore his ideas are ones we might expect to be implemented in the next five years. You might find a perusal of @stevehiltonguru on Twitter to be interesting, his TV appearances suggest he has been coach to “Call me Dave” in the way Chris Barrow has been a polarising national coach to the UK dental profession.

Our profession has massive frustrations with our daily lives and the restrictions which are all around us, reaching out to almost affect our pattern of breathing. Steve Hilton argues that what has happened, as our information society has developed, is that it has become easier and easier for systems which we must follow to be written and then codified. I believe our dental profession has been trapped by this codifying of systems, almost trying to make every dentist work and behave in the same way, with the same paperwork, the same records. The words I am using here could be used for every field in the UK, ask your spouse, your friends, professional colleagues, business people, all are being stifled by the weight of the state's hefty duvet of regulation.

In the 20th century, Hilton argues, due to the way communications worked, only the people in the centre were able to make decisions, and these rippled out, in some cases enforced. Before the Industrial Revolution, decisions were taken locally as the communications of the times meant a distant ruler in the capital city may impose large scale decisions such as war and taxation. The King in the castle could not micro-manage the daily actions of subjects hundreds of miles away, the local lord, or sherrif imposed their version for their area.

Can the philosophy of applying those systems allow us to be trusted again with making our own decisions, our own leadership, rather than being force fed by the nanny state?

Nationally, this broad idea encompasses powerful, executive, city mayors. This concept is being taken forward, we will see this as more and more city mayors take office across the UK. The benefits will be a translation of what may be a well meaning law or regulation emanating from a Whitehall Minister's desk, into what this means in a locality, where a well argued, seemingly sensible, national edict may be counter intuitive to the situation on the ground.

If there are to be more and more local mayors, or decision makers, could this idea be applied to dentistry? Many agree that the whole profession is frustrated daily by the national edicts which do not fit in with how we run things on the ground, in our own practices, or in our own areas?

In oral health provision, the needs of differing areas do vary widely. Truly local decisions will help people on the ground, the providers of healthcare working together with the recipients of this care. How can we move the profession away from political control, away from the politicos who are able to speak publicly and utter soothing platitudes, but when devising and enacting changes, they seem to be regularly and plainly wrong? But our decision makers must be of the people, possibly elected, and definitely not from the present Dental Public Health elite who continue to drive change in their narrow eyed image.

Decision making for the future of our profession needs to be more human, more involving, and not just showered onto dentistry from the top down. This itself will mean different things to different people, but will allow concepts from grass roots to flourish, we have many mechanisms for communication, to set the agenda, and make the changes. The age of imposing change must now be over.

My call now is for our largest trade union, the BDA, to take this forward to this new Government on terms that fit in with their style, their politics, their understanding,  in order to make a change to the top down mindset. This is about freedom, modern politics, and a move away from the paternal style of the last century, using modern coimmunications but not only in a single direction.

Image from Guido Fawkes site
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Recent Comments
Anthony Kilcoyne

Top-Down remote Hierarchy

I agree TJ, the past Decade+ of top-down dictatorial experimentation has failed Patients and the Profession. It's time to acknowl... Read More
Thursday, 21 May 2015 09:11
Keith Hayes

Human scale yes, but which hum...

I agree, wouldn't it be nice if we could take the clock back and have a dental profession which was responsible and self governing... Read More
Thursday, 21 May 2015 17:55
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The world is going mobile!

Things are changing in the website world, mobile websites are becoming increasingly important with Google placing an emphasis on websites having a mobile version. Users of mobile phones now expect a mobile version or an app for the business that makes their lives easier.

Over the last few years, there has been a huge growth in mobile apps, with large businesses having their own mobile app but things are now changing and evolving with smaller businesses now getting in on the act. It is now possible to have one for your dental practice. This seems a strange concept to some but there are a number of benefits that could really help your dental practice.

As we all know, everyone seems to be using their mobiles for the majority of tasks, with the average person in Britain, using their mobile for over 2 hours a day. Your patients will be no different.

The GDPUK Services team can now offer you the ability to have your own app custom built for your dental practice. Once it is built (usually takes approx 4 weeks) it will be made available on the Apple and Google Play Stores for download by your patients.

Below are five reasons an app could benefit your practice.

  1. Loyalty Scheme

With the loyalty scheme built into the app, all you have to do with an app is scan a code in the practice and the patient's loyalty card is automatically marked, they can then redeem a voucher when they reach a certain number. All this is done automatically. This will be a reason your patient will keep the app on their phone, they will feel like they are getting extra value / service from visiting their dentist.

  1. Presence

Having your own app is a great way of doing something different and innovative in your local area and will impress your patients. Having an app gives your patients a constant reminder of your presence in the community and that your practice can be seen as innovators.

  1. Engage with patients

Patients can message your practice directly from the app, they can request an appointment for specific items of treatment. They can also gain direct access from the app to your Facebook and Twitter accounts as well as your blog or any other social media etc.

 

  1. Push Messaging

You can push messages directly to everyone who has it. Push messaging is free and has close to a 95% read rate which when you compare to an average open rate of just 20% for an email that practices send to patients.

  1. Referrals

With a mobile app your patients can refer you directly to their friends and family via Facebook, Twitter, email or text. As we are all aware there is nothing more powerful than a personal referral for any business, for dentists personal recommendations / referrals often work brilliantly because they provide confidence to the potential new patient and also prove to your team and yourself that you are doing the right things. A number of referrals a month from the app will make the small investment in the app totally worth it.

 

 

For further information on the app and the costs involved please have a look at our new services website and specific page on the app. Links below. If you have any further questions please email us - This email address is being protected from spambots. You need JavaScript enabled to view it.

www.gdpuk.com/services

www.gdpuk.com/app

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Hitting the right target?

Hitting the right target?

Is it safe to come out from my cave now? Can we talk politics?  It is tempting to be cynical and use that worn phrase, Plus ça change … [1]  

To those of you with connections in Nepal, my sympathy and best wishes - coping with such a series of natural disasters is never easy. The Nepalese Governments rejection of the UK's Heavy Lift helicopter offer suggest that politics can rear its ugly head in any circumstance.

In a small way, I suspect UK dentistry will prove no different.

 

Unfinished Business

The election has been and gone. [You have noticed, haven’t you?] As revolutions go it was typical – the outcome was unexpected, although change was assured.  Everything is up in the air, and yet already the dust is settling and the view of the future challenges is clearing. There is a sense of unfinished business in many respects, allied to concern that reform, be it to Regulatory Bodies or or Contract Reform, is going to suffer Mission Creep

In the space of a month for all its abject lack of mention during the election campaign, there has been a series of small seismic shifts in dentistry.

 

Tremors of Change

The new CDO was appointed [2] and Colonel Dr Sarah Hurley's name was confirmed; although announced on the NHS England web site, it is strangely absent from the DH Portal.  NHS England stated:

Sara will ….. champion the role of dentists and dentistry within the health system.

I look forward to that because it was for sure absent under the previous incumbent who even now is espousing the increased use of Dental Therapists.  Her military experience should stand her well in trying to wrench the proud profession of dentistry away from the red braced bean counters.

The BDA Conference, following on the heels of the UK wide Vote, was a successful venture, multiple stages and speakers offering a cracking breadth of topics to hear about. Big Dr Mick issued his rallying call, [3] and if anyone can lift an Agincourt like salute to the DH, he and his PEC  are your ‘archers’.

The election threw an unpredicted outcome of a moderately strong Government, albeit with a large degree of SNP oversight.

The former CDO has already hit the lecture circuit and interview network, the glossy big magazine from Practice Plan being the one to catch the early eye, but with what agenda in mind it remains to be seen, except perhaps to self-aggrandise the achievement of the 2006 UDA contract. A strange retirement project I would suggest.

Jimmy Steele, the ubiquitous Toon Professor of all that is good, has spoken about the new Prototypes in guarded terms [4]  – suggesting that we are heading toward a sensible format for NHS funded dental delivery. The nature of his caution suggest that money will be the driver or the deal breaker.  Model Two appears to win his tentative vote at this time

Perhaps most interestingly, the FGDP, in a move to assist beleaguered dentists, has made their standards Open Source, [5] as well as criticising the GDC and its appointed ‘experts’ for constantly placing the bar too high in FtP cases.  The GDC it must be said have publicly challenged this respected professional body. [6]

 

So what now?

We now face the prospect of proper austerity, with a new budget in July. Further real cuts are forecast  and I for one would not bet on dental funding under the NHS increasing to ensure proper delivery of any new contract.  Suddenly massive promises are on the horizon for 24/7 operation allied to an increase of 5000 WTE GMPs – and you can see dentistry as funded by the Government being parked up a narrowing alley.

 

So the rallying call is very simple –

We must expose the lack of clarity of the NHS offering which looks to be similarly present under the new contract proposals.

We must drive increase dental funding to be directed at child dental health

If ever the case for fluoridation should now be put to bed, it surely must be now – the cost effectiveness alone must appeal to a newly empowered Chancellor.

And the GDC are still awaiting the HSC Report, but our regulator is hardly a reformed body despite their strongly worded rebuff to the FGDP

Dental revolutions are often subtle, like slow burning fuses.  I think there are a number of fuses smouldering here.  The summer should be interesting because at some stage there will be a loud bang.

Enjoy your long weekend

 

[1] http://en.wiktionary.org/wiki/plus_%C3%A7a_change

[2] http://www.england.nhs.uk/2015/04/27/new-chief-dental-officer/

[3] https://www.bda.org/news-centre/press-releases/Pages/Dentists-leader-issues-rallying-cry-to-the-profession.aspx

[4] https://www.bda.org/news-centre/press-releases/steele-on-contract-reform-type-b-prototypes-closest-to-my-original-vision

[5] http://www.fgdp.org.uk/content/news/fgdpuk-launches-the-open-standards-initiative.ashx

[6] http://www.gdc-uk.org/Newsandpublications/Pressreleases/Pages/General-Dental-Council-challenges-FGDP(UK)-stance.aspx

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Getting the best out of patients - A Manual

Dental Patients - a quick set-up guide.

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NSK win prestigious Edison Award

Since 1987, the Edison Awards™ have recognized and honored some of the most innovative new products, services and business leaders in the world. The Awards are named after Thomas Alva Edison (1847-1931) whose extraordinary new product and market development methods garnered him 1,093 U.S. patents and made him a household name across the world. The Edison Awards symbolize the persistence and excellence personified by Thomas Edison, while also strengthening the human drive for innovation, creativity and ingenuity.

 

The Edison Awards™ are among the most prestigious accolades honoring excellence in new product and service development, marketing, human-centered design and innovation. Unique to the world of award programs, the Edison Awards™ are focused on the innovators as much as the innovations. Award winners represent "game changing" products, services and excellence and leadership in innovation around four criteria: Concept, Value, Delivery and Impact. An Edison Award represents significant value to the award winner and to the cause of innovation.

 

In the Dental Tools catergory, NSK won gold for the Ti-Max Z45L. The handpiece is the worlds first 45 degree electric attachment handpiece. It features a unique, two-way water spray mode. A jet spray option helps prevent subcutaneous emphysema in surgical procedures and a mist spray option effectively cools the bur making it suitable for both surgical and traditional procedures with difficult access.

 

Link to the award winners here. If you have a look at the page, there are some very interesting and innovative products that have won awards. Worth a read. 

Below is a video about the handpiece that won the prestigious award.

 

 

Further information on the handpieces can be found on the NSK website

http://www.uk.nsk-dental.com/products/contra-angles/ti-max_z/

tel: 0800 634 1909

 

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Children have teeth too

Children - They have teeth as well, you know.

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Where are we now?

Where are we now?
Where are we now?
 
Just a few days ago, all talk was about coalitions, the end of single party government and the need to accommodate more and diverse voices in political discourse. Many people must be feelings like idiots now, including myself, for thinking that change could happen even with such a dysfunctional voting system as First Past The Post. 
 
In any case what we have now is single party government. We have a weakened Labour Party which will take years, if not decades to recover in England and may never fully recover in Scotland. We have a Liberal Democrat Party that has been massacred for bring a junior partner in coalition. The country has spoken. It does not want coalition. It wants single party government and it is happy with division. It is a polarised country now. There will be a referendum on membership of the EU within 2 yrs and there may be a second referendum on Scottish Independence over the next 5-7 years. But has the country actually said this? What about the millions who voted Green and UKIP but see little representation? The system IS broken, but it may not be in the victors' interests to reform it. 
 
In my seat the Liberal Democrats were a close second in 2010 and are now down to fifth place, not just due to an SNP surge but also due to a unionist attempt to stem that surge. Thousands of Liberal Democrat voters including party activists and members voted for Labour to keep out the SNP. In this seat they succeeded in doing so and returning Scotland's only Labour MP, Ian Murray, to whom I convey my best wishes. 
 
There are a lot of challenges ahead for governing and non-governing parties alike, and for me the next big challenge is to find a job! I still am a dentist and it will be good to return to a practising life! Anyone out there looking for an associate? 
 
 

Tony Jacobs writes: Massive thanks to Pramod for writing this series of blogs against a backdrop of political change both in Scotland and of a backlash against the Coalition's minority partner party. All at GDPUK wish him well in finding a job and settling back down again, I will make sure he keeps us informed!

 
 
 
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Decision Time!

Decision Time!
Decision time!
 
Now we have all the manifestos. We've had all the debates. We've had more hustings than in normal years. I've had over 10 in my constituency and some candidates in other seats have had over 20. We've had independent and "independent" reports. It is now decision time. 
 
I know that I had planned to report on the various manifestos, but having seen this post manifesto drama play out over the past few days, it has become clear to me that NONE of the parties can implement their manifestos in full and that ALL manifestos are more likely Talking Points for coalition negotiations. What we are seeing are not set-in-stone manifestos, but pre-negotiation posturing. That is an observation I hold as a candidate who is not from the world of career politics. Obviously all parties have their Red Lines and things they will not compromise on, but hey, if all stay rigid on everything, there will not be a government formed unless there is a single party majority which we know will not happen! Manifestos made sense when there was single party government, but in this new world, unless parties fight elections as coalitions with a common programme, individual manifestos can be seen as starting points, no more, no less. I think any business or any individual who has ever gone into any negotiation of any kind will understand this simple reality. Whatever else any party leader says is just part of the script of electoral theatre! 
 
We can only know what levers any party can use when the final figure of votes and seats is known. Any party that sits in opposition or refuses to negotiate to form a government will have NONE of its manifesto commitments implemented. This is a message not only to Liberal Democrats, but to any voter or activist of ANY party who may be wedded to a particular manifesto commitment or any voter who pretends that some party that will not participate in government formation will magically achieve its objectives just by being there in parliament! I say this knowing fully well that we are not only electing the next government but also the next opposition, we are not only electing an individual to represent the constituency but also someone who may play a substantive role on many parliamentary committees, the work of which is as important if not more important than the work of governments and oppositions. Finally, the power of an individual voter is limited to voting for one person. It is then up to a collection of such elected persons to decide who will form the next government and the next opposition. 
 
We are entering a new phase in our democracy. Gone is the 2 party state. We are now a multi-party democracy. It may not feel that way to a reader who is in a safe seat, but where I'm standing, Edinburgh South, it has been marginal for years! This time, thanks also in part to local factors, the seat could well be a 4 way marginal with the balance tipping only if tactical voting comes into play. A state of affairs that shows how unfit our First Past The Post system is for a multi-party fight. Strangely enough, it is that very system, which was designed for a two party fight and one party rule that has brought this about! But it has brought with it the spectre of tactical voting, which means that we can never really truly assess what people want or the parties and policies they really support, and we have to go more by what they DON'T want or their lesser of the evils choice. Surely, a big failure of our democracy. In Scotland, there is the likelihood, as much as I hate the idea, of tactical voting in favour of the SNP by voters who voted YES to independence, and tactical voting in favour of the party best positioned to defeat an SNP candidate by voters who voted NO in the referendum. Can you even imagine the pain on the faces of Labour and Conservative voters facing the prospect of voting for each other's candidates? 
 
What I'm also seeing is support for coalition. I could never have imagined that there would be so many Conservative voters so keen to vote for me, a Liberal Democrat. It does help that I stand for fiscal responsibility and that I'm strong on defence, but what I see is a possibility that moderate Conservative and Liberal Democrat supporters have warmed up to each other due to the shared experience of coalition. We have travelled together a long way these past five years and though there remain fundamental and wide differences on many issues, there is recognition of the fact that the coalition has worked for the country and we have surprised ourselves and each other on our ability to work together in the national interest, setting aside differences and making the necessary difficult decisions. I'm sure that there may be Conservative candidates in other seats that have seen some reciprocity too. 
 
This spirit of co-operation and consensus is to be welcomed and I do hope that the next government, whatever its combination of voices can work in the same way. 
 
I will give you a post match analysis next weekend, but for now, I have voters to meet! 
 
 
 
Image credit - André Zehetbauer  under CC licence - not modified.
 
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Dentists - Weird or What?

Dentists-Wierd or What?

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The Only Way is Ethics

The Only Way is Ethics

The one thing that has been a constant in my entire career so far, and has been the fundamental guiding force to everything I do, has been my ethical compass.

Where it came from originally I suppose was my upbringing, but then further refined by exposure to teaching (particularly clinical) of such a style it helped me to understand what an important position we as professionals hold, and the huge responsibilities we have to other people, primarily our patients.

Whilst clinical experience and techniques have doubtless changed through my practicing career as it does for all of us, the ethics of how and what I do have remained a fundamental baseline that cannot be compromised in my opinion.

I’m sure for the majority of the profession this rings happily true. So much so I have wrestled with even submitting this blog for publication. After all, none of us know anyone in the profession who could do with taking a good look at themselves and thinking about what I’ve written here…..

There are times when I have had to wrestle with what the right course of action is clinically, but these dilemmas have always been fairly straightforward when put in the perspective of how other medical professionals might have to act, and I’m actually quite grateful that for the vast majority of us our day to day decisions are rarely likely to have life changing impacts on our patients, especially when compared to the huge responsibilities of cardiac surgeons or oncologists for example.

But….

If our ethical compasses have become somehow magnetized by a malign influence that we fail to see, ignore, or indeed we positively allow to affect us in some way, then our actions will have potentially life changing impacts on our patients. Ok, so maybe not as severe as for the medical professionals mentioned above; but certainly at odds with the ‘First do No Harm’ principle we swear an oath to.

I am purposely NOT going to go into the potential malign influences of the NHS contract and how it might be abused or gamed; I leave readers to draw their own conclusions about this after reading this piece. What I will say is that my examples below probably only scratch the surface of what might be happening in our profession.

There is huge increase in the cost of indemnity, and whilst we have a GDC that is not fit for purpose causing at least part of this increase, it surely cannot be solely due to that alone. We can blame no win-no fee solicitors to a degree, but don’t forget that cases have to have some merit to be paid out, even if only on the balance of probabilities. Otherwise, they are defensible.

So, consider the parallel increase in availability of orthodontics and implants in recent years. This blog incidentally is NOT aimed solely at the orthodontic aspect although it may seem so; it is purely written from my personal experience of one aspect of our profession that I have experience in so feel able to comment on a bit more.

These treatments are by their very nature high value items, and potentially have a higher profit margin that some of the more routine treatments offered. The courses maybe expensive, as is the equipment needed to carry out the treatment. Being the principal of a practice that offers both these treatments, I am pretty well placed to know the financial aspects of them. What is worrying is that there seems to be a section of the profession that immediately has a new direction on their ethical compass when they start to offer these services, sometimes after only a weekend course. Admittedly this might apply more to the orthodontic side of things as I think it is now more recognized that implants are not quite as simple as Meccano to install.

But with the increase in availability (or is it an increase in higher pressure marketing and selling??) we see the parallel, and often steeper rise in litigation and Fitness to Practice associated with these treatments. Personally, I think a good chunk of this is due to the magnetism that potentially affects the compass of some of the profession after being exposed to these treatment modalities.

It’s one thing coming away from a weekend composite course having learnt what is likely to be a refinement of an existing technique, to actually introducing a whole new treatment modality to your patient base that wasn’t taught at all at undergraduate level. The ethics of such a situation are different in my eyes. When at least some of the course is given over to how to sell the new treatment to your patients on some courses (rather than spending it further exploring the ethics, assessment, case selection etc) it is not surprising that magnetism is already starting to alter the direction of the needle on your compass…

There is nothing wrong with a return on investment, but it’s how you go about getting that return that might be the problem.

Let me give you some background with regard to my orthodontic experience to put into perspective where I am coming from.

I was fortunate to work as a clinical assistant in the mid 90’s in orthodontics. One morning per week I treated patients under the supervision of a consultant in a regional hospital, and this continued for about 4 or 5 years. By that time I had seen and indeed treated some pretty advanced cases under very close supervision. I was also treating simpler cases in practice as an associate. Along with another general practitioner, we estimated this experience prepared us to treat perhaps 30% more of our orthodontic patients in practice, but more importantly it had taught us how to identify what we definitely couldn’t or shouldn’t treat. The ethics of what we could now do was drilled home all the time since we often got to see the slightly more ‘random’ orthodontic treatments that had failed in the hands of practitioners with experience only of removable appliances at undergraduate level.

We had begun to Know what we Didn’t Know.

Since then I have also been on the courses for commercially available appliances of different types, and had the advantage of my previous experience in looking at the systems and the teaching a little more objectively than perhaps some of the other delegates.

The problem comes when some of our profession don’t have these limiting factors in their internal ethical system. Some are possibly not enough motivated by the desire to always only do the right thing by their patient, but by their own financial and even egotistical drives. There have always been those in our profession who seem to have a sliding scale of principles, and are more driven for their own gains (and the patients may or may not gain as a result). I actually don’t feel that there are any more truly ‘bad guys’ in dentistry now as a percentage than in the past despite what the GDC think; but I think the potential for damage to our patients has increased because perhaps the fundamental ethics we should all have in place, in some are allowed to erode.

Combine this with the further issue now that with a lack of experience at undergraduate level for some aspects of dentistry, the starting point for not knowing what you don’t know is now much lower than perhaps it was in the past. This is where the ethics should come in to play, and whilst I applaud the efforts to fill a gap in the treatment needs by offering training in fields not covered by the undergraduate training, there doesn’t seem to be an ethical ‘lock’ in place with some practitioners to prevent them seeking their financial gain over that of the patient.

