‘One UDA’ Breach Notice Successfully Appealed

‘One UDA’ Breach Notice Successfully Appealed

A dentist who was one UDA short of her annual target as a result of the pandemic, and was given a given a contract breach notice by NHS England, has won an appeal against the decision.

The female dentist, who practises in Derbyshire, appealed against NHS England’s decision, to NHS Resolution, part of the Department of Health and Social Care.  NHS Resolution provides expertise to the NHS on resolving concerns and disputes fairly.

The BDA News website said “The applicant and BDA member in question had fallen short of their annual UDA target by 30 UDAs using the most favourable of NHS England’s reconciliations methodologies for the contract year 2019-2020.”

“They were just one UDA off the 96% threshold to carry over the underperforming UDAs for the contract year 2019-20.”

The BDA News website said that the BDA member had asked NHS England to use its discretion and award the single UDA.  The practitioner had patients booked during the practice closure and could demonstrate that one further UDA would “Easily have been achieved had the practice not closed.”

NHS England failed to award the UDA and so the dentist, a BDA member, appealed to NHS resolution.

The Head of Operations of Primary Care Appeals said in the summary of the outcome “Following a review of the Contractor’s particular circumstances, NHS England ought to have considered the high likelihood that the Contractor would have performed more than 1 UDA following the temporary suspension over the actual activity provided and that discretion ought to have been applied to managing this particular case.”

“In the absence of a clear rationale for taking the approach it did, I am of the view that the methodology used to calculate the UDAs for the Contractor was not fair and proportionate based on the information before me.”

In April 2020 via webinar, England CDO Sarah Hurley asked Matt Neligan, Director of Primary Care and System Transformation, to address dentists on the financial measures being implemented to mitigate the effects of disrupted dental services in March.

Mr Neligan told dentists on the webinar  that a process of reconciliation of UDAs would be implemented to mitigate the effects of the lockdown on UDA provision.

“He acknowledged that any such reconciliation would be imperfect and that any resulting unfairness should be worked through with local commissioners. He said that he had sent a message to Local Area Teams underlining the principle that a “fair, sensible and proportionate approach should be taken, and one where the application of common sense should take precedence,” the Head of Operations said.

The appeal heard “The contractor had requested that their Local Area Team apply their discretion to amend the reconciliation figure, bearing in mind the existing methods of calculation have brought about mitigation of only 1 UDA (Financial value £23.69) to the Contract, in lieu of approximately 2 weeks of surgery time at the end of March, at which time the Contractor was performing at a level of more than 18 UDAs per week in order to meet their UDA target.”

“As a direct result of this, the Contractor has been informed that their UDA target has not been met by an amount of 30 UDAs and that clawback of over £1200 will ensue, commencing this month (this figure includes carry forward from last year).”

“Outlining the appeal decision, the Head of Operations at NHS Resolutions said “Following a review of the Contractor’s particular circumstances, NHS England ought to have considered the high likelihood that the Contractor would have performed more than 1 UDA following the temporary suspension over the actual activity provided and that discretion ought to have been applied to managing this particular case.”

“In the absence of a clear rationale for taking the approach it did, I am of the view that the methodology used to calculate the UDAs for the Contractor was not fair and proportionate based on the information before me.”

“I conclude that NHS England, working with the Contractor, should review this matter and apply their discretion to give an increased total UDA for March 2020.”

The BDA News website called the decision a “Win for common sense.”  

“We are pleased with this decision coming from NHS Resolution and it tells NHS England to use its discretion to make sure that its policies do not cause unfair outcomes.”

Text from the appeal can be found here

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