Contract Delays Must Stop, LDC Conference Is Told

Contract Delays Must Stop, LDC Conference Is Told

NHS contract reform “Needs to be in place for April next year” the national Local Dental Committee Conference was told at the weekend.

“I know that’s ambitious, but time is running out.  The decade of delay and repeatedly kicking of the can down the road needs to stop” Shawn Charlwood, Chair of the BDA General Dental Practice Committee (GDPC) told LDC representatives at the opening of the conference.

Regarding the NHS UDA targets, Dr Charlwood said “My view and that of my team, is that the 60% is overly ambitious.  It will be very tough. It (the target) was imposed, and we consistently argued against it.”

“In our view I think the figures may start to support that it’s certainly overly ambitious compared to the other three developed nations. Another example of stick rather than carrot targets.”

“Support for dentists in the other nations have contrasted greatly with England in terms of ventilation support as one off payments. The continued lack of support from ventilations for English dentists is telling and the start contrast is very apparent.”

Addressing dental health inequalities, Dr Charlwood said Healthwatch England had pointed out that dental charges are a barrier to dental care for the most vulnerable in our community and didn’t fit in with ubiquitous promises to attain “equality” in access.

He asked “How do above inflation increases in patient’s charges fit with the sound bite that we hear all too often.  It’s appalling there should there be a charge for dental examinations in the NHS.”

“Should we not have a system where entry to the NHS dental system is free in terms of examination, to actually support access in a practical and meaningful way access rather than talking about it?”

Ed Waller Director for Primary Care followed Dr Charlwood. He thanked the dental profession for its work during the pandemic, but with regard to targets and improving access, he said “It’s absolutely vital we do need to remember that we do operate within a budget.

“It would be a lot easier for me to have more money to spend, clearly, but we do need to operate within the budget that we have for dentistry and that means we do need to think carefully about how we solve challenges with the resource we’ve got, and how we prioritise them.”

The Chief Dental Officer of England Dr Sara Hurley also thanked dental professionals for their work over the past year and addressed criticisms which were levelled just before the dental start-up in June 2020, when dentists protested at the lack of information and short notice given regarding a reopening date.

Dr Hurley said “I’m not ignoring what was top of your request list quite naturally. It’s the need for clarity on the national IPC requirements and the consequences of any change in public health measures you want (in order) to get back to normal.  I get it.”

“Indeed, all four UK chief dental officer share the ambition for increasing access which needs to be done safely and effectively. As we’ve already explained, there is already a national process in place to review the UK wide guidance, and this absolutely includes the necessary risk management for dental settings.”

“We also await confirmation of how any relaxation in public health measures may translate into easing measures in healthcare settings. Believe me as soon as we know, we will tell you,” Dr Hurley added.

This was the second LDC conference to be held virtually, and was chaired by Dr Stuart Allan.

Dr Eddie Crouch presented a special motion on behalf of the GDPC, asserting that all forms of discrimination have no place in dentistry. The motion was passed unopposed with a 100% vote.

A motion calling for an increase in the number of places for candidates to sit the Overseas Registration Examination and an improved application, presented by Dr Martin Longbottom of West Pennine LDC, was carried by 87%.

A motion proposed by Dr Simon Thackeray on behalf of Nottinghamshire LDC was passed overwhelmingly.

The motion called for an urgent review into the need for enhanced PPE in the clinical setting, with a particular focus on comfort, staff fatigue, burnout and the devastating environmental impact of such measures, clearly weighed against the risk of contamination.

Dr Thackeray said the risk to dental staff from aerosol generating procedures is “between zero and negligible.”   

“Whilst it can be understood the precautionary principle may have been appropriate the at the very beginning of the pandemic, it is now clear that these precautions can be seen as overzealous in an endemic situation.”

“We are likely the only country in Europe, if not the world, still employing the level of pp that we currently are using and there’s still been no reported super spreader events in dentistry anywhere in the world.”

He added that abiding by a core principle laid down by the GDC that require practitioners to obtain informed consent is  difficult, when communication is hampered by the wearing of enhanced PPE, particularly for patients who have hearing impairment.

Dr Thackeray also made the point that clinicians becoming overheated in PPE compromises their dexterity and optimal finesse.

He joked “I’m sure you will all agree that being dressed in plastic and overheating like a boil-in-the-bag kipper and rustling like an overgrown bag of Doritos, is not what you all thought dentistry would be like.”

An important motion proposed by Tejaswi Mellachervu of Wakefield LDC, passed with no votes against it.  Wakefield LDC said regarding the new proposed contract, “It is essential that the UDA treadmill is not replaced by another one in disguise.”

Northumberland LDC asked if the BDA could adopt a position in negotiating a reformed NHS contract which allowed use of the full range of Dental Care Professionals, to address the issue of difficulties in recruiting associates in rural areas.

Dr Duncan Thomas said “Dental therapists have the training to be able to complete examinations and screening for dental disease and to provide much of the treatment identified in those examinations.”

He explained that because of “Current NHS regulations, many of us find it very difficult to make a therapist model of delivery work.” He said that because of the barriers within the regulations, newly qualified dental therapists had often worked exclusively as hygienists and therefore  rapidly deskilled.

He said “Why can’t a dental therapy therapist be recognised as a performer under the NHS, opening courses of treatment and managing patients without the need for a dentist to sign everything off. I would also contend that there is no reason why they can’t receive the same benefits of NHS pensions and maternity rights as dentists.”

The motion passed with a substantial 74% vote for the motion.

Another motion by Northumberland LDC demanded that in order for the dental profession to flourish and deliver a high standard of care, any new NHS contract must recognise that more time needs to be spent with each patient encounter.

The motion, again presented by Dr Duncan Thomas, passed with what conference Chair Stuart Allan described as a “Thumping majority.”



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