More controversially with regards to their ethical direction, perhaps they Don’t (want to) know what they Don’t Know about ethics?

So when the treatment goes awry because of not knowing enough about what wasn’t known, and the ethical direction was slightly (or massively) off, the profession has a HUGE potential for life changing impacts on both patients and its members.

This brings me on to the thorny subject of ‘selling’ in dentistry. Now, I have absolutely NO issues with dentistry as a retail environment, offering services to patients. Indeed, in order to keep a viable business in this ever competitive age, you have to consider how best to let your patients know the services you can offer them. I certainly do, and I feel it is another method of protecting ourselves from criticism that we are not offering a full range of options to our patients.

But ‘selling’ has to be fundamentally and overwhelmingly in the patient’s benefit, and not ours. I worry about some of the techniques I know can be used by some industries that if (or should that be when?) used in ours would exert an influence on the patient designed to get them to agree to treatment whether that is the right thing for them or not, or even more worryingly, whether the practitioner is truly capable of providing the treatment correctly or not. The pound signs appear, the ethics can get completely switched off, and it becomes a one sided benefit.

But what if you actually CAN’T solve those issues? (and are either aware you can’t, or just bite off more than you can chew?). The classical ‘Over Promising and Under Delivering’ is a guaranteed route to problems for patients and the reputation of the profession.

This is where the huge problem occurs. The practitioner that doesn’t know ENOUGH about what he/she doesn’t know, having been blinded by clinical and other courses that seem to offer all the answers to patients problems and get them to agree to treatment, with an underlying anaesthesia of the ethical values (if they ever had one in some cases) for what ever reason is not doing the best for their patient.

At all.

Without the ethical compass pointing in the correct direction, then there are those in the profession who cannot with their hands on the hearts say that they are truly driven by doing the right thing for patients. Take the ego and the financial aspect out, and their direction is quite possibly completely lost.

Until we make sure all our ethical compasses are calibrated properly, I’m afraid the GDC (in whatever guise it takes) will continue to be on our backs, and our Indemnity will continue to rise. The press will see us in the wrong light, and so will patients.

We need a return to the fundamental values of what we do and what that means to us and the patients.

And to do that, The Only Way is Ethics.

 

Image credit - Paul Downey  under CC licence - not modified.

 

 

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Evolution of a Revolution?

Evolution of a Revolution?

These are politically exciting times in which we live. The earth shaking events in Nepal are unrelated of course and to those of you connected in any way, I hope that our thoughts and prayers provide comfort.

The French have had their revolutions. So have the Russians. The North American history is littered with conflict. Closer to home the Scots were victim of some brutal clearances.  The Irish found themselves on a similar receiving end of some English-driven realpolitik. The English have had their civil wars be they flower based or parliamentary in origin.

The definition of the word revolution includes this:

  • a dramatic and wide-reaching change in conditions, attitudes, or operation.
    • synonyms:  dramatic change, radical change, drastic/radical alteration, complete shift, sea change, metamorphosis, transformation, conversion,innovation, breakaway;

 

The 8th May - the day things changed

 

And now we are about to witness a UK wide political revolution.  A conflict of ideas and ideals as dramatic as any more military revolution.

On Friday the 8th May, the manifestos of the various parties will be torn into small bargaining chips. All political discussion will become secret and behind many sets of closed doors as the hidden powerhouses of advisers thrash out a deal which allows either Mr Miliband or Mr Cameron to pay a visit to Her Majesty and request that they be allowed to form a Government.

Your conversation with your patients on Friday 8th will at least be a bit different from the usual weather and holidays. But what will you think?  If we have no clear large party, by definition we have a coalition at best and minority Government at worst.  First past the post only work if you have a winner. Imagine you are overseeing a race and because you forgot your stopwatch and glasses, the result looks like a sort of fuzzy dead heat where does that leave the voting system?  In dentistry of course we used to have transferrable votes for electing the GDC - heady days, eh? We were ahead of the game I suggest.

Where does this leave dentistry in the minds of our politicians?

I for one find it quite extraordinary that less than a year ago we as a profession were making headlines with child dental health and child hospital admissions being the headline concern, but allied to issues of obesity, diet and refined carbohydrate.  You all know what it takes to be dentally healthy.

The drive for caries-free children is not a mystery. You all know that.

 

Dentistry... why, is there a problem?

 

So has dentistry been, if not a headline element, perhaps a second string part of any debate?

Nah.  Non.  Nyet.  Not a dicky bird.  It’s as though the 45% of the population who never visit a dentist are happy to take their own teeth out, [and for those of you so inclined to listen again, our colleague Dr Tony Kilcoyne had to endure a strange slot on Jezza Vine on BBC R2 recently].[1]

Meanwhile the 55% of the population who do visit a dentist are commendably happy with their service and experience, and are no doubt filling out the FFT as we speak.

Well they will be, until told by dentist A that their crown and root canal must be privately funded, and yet dentist B can provide the same treatment for a friend under the NHS and everyone is correct!

Clarity of NHS provision in dentistry is a ticking political time bomb with a shortening fuse. The lawyers are the ones who keep relighting the fuse and at some point it will be a major problem.

And yet sadly, dentistry has as a profession and an NHS Primary Care service been parked in the sidings of political irrelevance. We have in political terms, been marked with a large tick.

Have the politicians taken their eyes off the dental ball? You might think so. If you read the NHS Confidence Survey by Practice Plan, [2]  the mood of dentists is darkening from so many angles it is hard to find true optimism anywhere for Government funded activity. [3]

Well come the 8th May we are going to witness the start of a Revolution whoever polls the most votes.  Indeed those who poll the least may feature the most.

Perhaps dentistry will feature during the post-election negotiations?

 

And of course for those of you in Manchester for the BDA Conference…  [4]   Well maybe that will be the long-needed start of a dental revolution.

It’s not too late to check in and go have an excellent three days of networking and updating across a huge range of dentistry

A chance perhaps for at the very least a bit of private revolution.

Enjoy the long weekends coming up.  That grass is still growing...

 

[1]  Dr Tony Kilcoyne on BBC R2  http://www.bbc.co.uk/programmes/b05qsjpl

[2]  Practice Plan NHS Confidence Monitor  http://www.NHSDentistryInsights.co.uk

[3]  Dr Claire Roberts at Dentistry portal http://www.dentistry.co.uk/2015/04/22/reflecting-future-nhs/

[4]  BDA Conference agenda 
https://bdaconnect.bda.org/wp-content/uploads/2015/04/Conference-Preview-Brochure-2015-WEB.pdf

 

 

 

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Burnout

Burnout syndrome

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Reflections from the Dentistry Show

 

GDPUK were proud to have exhibited last week at the Dentistry Show 2015. We really enjoyed being there and taking part in the wide-ranging exhibition.

Below are a few short observations from my two days at the show…...

 

  • The stands and displays seemed larger than ever, a sign that the show is growing and continues to evolve.

  • There was a huge range of exhibitors and lectures, this meant there was something for everyone

  • The inclusion of DTS alongside the Dentistry Show made the exhibition even bigger and inclusive.

  • Closer Still Media (the owners of Dentistry Show) are very commercially minded which reflects on the show, is this good for dentistry? I would say yes because it means the other exhibitions improve what they are offering and they have managed to gain support from the majority of the larger dental trade companies. What do you think?

  • Great to meet loads of people from the GDPUK community. Feedback on the site is always important and it is great to receive compliments about the website. It remains extremely popular with dentists and an amazing resource for advice, information and opinion. Join for free today. We have had nearly 400 new members in the last 6 weeks alone.

  • From a personal perspective, loads of interest and commitment to advertising on the site, GDPUK is seen as a great marketing tool and community to be involved in! It was great to catch up with old friends and new. Over the next year we hope to improve the service and range of options available to our clients.

  • The one negative from our experience was that in our exhibitor agreement with the Dentistry Show we were to be associated with the GDP Theatre but on arrival at the show, there was no GDPUK logos anywhere to be seen, either at the theatre or in the programme. This was very disappointing, as it was something we had heavily publicised before the show.

  • A positive thread was posted on the forum in the aftermath of the Dentistry Show, created by an enthusiastic dentist on the site, Jeremy Cooper. Why the Dentistry Show is the BEST. It has thoughts on the show from a number of prominent people in dentistry including members of the trade. Worth a read!

Members of the forum meeting - putting names to the faces!

 

Our feeling about exhibiting was summed brilliantly by our website designer, resident techie and dentist, Steve Van Russelt who posted on another thread Its great to meet up with the real people behind the posts that make the forum so vital. Most people think or suspect that we are there as a commercial concern so have to be reassured that yes it is free to members and no we're not going to sell their contact details. So we encouraged new members to join, but the majority of the voluntary traffic and the most heart-warming aspect was all of those current members that went out of their way to visit, say how important the site is to them to keep them informed, entertained and in the loop - reducing any sense of isolation and just saying thanks for that.”

 

So overall it was a very enjoyable few days in Birmingham. We hope we will be able to exhibit again next year. In the meantime we will continue to improve the site and all it offers. It was great to meet people in the flesh and not just from their online persona or email address, we look forward to meeting you all again.

 

 

**Thanks to Erica Kilburn and her team at EK Communications for the pictures - http://ekcommunications.co.uk/

 

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Dental Nurses - all you need to know

All you wanted to know about dental nurses.

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Buy an AED - a patient arrested in my dental surgery

Buy an AED - a patient arrested in my dental surgery

 

Thursday 16th April 2015 is the day I will never forget.  I was in surgery with Amy.  Bea was at reception.  It was a life changing moment for me and I am sure, for all of us, by Dr Chris Tavares BDS

 

 

 

 

 

 

 

THE CARDIAC ARREST

We were ready to get the patient in.  At around 3:45 pm,  Amy went out to get him in.  As the surgery door opened I could hear him having a laugh with Bea.  He came in, we exchanged the usual superficial pleasantries, had a laugh.  Asked him how he was. He said “Fine, very well thank you”.   Soon, was this to change.

He told me he had fractured a tooth in the upper right area this morning. There was no pain but it was sharp.  I turned round to type this into the clinical notes.  I could see that his ASA rating was 1.  Nothing medically to worry about.  As I was typing, I heard heavy breathing behind me.  I turned round and saw his eyes had closed, his right leg was hanging off the side of the dental chair and as I faced him, calling his name and shaking him and lightly slapping his face, the breathing became more laboured.   I lowered the chair back right down and called him again.  Suddenly he came round and said: “Yes, yes I’m ok”…and then….he was ‘gone’ again. The breathing became more laboured to an alarming level. 

I asked for the emergency kit and Amy came back with it.  He was still breathing heavily.  As I attached the pulse oximeter to his finger, his head suddenly came forward, tongue protruded and his breathing become a desperate stridor.   His face then went completely purple / ashen. 

Immediately I instructed Amy to let reception know “Medical Emergency.  Cardiac Arrest. Call an Ambulance.”  She went straight outside.  I noted the time and started CPR immediately.  30 compressions to 2 breaths.   At one stage, I vaguely remember thinking part consciously, that If I don’t do this, he will die. It was a battle between death and I and death was not going to take him, not on my watch.  I pumped like mad.

I heard Bea, shout, if he was breathing. I shouted back: “No. Cardiac arrest. Not breathing.”  

Amy came back in and brought the AED in. We connected it up and followed the instructions.  Bea stayed on the phone in, in case 999 needed to speak to her.

 

 

The AED spoke in an incredibly loud ‘voice’:

“Stand back. Do not touch the patient.  Assessing rhythm…..Shock advised…….Press the red button and shock.”  I did this and the whole chest arched and lifted off the chair with part of his body.  The AED assessed the rhythm again and instructed us to continue to carry out CPR. 

Meanwhile as Bea had more training in Med Emergency, she came in and Amy went outside to wait for the ambulance.  As I carried out compressions, the pulse oximeter showed a pulse of 110  and oxygen content of 70%.   This little bit of information was reassuring as our AED did not have a screen with the ECG tracing. 

The AED instructed again:  “Stand back. Do not touch the patient.  Assessing rhythm…..Shock advised…….Press the red button and shock.”  I followed the instructions.

The first paramedic arrived. This was about 11 minutes from the time the patient went into cardiac arrest.   I continued CPR.  He took over immediately to check the back of the chair was firm enough and immediately said ‘yes’, good.  I then took over again as he got his gear out.

The AED instructed again:

“Stand back. Do not touch the patient.  Assessing rhythm…..Shock advised…….Press the red button and shock.”  I did this and the chest arched and lifted off the chair.  The AED assessed the rhythm again and instructed us to continue to carry out CPR. 

Suddenly the patient responded and pushed my hands off his chest!  Then went still again.

The paramedic was in no hurry to attach his AED.  He asked if our AED showed what was happening on a screen.  I said no.  He seemed happy to continue with our AED at the moment.

The AED instructed again:  “Stand back. Do not touch the patient.  Assessing rhythm…..Shock advised…….Press the red button and shock.”  I did this and the chest arched and lifted off the chair.  The AED assessed the rhythm again and instructed us to continue to carry out CPR. 

By now two more paramedic vehicles and the ambulance had arrived.  Literally minutes if not seconds, 4 more paramedics came into the surgery.   The lead paramedic, the first one who arrived, switched over to his AED which had an ECG tracing.   The second lead asked about the medical history of the patient and I informed him it wall all clear. 

The third paramedic took over external cardiac massage as the second put an IV line in.  Sugar level was tested. Negative.

It is difficult to recall exactly what happened when and what was done when and in what order.  An airway was put in.   A drip was set up.  At some time I think they also injected something.  They did other things I am not sure what.  They also attached a contraption that carried out external cardiac massage.

As they looked at the ECG I heard the second paramedic say to the lead, “That’s VT” (I think that’s what he said. There was definitely a ‘V’ in his sentence) and this was confirmed by the first.  Everyone was instructed to stand away from the patient, they pressed a button, you could hear a ‘whine’ as the defibrillator charged and they shocked the heart again. 

The ECG tracing went flat and suddenly started up again and I could see what appeared as a more ‘normal’ tracing.  Then it took on another pattern again. 

They were in the surgery for about 1 hr to 1 hr 30 mins.  The tracing on the ECG was erratic and inconsistent in that time.  Every time they shocked him, the line went flat and then started again.

I had to help to deliver the oxygen for a few minutes.   In total the patient’s heart was shocked 6 - 7 times.

I am sure he had ‘come’ round a few times in that 90 minutes.

After the last shock, I cannot say exactly when but I suddenly realised they had stopped the compressions and delivery of oxygen.   They were moving around more relaxed. The lead paramedic asked one of the ambulance drivers to bring something in.  Then he asked her to bring the stretcher in.  I thought: “What, is he…dead?”. 

I had forgotten about the ECG.  I suddenly remembered it and looked over at it…..even though the patient was unconscious and no obvious signs of life, to me, ……… there was a ‘normal’ heart tracing on the ECG.   Very regular and steady.  I looked at his chest…he was breathing on his own!  I thought: “My God, there’s a normal rhythm!”  

They lifted him onto the stretcher with the airway and ‘automatic cardiac massage’ contraption still in place, I think. The airway was definitely in.   I suppose in case he needed it again.

3 of the paramedics went with the patient to the hospital, having taken the patient’s personal details.  2 stayed behind to pack up and clear up.  I asked the second paramedic if the patient was OK.  He looked at me, looked at our AED the oxygen cylinder and said pensively:

“He’s OK. Will have to see if he pulls through.  Hopefully there is no brain damage.  You got the oxygen,…. (he looked at the AED again, which was lying on the surgery floor) …….you had the defib…….you saved his life.” He said nodding.   It had not dawned on me at the time the significance of what he was saying.

The two remaining paramedics left, saying that they’ll be back to pick up the last remaining paramedic vehicle when they’ve finished at the hospital.

 

THE IMMEDIATE AFTERMATH

The three of us sat down, numb and started talking about the incident.  Bea made cups of tea and we sat in the staff room.  We agreed we could not have done anymore.  When he had been put into the ambulance, Amy said she heard one paramedics say to another that the patient had pulled the airway out.  This was put back in then the doors were closed. So it was good, it was reassuring to know that he was alive when he left the surgery to be taken to the hospital. 

There were no elation and shouts of joy. Just numbness.  The shock and disbelief that we had just be part of and witnesses to a full blown cardiac arrest in our dental chair.

As Amy and Bea were talking, I remember I had asked one of the paramedics if there was something we should do or someone we should report to. He said there was nothing.  If the patient dies, the police will be round to make their enquires and investigate.  If he pulls through, we probably won’t hear from anyone.

When I look back now, I cannot help but feel what a sad and unacceptable and ridiculous situation the profession has been put into by those who have the authority to ‘rule’ over us but really have been given or taken more authority that they deserve.  I have been told by a paramedic that we did the right things and possibly saved someone’s life, at the moment, but instead of elation at a professional stance of doing the right thing, unfortunately I started worrying about whether I had all the right ‘paperwork’, dotted all the ‘i’s and crossed all the ’t’s if there was an investigation!

When we finished our tea and I could see we were alright, we went down stairs to tidy up.  Bea put a note to order a new set of adult pads for the defibrillator.  I checked the oxygen content whilst Amy put the Medical Emergency things away.

It would have been about an hour to 90 mins when the door bell rang. Paramedics 1 and 2 were there.  We looked at them holding our breaths.  I asked how the patient was.  The lead said, looking at the ground:

“We have some news for you.  Looked up and smiled. We have him up and talking.  He’s actually up and talking.  He must have had a massive blood clot in the artery. They are thinking of discharging him in a few days. Well done” as he looked at each of us.

The relief from the three of us was palpable in the air.  He’s OK!

The 2nd paramedic looked at the three of us, then at me in the eyes and said something about CPR, getting the oxygen in then…..

“You had the defib…….YOU SAVED HIS LIFE””, nodding and repeated as he looked round at the three of us: “you saved his life, well done” and smiled.

I thanked them for delivering the good news, thanked them for getting here so quickly and for all they had done.

The two then left.

 

We shut the door and elation!  The total release of suppressed, involuntary tension.  Earlier on once the paramedics had arrived, Bea had cancelled the rest of the patients for the day and evening. I felt they deserved to have the rest of the day off!  Fortunately we weren’t seeing patients the next day.  They went home.

I stayed behind for a bit.

 

PERSONAL REFELECTION

Bea and Amy were just great.  I could not have asked for better support.  This was the first, and last I hope (!), medical emergency we had to deal with and, for all that, in at the deep end.    Amy just carried out unquestioning what she was asked to do.  Bea, calmly called the ambulance and handled the reception area.  In fact, as Bea was cancelling one of the patients’ appointment, he commended her on how calm she was when talking to him, given what she was in the midst of.

We were lucky there were no other patients in then.  No one ‘collapsed’ , broke down in tears or freaked out.  They both held it together.  Just amazing.

I will forever be grateful for the regulation that insisted we had Continual Professional Development (CPD) on “Medical Emergency” every year.  Every year we had a hands on 3 hours training session and I would also attend an additional lecture session.  I was never sure how much of this I actually retained in my head.

I made sure we held a medical emergency drill once a month. Only I knew when I would call one. I would always choose a time so we had a different number of staff around. We may miss a month at most but we held the drill regularly.

I am in no doubt this was one of five things that affected the outcome.

INSTINCT

When something like this happens, there is no time to think, no time to work your way through some mental venn diagrams or following the boxes of a mental flowchart.  It had to be instinct and what was already in your subconscious. 

Everyone just went into action. Everything just went so smoothly.  The call for the ambulance. Staying online with the 999 operator. Waiting outside for the ambulance.  Amy saw him and made a beeline for him.  CPR: 30 compressions to 2 breaths.

I have no doubts the regular drills helped us all.

 

STRIDOR & SUBSEQUENT LOSS OF COLOUR

I did not have to work out if he was breathing or his heart was beating. This just told me …negative.  I was lucky to have had these signs.

I just started immediate CPR and the ambulance was called. 

The rapid response I am sure contributed to the outcome.

CARDIAC COMPRESSIONS

One can never know if one is compressing chest deep enough.  You can’t measure the depth of compressions in such situations.In this case the colour of his face instructed me.  I could actually see the colour come back to his face.   This helped a lot when one is not consciously in a thinking mode and operating on instinct.

AUTOMATIC EXTERNAL DEFIBRILLATOR

The enemy to anything we do …….is ‘doubt’.  If you start asking yourself, doubting your actions, for anything, it is a recipe for disaster or failure.

He was, as I came to know, in VT/VF. I have no doubts the AED contributed to the positive outcome, directly and INDIRECTLY. 

Before the AED was connected, I was just pumping away but no idea if it was helping. 

The question always in the back of my mind is if I’m doing the right thing at the right time. 

When I connected the AED up, the minute I heard its “voice”, I was immediately aware of a sudden mental, physical and emotional relaxation. It was like having the consultant cardiologist in the surgery.

“Stand back…do not touch the patient…assessing rhythm….shock advised….press the red button and shock.”  I just thought: My God, his heart is being monitored now.  “Somebody” knew what was going on.  There is nothing more to do but follow the instructions.  It had an immediate calming effect on the whole process.

I had wondered if I should buy the AED.  I did. We’ve had it for 5 - 6 years now, every day checking the “green ready” light is on, never once thinking we will need it.  I have absolutely no regrets in buying it. 

I am well aware that there is still going on a major disagreement amongst professionals whether the AED is necessary in the dental surgery.  I will have no hesitation now to say YES.  I cannot be more appreciative of the AED.  It made the whole incident so much more easy to handle and I will forever be grateful we had one.  It actually helped to calm the room.   Was it ‘the thing’ that saved his life?  I don’t know.

I remember hearing at a lecture on Medical Emergencies.  I cannot remember who it was.  What he said was that we can never fully know exactly what is happening to the heart muscle and how it will respond to anything we do.  The patient, to all intents and purposes, is dying or nearly dead. If there is anything we can do that will remotely contribute to a positive outcome….DO IT.

Of course there is never absolute certainty in life.  The consequences of our actions can never be fully predictable.  If one will only act if one is always absolutely certain of the consequences of one’s actions, then one would just sit and do nothing.

The AED contributed in two major ways:

1    It really calmed the room whilst we waiting for the paramedics to arrive.

2    As I saw on the ECG screen later, it gave the heart a chance to re-establish a normal rhythm.

I HAVE ABSOLUTELY NO DOUBTS THE AED CONTRIBUTED TO THE POSITIVE OUTCOME in this case.

LUCK

Pure luck had a lot to do with it.  We were lucky the paramedics were able to arrive so quickly and there were so many.   They were just amazing.  They went about what they had to do in a calm, confident and controlled manner. 

We were lucky, before the paramedics arrived, none of us freaked out.  I have no doubts the regular drills we had played a large part.

One can never say for sure what exactly it is that brought about the positive outcome but I am sure luck played a part in it.

 

WHERE AM I NOW?

There is the disbelief that I was actually  deep in the middle of it all.  I actually looked at the face of someone who was clinically dead and he pulled through?   I came back from the Dentistry Show the day after ‘the event’ and went straight to the surgery, to call the hospital to see how he was. There was a slight eerie feeling going into that empty building, into the surgery. It was all clean, tidy and quiet. I could not help but wonder if 24 hours earlier, did all that really happen?

The suddenness of it all is what is so frightening. There were no medical history concerns.  One minute he was there, two minutes later he was gone. If he had been in his car, 5 minutes late for his appointment, he would have had it in the car and could have ploughed into a bus stop with men, women and children.

I value my life much more now.  An appreciation of what I have, life, wife and children,friends and who I am.  So much we take for granted. 

I was surprised how well we all were when we attended to patients two days later.  It will take some time for the slight apprehension to dissipate.  Is this person going to suddenly have a heart attack on me?

The recent developments, all the nonsense, in the dental profession had really got me down.   All the effort in having to keep a surgery running with all the nonsense regulatory compliance and then having more piled on, unnecessarily.  I had been tired of putting so much effort into working as a dentist and getting so little back in return as the pressure of legislature piled on.  I was tired of legislature getting in the way of patient care. 

This ‘event’ has helped me to see things in perspective. This has been a good boost in morale as at least, all this effort came to fruition.  I am very proud of my staff and I hope they are of themselves too.

There is a mixture of emotions or feelings in myself.  Of course there is an immense feeling of gratefulness that we had a positive outcome.  Then, there is the feeling that one has been in a ‘privileged’ place, if that’s the word to use.  To have been involved in the thick of things and have a positive outcome.  Then there is something else I am aware of.   I am not sure how to describe it but it is a good feeling……….there is a deep seated feeling of stillness.

Every so often, the words that still ring in my ears:  “You had the defib……you saved his life.”

That inner stillness…..is….good.

Chris.

 

Dr Chris Tavares,

Dental Practitioner, Derby

April 2015

 

This blog was first published in April 2015, a few days after the event. In May 2016, after seeing more data, Dr Chris Tavares added the following:

I wanted to correct a few inaccuracies so as to be fair to the East Midlands Ambulance Service who did such a fantastic job on the day and to give credit when and where credit is due.

In the heat of things, a second can seem like a minute. A minute can seem like three minutes. I was able to download the data from the AED which records an ECG tracing every second. The AED analyses the rhythm every 2 minutes and advises to shock or not.  I was able to work out the exact timeline from this.

The heart was in VF.  CPR was started within 10 seconds of cardiac arrest.  The first shock to the heart was within two minutes of cardiac arrest.  The first paramedic arrived 5 minutes from the time we dialled 999. The five paramedics were in the surgery for about half an hour when a normal heart rhythm and spontaneous respiration were re-established and the gentleman was taken to the hospital. 

I have no doubts the rapid sequence of responses added to the positive outcome.

 The whole situation can best be summed up:

 “We did what we had to do ... the paramedics did their magic ... and the hospital staff performed the miracle.”

The gentleman is alive and leading a full life, no brain damage, no external scars.

Buy an Automated External Defibrillator and save a life.

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Standards 1.0

Standards 1.0

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Recent comment in this post
Andrew Adey

So sad because it`s true.

The title above says it all. It`s all absolutely true. ... Read More
Wednesday, 06 May 2015 14:34
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Battle Of Hustings

Battle Of Hustings
I had originally planned on discussing manifestos this week. Something that would have a lot easier if I actually had the manifestos to hand! Unfortunately none of the parties has released theirs so far and we will have to speak instead of the Battles of the Hustings'
 
Three such events have been on my agenda so far. My first was on the 26th of March for the Edinburgh North Lib Dem candidate who could not attend his Common Weal Hustings as he was stuck on an oil platform overseas! It was a good first experience and a good though mildly hostile audience as they were mainly YES voting and far left leaning. A good audience for Left Unity( a new party ), SNP, Greens and Labour in descending order. Ranging from mildly receptive to indifferent to mildly hostile to the Lib Dems and very hostile to UKIP and the Conservatives. 
 
My best received comment was about increasing diversity of representation in parliament, both of people and of parties. My worst received comment which I had expected of a far left audience was my opposition to a position by the Greens and Left Unity that a £10 minimum wage should be legislated for in the next parliament. Yes you read that right, a £10 minimum wage!!! Yes practice owners, I just heard you drop your iPads, iPhones and laptops to the ground! I did make the point that it would be very difficult for small employers and that many services would either have to be sacrificed of reduced to fund such an idea! I was open to raising it to £8 by 2020, but £10 is just a step too far for anyone not in London! In any case it would make it tricky for NHS dedicated practices and fledgling private ones too. I got a hear, hear from the conservative candidate when I was speaking about the benefits, values and achievements of the coalition. He gave a non response to the suggestion that coalition governments will be the norm from now on! But that is something that is looking likely with the way the polls are heading. 
 
My second hustings was with students at Edinburgh University on the 30th of March. This was an Edinburgh South hustings and a very interesting one as each candidate was accompanied by a student of their party! Law student Jonathan Ainslie joined me. 
 
As expected, we got abuse over tuition fees  and the audience laughed at us when I said that there were limitations to what a smaller party could achieve in coalition, that we could not win on every policy. Then I got applause for support for the post study work visa. Obviously! You do not mine a diamond, shape it to brilliance and return it to the mine! The Labour and SNP candidates had a lot of support from the audience as their student associations attended in full strength. 
 
My most recent one was a pan Edinburgh hustings with the English Speaking Union in Edinburgh on 7th April. This was a well balanced audience with all parties' supporters in the audience. 
 
I got thunderous applause and laughter when I turned to the SNP candidate and said " the Lib Dems lost a referendum ( AV ) and moved on, it would be good if certain other people who lost their referendum moved on too! " very well received that! Excellent questions about TTIP, post study work visa, Human Rights, Austerity, Trident,  and so many other areas. It was a balanced  debate and a balanced audience. Young journalists from the wonderful website 50for15.com were in attendance. It is a website following the 50 most marginal seats at the election. 
 
Now let's hope that all parties get their fingers out and release their manifestos next week! 
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Dental History by @DentistGoneBadd

The Making of Dental History

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Clearly - an Election with promise

Clearly - an Election with promise

The Clock is Ticking

As of writing, there are about 30 odd days to go to the UK General Election [1] and politics may have changed for ever. The 2-party system may well be broken. It seems likely that the smaller parties will have a relatively huge amount of influence over the eventual policies of the Government that emerges. If Proportional Representation had no role to play in “First Past The Post”, it perhaps does under a mixed multi-party system of coalition where FPTP does not produce a clear Government.  A clear outcome is … well, far from clear. I sense a theme I might return to.

 

Who remembers the HSC?

Until then of course, we are in the frenetic work up to Election Day across the UK, allied to significant numbers of local elections are due to take place on 7th May.[2] Parliament dissolved of course at the end of March. The Health Select Committee report of the GDC Accountability Hearing will now have to be signed off under the new Government.  Wouldn’t you just love to know what’s in the draft that no doubt sits in a pending tray somewhere?  You can never get a decent leak when you want one! For those of you with short memories in Wimpole Street, it was clear the HSC were collectively unimpressed with the performance of certain executives.

 

Dentist in Politics

Many Dentists and Dental Professionals play their part in local communities and will have local or national agendas of their own. To all of you, the very best of luck. It’s a busy time.  Stay focussed and may the votes go your way.

 

Indeed in the GDPUK forum we have our very own blogger Dr Pramod Subbaraman [3] who is a parliamentary candidate for the Liberal Democrat party in Edinburgh South. Scotland of course are still vibrant in their political engagement after the 2014 independence referendum. Sir, we wish you well.  Ironically, if present polls are to be believed, the Independence agenda re-emerge after the election because of the influence of an enlarged Scottish National Party in the House of Commons.

More wet fingered dentists in top level politics is a positive process – it can only help the cause of the nation’s Oral health and ensure that the dental and oral health inequalities rise up the political agenda.  There is a sense of “Rome burning” about the facts on the ground of GA Admissions for children for surgical dentistry [4] while the Department of Health and its mouthpieces at NHS England assure one and all that the system of UDA related access  has clearly been a big success, broadly speaking. I really must get a new pair of hindsight-o-scopes.

 

You ARE political influence

But imagine you are standing around one day in your local market place and the candidates for your local seat are canvassing your support.  You were planning to “do you bit for the profession” and therefore plan to ask one question. 

 

What should it be?

What would swing it for you if a candidate were to ask you for their vote?

Let me take you back to a previous blog in which I raised a “Trumpet Call for Clarity of the Deal”.[5]  In it I suggested the GDC might take this role on and demand clear rules on what dental care is available under the NHS.  For those who are interested, I did write to the Chairman of the GDC and he delegated his reply that “It was not their job”. Too busy counting the FtP hearings, I suspect!

The consumer organisation Which? [6] and the Office of Fair Trading [7] tear their hair out over the constant complaint that patients never know what’s available under the NHS and what’s not . Report after report is critical – and yet – this strange fudge is NOT of the dentists’ making.

 

We did not choose this system or the lack of clarity. 

 

The DH chose this. It is the Department of Health who seem content to see dentists accused of misleading patients.  What could their motive possibly be?  Surely not to deflect eyes and attention away from the other concerns over Government funding and management of oral health?

It is patently wrong that every individual dentist should decide what constitutes ‘need’ on a one by one process with every single patient.  How can anyone with half a political brain even remotely justify it?

 

Unclear Prototypes & Mixed Practice

The new Prototype Contracts are being rolled out at “Pilot” level and still there is no clarity.  The now retired CDO was on record as saying it was not required as part of the new contracts. We can but hope that the new incumbent will see sense and change this unsustainable approach.

The future of dental practice in this country will depend on the success of mixed practice.

The ability to fund privately some dental care alongside an NHS funded element is critical to the small business that is dentistry. Multiple strings of income may well be the ONLY reason that many practices will continue to subsidise the State offering for the benefit of their patients.

But there have to be clear rules. At the moment there are NO rules.  In fact it is so ridiculous at the moment that the rules appear to be written only when the patient complains. At that point the GDC seem to think that investing in your London Day Care might be a jolly good use of funds.

 

If McEnroe had been a dentist ...

Our old ranting tennis star John McEnroe would have had something to say.  “You cannot be serious” [8]

The patient has a right to know where the boundaries lie. All patients should be able to share an experience of the same rules being applied. The dentists need to know where the boundaries lie. 

Otherwise there is a great risk that the GDC call you to order at an FtP hearing should the patient complain that you applied too harsh a judgement of NHS “need”.

So the one question, I put to you, that you should raise with your candidate who asks for your vote is

“Will you ensure Clarity of NHS Dental Treatment?”

Our politicians need to look at dentistry through the patients eye’s, not through the upturned bottle lens that the Department of Health use.

Patients deserve better and it is the Parliamentary candidates you will meet in the next 4 weeks who will influence future policy

At present 22000 dentists apply different rules across 20 patients per day – because that is what the DH require.

 

That’s half a million confused patients per day

 

Ask them:  Will you put a stop to the confusion?  Will you provide absolute clarity on what the patient can expect under NHS dental care?  

If not, why not?

 

 

Meanwhile – control that excitement out there.   I am off to watch some paint dry …

“Now, will you be voting Mrs Goggins, open wide, there’s lovely, bring the next one up Nurse …!

Makes a change from talking about the weather and holiday plans. May your Easter break be relaxing and Spring like. The onslaught has yet to come!!

 

 

[1]          http://may2015.com/

[2]          http://www.parliament.uk/about/how/elections-and-voting/general/general-election-timetable-2015/

[3]          https://www.gdpuk.com/news/bloggers/pramod-subbaraman

[4]          http://www.telegraph.co.uk/news/health/news/10964323/Tooth-decay-is-the-biggest-cause-of-primary-school-children-being-hospitalised.html

[5]          https://www.gdpuk.com/news/bloggers/enamel-prism/entry/907-the-gdc-clarity-of-purpose

[6]          http://www.which.co.uk/campaigns/dental-treatment-costs/

[7]          http://webarchive.nationalarchives.gov.uk/20140402142426/http:/www.oft.gov.uk/shared_oft/market-studies/Dentistry/OFT1414.pdf
 

[8]          https://www.youtube.com/watch?v=ekQ_Ja02gTY

 

 

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Let the games begin!

Let the games begin!

This week marks the beginning of the election period. Parliament has been dissolved, there are no longer any sitting MPs and the most unpredictable and arguably the most interesting election begins! I have had a busy month leading up to this.

There were two Liberal Democrat conferences ( one Federal and one Scottish ). I had the pleasure of meeting with Norman Lamb, the Liberal Democrat health spokesperson at the federal conference and I informed him of the various concerns of the profession, especially those to do with the GDC.

 

Obviously, it was too late for anything specific from our discussions to get into a manifesto for the election, but I remain hopeful that Liberal Democrat MPs in the next parliament will be more amenable to our concerns especially to do with proposals for a new NHS contract for dentistry in England.

In addition, I also met with Jim Hume the Scottish Liberal Democrat health spokesperson and informed him of the issues faced here in Scotland. Unsurprisingly, the GDC figured prominently in that chat too! One thing is for sure and that is " The era of single party government has come to an end ". Whatever the combination of parties in the next government and whatever their arrangement ( coalition or confidence and supply ) it surely will not be a government with the agenda of just one party.

 

 

 

There will have to be discussions about policies and no single person or single group of persons can have undue influence on any policy decision. I also spoke at the Scottish Conference where I gave the EMLD (Ethnic Minority Liberal Democrats) address.

In this speech, I stressed the importance of diversity. We see it in the dental workforce and industry where there are more women and minorities than ever before, why is parliament lagging behind so badly? And diversity isn't just about ethnic minorities, it is also about the representation of women, sexual minorities, the disabled, in fact anyone who isn't a pale male!

Parliament does need people from non political backgrounds in it and we all lose when there is insufficient diversity. The most successful businesses are those that can represent the diversity of their target populations in their work forces and on their boards. Parliament should be ahead on that count! Not far behind as it is now!

 

I had a hustings on the 26th of March which I attended on behalf of the Edinburgh North Lib Dem candidate. The hustings was conducted by the left leaning Common Weal. It was a very interesting first experience and I will report on the various hustings' that I attend over the coming weeks. This week, my nomination papers will be filed and I will be working on producing a second campaign leaflet as well as an election address. Interesting times ahead! I now hope to be able to contribute to this blog weekly and then maybe daily in the last few days leading to polling day and afterwards until the formation of a new government with an analysis of what I see on the ground.

Next week, my plan is to discuss the various manifestos.

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Engaging- with-the-Friends-&-Family-Test

Engaging- with-the-Friends-&-Family-Test

Friends and Family Test [FFT]

 

This blog article is a personal opinion piece by Dr Ian Mills BDS (Glasg.), MFDS RCPS (Glasg.), MJDF RCS (Eng.), Dip Imp Dent RCS (Eng.), FFGDP (UK), FDS RCPS (Glasg.)

Ian is a partner at Torrington Dental Practice, in Devon.

 

The FFT will be introduced to dentistry in England on 1st April 2015, which some might consider an appropriate date to introduce such a tool. David Cameron is an enthusiastic supporter and believes this simple test will provide “a single measure that looks at the quality of care across the country."

Others, including the Picker Institute, the Kings Fund and the British Medical Association are somewhat less impressed with the value of implementing such a tool. Chris Graham of the Picker Institute has stated that “the ‘simple, headline metric’ used for the test does not provide a reliable basis for comparing services or identifying those performing best.” Dr Kailash Chand, deputy Chair of the BMA, is slightly more direct in his criticism. He has described the FFT as a “political gimmick” and asserts that the last thing we need is to collect “more meaningless or misleading data”, a comment which I’m sure will resonant with many dentists.

Sadly this point is obviously lost on the Prime Minister, who continues to believe that the FFT will allow everyone to “have a really clear idea of where to get the best care”. It is hard to believe that such a simplistic tool could actually improve the quality of patient care in dentistry. (I refer to the FFT, and not the Prime Minister!) 

The only value would appear to be in the free text question, which we have naively been given freedom to design ourselves.

The simplest approach would be to ask …. “Why?”

As in, “why did you answer the previous question in the way which you did?” Rather than “WHY?” in the context of a dentist screaming at the moon, as another pile of ill-conceived bureaucracy is dumped on them from a great height courtesy of some narcissistic NHS manager.

Other suggestions for free text questions have included:

“How much of a waste of time do you think this is?”

“What three words best describe the people who developed this questionnaire?”

In the spirit of Patient and Public Involvement, it might also be worth considering the following as a suitable second question…..

“What question do you think we should include as our second question?!!!!”

It is tempting to treat the FFT with the respect which it deserves. NHS England appears to be resigned to this approach, judging by the fact that there is currently no target set for the number of responses required! The introduction of FFT is a contractual obligation and I can’t imagine that this laissez-faire attitude will persist. Perhaps they will include it within a future iteration of the DQOF as another measure of how well we complete our paperwork. The term “biro dentistry” is about to take on a whole new meaning!

So what should you do?

In our practice, we are fortunate to have a highly motivated, efficient practice manager, who seems to revel in the imposition of NHS bureaucracy. She obviously looks at the FFT as yet another challenge to be overcome, and failure to do so would be seen as a sign of weakness. She has organised strategy meetings, staff training, team discussions and already delegated duties. None of which involve me filling in a pile of FFT forms…… as yet!

There is unanimous agreement within our practice that the FFT question is a complete waste of time. It is not a reliable indicator of quality and provides inadequate information compared to our existing patient questionnaires. We see this as an additional burden on our staff, our patients and our practice, but will reluctantly comply and attempt to use the free text question properly to gather some feedback.

So what should the profession do?

As a profession, we need the BDA to take a strong stance and challenge NHS England on the introduction of additional bureaucracy, which quite clearly has limited patient benefit. It is correct that the BDA support the introduction of measures of quality, but such tools need to be valid, appropriate and worth the paper they are written on. 

 

Patient experience data is of considerable value in terms of improving the quality of patient care and there is obviously an increasing amount of data that is going to be collected, analysed and interpreted. This takes time and resources, but can only be justified if the data collected is robust, reliable and can ultimately be translated into improvements in patient care. If the data is not robust and reliable, the exercise will be a waste of time and simply add to the level of unnecessary bureaucracy and administration, which we have to deal with. It is not acceptable to measure what is easy to measure, rather than what is actually meaningful. This is ineffectual, burdensome and demoralising for staff.  

Jocelyn Cornwell of the Kings Fund states that “patient experience measures will only work if clinicians as well as managers take them seriously, and in general they don’t. Clinicians will reject measures they see as inappropriate or unreliable, and will not act on the results.”

 

We have an opportunity to put quality at the heart of the dental contract reforms, and Patient Reported Experience Measures are going to play an important role in the evaluation of quality. The current approach of NHS England does not instill confidence and it is therefore vital that the BDA, the FGDP and others influence how quality is measured within general dental practice.

 

1.    Department of Health. NHS dental services in England - An independent review led by Professor Jimmy Steele. In: Health Do, editor. London: The Stationery Office; 2009.

2.    Professor the Lord Darzi of Denham K. High Quality Care For All. NHS Next Stage Review Final Report. London2008.

3.    Kings College London and The Kings Fund. What matters to patients'? Coventry2011.

4.    Department of Health. Dental contract reform: Prototypes, Overview document. In: Legislation and Policy Unit DaES, editor. London: HMSO; 2015.

 

 Image credit - Glyn Lowe  under CC licence

 

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The ID Block

The ID Block

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Recent comment in this post
Stephen Hudson

30%

Is that 30% figure accurate or just make believe?
Tuesday, 07 April 2015 16:17
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Measuring Patient Experience in NHS Dentistry

Measuring Patient Experience in NHS Dentistry

Measuring patient experience in NHS Dentistry

 

 

This blog article is a personal opinion piece by Dr Ian Mills BDS (Glasg.), MFDS RCPS (Glasg.), MJDF RCS (Eng.), Dip Imp Dent RCS (Eng.), FFGDP (UK), FDS RCPS (Glasg.)

Ian is a partner at Torrington Dental Practice, in Devon.

 

A consistent criticism of NHS dentistry has been the continued focus on treatment and activity rather than prevention and oral health outcome; a pre-occupation with “quantity over quality.” Jimmy Steele acknowledged this in his 2009 report and highlighted the need to design a contract which provides “much clearer incentives for improving health, improving access and improving quality.”1

We would all agree that dental care professionals should provide care of a sufficiently high quality for our patients, and it would not be unreasonable to expect to work within a system that supports this. Sadly, it is generally accepted that the current NHS contract does little to incentivise or reward high quality care, and I guess we should be encouraged by the fact that the contract reforms appear to be addressing this by developing a Dental Quality Outcomes Framework (DQOF).

The DQOF was initially based on three dimensions of quality as recommended by Darzi2: Clinical Effectiveness, Safety and Patient Experience. This has subsequently been refined with the introduction of two additional domains (Best Practice and Data Quality) within the prototype contracts. The addition of a domain which rewards dentists for submitting NHS claims on time perhaps gives some insight into the level of confusion which exists around the concepts of quality management and performance management. Submission of claims on time is certainly important for the smooth running of the system, but it is difficult to comprehend how this is related to the quality of patient care.

The Dental Quality and Outcomes Framework (DQOF)

This lack of understanding about quality in dentistry is further highlighted by the current design of the “patient experience” domain within the DQOF. Patient experience is recognised as a key component of assessing quality within the NHS, and the current DQOF includes seven questions purportedly related to experience. At first glance these questions may appear relevant “How satisfied are you with the NHS dentistry received?” or “Would you recommend this practice to a friend?” or “How satisfied were you with the cleanliness of the practice?”

They all seem quite reasonable questions, but do they provide an accurate assessment of patient experience?

You would certainly hope so, as the current intention is to assign 10% of your GDS contract to DQOF, and a failure to hit your target will result in financial penalty. When the QOF for GPs was introduced in 2004, significant investment was made to incentivise improvements in quality with a 25 – 30% increase in practice funding. Unsurprisingly, the situation is very different in 2015 for dentists. There will be no additional funding and no financial incentives – only financial penalties if we don’t hit our targets. They get the carrot, we get the stick!

When we look more closely at the questions within the “patient experience” domain it becomes apparent that the focus is primarily on patient satisfaction. This would seem strange as the NHS Patient Experience Framework actually states that “measures of satisfaction have a commonsense and political appeal, but they are the measures that experts, including experts in quality improvement, consider the least useful”.3

 

This all might seem a bit academic, and in practical terms not that relevant. Surely if you provide a good patient experience you will end up with a high level of satisfaction? This is possibly true, but definitely not the whole story.

Patient satisfaction surveys are widely used within healthcare and are a very useful way to obtain feedback and improve services at a local level. Dental practices regularly use patient satisfaction surveys to understand what their own patients want and respond accordingly. It is a fundamental strategy in developing and maintaining a successful dental practice. However, there is a subtle difference in using patient satisfaction to improve services and attempting to use the same approach to measure quality across a wide range of providers.

Patient satisfaction has been developed from consumer marketing and is based on disconfirmation theory where the quality of the service is measured against the expectations of the individual. The level of satisfaction expressed can therefore be as much about the patient’s expectations as it can about the quality of the service provided.

This can perhaps be best illustrated by the example of two colleagues, let’s call them Eddie and Mick, who decide to go out for dinner at two separate eateries. Eddie decides to go to a Michelin star restaurant; Mick chooses McDonalds.

Eddie’s restaurant is very exclusive, with attentive staff and lovely surroundings. Unfortunately, Eddie has a bit of a weak stomach and he doesn’t particularly enjoy his grilled octopus. On completing his customer satisfaction form, Eddie considers himself to be “satisfied”, despite the disappointment of his main course.

Mick has fairly low expectations, but is pleasantly surprised with his ‘happy meal’ and the unlimited access to free ketchup. He is even more impressed when he receives a complimentary toy, which just happens to be ‘Olaf’, his favourite character from Frozen. On completing his customer satisfaction form, Mick considers himself to be “very satisfied”.

In analysing this data, one could conclude that both ‘customers’ were satisfied, although Mick was more satisfied than Eddie. We might therefore assume that the quality of the experience provided at McDonalds was superior to that of the restaurant. This may of course be entirely inaccurate, and could simply be an indication of the varying expectations of the two individuals.

I would not wish to repeat the same mistake as our beleaguered Chair of the GDC, by comparing dentistry to supermarkets, but hopefully this example might illustrate the dangers of using patient satisfaction as a measure of quality. In our world, the same situation applies where patients rate services based on their expectations and not on the quality of care provided. We all work in very different practices, in different communities with patients who have different backgrounds and very different expectations. It would therefore be inappropriate to use a measure of quality for dentistry based on patient satisfaction alone.   

There is extensive literature on measuring patient experience, which is closely aligned to the dimensions of “patient-centred care”. Various tools have been developed and validated, and it is disappointing, although perhaps not surprising, that NHS England have chosen to design their own non-evidenced approach. To be fair to NHS England, they have stated that they are developing new Patient Reported Experience Measures (PREMs) which they intend to validate before introducing them4. A refreshingly robust approach when compared to the imminent introduction of the Friends and Family Test.

 

 

Image credit -  Chance Projects  under CC licence - not modified.

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Tony Jacobs

Discuss this on GDPUK forum

Colleagues, Ian is keen to discuss this with GDPs, see thread on the forum, http://www.gdpuk.com/forum/gdpuk-forum/measuring-qual... Read More
Monday, 30 March 2015 12:25
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The Light At the End of the Tunnel

The Light At the End of the Tunnel

What is it about our profession that makes us targets for everyone? From the press to the government, from our patients to regulators, what have we ACTUALLY done to deserve the increased regulation, the increase in complaints and litigation, and the constant vitriol of the press?

There is a constant ‘hum’ in the background in my opinion that represents the unrelenting pressure we are under, and in my opinion, for no real reason.

We have the press always looking for a ‘Dodgy Dentist’ story, with hopefully some evidence of how we rip off the public, but if they don’t have that evidence, they’ll misrepresent something anyhow. We have some of the regulators literally strangling the freedom out of our profession, and we have the legal profession all too willing to take advantage of our (costly and rapidly increasing) indemnity.

Have we let ourselves become some sort of professional whipping boy by our virtue of our dignity and professionalism in the past? Or do some of our colleagues (both past and present) have to answer for this perception of us? By not standing up more vociferously in the past, have we allowed what amounts to the various playground bullies to keep on taking a free hit at us knowing we don’t, won’t, or can’t fight back? Whilst I agree we need to put our house in order where some things are concerned (such as gaming) for which I then feel the criticism is just; but I can’t be the only one who feels that we are just waiting for the next onslaught of negativity to land on us from somewhere.

Why else would the public still believe the often ridiculous stories printed in the press? Interestingly, they never seem to associate ‘their’ dentist with the type of stories that come out. In that case why on earth do we still have the bad press? Where is our PR? Why do we have to couch everything positive we do in such woolly airy-fairy language so we don’t look like we are blowing our own trumpet?

If this blog seems to be coming from a negative direction, then you’re right; The state of mind that I carry from time to time about my profession is the reason for this, and I know I’m not alone feeling this way. Both the BDA and DPL have recently released press statement with evidence that dentists (and probably by association their teams and families) are generally more ‘down’ than the rest of the population. Given that we are largely exposed to the general issues affecting all the rest of the populous in the same way, then the only reason we must be feeling more depressed is because of how we are additionally affected by the profession we are actually in.

Any profession that has a desire to care for another human will always have more than its fair share of pressure heaped upon its members; that comes with the territory. This isn’t the issue here though; it’s the overload that comes from all the different influences that drive down the morale and therefore the well being of the profession into the ground. In a previous blog, I asked the question  Are you Scared? It would seem we have good reason to be if the GDC figures for the likelihood of appearing before FtP are to believed (but then the phrase ‘believable GDC Figures’ is actually an Oxymoron according to the High Court J) and now DPL have added their figures that 90% of practitioners fear they are more likely to be sued than 5 years ago which further adds to that fear.

I remember being told when I first qualified that there was a chance that I would be sued once in my career. Because of the mindset now more common in Uk Dentistry, I think I’m now on borrowed time having not had this in 24 years of practice, rather than actually thinking I might be doing the right thing by my patients. It’s the same fact, but the wrong way of looking at it.

There seem to be more people wanting to leave the profession than ever before. I doubt that we know this solely because of the advent of social media making it far easier to share and disseminate ones feelings. We have always had some form of dental grapevine telling us what is going on, and social media makes news get round faster and more widely. The ripples of discontent are now turning into a tide, and one hopes this will stop before a veritable tsunami hits the profession. Add to that the tragic but increasingly common stories of professionals committing suicide as a direct result of the pressures they are under and we have to come to the conclusion that some of our colleagues are drowning under the waves of increasing risk, not of their own making.

We seem to be torn between pillar and post all the time. Comply with this, inform about that, don’t do that anymore, make sure you’ve certificates for this, you have to pay for this now, you need a licence for that, and so on seemingly ad infinitum. I joke with my patients (those that I don’t think will sue) that I wonder how many rules, regulations, recommendations, dictats and compliances I will breach in their appointment today…..

And then some bright spark comes along and thinks the Family and Friends Test is a good idea to load on a profession already appearing to spend most of its time on complying with stuff rather than actually producing things that benefit others. Remember it only takes that final straw to break the camel’s back.

The problem is that there often seems to be no-one to turn to for advice when we are suffering from this mindset. We are all in the same boat at moment and there is seemingly no escape from any of this. Is it any wonder then that people have a poor state of mind? The public has their perception of us that never seems to change, and there is little or no organized support from within the profession; we have to actively go and seek professional advice independently.

We are not alone in this though; it seems to be all medical professions generally that are coming under increasing pressure. For the GMC to actually consider the wellbeing of its registrants who are under investigation and begin to put in place a form of support network is both tragic and admirable. It seems it has finally dawned on a regulator that registrants are human beings as well. One would like to think the GDC have read the recent article in the BMJ about the impact of complaints on its registrants[i], and indeed I have submitted a freedom of information request to find out if they are even aware of this document.

From time to time I utilize the skills of a very skilled NLPT (neurolinguistic psychotherapist) in order to re-calibrate myself. I’m lucky that I have a support network around me and (now) have an ability to realize when professional life is starting to get to me. I have no issue admitting this, but I’m sure there are many who wouldn’t dream of taking this sort of step, let alone admit to it. Whilst some people might be happy to whinge on GDPUk or social media about how they feel, it’s the silent ones who we need to perhaps be more concerned about. We are all in this together, and we are a caring profession. That doesn’t just mean our patients though; it means those within our profession as well. There is no formal or indeed informal system in place for professionals to seek out the kind of positivity they need. Whilst there is a Sick Dentist Scheme and the BDA Benevolent Fund, there is actually nothing in place for the Wellbeing and State of Mind of the profession. This is something the BDA could and should run with in my opinion. Access to professional advice and counsel about our mindset is more important than HR, Indemnity and Compliance issues. After all, none of those are relevant if we are in the wrong personal mindset. Dentistry is ONLY a job, and we can personally survive without it if we have to.

Our responsibility as a caring profession MUST include ourselves. We have never been more united than recently, and I finally think that there is a tipping point being reached about how we can unify for the good of the profession and therefore the patients.

But how do those isolated and with the wrong state of mind know there is finally a light at the end of the tunnel?

I think that’s our responsibility. We have to continue to grow stronger, to grow more united, and to reach out to all our professional colleagues. We need to show people that there is a way to fight back against this feeling. The speed with which the legal fees for Keith Watson were raised within 48hours shows there is the support out there from the profession for each other, and this needs to continue.

So its time to stop this feeling and to draw together the collective support we can. We need to make ourselves available in physical or virtual form for our colleagues. More importantly lobby organizations like the BDA to put in place formal systems of support to allow practitioners to gain access to. If we felt it would be appropriate to trust the GDC to not act judgmentally, they would also be an ideal organization to have some form of support system allied to their role; after all, what better way of protecting the public than to ensure the well being of the registrants?

There is light at the end of the tunnel; and we’re holding it.

 

 

 

[i] The impact of complaints procedures on the welfare, health and clinical practise of 7926 doctors in the UK; a cross-sectional survey

Bourne T et al. BMJOpen 2015;4e006687.doi:10.1136/bmjopen-2014-006687

Image credit - Kudomomo  under CC licence - not modified.

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Stress In Dental Practice

Stress In Dental Practice

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GDPUK Q&A Session with Keith Hayes

Keith pictured with his mug for
2000 posts on GDPUK
 
Here at GDPUK towers we have conducted a short interview with Keith Hayes, who is a retired dentist and currently runs a business called RightPath4 which advises dental practices on CQC inspections. Keith is a keen user of GDPUK and incredibly passionate about dentistry in the UK. We hope you enjoy reading some of his thoughts and ideas for UK Dentistry.
 
JJ:Please give us a brief background to your dental career?
 
KH:I’m celebrating a joint 120th birthday party with my dear wife and RightPath4 partner in crime in exactly one month. I qualified from the Royal London Hospital, fount of all knowledge in 1977. 
I returned to teach undergrads part time as well as joining a partnership in a mixed practice for 25 years; selling to a small Corporate in 2000.
 
I then started a private squat in a village setting and built the practice quickly to be three dentists and two hygienists working 6 days a week. Unfortunately I needed to take early retirement owing to an arthritic problem and this showed me that retirement was never going to be a suitable option for me! 
 
I have also been Clinical Director for a small Corporate as well as a compliance organisation. I have started an MSc Healthcare Management and Governance and my dissertation topic is ‘Efficacy and the CQC, on the right path?’
 
I am still a dental registrant, paying my indemnity as I believe I can’t advise others unless I too sometimes share the pain and disappointment we feel at the hands of those who claim to be our elders. Fortunately I still feel that Dentistry was exactly the right career choice for me.
 
JJ:How did you end up becoming so involved with all things CQC?
 
KH:Since 2009, I have become interested in how we are regulated in dentistry. Around the same time I began posting on GDPUK.
 
Probably as a result of my articles and occasional outspoken postings; I was invited to work with the CQC by the National Dental Adviser and enjoyed immensely being able to add my thoughts on dental regulation as well as making my suggestions for appointing dental bank expert advisers and then carrying out a great many dental practice inspections. Dental practice inspection is stressful not only for those on the receiving end and it’s extremely important that inspectors are calibrated and proportionate with their judgements. I believe that the new round of inspections starting in April will make significant improvements and will also allow practices to feel they have been endorsed by passing a more focused inspection rather than admonished by a less relevant generic one.
 
JJ:How long have you used GDPUK? What do you enjoy about using it?
 
KH:I’ve been a member since 2008 and that means I have averaged making almost two postings per day! I think this demonstrates how useful I have found being able to be an active member of a professional group. Too often, especially now days with so many pressures heaped upon the dentist, it is all too easy to think you are alone or unique with these problems. I have often been helped in a practical way to come up with a solution to a dilemma and I hope I have managed to help a few colleagues with theirs. From the size of my daily email inbox; I think we can say that there are a lot more lurkers than posters on GDPUK.
 
Whenever I am invited to speak at a meeting, I always take a straw poll of GDPUK er’s in the audience. It surprises me still that there are many out there who have yet to tap into this fantastic resource, probably the best we have by far.
 
JJ:As an advertiser on the site, have you found the site a good place to gain business and credibility?
 
KH:Well it’s always the first site I would go to when considering advertising my product. Not only do I seem to have a great response, but I find the quality of the inquiry is often at a higher level of understanding than other sources. It really is easier to help someone who knows what they are looking for.
 
I got a stunningly informative and significant response to my CQC Efficacy survey (nearly 200 replies) and the CQC are listening to what we have said.
 
At dental exhibitions, it never ceases to amaze and thrill me at the numbers of colleagues who tell me they follow my postings and are then encouraged to ask me their questions. I retired (I thought) a little while back, but I can tell you that I have never felt as involved in dentistry than I am now; much of the credit for this goes to GDPUK, thank you.
 
JJ:What changes do you expect to see in the CQC over the next few months? and also moving forward over the next decade?
 
KH:I think they are concentrating on the new changes they have made in the inspection process and will be surveying all practices to provide feedback following on from a visit. I personally think their survey is too long (9 pages) and should not be mandatory with identification as this may stifle any true opinions. The CQC have asked me to repeat my survey later in the year and I hope this will give a true reflection of their performance.
 
I am hopeful that John Milne will bring greater understanding of dentistry to the CQC and I still hope that I will be allowed to contribute my sixpenneth.
 
All providers of health services require regulation and yet it must be sensible, appropriate and fairly applied. I believe the CQC started with a very broad and ill-defined mandate; have listened and focused more clearly on the nuances of dental practice. They now need to carry the profession with them by demonstrating that when businesses make sensible improvements and work with clearly defined systems and an open and positive team culture, they become better businesses not only for the owners but also the patients and staff.  If the CQC can use more carrot and less threat of stick, we may yet see real benefits over the next ten years. There is always a risk however that the CQC is used by some people for their own agenda; I hope this will not continue.
 
JJ:What are your predictions for UK dentistry over the next 5 years?
 
KH: Wow, crystal ball time!
 
I hoped that we were about to have an honest debate about what we can and what we can’t afford to provide in the NHS. Sadly it seems that all politicians of whatever creed will want to dance around their handbags for fear of being attacked by daring to suggest that the NHS is something less than perfect. This is of course a terrible lost opportunity to design a high quality core system which allows the profession to discuss all options and encourage patients to take responsibility for their chosen path. If we could allow the profession to deliver all that we are capable of without these artificial barriers of NHS vs Private, then I believe UK dentistry would indeed become world class.
 
At the present time, if I were 30 years younger, I would be looking to enhance my skills and use them in my own private practice. I believe that we may have to allow the Corporates to take on most NHS dentistry and to dramatically shift the skilling mix to allow the most cost effective person to provide each aspect of care.
 
JJ:Which three people from the world of dentistry would you invite round to your house for a dental dinner party?
 
KH:I’m afraid that at the moment I don’t have names for two of my dinner guests as I would want to invite the new CDO as a person who has current wet fingered experience of actually delivering the expected standards required by the GDC and the CQC and who is also co-opted into a senior position on the GDC executive.
 
My second guest would be the new CEO of the GDC, who would also be a dental registrant of course and in a much better position to both put patients first and understand how dental teams can be expected to deliver. I could not invite someone who has little relevant understanding of operating a dental practice as I fear they would be uncomfortable guests.
 
My third guest would be the Secretary of State for Health, although I suspect I may need to draw up another place name in the near future!
 
The theme for the evening would be a murder mystery; ‘Who was most responsible for murdering NHS Dentistry?’
 
JJ: Thanks Keith
 
For further information on Right Path 4 and how they can help your dental practice please check out www.rightpath4.com
 
If you would like to further information on GDPUK.com please get in touch with This email address is being protected from spambots. You need JavaScript enabled to view it.
 
 
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6381 Hits
MAR
17
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Two Hundred Thousand Posts!

 

Last weekend (14th/15th March) saw the 200,000th post to be penned, posted and published on the GDPUK forum, an amazing achievement! The milestone has been reached in approx 6 years since we created this present site (over 100,000 posts on the old site) and is something that demonstrates the passion and high levels of interaction that exists in the community.

 

To put it into context, it means there has been an average of 92 posts a day on the forum for 6 years!

In 2014 alone there were just under 1000 different contributors to the GDPUK forum pages which gives a further idea of the amount of varied opinion and information that is shared in the GDPUK community.

Thanks again to the whole dental community for supporting the site and making 200,000 posts possible. We hope you continue to find gdpuk.com an incredible resource.

The site also continues to publish news and original content on a daily basis.

The site continues to develop, with the launch of a GDPUK Services site which offers our members a range of useful services, with two added features, group discounts and donating to the GDPUK Fighting Fund for UK dentistry.

 

If you would like to join the GDPUK community, the link can be found here.


Advertising is also available on the site, please find a link to our media pack here and if you need further information please drop a line toThis email address is being protected from spambots. You need JavaScript enabled to view it.

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4477 Hits
MAR
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The GDC "Current state of play"

The GDC "Current state of play"

The GDC Current state of play

Last week saw the GDC Accountability Hearing - the link is below. If the state of play of the GDC is anything like England's cricket, thety are back in the pavilion and on a losing wicket again.

 

As presentations go, it reeked of nervousness bordering on the incompetent. Professional beaurocrats being good at their jobs – which in this case seemed to be to avoid answering questions and to avoid taking responsibility.

 

I know it is the ultimate in boring TV that may well not come a close second to Jeremy Kyle – but do it, people. I  strongly suggest you watch it. In fact why not mail me privately and I will send you a vCPD Certificate for 2 hours.

 

Answer the question, if you please Dr Moyes

It started dramatically as Dr Moyes seemed ill prepared to answer the first question directly much to the annoyance of HSC Chair Dr Sarah Woolaston. Dr Woolaston is of course medically trained. Dr Moyes’s doctorate in Theoretical Chemistry may have been of more use if he had majored in The Chemistry of Body Language, whether from in front from the MPs or indeed from behind, where a motley commoners jury of his dental peers had gathered.

 

Given that on appointment he was nice kindly “Bill” I do wonder if he has started using his proper title to gain some presence in the company of those he seeks to lead?

 

The state of play with FtP

If there was one line of questioning that caught my eye, it was Rosie Cooper MP “What is the current state of play with respect to FtP?” she asked time and again.

She drilled deep on the state of FtP numbers. Persistent as she was Ms Gilvarry simply did not know the answer. It was stark, and if it had been a job interview, she lost the job at that point.

So I urge you to watch this report.

By watching this select Committee meeting you will learn:

  • ·       Why parliament is to blame for failing to legislate
     
  • ·       Why the Professional Standards Authority audit is flawed
     
  • ·       Why confidence in the GDC profession wide is actually high
     
  • ·       Why the GDC see Dentists as a minority stakeholder group
     
  • ·       Why the BDA is a minority representative body of a minority stakeholder and can therefore be disregarded
     
  • ·       Why e mails from the GDC are not arrogant
     
  • ·       Why a case load of 1400 per year was reported as doubling
     
  • ·       How this was used to justify the ARF increase
     
  •        In turn how 1400 doubled means an annual case load of 1600
     
  • ·       The nature of  body language in communication.
     
  • ·       Reflect upon the quite informative posturing by both the Chief Executive and Chairman toward each other.
     
  • ·       Learn About the GDC having a contract with the NHS’s National Clinical Assessment Service for triaging FtP with clinical input.
     
  • ·       Why dental knowledge and experience at Executive level is not required
     
  • ·       The Patient panel of 5000 patients, 2500 of whom are mystery shoppers coming to a reception desk near you soon
     
  • ·       How to avoid answering a question
     
  • ·       Which lessons have not been learned and will, in the opinion of the Select Committee, will never be learned.
     
  • ·       How, as a Chairman, your role is to protect the Council at the expense of your Chief Executive
     
  • ·       How Case Examiners won’t save [much] money but will improve the FtP process.

·        

Cringe TV

For those of you who do not worry about the GDC in a resigned sort of manner, move along now, there is nothing for you here.

For those of you who like use wonder at this broken regulator, this House of Commons TV presentation is critical watching.

 

So what is the GDC current state of play?

After an admitted tough year in 2014, my advice is not to place your bet on a proven level of improvement just yet

The future for the Chief Executive looks at best in the balance.

The future of the Chairman [for that is how he referred to himself] is perhaps better since he distanced himself from his colleague

 

The future of the GDC?

I think that will be a subject for a future Parliament – with 50 Shades of Grey Electioneering upon us, the time is lost and this matter is deferred until the next Accountability Hearing. 

Their folders are shut but I think their report may well be damning

 

Caught at First Slip

For me … it’s that contract with NHS’s National Clinical Assessment Service that catches my eye. Contract? 

Now there’s a regulator that has crept under the radar.  As old fighter pilots used to be trained, "Check your Six" because you need to CYA

 

 

http://www.parliamentlive.tv/Event/Index/7e1458c7-a8ef-48a6-b5b2-248f85597ecf

 

http://www.ncas.nhs.uk/

 

 

  5313 Hits

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© Enamel Prism, GDPUK Ltd 2015

5313 Hits
MAR
15
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Amalgam

Amalgam - is it all bad?

  7141 Hits

Copyright

© DentistGoneBadd, GDPUK Ltd 2015

7141 Hits
MAR
11
0

The power of a community!

 

GDPUK is a community of practice. It is a group of people that share in the same activity; dentistry.

 

This means that in a community of practice, our members are encouraged to share their best advice, filter out the good from the bad, and steer discussions towards what lies upon the cutting edge of the sector or profession. So for instance what changes in the political, social, economical, or technological environment are impacting upon the sector? From observing GDPUK over the last few years, that seems to be the majority of threads that prove popular!

 

In the last couple of weeks we have seen a different side to the community. The GDPUK community have rallied behind the profession, shown amazing engagement and made something happen. I am course talking about the recent case of Keith Watson. Brief details below:-

 

Keith Watson lodged the defamation action against Andrew McIntosh, relating to claims that led to him being investigated by the dental industry's governing body.

 

Mr McIntosh made a series of allegations about Mr Watson's professional conduct at Discovery Dental Centre in Dundee and the case was taken to a full hearing by the General Dental Council (GDC).

 

Mr Watson was subsequently cleared of all misconduct and lodged a £50,000 defamation damages claim at Perth Sheriff Court, but court officials have now confirmed that he has instead been granted a Minute of Abandonment and ordered him to pay £10,050 in expenses to Mr McIntosh, from Invergowrie, Perth and Kinross.  

 

So Keith was suddenly in the bizarre position of having to pay £10,050 legal fees, after he had won the case at the GDC!

This is where the GDPUK community spirit came into action. Victoria Holden, one of the GDPUK Moderators setup a gofundme page and within 5 days over £10,000 has been donated. An amazing achievement by all and a fantastic demonstration of the power of a community.

From a GDPUK perspective we think that it is amazing that within a few days, over ten thousand pounds was raised and at the same time we saw generosity and charitable behaviour from the dental community which should make us very proud.

Moving forward, we believe GDPUK can be a force for the good of the profession in getting involved in situations that need support from the ground up and as the sites influence and popularity continues to grow, we will continue to facilitate great achievements like the one mentioned above.

An amazing example of the power of the GDPUK community, where else can this be seen in UK Dentistry, where thousands of dentists are actively engaging on a daily basis?

 

http://www.gofundme.com/keithwatson

  5524 Hits
5524 Hits
MAR
07
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Rake in the Recommendations

Are you recommendable?

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© DentistGoneBadd, GDPUK Ltd 2015

6706 Hits
MAR
06
0

Take me to the Leader

Take me to the Leader


In forming the ideas for this blog, I have thought about the changes that have occurred in the leadership and role models for the dental profession in the UK in the last decade or so. Some bodies have not changed their style, nor the stature of their dental leadership. In some government controlled ones, they have.

I will consider two leaders, Chair of the General Dental Council [GDC] and the Chief Dental Officer [CDO] of the Department of Health [DH].

As you will know, an era is over with the retirement of Dr Barry Cockcroft as Chief Dental Officer, NHS England. I am sure the whole profession wishes Dr Cockcroft well, we hope he has a long and healthy retirement.

The dental profession knows the role of CDO was downgraded when this incumbent was moved sideways from the Department of Health, giving advice directly to Ministers. Of course this role has always been a civil service post, but included advisory duties as well as the expectation of leadership qualities.

During this recent tenure, the role of CDO seems to have changed to a more "director of dentistry" style, implementing imposed changes from the DH, in order to carry out the political will of the DH.  Not necessarily changes which benefit patients, nor the public, nor the profession, sad to say, but changes which have benefited HM Treasury. No doubt this would be argued against by the outgoing CDO, the changes under his watch have been dictatorial, and controlling, often based not on evidence, but on political expedience. In fact that concept of lack of evidence base is a marker for his term, of course dentists must follow an evidence for all our decisions, but UDAs and HTM01-05 demonstrably lacked any proper evidence. Only one person would argue that they do.

The historical model was that a highly respected, highly qualified colleague fulfilled this role, and often with a public health aspect, and watched over dental developments emerging from the DH, supervising in a more nurturing, parental style. We do not know how internal battles were fought with the DH over dental policy historically, but the role of the CDO appeared to be protective of patients and the profession. Will these days return?

Now over to the GDC at Hallam Street and now Wimpole Street, and from 1956 to 2012 leadership was provided by a President, who served a fixed term, elected from the body of the elected GDC.

The Presidents of the GDC over the years have included some of the heavyweight names from the surgical and scientific fields of the profession. Those dentists may have been in positions of authority, but they were colleagues that other dentists could look up to, admire their achievements, and accept leadership in thoughts, philosophy and deed.

The same thoughts would also go for the holders of the post of Chief Dental Officer.

But, as we know, the present Chair of the GDC, imposed by the Government, and put into position by the  Privy Council, has been a lay person, Dr William Moyes. Not a leader of the profession, and indeed, someone who has shown little insight into the way the UK dental profession ticks. For example, in a speech, he suggested that UK dentistry should be comparable to the supermarket industry, with shoppers able to choose between the Waitrose style practice, or the Aldi/Netto/Lidl style.

Colleagues in dentistry shudder to think who will be appointed to be the next CDO. I personally hope the appointee will be able to show the profession the way forward, to be able to speak to the profession, and not be one who is planning further degrading downgrades to professional status, or perish the thought another appointee who sets in train solutions which offer lesser results for the people of the country, or which transfers the blame for reduced outcomes back onto the profession. We need a CDO who stands up for the profession and professional ideals.

We have figureheads of the indemnity societies, the faculties of the Royal Colleges, the universities [who seem to be inward looking], trade unions, private care providers, corporate bodies, online groupings, in place, all carrying out their roles, but none of them have yet emerged as a true leader, widely recognised.

My hypothesis is there is a vacuum in strong, thoughtful, highly moral leadership of the profession, this vacuum has been created by barmy ministerial edicts over a decade or more, when politicians have either not had advice or ignored it, and have chosen to appoint different types of people, the wrong people. What do you think?

Who will provide the leadership? From where will this person or people of stature emerge, when the profession so badly needs the core values of moral, philosophical and intellectual guidance?
 

http://www.gdc-uk.org/Newsandpublications/Publications/Publications/Thefirst50years_Gazetteinsert_summer06[1].pdf

http://www.thetimes.co.uk/tto/health/news/article4081701.ece

http://www.breathebusiness.co.uk/blog/make-a-visit-to-the-dentist-more-like-a-supermarket-trip/

https://www.flickr.com/photos/pedrosimoes7/


 

 

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© Tony Jacobs, GDPUK Ltd, 2015

11178 Hits
MAR
05
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A-Bit-Too-Social Media

When I qualified back in the early 1990’s, social media wasn’t exactly on the radar. The thought of being able to connect with a multitude of people instantly was the stuff of imagination. The Pub was our Facebook, and the only ‘likes’ we had were the various guest beers.

Now it’s such a part of our everyday lives that normal channels of communication are seemingly used in the minority. When you can connect with the entire world’s population from the comfort of your home, and carry on multiple conversations about multiple subjects simultaneously, the days of popping out for a beer and a chat with a mate seem numbered.

But what about the social etiquette, and more importantly the professional etiquette we employ when online? The GDC have standards that we should adhere too, and indeed GDPUk is actually specifically mentioned in them such is the impact social media has made on the profession. Specific specialist sites like GDPUk aren’t generally the issue, and whilst there are sometimes a few comments made that might get the GDC or lawyers a trifle interested, these sort of sites are generally appropriately populated and commented upon.

The problem are the wider platforms especially those such as Twitter and Facebook. Some users don’t seem to get the fact they are in no way whatsoever a place to remain private and anonymous despite what you might think.

Whilst the ‘more mature’ professionals seem to have the general hang of the way we should conduct ourselves, I worry that some of the younger members of the profession haven’t quite got the gist of what being a professional is yet and how they should present themselves in public to the public. Because no matter what steps they take, if they have a social and professional presence on media like that, they are well and truly exposed to public scrutiny.

There are a multitude of Facebook pages for Dental matters. Some are better than others, but all suffer from the same fundamental problem. They are not private. In order to use them you have some sort of visibility. For instance, if I wanted to discuss a case over a beer in the pub with a mate, I wouldn’t be doing it whilst posing in a mirror with oiled muscles. But that’s what communicating with some of the personas on social media is like. Some of the fairer sex seems to be somewhat less than modest in their attire on occasion, and one has to wonder if this is what the public expect of its professional classes. A couple of clicks and you generally have a range of private information about ‘friends’, particularly the more self-obsessed ones.

What about commenting into the perceived anonymity of an electronic device in such a way that you wouldn’t do in person? I’ve witnessed many an argument that would never happen in real life due to the social ethics the majority of us have; but once in the safety of the digital world the ‘keyboard warriors’ tend to lose all sense of propriety and the moral compass seems to have lost its direction.  And then there are the artists of self-promotion who feel every other comment has to be some form of pseudo advert for a business venture, or course you can’t possibly miss. I’m becoming guilty of the last one as my Twitter account now is used almost solely for the promotion of this blog and GDPUk. You see, the boundaries of who you are as a person, and who you are as a professional are becoming so grey with social media like Facebook that it feels safe to make that sort of comment, and think there is no comeback.

 

Finally, there are the vast numbers of photos of patients and cases that we see bandied around social media. The GDC is very clear on this,  in standard 4.2.3, where it states ‘You must not post any information or comments about patients on social networking or blogging sites’. Period. We can use ‘Professional Social Media’ but social networking sites are a no-no according to the exact wording. Personally, I think the GDC are possibly a little behind the times on this, as there are a good number of very good Facebook pages where some quite good discussions take place; however it remains to be seen if the GDC feels this is ‘professional social media’ when used in this way, as after all, they are the ones who get to decide….

The big problem though is that many people forget just what can happen to these comments and photos once they've been posted.

I’ve heard stories of people using screenshots of comments made on social media and then threatening to use them as evidence to send to the GDC. Screenshots can be shared outside the domain we think we are posting in, and as such can be disseminated far more than we might have considered when we posted. Unfortunately the self-righteous are rife on social media, and often mistake what is only free speech for something to get offended by, and take draconian steps.

 

I’ve seen the fallout when comments in a public section of a site then get even nastier privately; and I’ve seen wholesale bar-brawls break out in some places (although they’re usually involving musicians ? ). This is like taking a voice recorder or video camera to every meeting you have with a professional in case they say something that offends you so you have evidence and can report them. Since the GDC love nothing better than a good old Fitness to Practice case, we need to really be aware of what we put on social media, how we do it, and the persona we use on there. I think it is only a matter of time before there will be a full-blown case against a registrant involving some indiscretion or inappropriate comment on social media.

Now I’m no Luddite, prude, or some ‘holier than thou’ observer; as a forthright Yorkshireman I tend to say how it is and if you don’t like that then that’s your problem not mine. I’ve got patients as Facebook friends, and I tend to be exactly the same person online as I am in real life. I’m aware that anything I say there is something that I should be happy to share in a professional environment. I’m a real person and don’t have any airs and graces or chip on my shoulder that mean I think I’m some sort of superior being because I’m a dentist. But I can’t help thinking that some of the comments, personas, and attitudes we see as the public face of some of those in dentistry give the GDC every right to be concerned about the public perception of the profession, because if people can’t differentiate between a digital persona and a real one when they are posting then they really do deserve the attention of our regulator. The rationality and politeness filters seem to disappear from some of our profession when they get infant of some kind of keyboard. Couple all this with a competing bunch of the self-righteous, and the self-obsessed and we have a recipe for the profession to start imploding.

It certainly feels like it is one rule for the GDC and one for us where social media is concerned; the sheer fact you can ‘like’ the fact a colleague has been struck off, suspended etc, is not what I call professional. There’s also no associated comment when a colleague has been exonerated, like in the case of the Scottish dentist Keith Watson, who then attempted to take a vexatious patient with an apparent history of suing dentists, to court for defamation, which unfortunately he has had to abandon at great financial cost to himself.

But, this case shows there can be huge good come out of social media and its immediacy. In the space of less than 24 hours a fund had been created to support Dr Watson, a newly qualified member of our profession who would no doubt be financially challenged by a huge legal bill this early in his career.

http://www.gofundme.com/keithwatson Not only that, the messages of support for Keith have been flying around social media all day and latterly on GDPUK itself.  When used appropriately then, we have a fantastic medium to help people.

We need to embrace social media as its here to stay; it can be hugely useful, and massively informative; but we must use it appropriately, and think about the consequences of our presence in the virtual world. That’s what it means to be a professional.

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© Simon Thackeray, GDPUK.com 2015

11313 Hits
MAR
04
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Tiers for fears …

Tiers for fears …

Let me start with an apology ...

Those of you of a certain age may recognise my poor attempt at an ironic pun. That of course is nothing to do with my age – I am just a poor punner, so to speak.

 

One Week to go, Eight Weeks from certainty, 

We are 8 weeks from a General Election the outcome of which is regarded widely as the most uncertain for many generations. We are also less than a week from a most important event: Roll up, roll up, it’s the GDC under the microscope of political accountability … [well, hopefully!]

By the time you read this the House of Commons Health Committee will have parked dentistry [though the GDC Accountability Hearing] on the electoral back burner.  We’re done, the politicians will say, slamming shut their leather bound folders.

 

Long live the GDC

Of course we have all blown a lot of hot air about the GDC. I for one wrote majestically of the

“Delusional Management Executive and Council, demonstrably out of touch with the real events”.  I have to say I was rather proud of that!

What’s the point is making such a comment, though, if the examining Health Committee were to be so easily misled by a slippery GDC presentation?  We shall see. Our medical colleague, Dr Sarah Woolaston [a GMC Registrant] strikes me as a good pair of hands to chair the Committee and we live in hope that the GDC are “flamed”.  I for one called for the GDC to be placed in Special Measures.  Will there be tears for the GDC? I suspect not.

So for this Parliament, dentistry is all over. The Chief Dental Officer [NHS England] appointment is not even worthy of news yet.

 

Tiers of Tears?

And yet an ominous clinical change is afoot which will potentially be a most divisive one.  I refer to the introduction of Tiers to the delivery of dental care.  Orthodontics is now beginning to see it being proposed, while it has been flagged for some time in GDP and of course Oral Surgery have systems being rolled out.

In essence, perhaps we could liken it to our childhood friend Noddy:

 

Tier 1  -  Noddy can talk to Big Ears about driving but not drive a car

Tier 2  -  Noddy can drive, but not on the road at the same time as  Big Ears

Tier 3  -  Noddy can drive on the same road as Big Ears at the same time

Tier 4  -  Noddy and Big Ears can share the driving of Mr Plod’s police car

 

If there is one subject you should examine for your future practice, I urge you keep your eye on this ball.  As a young practitioner, it may simply guide your career development.

But as an older practitioner, the way these tiers are being mooted may expect to have an enormous impact on your ability to provide more advanced dentistry as part of your mixed practice.
 

You may wish to plan your practice development now, before the prototypes come in and before Tiers are presented to you on a plate, rather like a new diet of limited crumbs

Because I suspect many practices are only truly viable because of the ability to mix NHS and private care. Their clinical skill comes from the apprenticeship that is a life in General Dental Practice

While Tiers are arguably driven by good thinking about the big picture, and are here to stay, I worry that the unexpected outcome will be to drive unexpected massive change through older practitioners, who in many cases of course are the practice owners.  In all of this, the reality of Austerity 2 after the election – there has already been flagged real terms budget cut of up to 20% - makes the reality at GDP level quite different

Don’t let you and your practice be the one to experience Tears for Fears.  The Law of Unexpected Outcomes may well be alive and well

 

Valedictum

On a closing note, not unrelated, I am sure tears will be shed for the retirement of our colleague , the Chief Dental Officer, Dr Barry Cockcroft. The old position of CDO was of course downgraded, politically speaking, to NHS England, now outside the Elephantine corridors of power in London. This poacher turned gamekeeper [for he was indeed in high office at the BDA] can have improved access to a safe retirement in the knowledge that his project of UDAs has lasted the test of time, even if did not pass any other test!!  Let us hope that the next incumbent of the position does not also leave office with the same defunct system in place in years to come.

We reserve the right to have a barney with you Barry, but the least you deserve is a drink on us.  A glass of Chateau Fluoride perhaps – the one with the varnished cork?

 May your retirement be a long, happy and enjoyable one. 

 

 

 

 

http://www.parliament.uk/business/committees/committees-a-z/commons-select/health-committee/inquiries/parliament-2010/2015-accountability-hearing-general-dental-council/

http://www.parliament.uk/business/committees/committees-a-z/commons-select/health-committee/membership/

http://www.england.nhs.uk/wp-content/uploads/2013/02/commissioning-dental.pdf

 

 

 

  6927 Hits

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© GDPUK Ltd 2015

6927 Hits
MAR
01
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Treatment Selection

Best Treatment Mode

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Patients embrace online booking services

As a digital company, we are always interested in digital innovations and improved efficiency, especially in the dental sector. One area of dentistry that this is particularly apparent, is in the booking of dental appointments online. Although this is a relatively new sector, there are a number of companies who are improving access, customer service and ease for patients.

Toothpick who are one of the leaders of this revolution, shared some amazing numbers from 2014, which they have given us permission to share. The infograph below gives a great indication of the growth of the sector, can dental practices afford to miss out on offering this service?

A few stats that caught our attention:-

  • The fastest time from booking to seeing a dentist was 23 minutes
  • 56 per cent of bookings were made in evenings and weekends
  • Peak booking time for appointments is Monday and Tuesday mornings, when a booking is received every 30 seconds!
  • Over 60 per cent of visitors to Toothpicks website are accessing via a mobile device

We believe this sector will continue to grow over the next few years. Dentists are always looking for new ways to gain patients and offering 24hr online booking seems a great way of doing this. The general public are increasingly familiar with doing many things online, so why should booking a dental appointment be any different? The service seems to benefit all involved. The continued growth of smartphone usage, plus the introduction of dental practice apps or mobile webpages will also fuel the growth of this sector in 2015.

It will be interesting to see how this sector evolves over the next few years but our suspicion is that it will soon be an expected feature on the majority of dental practice websites, mobile sites or apps. 

Please enjoy looking at the infograph and you can find some further information on Toothpick below. 

 

 

 

Toothpick launched in the UK in 2013. Since then, one million people have used our booking technology and we've passed £17M worth of dentistry to our practices. We're leading the way in bringing medical bookings online, with over 50 per cent of appointments booked outside of our dental practices' opening hours, and 60 per cent via mobile devices.
 
Toothpick is now being rolled out in Holland, Australia, New Zealand and the United States.
 

 

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Saliva

Saliva

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Free online exposure for your dental business!

 

In the run up to the Dentistry Show 2015, GDPUK are hosting an online guide to the show, with exhibitors invited to send us articles about new services / products, competitions they are running or reasons to visit their stand.

Reasons to publish your article in the GDPUK guide:-

  • Established since 1997, GDPUK reaches thousands of dentists on a daily basis
  • We use social media to share the articles and increase recognition of your brand or product
  • Promotion of the guide on our GDPUK Forum which currently has 8000 members and growing
  • Our 2014 guide attracted 5000 views
  • Articles stay on the site for one year at least, so could potentially gain you business long after the show.

So if you would like to feature in this FREE guide, Please send us information about your stand, your latest products or services or anything else you would like to share and we will publish the information in our online guide.

We will be featuring and promoting the guide in the run up to the show.

If you would like to share some information about your business and your plans for Dentistry Show 2015, please send a word file (max 500 words) and images (max 3 per article) to This email address is being protected from spambots. You need JavaScript enabled to view it.

If you have any further questions or would like to advertise on GDPUK in the run up to the Dentistry Show, please get in touch. 

 

 

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50 shades of G.R.E.Y

50 shades of G.R.E.Y

I bid you all a good day.  Those of you that have read “the books” will have no doubt pondered the extracurricular uses of a dental dam and floss for example. This weekend of course see the film emerge – regarded by many as a rather poor representation of the book, in itself not exactly a literary classic, I am told by others you understand …

But we dentists know better . Relax, it’s not the aesthetic dentistry shade guide!

You see, its a little known fact:  GREY stands for GDC Regulatory Examination for You

This week sees the 2015 Accountability Hearing with the General Dental Council by the Health Committee of the House of Commons. [1] 

You have 4 days to respond

This is very much the Headmaster’s Interview.

Now do not get over excited - this is not going to be passionate demonstration of Parliamentary S&M as the Chief Executive of the GDC is tied up and verbally thrashed by rabid members of the committee.

You only have to explore, for example a past accountability hearing of the GMC or the 2014 Accountability hearing with the Health and Care Professions Council to realise much of it will be affirmation of what has been undertaken on behalf of Parliament.  An Annual Report to Stakeholders.  There is a danger that the men and women in grey will merely spend the day formally noting this and noting that. The stench of white emulsion may well fight the colour sense of a very dull affair. Potentially grey indeed.

 

UNLESS YOU ACT …

We dentists and our teams must use this opportunity to raise the GDC up the Parliamentary agenda. At the end of this hearing it should be clear that the Health Committee are examining a failed organisation with a runaway budget, and absolutely no idea about how to organise FtP. The Committee should be under no illusion that the profession regulated by  the GDC is running scared  and disengaged in the extreme, while the report from the Professional Standards Authority could have used one word to describe the GDC: Useless.

Proper calling to account of the GDC simply will not happen if we allow The GDC’s presentation team to smooch their way under the skin of the Committee unchallenged in any way.

 

UNLESS YOU ACT …

We, as registrants, must assume that the BDA, Dental Fusion, and other professional representative bodies are submitting some solid evidence. If you are a member of Dental Protection or the DDU and MDDUS you may assume these widely respected bodies, which are in the thick of FtP, will be presenting heavy hitting material of their own. If you want to be sure, ask your Indemnifier!  One would like to think that the FGDP[UK] also will rise to the challenge.

 

There really is only one major area of concern that the profession has about the GDC – it is the abject mismanagement of Fitness to Practice and its cost implications allied to the inevitable. but unwanted, change to excessively defensive practice.

 

No one is suggesting there is not a task to be undertaken.  But the sheer crassness of assuming every banal criticism reflects a wider risk to the public which must be aired expensively and in public beggars belief. If like me you read the Charges are of the GDC website, [2] I am sure you cannot fail to agree that many of the cases simply are not worthy of a full FtP process at £78000 of YOUR money PER DAY …

 

UNLESS YOU ACT …

 

If you have an experience of FtP I must ask that on behalf of your colleagues you summon up the strength to report your experience to the Health Committee as I am sure Mr Colin Campbell may well do. Please do read and share his blog [3]   As if by serendipity, as this Health Committee is meeting a colleague, Mr Colin Campbell, is beginning to publicly reflect upon his most extraordinary experience at a full GDC hearing.  The sheer injustice is almost mediaeval in magnitude. And to think that many of our colleagues sit upon the panels. Whether they are part of the problem of course is a separate debate.

If one event appears to demonstrate all that is wrong with the GDC and its massive problems this case might be it.

If you live in fear of that letter from Wimpole Street and feel FtP is an issue, write to the Health Committee.

 

UNLESS YOU ACT …

Keep it brief. Keep it factual. Keep it succinct and to the point.  But please: communicate . The Committee’s guidance on a submission may be read here. [4]

This Accountability Hearing does present our best  opportunity since the ARF Court Case [which despite the GDC claims, I seem to think they lost!] to flag to the Health Committee the many concerns we have as registrants. I suspect we might have to remind the HC of this Court Case if we judge by the GDC Chairman’s e-mail and his failure to mention it!

Do not count upon the GDC to present anything but a self-congratulatory review imbued with a warm rosy light .

If the Health Committee are to gain a true measure of the profession wide disbelief and anger, you have a small but essential part to play.

Remember that cheque you wrote before Christmas … the £900 odd pounds one ….

It’s payback time

50 Shades of Grey ….  More like a Multi Coloured Swap Shop of stories of disgraceful Regulation in action.  Now I am showing my age ! [5]

The deadline for submitting written evidence is 5.00pm on Thursday 19 February 2015

It’s the GDC Regulatory Examination for You

 

UNLESS YOU ACT …  YOU RISK THE GDC GETTING AWAY WITH IT.  

It will be you that goes 50 shades of grey if you get a letter.

 

 

Web References

[1]  http://www.parliament.uk/business/committees/committees-a-z/commons-select/health-committee/inquiries/parliament-2010/2015-accountability-hearing-general-dental-council/

[1b]http://www.publications.parliament.uk/pa/cm200102/cmstords/27519.htm

152.—(1) Select committees shall be appointed to examine the expenditure, administration and policy of the principal government departments as set out in paragraph (2) of this order and associated public bodies.

 

[2] http://www.gdc-uk.org/Membersofpublic/Hearings/Pages/Hearings-list.aspx

[3] http://colin-campbell.co.uk/index.php/2015/01/gdc-persons-view-process-part-1/

[4]  http://www.parliament.uk/get-involved/have-your-say/take-part-in-committee-inquiries/commons-witness-guide/

·         Guidelines

·         To successfully make a submission via the online form on a committee’s website, documents need to:

o   Be less than 25 MB in size

o   Be in Word (doc, docx, rtf, txt ooxml or odt format, not PDF)

o   Contain as few logos or embedded pictures as possible

o   Contain no macros

o   Comprise a single document. If there are any annexes or appendices, these should be included in the same document.

o   It also assists the committee if those submitting evidence adhere to the following guidelines. Each submission should:

o   State clearly who the submission is from, i.e. whether from yourself in a personal capacity or sent on behalf of an organisation, for example the submission could be headed ‘Written evidence submitted by xxxxxx’

o   Be concise – we recommend no more than 3,000 words in length

o   Begin with an executive summary in bullet point form of the main points made in the submission

o   Include a brief introduction about yourself/your organisation and your reason for submitting evidence

o   Have numbered paragraphs

o   Include any factual information you have to offer from which the committee might be able to draw conclusions, or which could be put to other witnesses for their reactions

o   Include any recommendations for action by the Government or others which you would like the committee to consider.

 

[5]  http://en.wikipedia.org/wiki/Multi-Coloured_Swap_Shop

 

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© Enamel Prism, GDPUK Ltd 2015.

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Awards

Dental Awards

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Which sales method would work for your business?

We have written a short guide to the different marketing tools that are available to our clients, that can lead to online marketing success.

Our clients utilise a range of methods to get returns on their marketing investments. Once a banner ad is sent over to us, the client will let us know where they want their potential customers to be sent, after a banner receives a click.

There are a number of options for the client to choose; the client’s homepage, a specific landing page, a PDF brochure, a survey or sometimes a data collection page on our site.

Let’s looks at the different methods that can be used by our clients.

1.   Email Form

Recently we have had a client use an older fashioned method for when a user clicks on a banner and that is email. So when the user clicks on the banner, a new email automatically pops up, which asks for the clients details (data collection) and then how many they would like to order (sales). The email is then sent direct to the advertiser and hopefully orders are received via email.

Although very direct, it is a simple way of collecting data and ultimately sales! I believe this method can only be truly successful if the offer is incredibly enticing or the brand is well trusted and doesn't need an introduction.

As an example of how this method works, if you would like our latest media pack or would like to know more about gdpuk.com, please clickThis email address is being protected from spambots. You need JavaScript enabled to view it.!

2.   PDF Brochure

When a client clicks on a banner (usually from a distributor or equipment manufacturer) they can get taken to a pop PDF page, which has the benefit of looking like a real brochure and you can flick through the brochure as you look at the different offers or incentives. The disadvantage of this method is that there is not always an obvious place to actually order a product or make an enquiry.

3.   Survey

Surveys are an effective way of gathering data that is useful to your business or organisation. We believe that to get a satisfactory return from a survey there has to be some form of incentive in place. The incentive could take the form of a prize or even some free information that may not be available elsewhere.

We recently ran a survey on our site that was based on the CQC. Anyone responding to the survey was sent a free information pack on the next CQC inspections. Over a two month period, the business running the survey received 170 replies which creates a fantastic amount of data for our customer.

Surveys can be hosted on our site or they can be hosted on a survey site such as survey monkey or snap survey.

4.   Landing Page

I have written about landing pages before (can be found here) but a specific landing page remains one of the most effective tools for gaining customers or building data. When a landing page is produced that is clear, concise and simple, they often produce the best results.

Large businesses will often build a number of landing pages for their product range so the visitor can view the information with minimum fuss. For smaller businesses it is not always cost effective to produce separate landing pages but one page that takes the user straight to the product or services you are offering could make all the difference.

5.   Homepage

When you place a banner ad on a website you are obviously keen for users of the site to click on the banner. If the user gets taken to a generic homepage, it then becomes difficult to track results because the user will get presented with a load of information and may not even be able to see the specific product or service that made them click. Sending a visitor to your homepage is one of the least effective methods you can employ. In our opinion it is worth investing your time in having a specific page that will help generate a return on your marketing investment.

A comprehensive guide to landing pages can be found on quicksprout.com plus on loads of other sites! 

6.   Data Collection

Data Collection is often something that our clients are looking for, they want to build up their list of contacts or receive email addresses so they can send the user further information. Data collection landing pages can be hosted on either our site or the clients own page.

For it to work in an effective way, there has to be either an incentive in place for the customer or the product or services you are looking to provide is extremely innovative or unique so that is catches the eye of the user and they want to leave their data with you.

Choosing the right method, could really help increase revenue!

 

We hope you find these options useful and it kickstarts the process of you thinking about the different ways you can engage with your customer. Once a customer clicks on the banner, the method you use has to be viewed as a sales tool and depending on what you are looking to achieve, you can then make a decision on what will hopefully bring you the most success & revenue to your business.   

If you would like further information on how targeted advertising can work for your dental business, please get in touch viaThis email address is being protected from spambots. You need JavaScript enabled to view it. or at the GDPUK office, 0161 270 0453

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The Dental Professions and the 2015 General Election

 
The Dental Professions and the 2015 General Election
 
I write this at a time when I'm a dentist, and a candidate for what will be the most unpredictable General Election that most people can remember. There are just so many factors in this election that only a fool would even attempt to predict its outcome. With such unpredictability also comes power. Power to the voter. The voter can now expect every candidate to work hard for their vote. I never liked the two party state or the disgusting reality of safe seats. The very idea of safe seats is so disempowering! Imagine a seat which is so predictable that your vote doesn't change much locally, that your MP takes their seat for granted and never really has to fight for your vote! The sad reality is that there are too many such seats. But, 2015 could change that to some extent, with the arrival of a multi party democracy like we haven't seen before. Where every candidate and every party will have to fight for every vote. I welcome this new era. 
 
Now how can dentists benefit from this? What is it that makes dentists vote one way or another? Dentists are a very well educated, articulate and intelligent lot! There will not be one or two issues that sway them, but a range of issues and not always dental issues. But dental issues are important, and not just to dentists who predominantly work in the NHS. 
 
Here are some issues which face dentistry over the next five years:
 

1. What do we do about the General Dental Council? 

 
The GDC is now viewed as being draconian and out of touch with the profession. I can't see any world where it would be acceptable to demand such an extortionate Annual Retention Fee. I have discussed this with many politicians, patients, and other people whom I meet on the campaign trail, and every last one of them is alarmed at the figure of £890. I have contacted the health team of my party and requested them  to include  a line about reform of the GDC in our manifesto. Obviously, there will have to be further discussions about this and I am hopeful that we can do something about this in the next parliament. Reform of the professional regulator is something on which almost all dentists agree! 

 

2. What do we do about NHS dentistry in England? 

 
I have worked with the Unit of Dental Activity ( UDA) system in England. I worked in the North of England ( Middlesbrough, and then Hull ), areas of high dental need where this system just did not seem fair to performer dentists. My bigger problem with the system was a lack of transparency and fairness. With the fee per item system in Scotland ( which was the system in England prior to 2006) the fees were clear for all to see and distribution between owners and associates was visibly fair, also patients knew exactly what they were paying for . But with UDAs, associates having no Idea what the real value of a UDA was, it was easy for them to be squeezed! I struggle to see fairness in the system. Fairness for the patient who does the right thing and may need the occasional filling or crown , but finds themselves paying a lot more under this system for that filling or crown. Fairness for the conscientious dentist who would like to practise the way they were taught dentistry, the way it is to be practised, with emphasis on prevention. There doesn't seem to be any provision for prevention to be done properly!  Fairness for the provider who may be in an area of high need but who may be stuck with a lower UDA rate than the needs of the area demand. 
 
I'm not saying that fee per item is the best system. I currently work in this system in Scotland and it has its disadvantages, but it is transparent and it is generally fair to all parties concerned. ( Obviously we would like to see higher fees for certain items of treatment, but that must be tempered by the fact that  I'm yet to meet a dentist who would ever say that any particular fee was high enough! ) 
 
There are many pilots in operation and we must study them carefully. I believe that healthcare planning and delivery in England must be devolved. The needs of the Home Counties are very different from the needs of Wales or Northern England. A one size fits all approach just cannot and does not work! I really hope the BDA takes this change very seriously! It is easy to accept a new system, but when the system doesn't work very well, it does take an awfully long time to change it as we are all seeing. 
 
If there is one reform to healthcare in England that we must achieve in the next parliament, it must be devolution of planning and delivery ( with protected budgets for areas of high need, and/or deprivation ) 
 

3. What can all dentists look forward to in the next parliament? 

 
NHS or private, we can all agree that regulation of all forms has gone insane! We are over regulated! It just appears in some cases to be regulation for regulation's sake! We must review the regulation that currently strangles the profession and do away with unnecessary regulation, definitely with double regulation ( it just doesn't make sense for the same criterion to be regulated by multiple regulators! ) Simplification of Regulation! Another thing that I will bring up with my party's health team. 
 
In general terms, dentists as citizens care for the same things that most other citizens do. A strong economy, a just and fair society, an environment where we and our children can thrive happily. Whichever party or combination of parties as is more likely the case in this era of coalitions, delivers all that will deserve our votes. 
 
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Keith Hayes

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Irate Patients

Irate Patients - A Strategy

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Are you scared?

Are you scared?

The Health Select Committee will be holding an accountability meeting with the GDC on the 3rd of March. It’s about time too, as they haven’t been asked to account at all to anyone but the judiciary recently (and they lost). It will be interesting to see if they try to spin that meeting in the same way as they did in the press release just after the decision in the high court in December.

It looks like the GDC have finally got to face the only people who they are answerable to. I wonder if they are going to try to wiggle out of the unavoidable truths?

I presume everyone reading this is going to submit his or her evidence to the HSC through this link before the deadline of 19th February.

No?

Why not?

Are you scared?

Well actually, that is probably extremely close to the truth. I am personally quite worried these days that a GDC letter will arrive on my doorstep for some reason or another (and that is not because I know I have something to fear – my inherent belief structure tries to ensure I do the right thing by patients at all times, but I have also been openly critical of the GDC, which I’m sure they do not like – and they get to decide what is deemed as professional or not).  All someone these days has to say (even in jest) is “I’ll report you to the GDC for…” or ‘I bet the GDC have their eyes on you” and it feels like a letter from Wimpole Street is already winging its way to you starting the process of investigation and a potential loss of livelihood.

The lack of proportionality that has been written about previously means that a situation like this could be an increasing possibility for all of us. It’s why the ARF had to go up according to the GDC for goodness sake. To put a few figures on this, if you reckon on 40,000 dental registrants having about a 40 year career, and the current data from the GDC is that there were 1700 complaints in the first 6 months of 2014, then the maths shows that each registrant will have 3.4 complaints in a career. (3400 complaints x40 /40,000). Some of these complaints are against DCP’s, ok, and not all of them will go to the full Fitness to Practice hearing,  (but 40% of them currently do) but I’m sure you get the overall idea. Is it right that if this way of dealing with complaints continues, on average, every single dentist will have to face this career-wrenching possibility more than once? This alone tells the general reader that the regulator is going the wrong way about it.

Since the GDC are the initial arbiters of our standards and decide an investigation will run to see if there are any grounds to an allegation, and there is currently the interminable wait for a hearing, then I don’t honestly think I could mentally deal with that kind of pressure for that long with the fear of loosing all that I have put into patient care, this profession, and that of my livelihood and ability to provide for my family. Even if an investigation goes all the way to a hearing, is there any guarantee that there will be an understanding of the pressure we are now practicing daily under from the committee, especially when it is made up of so many lay persons?  Tony Jacobs wrote an excellent blog on this subject.

Some of you will have no doubt read the very eloquent and erudite blog written by Colin Campbell, a very well thought of colleague in my locality and indeed nationally. Colin is one of the most ethical and conscientious practitioners I have ever met. If you haven’t read it then it is a ‘must read’, because Colin is a person who wears his heart on his sleeve and this series of blogs are likely to be a wholly authentic and personal view of how HE felt during the process he went through.

There are many (most of us?) out there that fear the GDC, and not for the correct reasons. We need to respect our regulator, and know that whilst it absolutely MUST act to protect the public, it is not effective ‘right touch’ regulation to do this by ruling the profession with that kind of fear. Using a methodology akin to continuing the beatings until the morale improves is not how it works these days.

Mistakes happen; I was once told right at the beginning of my dental career by an older practitioner the reason he was more experienced than me is because he had made more mistakes than me. Nobody is ever going to excuse the type of mistakes that are so dangerous they have to be dealt with swiftly and appropriately. But if we are to be perpetually living in the fear that one minor transgression will bring the full weight of our regulator down on our backs then that is wrong.

There are also bad people in our profession; nobody is denying that, and I will certainly make no excuses for them. But the climate of fear that pervades the profession at the moment is no way to prevent mistakes from happening, and it certainly wont do ANYTHING to stop that minority who are out to damage people because  they probably don’t have the emotional or ethical values to allow them to feel the fear those of us that practice ethically and responsibly (and fearfully) do.

So at the moment I remain scared. But I will still be submitting evidence to the Select Committee because I cannot, and will not be made to feel this way for the rest of my practicing career. We care for patients every day, but we also have to care about our future health for the sake of our families. After all, we too are human, just like the public the GDC must protect.

We have to stand up to the GDC and now show them the true and high calibre of the vast majority of Dental Professionals.

Blog image Edvard Munch [Public domain], via Wikimedia Commons 

 

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Dental Philosophy

Dental Philosophy

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Record Keeping

Good Record Keeping

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The GDC - Clarity of purpose?

The GDC - Clarity of purpose?

A "Daily Clarion" call for Clarity

 

What ever happened to January being a dead month when we hunker down to pay all our Christmas credit card bills?  The CQC close a Salisbury practice facility [albeit for a month only]. [1]  The GDC’s CEO has written a feisty fob off letter to the BDA [2], revelling in the end of year report she produced .[3]

But the real January action comes from two directions.

 

What? Which? Again?

The Consumer organisation, Which? Have published a report on the lack of clarity of dental fees. The link [4]  below will allow you to read this.  Indeed follow the page and you will find many leading colleagues at Oasis and BUPA all shouting loudly in favour of clarity of fees [5].  Indeed across the profession, and for sure on GDPUK, there is agreement that charging a fair fee is not the problem, it’s about letting the patient know in advance and giving the patient a proper chance to consider the fee and their decision.

“Clean Up Dental Costs” is the clarion cry from Which?. They already have quite active assistance with understanding dental costs at [6] and [7]. 

 

A Mixed Game

Of course the problem seems in part to lie in that murky area of practice, where some treatment is NHS funded and some is not. Mixed practice, in which the sliding scale of gaming can be applied.

“If the patient pushes, I can do it under the Nash, but if they don’t object I will whack in a proper fee because they don’t REALLY need it …”

Which? state in their campaign “Mission Statement that

We're calling on NHS England and regulators to make sure all dentists comply with existing rules and make information on prices clearly available. Dentists need to explain the treatment options properly and make sure patients know whether or not their treatment is available on the NHS.

 

Here is my challenge:

How can dentists be expected to explain how much or what treatment is available under the NHS consistently across the country when NHS Choices states that “all treatment that is deemed necessary“ is wholly available and yet it is the soon to be ex-Chief Dental Officer himself  who has repeated that this decision of need is down to the individual dentist, in front of his or her patient.

Which? demand consistency, while the CDO [He of NHS England] espouses inconsistency.

Patently this cannot go on. Perversely, the Chairman of the GDC, being an OFT man ‘n’all that might be just the ally the profession needs.

As if by magic, albeit with ironic timing, the Department of Health’s long awaited Prototype Contract Document has emerged [8]

 

Nothing changes – the dentist decides “need”

Crucially, the suggestion is that nothing changes so far as the clarity that Which? and many others want.

The DH State

26. It is particularly important to be clear that nothing in the changes planned is intended to reduce or change the scope of NHS care available to patients. The changes are intended to ensure clinicians are supported to deliver the full range of care appropriate to a patient’s need. As with medical care, the NHS role is to meet clinical needs.

27. There is also no intention to end a patient’s ability to choose, if they wish, to have private treatment alongside their NHS care. As now patients will continue to be able to choose to have NHS care, private care or a mix of the two.

 

So contrary to what the Which? want,  the DH propose to roll out yet another way of delivering dental care in which the opportunity for mixed practice will remain, but the rules are decided by the treating dentist with his individual patient.

So, not one consistent rule for all to work to but 22,000 odd individual rules and utter confusion for the patient.  And more fodder for angry consumer organisations and patients “who know their rights”,

 

Is this really the best the DH can come up with?

The GDC are clear in their expectation – and this is COMPULSORY FOR ALL through their Standards for the Dental Team, [9],

PLEASE LOOK AT THAT WORD “PREFER”

1.7.4 If you work in a mixed practice, you must not pressurise patients into having private treatment if it is available to them under the NHS (or equivalent health service) and they would prefer to have it under the NHS (or equivalent health service).

2.3.7 Whenever you provide a treatment plan you must include: • the proposed treatment; • a realistic indication of the cost; • whether the treatment is being provided under the NHS (or equivalent health service) or privately (if mixed, the treatment plan should clearly indicate which elements are being provided under which arrangement).

 

Clear as Mud?

So the leading UK Consumer organisation are calling for the boundaries and costs of NHS and private dental care to be clear. Dentists and their LDC representatives are calling for the same thing.  The GDC has made it compulsory for there to be clarity, and breach of this clarity demand will result in you visiting London for an FtP day out.

But the DH produce a Prototype Contract that suggest maintaining the present confusion.

Aside from it all beggaring belief, it is also now time for our Regulator to earn their spurs and take on the DH.

 

Calling Mr Moyes, calling Mr Moyes

It is time for the GDC to lay down to the DH in one hopes clear terms that lack of clarity for dentists and patients as to what is on offer under the NHS simply is not acceptable.  It is no use asking the GDPC to achieve this for the DH simply bounce them.

This needs a man of words, in a position of influence, perhaps ideally with Consumer based experience,  to deliver a Clarion Call for Clarity on what the NHS expect dentists to do, not for the dentists, but for the patients, whose very protection the GDC under your Chairmanship is charged with.

Come on down, Mr Moyes – time to play Dental Regulation for real.

Your time has come.

 

 

LINKS – THE NEWS

1 http://www.salisburyjournal.co.uk/news/11739251.NHS_suspends_dental_practice_following_inspection/

2 https://www.gdpuk.com/news/latest-news/1812-gdc-remains-defiant-over-jr

3 http://www.gdc-uk.org/Aboutus/Documents/FTP%20Improvements-Dec2014-MA-FINAL.pdf

LINKS – WHICH? CAMPAIGN

4 http://www.which.co.uk/campaigns/dental-treatment-costs/

http://www.which.co.uk/campaigns/dental-treatment-costs/2015-01-19-Dentists-respond-to-Clean-Up-Dental-Costs/

6 http://www.which.co.uk/home-and-garden/bathroom-and-personal-care/guides/get-the-best-from-your-dentist/private-and-nhs-dental-charges/

7 http://www.which.co.uk/home-and-garden/bathroom-and-personal-care/guides/get-the-best-from-your-dentist/dental-treatment-checklist/

LINKS – DH DOCUMENTS RE PROTOTYPES

8 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/395384/Reform_Document.pdf

9 http://www.gdc-uk.org/Newsandpublications/Publications/Publications/Standards%20for%20the%20Dental%20Team.pdf

 

 

 

 

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Prototype or re-hash?

Prototype or re-hash?

Will there ever come a time in the dental profession when solidarity will create meaningful change?

Recently some bus drivers in London realized that some drivers were getting paid more than others, so they called a 24 hour strike last week, with less than a days notice.  Around 2.3 billion bus journeys are made in the capital in a year and on that day millions of people were affected as they were forced to use alternative transport. Clearly the knock on effect means that the underground and road traffic becomes clogged up. Cab drivers drove the capital to a halt when they realized that a US competitor was taking their lunch.

What is always clear when the press covers these stories is that the system itself is identified as the fault, not the actual providers of the service. Striking workers comes as no surprise for most of us. whereas health professionals standing up for their rights seems to be rare. It is unlikely the bus drivers that were getting above average pay would be so keen to raise the alarm. Akin to those contract holders with UDA values well above national averages.

In truth, the announcement of “evolution not revolution” by Earl Howe with the imminent roll out of the prototype contract scheduled over the next 3 years will mean it’s a long wait for those unhappy NHS contract holders. Indeed has anything really changed in the last 9 years ? Limited exposure from an ever-hostile press rarely highlights the disparate and confusion of what is literally affecting the vast majority of hard working and ethical health professionals every working day.

The cynic in me would say this is classic posturing from the commissioner of the service. After all “If the profession hasn’t responded firmly in the past, it is unlikely to do so in the future”.

When the doctors went on strike in 2012 , the press did not make out it was money focused doctors at fault rather a change in their pension structure at the core of the story.

If history teaches us anything about the department of Health then we know that it's going to a lot longer than planned to see real tangible change in the dental contract, which is intended to remain in place for 20-30 years.

The pricing transparency issue unveiled by a Which consumer review makes it even easier to point the finger at the “ money focused” dentist. What is left for the profession? How can we take real action to illustrate what causes the problem and that hard working NHS dentists cannot continue like this for years to come? (?)

Consider the facts for a moment

-       No increase in NHS dentistry budget planned for the next 5 years

-       Marked decrease in patient access across every existing pilot site ( speak to any pilot site and ask them how long their patients are waiting for an appointment)

-       Hygienists and less so therapists will take an increasingly larger role in prevention and health assessments 5 years from now.

So the question of solidarity, can it actually happen in dentistry? I sadly suspect not. Perhaps because every NHS contract holder has too much to loose if they were held to account. Perhaps successive governments only take real notice about dentistry when the press shows the long lines outside a new NHS dental practice opening up. Perhaps its fear of persecution in the press, or genuine concern for our patients well being and we are not prepared to leave our patient in the lurch? So maybe its time for dentistry to take stock and unite to take its part in controlling its destiny?

If not, the finger of blame will continue to point at the dentists who appear to be the bad guys.

We launched http://www.toothpick.com in 2013 with a clear objective. Make dentistry more consumer friendly for patients and provide an efficient way of building a patient list.

Having travelled and experienced different dental remuneration models around the globe I became acutely aware how different patients perceive dentistry. I suspect the combination here of the press portrayal and the rising patient expectation under a limited system has created a terrible reputation for the profession.

Its hard here as the NHS patient journey is far too short to form a positive opinion and a hostile press that is ready to dentist bash it becomes a downward spiral unless urgent action is taken from within to reverse this effect.

If it’s another rehash of the broken and failing system rather than a workable new contract formed then perhaps the new prototype signals the beginning of the end. Or could this be the trigger to start real action to identify the cause of the problem and have real inclusive dialogue for a solution that gives that gives a fair deal for the patients and the providers.

I feel only with this approach can we restore the professions reputation and trust with the public and the press, which takes years to build and seconds to destroy.

Sandeep Senghera

Image credit - Sludge Gulper   under CC licence - not modified.

 

Dr Sandeep Senghera BDS, CEO and Founder Toothpick
 

Sandeep combines his 12 years of experience and knowledge as a Dentist since 2002 with a passion for internet technology to create www.toothpick.com to help patients book a dentist online at over 3500 NHS and Private dentists in the UK.

Drawing from a family heritage in business and start ups, his entrepreneurial nature and desire to improve patient experiences in Dentistry drives his business.

 

 

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Hazards in Dentistry

Hazards in Dentistry

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Coming Home to Roost

Coming Home to Roost

Its becoming very apparent that there is a distinct lack of transparency where some practitioners are concerned with regard to what is and isn’t available on the NHS. This has been going on from the beginning of the new contract, and has caused much heated discussion over the years.

When you consider that not even the CDO was prepared to give an actual list of NHS treatments, instead relying on the ‘All that is Clinical Necessary’ definition that is deliberately intended to obfuscate, then it isn’t really surprising there are almost as many different interpretations as there seem to be contract holders.

We can argue amongst ourselves as to when something should be, or can be provided on the NHS, but the end consumer, the Patient, is stuck in the middle of this unsatisfactory situation, and that should be our prime concern.

The GDC are now starting the come down on those practitioners who they feel have been misleading, or even dishonest in their definition of what is available, and since the balance of probability legal test is used, the weight of evidence does not have to be as high as a criminal issue to find a practitioner guilty, and then suffer the consequences.

However, until recently, the difference of opinions as to what is legitimate and what is ‘gaming’ has largely been discussed only within the dental profession itself. This is NOT intended to be a blog about what gaming is; it’s sufficient to say though that we have to acknowledge it exists within the profession.

This week, Which? have now waded into the argument, with a campaign to ‘Clean Up Dental Costs’

It would appear that they have found this distinct lack of transparency in the pricing of dental care, and in particular the differences between private and NHS care. Not only that, they appear to have also found that about a quarter of those surveyed were unsure of the differences between NHS and Private.

More worryingly, 40% of respondents were unaware that all treatment that was clinical necessary was available on the NHS. This lack of awareness plays right into the hands of those practitioners who have been guilty of perhaps ‘massaging’ the NHS contract to their benefit and not that of the patient. One question it asks is who is responsible for the overall education of the general public as to what is available to them; it is accepted that expert opinion and advice is needed when the general public seek the aid of a professional, so they can perhaps not be held completely responsible for not knowing the ins and outs of dental treatment. On the other hand though, is ‘All that is Clinically Necessary’ too difficult a concept for the Government via NHS England to convey to the populus in some way? The lack of this clarity has lead to varying degrees of confusion, alternative interpretations of the contract (not tested in law to my knowledge) and downright dishonestly and misleading behaviour at the expense of the patients.

Whenever gaming rears it head in discussions on this and any other forum it polarizes opinion hugely, and usually ends up in a slanging match of NHS vs Private. As I’ve said this is not the aim of this blog, but merely to get people to think about the consequences of what we in the profession have begun to create for ourselves and our patients.

It’s one of the huge elephants in the room in our profession at the moment.

There is no doubt that gaming is rife amongst some practitioners. Not all of them, but I would wager that there will be a fair number of mixed practices that are operating at the very edge of what is actually the correct definition of ‘Clinically Necessary’ throughout the country. The fact this aspect of the contract has not been tested in law is probably somewhat fortuitous for all concerned.

Of these practices, I think there will probably be some of them actually deliberately seeking to maximize their financial advantages over those of the patient. This is in direct breach of the GDC standards relating to putting a professional’s needs over that of the patient. It wont be an excuse to use ignorance of the rules of the contract to defend this either, or the continued financial survival of a practice. The continued ignorance of the patients in knowing what is and isn’t available themselves, and the plausibility of the explanations given (‘its isn’t available on the NHS’ is a difficult phrase to argue against for a majority of patients) mean it is simple for some practitioners to pull the wool over the eyes of the public.

If we want to take a stance against the way the GDC is acting at the moment, but there is sufficient evidence that some practitioners are being more ‘flexible’ with the interpretation of clinically necessary, then we can hardly take the moral high ground against them, as individuals are misleading the public the GDC are tasked to protect. How can we protest at that? When we have a Chairman of the GDC who has a background in the Office of Fair Trading it is not beyond the bounds of thought that his wish to broaden his remit has the tacit approval of the powers that be, and will include any future tests of NHS vs Private provision. Incidentally, Which? are not calling on the profession to clean up their act; they’re calling on our regulator and NHS England to do it for us.

In addition, if the Big Lie is to be exposed in all its glory, we as a profession can’t then be seen to be obscuring the failure of the contract by blurring the treatments that patients are receiving on the NHS and Privately. By misleading patients as to what is and isn’t available, to the benefit of the practitioner, is never going to expose the lack of funding inherent in the system.

Lack of transparency of fees has always seemed to be a problem with our profession. The artificially low NHS prices when compared with private means a significant number of the population have no understanding of the real costs of dentistry, and I think we really as a profession don’t go far enough to explain this to the public. Couple that with the confusion now as to what is and what isn’t available on the NHS then it is no wonder Which? have waded into the fray on the side of the consumer.

I personally don’t think it will be long before some form of disclosure along the lines of that seen by Independent Financial Advisors will be compulsory. With the GDC being final arbiters of our professional conduct, any lack of transparency in financial issues are already taken as being as serious as those of clinical errors. We will therefore reap what we sow where it come to financial misdemeanours.

We are in an ever increasingly consumer driven society, and we have to get our house in order if we are to retain the professional status we think we deserve. If we don’t, then we only have ourselves to blame for what is then enforced on the profession in the future. We can resist consumerism and try to hang on to the last bastions of professionalism, but if some of our profession are less open with their dealings with those consumers, then we will all pay the price.

The consequences of gaming are coming home to roost whether we like it or not.

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Recent Comments
Sandeep Senghera

Another reason to FTA ?

The new age consumer has plenty to spend their hard earned cash on. Tarnishing the profession with the same lack of transparency a... Read More
Monday, 19 January 2015 10:12
Anthony Kilcoyne

The average consumer just read...

Hi Sandeep, the 'average' consumer will have existing prejudices reinforced, with no 'antidote' of general dental knowledge or pre... Read More
Monday, 19 January 2015 21:09
13731 Hits
JAN
17
2

Momentum added to the Big Lie campaign?

Momentum added to the Big Lie campaign?
After a couple of years, is there now some momentum behind the Big Lie campaign devised, proposed and propagated by Dr Tony Kilcoyne BDS, often using the columns of GDPUK, as well as using ITV Daybreak, Jeremy Vine Show on Radio 2, and the letters column of the Daily Telegraph.
 
The basis of the campaign is wide ranging and Dr Kilcoyne often talks about protected time, so that dental professionals can have adequate time with patients that is not constrained by overbearing pressures of targets which must be met, targets set by unaccountable NHS managers. In addition, his campaign always mentions the un-noticed aspect that the most likely reason for hospital admission in England for children between ages of 5 and 9 is the disease of dental decay, and those children need extractions of multiple teeth under general anaesthetic, which, for safety reasons, must only be provided in a hospital environment.
 
Medical and dental professionals must stop politicians pontificating on the NHS being free at the point of demand, and repeat again and again, in reality, the politicians run a finite, cash limited service with growing and open-ended demand. 
 
Other aspects of the campaign must be patient education, a tax on sugar drinks and confectionery to fund better dental care as well as discouraging use, as with cigarettes. In addition, the dental professional of this country must takes steps using public relations techniques to educate and win over the public so they know that adding fluoride in tiny quantities to public water supplies will benefit their children and future generations.
 
I find it amazing that despite the public image of dentists, we are the only group in favour of this latter measure, yet this would make less work for us in our high investment, high expense practices. Because we are professionals, and we see the damage caused, and our professionalism makes us draw attention to the widely ignored preventive message.
 
Last week [13th January 2015] the august body that is the Faculty of Dental Surgery of the Royal College of Surgeons released their thoughts on what is going wrong for the teeth of young children in England, in the form of a press release. This body is not one of the wildest of institutions, it is hundreds of years old, with roots going back to 1540. Its' leaders rise through an establishment process of professorial rank in a high achieving and multi-qualified professions. In effect, by publishing the concerns of the Royal College in this rare move, they have joined the clamour with a loud hailer from the tallest building - children are suffering with a preventable disease and un-necessary hospitalisation, but the Government is looking the other way.
 
In our highly developed United Kingdom, the sales of sugar, sweets and confectionery continue to rise. In fact between 2008 and 2013, when consumer spend has been squeezed in the UK, cumulative rise was only 2%, [source Mintel] despite a fall in that time in disposable real family income. Every year more millions are spent on these items, and the manufacturers, the supermarkets, the retailers churn it out. For students of economics, these confections are great value added products for the manufacturers and the rest. But the culture of ignorance, and the sad culture of avoiding and deriding the dentist, together with the inexorable rise in sales mean tooth decay is on the up, and hospital admissions increase.
 
Cynically we can joke and say we need a "sugar czar" but maybe the way forward for this campaign is for a high profile leader to enact established, proven concepts, increase regions with artificial fluoridation of water, increase education regarding the effects of sugar, and reduce sales of confectionery aimed at small children. In addition a change in attitude, promoting the concept that families who allow their children's teeth to rot are neglectful, this is a totally preventable disease and this knowledge is not new.
 
Let us hope that more dental bodies, in fact all dental bodies, come together to raise the profile of this health failure, and improve the national oral health of our children.
 
The children of dentists do not suffer this disease. Full stop.
 
Tony Jacobs
Dentist
Manchester
 
 
 
References and further reading:
  1. Royal College of Surgeons report January 2015
  2. Daily Telegraph letter 2014
  3. Daily Telegraph letter 2015
  4. Mintel market insight reports

Image acknowledgement

Running to Paradise Garden
by Nicolas Alejandro
https://www.facebook.com/nicolas.alejandro.ph  
Shown under Creative Commons licence

 

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Anthony Kilcoyne

HMG should be fully Open & Hon...

We should expect no less honesty of HMG towards the Public, than is expected of us as Professionals. The public should be told Th... Read More
Saturday, 17 January 2015 21:20
Anthony Kilcoyne

Whistleblowers still demonised...

It's difficult still for proper Whistleblowing to be supported in the NHS system ,when even the Health Select Committee just a few... Read More
Thursday, 22 January 2015 15:53
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What’s in a date?

What’s in a date?

 

For those who despair at the actions of our fellow human beings at time, this weekend has been one to affirm that feeling. The 7th January will in time become as meaningful as 9/11 and 7/7 in its own way. [1]

 

What level of hatred inspires [if that is the right word] someone to kill a fellow human in cold blood? I for one struggle.  In the ‘Je suis Charlie’ motif, a worldwide empathy has poured upon our French neighbours as they ponder a surreal weekend. 

 

Dentistry does feel strangely safe after that sort of event. 

 

Of course, while a small number of unexpected and sudden deaths in the street of Paris seems to trigger a media frenzy, the mass loss of death in Africa from Ebola, [2] and the even greater human distress in the civil war in Syria seem to lie uneasily on our minds. [3]

 

Perhaps we struggle to understand the magnitude of the Syrian problem –  maybe that is one reason for the distancing of the issue. The UNHCR data indicates in excess of 3.2 MILLION people have been displaced. If you live in Manchester or Leeds, imagine just moving out. That is without pondering the 191,000 estimated deaths. [4]

 

West Africa seems so far away. At the time of writing over 8200 deaths have occurred from the disease 

 

And yet 20 die in Paris and we are not moved to fill the streets. I wonder why? 

 

As we all go to work this week, perhaps thoughtful, perhaps a little sad at matters outside our control,  just take a little more time perhaps to help your fellow human suffering. 

 

It’s what we do, and indeed it is by and large all we can do. 

 

The 2nd January marked the date of the second Dental Profession’s letter protesting our Governments dishonesty in dealing with our small but proud and effective profession. [5] 

 

Allthough the clock is ticking, The 7th May is after all far enough away that a week of reflection will do no harm. 

 

Indeed may you remain safe and loved.

 

 

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So why did I join the Liberal Democrats?

So why did I join the Liberal Democrats?
In the heady days leading up to the general election in 2010, when the political tone seemed to be very hostile towards immigration and immigrants,  the only sane voice seemed to be that of Nick Clegg's. Now for someone like me who at that time still was on a temporary work permit, that made a big difference. The UK can seem very hostile to immigrants in their early years here. Especially recently, and I lived for years in fear of that hostility. Nick's calm welcoming voice was a relief from all that I was hearing at that time.
 
I was so impressed by that first debate that I decided to donate some money to this good party, I went online and made the payment. I also ticked a box which then made me a member of the party. 
 
Now that made me research the party and then it was a no brainer. 
 
Liberalism, it really is a no brainer. It sounds right, it looks right and it is right ( well , centre or left of centre we would be more likely to say generally ) 
 
I found myself agreeing with all of the various liberal strands. Personal, Political, Economic and Social
 

Personal Liberalism:

 
Respecting personal freedoms, and protecting individuals from state and majority oppression, from the surveillance state ,from conformism. This is so important now in the aftermath of the Charlie Hebdo and other killings in France. The importance of freedom of expression, of the freedom to live as we may choose and without the expectation of conforming to any ' norms' defined by any single person or any group of persons, whatever their number.
 

Political Liberalism: 

 
Power is best exercised by or closest to the people affected by it. The idea of localism, the idea that brought about devolution, the idea of local and regional structures taking on more responsibility and not being dependant on Westminster and Whitehall. At the same time,the idea of internationalism and international co-operation. A recognition that we are all citizens of the planet and that there are too many artificial barriers that we tend to erect. 
 

Economic Liberalism:

 
The idea of the free market, of the freedom to make our choices of work and enterprise. The idea that monopolies, either state or private are bad. The idea that the market can and will find the solutions to our economic problems ( though needing a nudge at times to guard against excesses ). The idea that people should be free in the spirit of enterprise to make their mistakes, but that we should not let anyone sink beyond a minimum level and ensuring that the minimum is always getting better than the day before, the week before, the month before, the year before and so on. The state cannot be better than the individual in deciding what works best for them. The state should help where it can and then get out of the way! Only intervening where necessary to ensure fairness when there is obvious exploitation of the vulnerable.

 

Social Liberalism: 

 
The idea that more equal societies are also more happy societies. Now absolute equality is impossible to achieve and I would argue that there is no such thing! But we can do our best to ensure equality of opportunity as far as possible, to break down barriers where they exist or where they are artificially erected by vested interests. And while we can never ensure equality of outcome even where we remove inequalities of opportunity, we must strive to keep on getting better. This concept of always, continuous improvement, something that is the cornerstone of our dental CPD also applies to life in general and to society as a whole. 
 
 
When I considered all the above, I knew that I had joined the right party. I was a candidate for council in a Middlesbrough in 2011.  When I moved to Scotland, I was made the Scottish EMLD ( Ethnic Minority Liberal Democrat) representative and then I won an internal selection to be selected as the PPC ( for Edinburgh South ) and here I am now, to fly the flag of liberalism in this week when liberal values have been so threatened, and knowing that in early January almost 4 million people marched all over France and in the UK too expressing solidarity with their fellow citizens. Here I find myself, selected as a PPC a mere four and a half years after joining the party, a mere nine and a half years after having moved to the UK. I am definitely happy and proud of the distance that I've covered, but Oh! There's so much more to do and I've barely got started! 
 
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Cheerful

Reasons (Not) to be cheerful pt. 3

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Don't

Do's and Don'ts

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How is the CQC going to assess and inspect dental practices in 2015?

How is the CQC going to assess and inspect dental practices in 2015?

How is the CQC going to assess and inspect practices in 2015?

Here’s a check list that I have used BEFORE I plan a CQC visit:

·         Website for opening hours / NHS/private / services & treatment provided

·         Inspection history: Summary including date of last inspection, and including any breaches of regulation(s) or concerns identified at the visit. Date action plan completed.

·         Local Area Team (LAT) information return: Date sent and returned - any issues.

·         Provider information return: Notes re statement of purpose / compliments & complaints.

·         Feedback: A brief high level summary of any patient / other feedback from any other source.

·         Registration: Summary of changes to registration and registration issues, including details of the registered manager.

·         Notifications: Summary of notifications received at CQC, whether received when needed and within relevant timescales.

·         Concerns and enforcement: Summary of any concerns and/or enforcement not already covered above.

You have this information, so why not review it and decide what the CQC will make of it?

What does this mean in 2015?

CQC inspection in 2015 will be based on the following and in my opinion biased heavily towards Safe and Well-led. With this in mind, look down this check list and think about how exactly you could show me evidence that this is happening today in your practice.   I’ve put a few examples in each section.  

Safe

·         Lessons learnt and improvements made when things go wrong. Evidence? (risk assessments, RIDDOR, improvements made, changes planned etc.)

·         Care assessed to prevent unsafe care and treatment. Evidence? (Medical history checking system, treatment planning, record card audits, retrospective radiograph audit) 

·         There are systems, processes and practices in place to keep people safe and safeguard them from abuse.

·         There are systems, processes and practices in place to protect people from unsafe use of equipment, materials and medicines.

·         There are systems, processes and practices in place to prevent healthcare associated infections.

·         Potential risks to the service and individuals are anticipated and planned for in advance.

·         There are systems, processes and practices in place to ensure all treatment and care is carried out safely.

Effective

·         Patients are always involved in decisions about their treatment and the practice obtains valid consent and audits records of this. Evidence? (Record keeping audit, patient information in various formats, fees explained and written treatment plans, agreed practice wide system for recording treatment options understood by patient, pros and cons explained, time given for decisions, Mental Capacity Act understood)

·         Patients’ needs are assessed and care and treatment delivered in line with current legislation, standards and guidance. Evidence? (new patients survey considered, waiting time audit, opinion survey used, disability access audit performed, practice meeting minutes where GDC/CQC standards discussed, staff sign policy documents, system of governance operated)

·         There are effective arrangements in place for referring to other health professionals to ensure quality and continuity of care for the patient.

·         Patients’ oral health needs are assessed and care and treatment delivered, or referred, in line with current legislation, standards and guidance.

·         Staff have the right skills, knowledge and experience to enable the effective delivery of care and treatment.

·         Staff are recruited, inducted and appraised regularly and records are always available on the premises.

 

Caring

·       Patients are treated with kindness, dignity, respect and compassion while they receive care and treatment. Evidence? (Confidentiality always considered, patient survey acted upon, waiting times audited, comments book shows many patients are pleased with care, telephone answered promptly and politely with log kept, emergency spaces available every day, complaints tracker shows all complaints handled carefully, staff training logs, privacy and dignity respected).

·       Are people and those close to them involved as partners in their care.

·       Does the practice promote equality and diversity and recognise the needs of different groups.

Responsive

·         The practice staff routinely listen and learn from people’s concerns and complaints to improve the quality of care. Evidence? (Practice is growing, has plans for improvements, staff levels constant and staff encouraged to develop competencies, complaints handling regularly updated, everybody encouraged to participate, complaints tracker up to date and good comments in book, NHS Choices etc).

·         Patients receive an explanation of any need for referral with copy of letter and options/consequences.

 

Well-led

·         The governance arrangements ensure that responsibilities are clear, quality and performance are regularly considered and risks are identified, understood and managed. Evidence? (There is a written system of governance which is used in training and regularly updated, all staff are competent and have a personal development plan, there is a culture of openness and professionalism).

·         How does the practice engage, seek and act on feedback from people who use the service, public and staff.

·         How do the leadership and culture reflect vision and values, encourage openness and transparency and promote delivery of high quality care.

 

Let me ask you a few questions.

In your honest opinion, how do you think your next CQC report will look?

 

Bear in mind that It only takes one person to sink your ship.

Who actually runs your practice on a day to day basis?

Do you have a plan of where you want to be in a year, or five years?

How are you confident that all your staff know what the standards are?

How do you monitor standards of safety, effectiveness, care, profitability, popularity and are you moving ahead?

This is why you must have a system of Governance, I know this, you know this, the CQC insist on this. 

RightPath4 can provide a system of governance mapped to 2015 CQC requirements which is simple to implement and does not cost £thousands or run to thousands of pages. It is easy to bespoke it to your practice and use as an important part of your practice meetings and induction. We have a unique template tool which helps you give confidence to the CQC that your practice is safe, caring, effective, responsive and well-led.

£250, no ifs, buts or VAT

£540 and we’ll deliver it to you and spend a day showing you how to apply it to YOUR practice.  There are no ongoing payments, unless you want us to keep prompting you. (We do offer to update you and revisit your practice at a monthly cost of £70 payable by Standing Order, it’s optional though).

I hope we will be able to continue to help you.

Kind regards,

Keith Hayes BDS  Clinical Director RightPath4 Ltd.,

There when it counts.

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What's coming from CQC

What's coming from CQC

You’ve got CQC hindsight, but have you seen what’s coming?

The CQC have ‘Fresh Start’ plans for us in 2015        

It’s part of their strategy for 2013-2016, Raising standards, putting people first).

They are more focused than the previous ones and inspectors will be more

experienced in assessing dental practices.

The new standards are divided into eleven Fundamental parts. 

Fit and Proper Person (Directors) and Duty of Candour are 2 new standards.

The CQC have also beefed up their enforcement powers, meaning that they

may not give you a warning before they prosecute.

 

How do the old ‘Outcomes’ relate to the new Standards?

The simplest way to explain this is for you to complete my CQC survey: https://www.gdpuk.com/index.php?option=com_rsform&formId=57 and then I will send you an explanation of how to relate the old CQC to the new CQC and the new (ish) GDC principles. I will also send you an explanation of what the ‘Key Lines Of Enquiry’ (KLOE) is all about and how it will be applied in April 2015.

What effect have the CQC had so far?

Many of you kindly told me about your CQC thoughts in my survey, (see link above) which is still running.       By sending it back to me, you will now know what or who KLOE is. The CQC inspector will use these KLOE’s to guide the inspection process and make a judgement. The CQC still haven’t decided about publishing these.   

I have summarised what you have told me so far from my surveys and will be discussing them with the CQC. We may yet be able to have a sensible regulator looking at the right things in an intelligent way.

My prediction for 2015 is that FEES, Cosmetic dentistry and dermal fillers will also come under the spotlight.

Brief analysis (from 76 surveys)

I have used this as a pilot survey to determine whether there is a need to gather more information on how well the CQC registration and inspection process is received and what the beneficial effects may have been in driving improvement.

I think relatively few will have experienced re-registration and therefore a low %age answering YES to Q1 may be expected. However it is disappointing to see that 48% still felt that the process has not been made clearer. 

There continues to be much confusion over legal entities and I know (from personal experiences of clients that this is still a problem now, 76% of respondents agree.

 

81% felt that the inspection was not structured to reflect dental practices; even higher (87%) saying that the nuances were not understood and many said that a dental adviser is required.   

It seems that few felt that they understood what the CQC expectations are regarding safe, well-led and managed practices. I was particularly pleased that our own clients were in general more ‘upbeat’ about the potential benefits of CQC compliance and also felt more empowered and knowledgeable (judging from some open question comments).

The open questions were designed to test whether the process of declaring ‘compliant’ 48 times in the original application had sparked an interest in them to get things done before inspection, just in case. It seems that this was the case in as much as 72% said they had done some things, although I need to look more closely at this figure because some of what was said was fairly minor ‘window dressing’ was one comment.

The most significant results I feel were relating to the perceived benefit of CQC registration and inspection.

The positive improvements noted by patients and staff reached only 14% and the consequential improvements to the business reached 21%. Finally regarding your additional thoughts, there were many suggestions and yet only 6.5% of these were positive. I have concluded that an improved and much larger survey spread amongst a wider audience is required.

OK, so what?

From April 2015, CQC inspection reports will look quite different. Instead of considering just 4 or 5 Outcomes; the inspection will be constructed in a different way to test whether your practice clearly demonstrates that it is safe, caring, responsive, effective and well-led? A CQC inspector has described how the new process enables them to ‘get under the skin’ of the practice and see what is really happening.

Safety is now considered of paramount importance following on from the terrible instances of poor care graphically illustrated in the past few years. Although the CQC had considered that dentistry was relatively much lower risk; there was a severe jolt to this belief recently in Nottingham. The GDC are also convinced that there are also still much greater problems within the Profession. So it is my guess that safety will share top billing with being well-led.

It is hard to imagine that a well-led practice would be unsafe or that there would be many unresolved complaints or that there is a high staff turnover or patients don’t have fees explained properly.

RightPath4 can provide a system of governance mapped to 2015 CQC requirements which is simple to implement and does not cost £thousands or run to thousands of pages. It is easy to bespoke it to your practice and use as an important part of your practice meetings and induction. We have a unique template tool which helps you give confidence to the CQC that your practice is safe, caring, effective, responsive and well-led.

In the next blog article, I’m going to discuss how the CQC are going to assess and inspect in 2015.

Here’s wishing you a Happy, Healthy and Prosperous New Year,

Keith Hayes BDS

Clinical Director www.rightpath4.co.uk This email address is being protected from spambots. You need JavaScript enabled to view it.

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Body Language

Body Language in Dentistry

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Be of good cheer ...

Be of good cheer ...

2015… anticlimactic or more to come?

It been a funny old year.  As you sup your Christmas tot, you might perhaps take some time to reflect? Pull a chair up, let’s while away a minute. It’s cold outside, so would you be kind and throw a log on the fire?

For a profession that should really be quietly under the public radar, and in the state of a ship sailing steadily and smoothly, the waters have been mighty choppy this year.  The raging CQC currents have by and large subsided, while the torpedo of the ARF, allied to the air strike that is Medico Legal costs arising from the FtP debacle, was a direct hit.

Tears or Tiers?

The winds of NHS “Tiering” are gathering, and forecast is that a storm will develop around the Prototype Contracts which has yet to peak.  The UDA unfairness continues to block out the sun, especially for those of you who by whatever means have run out of UDAs for the last 3 months.

Great Deeds for Christmas?

The GDC have, shall we say, come to our attention this last year in an unprecedented way. The present leadership of the GDC have shown themselves to be arrogant, intransigent, out of touch, and in an irony befitting of their Standards document, utterly without a care in the world about the profession.

I hope you have not been in a time warp and that the events of the last few weeks have not passed you by.

The GDC now finds itself on the wrong end of a judgement at the High Court. Do not believe everything you read in their oh-so-friendly e-mails – honesty and transparency are two things woefully lacking in this broken organisation. However, they offer a level of Spin for which a former Prime Minister would be proud.

The time has come, the walrus said…

In answer to your question “What next?” I suggest you ALL whizz over to the petition at the link below to sign your support for the resignation of Mr Moyes and Ms Gilvarry.  It is you, my friends who will keep this agenda alive – please do your bit. Responsibility must be acknowledged and frankly after this last few months, there can be no other honourable way.

There are 36000 Dentists and if you do nothing else to support your profession this year, please sign it.  Unless of course you think the GDC are spot on and a fine example of public body efficiency…

PLEASE SIGN THIS PETITION

Please visit https://www.change.org/p/gdc-gdc-leadership-resignations-needed-the-courts-and-profession-have-spoken

Better Deeds for All?  

Go’arn, go’arn, go’arn … you know you want to

But the BDA in contrast have risen to the challenge. If you are not a member, and can stretch to the additional cost, my commendation is at least throw them one year’s membership as a thank you for their action on your behalf. 

https://www.bda.org/strongertogether

Because of their resistance to the GDC steamroller, a process has been started at the political level which, in my opinion, will likely see some change driven by ministers over the next year. If you did not see the debate raised by our colleague Sir Paul Beresford, it is worth an hour of vCPD to see Mr Dan Poulter the Minister state unequivocally that in his eyes the GDC were bang out of order! This is the link
http://www.parliamentlive.tv/Main/Player.aspx?meetingId=16685&st=11:00:00

 

A Christmas Truce?

As The Christmas season passes [and for those not so inclined, may it be an appropriately Festive one] it is time to stop worrying about matters dental and just chill out with your family & friends. If you are like me and prefer your own company, may the mountain that you climb offer perspective and energy. 

Perhaps we might find it in our hearts to wish all those at the GDC peace and goodwill.

 

So will 2015 quieten down?

We shall see. The agenda will change but it seems like there is much more to grab your attention on the way. To our young graduate colleagues, welcome to the funny farm and good luck coping with the massive changes that are brewing.

 

Be positive for 2015

Remember, the NHS is not the only outfit in town. Behind all the huff and puff of politics and the GDC qwankers1, private practice is a driving example of modern, efficient small business, focussed absolutely on patient care through a strong relationship with the dental team, offering a route to lifelong dental health aided by some amazing CAD CAM technology. Indeed the Good Ship SS Private Practice has been quietly sailing around all the politics and as any members of it ‘crew’ will tell you, when you sit down with your patient and start building trust, the rest of the world melts away.

If you have half an inkling to start a process of being less, or indeed NOT dependent on the Government for your business income, why not use the next couple of weeks to plan your first step. With all the changes afoot, allied to a certainty that there will be no more money when they demand extra activity from you, it’s the least you can do for your patients.

Life without the NHS actually makes tolerating the GDC a whole lot easier! And without NCAS and spurious GDC referrals, you will be a lot less likely to have your FtP day . Hurrah!!

 

So 2014 is a wrap.

To all my reader my thanks. To all of you, a peaceful end to the year and remember … they’re only teeth !  But they don’t ‘alf cause trouble, eh?

 

1                     http://www.urbandictionary.com/define.php?term=Quanker
 

2                     Join the BDA at https://www.bda.org/strongertogether
 

3                     http://www.parliamentlive.tv/Main/Player.aspx?meetingId=16685&st=11:00:00

 

4                     Sign the petition seeking GDC Resignations at
https://www.change.org/p/gdc-gdc-leadership-resignations-needed-the-courts-and-profession-have-spoken

 

 

 

 

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My journey with GDPUK

My journey with GDPUK

Hello All,

Ever since my selection as a Parliamentary candidate, I have been in touch with Tony (Jacobs) about this blog with my thoughts and experiences of the general election 2015, from the viewpoint of a practising dentist.

We have been looking back at my time with GDPUK and there is a fair bit to share!

I was first admitted to the e-group on 10th September 2000. That was a month before I sat my finals. 

I originally joined to follow how dentistry was practised in the UK. To follow advances in the field, to interact with fellow dentists in what was thother part of the world for me. 

I was mainly an observer back then, not much interaction until 2004 when Prof Raman Bedi visited Bangalore during his 2004 FDI India tour. He announced that he would hold a one time only sitting of the part 1 of the then IQE in India. That was an initiative to help solve the problem of a shortage of NHS dentists at that time in England. 

I sat the exam and waited for the promised clinical dental attachment which never came! Then I posted on GDPUK with queries about how things were for left handed dentists. I got some replies and a conversation began with Paul Thompson (Norwich) over the next few months in 2005 I got my clinical attachment  and arrived in the UK on 5th August 2005, a few weeks after the London bombs! I was having nightmares about the Jean Charles de Menezes shooting and as Paul will tell you, I did not wear a rucksack or even run to catch a bus for a few years!

I was to sit part B of the IQE on 8th August 2005, something I was totally unprepared for! It was then that Paul appealed to GDPUK members in London to help me with a few things. Victoria Holden from Chertsey responded, she opened her surgery on a Sunday and showed me what I wanted to learn! Vicki I will always be grateful for that day, thank you.

As expected, I failed that sitting! I had more trials and tribulations until I finally managed to pass the ORE a few years later. During that time I worked as a dental receptionist and dental nurse with Paul who remained steadfast in his support and then even worked as an SHO in Maxillofacial Surgery in Birmingham 2009-2010. I was again in observer mode with the GDPUK during those years. 

I returned to clinical dentistry in 2010 and have since worked in Middlesbrough, Hull and Stirling and now have experience of UDA and fee per item NHS systems and now of some private dentistry too. 

I have a lot to thank GDPUK for, for kindling my interest in the UK and in UK dentistry. For the networking which laid the foundations of a great professional and personal friendship with Paul Thompson. For people like Victoria Holden and Tony Kilcoyne ( good advice and an encyclopaedia of dental political knowledge ) . For Tony Jacobs who allowed me, a final year non UK dental student to join in 2000 and who has now invited me to record this blog. For all the members who have informed and entertained me over the years, and for a lot more in the future. 

I now hope to return the favour by informing and entertaining all of you with my thoughts and experiences during what will be a very exciting time for the country over the next few months as we vote for a new parliament on 7th May 2015.
 
Merry Christmas everyone. Have a good break.
 
My next post will be about how I came to join the Liberal Democrats and my journey from then to now as a parliamentary candidate.
 

 

 

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Record 24 Hours for GDPUK.com

Good Afternoon, yesterday (18/12/2014) was the busiest day in GDPUK.com history after the court case between the BDA & GDC. Read the latest news here.

On an average day, the site gets around 4000 visitors, yesterday 10,200.
 
Daily average for pages created is 100,000, yesterday 351,000.
 
News published yesterday late morning had over 12,000 readers within 24 hours. And the open letter [now subject of a Change.org petition] has had over 8,000 readers, over 760 Facebook shares and over 110 tweets.
 
It is great that together we can harness GDPUK & social media to unite and stir the profession. Thanks to everyone who shared, retweeted and got involved!
 
 

 

 

Thanks all for reading and supporting this blog over 2014.

Have a Merry Christmas and a Happy New Year.

If you are impressed by the fact that the ad banners received 150,000 impressions in one day, please get in touch about advertising in 2015. Contact details below! We would love to chat. 

Thanks all :) 

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Does an FtP await me? - a 2014 dental poem

Does an FtP await me? - a 2014 dental poem

Oh cripes, oh crumbs! What have I gone and done?
I’ve only gone and broken GDC Principle Number One.
I tried so hard to put his interests well before mine,
But he works shifts and wanted me on Sunday at half-nine
Does an FtP await me?

Oh cripes oh crumbs! Now I’m in the poo!
I’ve only gone and broken GDC Principle Number Two.
I tried to communicate effectively, I really really did.
But he's a Glaswegian Kiwi and I couldn’t understand what he sid.
Does an FtP await me?

Oh cripes, oh crumbs! They’ll hang me from a tree!
I’ve only gone and broken GDC Principle Number Three.
I thought consent was valid, I really talked it through,
But his Uncle’s anti-fluoride and now they’re going to sue
Does an FtP await me?

Oh cripes, oh crumbs! They’ll strike me off for sure
I’ve only gone and broken GDC Principle Number Four.
His wife checked his appointment, the nurse said he wasn’t in
He was knocking off his secretary, committing carnal sin
Does an FtP await me?

Oh cripes, oh crumbs! They’ll boil me alive!
I’ve only gone and broken GDC Principle Number Five.
Anyone can complain to us, be it grumble, moan or wail
We thought me made it pretty clear, but we don’t have them in Braille!
Does an FtP await me?


Oh cripes, oh crumbs! They’ll torture me with sticks!
I’ve only gone and broken GDC Principle Number Six.
I referred her to a Specialist, one I’ve used a lot,
But she wanted to see another one, and now I’m in a spot
Does an FtP await me?

Oh cripes, oh crumbs! This is DLP’s heaven
I’ve only gone and broken GDC Principle Number Seven
I thought I could root fill a tooth, but I’m not able to you see
There are many many lawyers who know much much more than me!
Does an FtP await me?

Oh cripes, oh crumbs! Is another career too late?
I’ve only gone and broken GDC Principle Number Eight.
I thought her weight loss was down to a calorie controlled diet
I didn’t know she was under stress and I shouldn’t have kept quiet
Does an FtP await me?

Oh cripes, oh crumbs! Open the bottle of wine!
I’ve only gone and broken GDC Principle Number Nine.
I try to be upstanding, honest, good and true,
But I follow the GDC’s example – now that JUST WILL NOT DO!
Does an FtP await me?

Mike Ingram

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2015!

2015 - Predictions & Resolutions

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A Perfect Storm

A Perfect Storm

By the time you read this it will be less than a week before the Judicial Review hearing over the GDC’s setting of the ARF, and after the Special Meeting of the LDC’s unanimously held a Vote of No Confidence on the GDC. That vote was excellent timing in my opinion, as it was the last piece in the jigsaw of No Confidence coming right before the Judicial Review.

 

The thought of having to appear to defend yourself legally when you don’t think you’ve done much wrong (or indeed anything wrong) is an increasingly familiar feeling amongst our profession, judging by the sheer increase in the number of our colleagues having to go through a similar adversarial situation. I truly hope there is now some realization amongst the higher echelons of the GDC of how it feels to have your career under threat.

 

After all, no matter what the result, its not a great addition to your CV when you have to add you were in charge when an entire profession voted No Confidence in your Leadership, and you headed up the first regulator to be taken to court by those it regulated. I wonder if the (unfortunately fictional) General Quango-crats Council ever impose conditions like the GDC do to make you inform future employers aware of what cases are pending or have been found against you?


The difference of course though is that if we showed the same degree of arrogance and lack of insight then that would be held against us by the regulator. They continue to show no insight that they might be doing something wrong; a vote of No Confidence from the LDC’s is the latest in a long line of similar votes and their response to that was as predictable as usual; once again failing to acknowledge the levity of the issue, that they were surprised, and repeating the mantra of saying they want to work with us to improve patient safety.

 

Unfortunately the judiciary are not going to be able to take into account these votes of no confidence; their remit is only to see if the correct legal process has been taken by the GDC in setting the ARF, and will not be influenced by our opinion of the regulator. Win or lose though, Pandora’s Box has now well and truly been opened by the BDA’s action.

 

Next Monday’s decision is critical in many ways, but almost irrelevant in others. Let me explain why I think that. In my opinion, if the BDA lose, then all that really happens immediately is we pay the increased ARF. Nothing else was going to change with a regulator with leadership that will not accept it is wrong. It does mean that the GDC will continue along the path it has chosen with renewed vigour, but that actually won’t make much difference to the registrants who live in constant fear of falling foul of the GDC’s interpretation of the law.

 

And what if the GDC lose? Does anyone really expect the current leadership to resign or admit they are wrong? One thing that has become apparent over the past few months is the lack of accountability and insight that organizations like this display, so my bet is that the current management will retire to lick its wounds if it is defeated, but not fall on its swords as would be the honourable thing to do.

 

So that’s why the result is almost irrelevant as whatever the decision, the fight must continue to bring the GDC to order. That is only likely to be done by putting them under ever increasing pressure no matter what happens next week.

 

So, on the other hand, the decision is critical in that it has to be the beginning of the tipping point against the GDC. This feeling within the profession will NOT and must not go away, because the fear that the GDC is instilling in all practitioners that the slightest infraction will lead to a draconian and disproportionate response is ruining patient care. When we practice so defensively that our first thought is to protect ourselves, then we cannot truly be acting in the best interests of the patient. Why can’t they grasp this concept? Is our profession really so bad that 15% of us deserve to have a fitness to practice case against us at some point? No it is not.  And this injustice is what we should continue to fight.

 

The GDC is also going to be subject of an Adjournment Debate this week, and whilst MP’s are usually conveniently unaware of dental problems in much the same way as our patients unless something happens to focus their attention, the fact that this issue has now appeared on their horizon is notable. Traditionally the profession doesn’t tend to get the kind of hearing they would like in Westminster due to the influence of the Department of Health. This debate might be different however as it is not about contracts and the NHS for once.

 

This is why it is now so important that the recent votes of No Confidence and the Judicial Review in particular are broadcast to a wider audience. Never has a regulator been so roundly condemned to such a degree as this before, and the MP’s must now be made aware of the strength of feeling in profession. This is the kind of pressure that brings change. Some might say that change could bring in a worse situation to the one we are not in. Really?? Could it get much worse when you already live in the fear of losing your career over a single patient complaint?

 

One wonders if the GDC Christmas party will be on hold this year; one of my previous blogs suggested the GDC would be running out of cash round about now, and given the tone of the ARF reminder emails that many of us have received this week, there seems a desperation to get some cash into the coffers fairly swiftly. I don’t think for a minute there is any compassion or helpfulness behind those emails to remind us to pay our ARF; if they had either of those virtues they would have come up with solutions to help registrants pay monthly, or not act so swiftly to erase for non-payment, and not continued blindly on the course they have chosen. No, this is a cashflow issue in my opinion, and possibly quite a desperate one.

 

Its perfectly possible they’ve run their reserves so low this time that they won’t be able to spend as much on the Christmas party as previous years – which a recent freedom of Information response reveals was about £80,000 of our money between 2007 and 2013 (including summer events). I know they are currently having a laugh at our expense, but should they be having a party funded by us as well?

 

So I think the GDC’s ship is heading into a perfect storm this week; starting with Questions in Parliament, then the Judicial Review, and finally the starving of its cashflow by our cancellation of direct debits, means now is not the time to sit back and wait for something to happen, but to continue to exert pressure on the beleaguered Executive and Council. This need not only be via organizations like the LDC’s and the BDA, but also by registrants as individuals taking whatever action they can professionally, ethically and legally.

 

After all, a ship sailing through a Force 10 Hurricane isn’t likely to appreciate a few well-aimed torpedoes is it?

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