Move To Core Service Aided By Covid Wind Down?
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- Published: Tuesday, 07 June 2022 07:32
- Written by Peter Ingle
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Practice inboxes have filled up with a variety of official emails recently. Dental teams have become used to multiple announcements, from leaders such as the CDO and national NHS management.
These missives often come in bursts containing repeated or inconsistent advice and requests, and are then followed by long periods of radio silence.
A recent burst of activity has been around infection control and urgent access. And it may be that read together they reveal the true direction of travel for NHS dentistry.
The challenge of reducing restrictions that were introduced to manage the Covid-19 pandemic has now collided with the arrival of Monkeypox. Not for the first time, dentists have waited for clear official guidance. And waited.
Without any direct announcement to the profession, the UK Health Security Agency (UKHSA) COVID-19: Infection prevention and control dental appendix was withdrawn on Friday 27th May.
Awareness of this was low and there was uncertainty in terms of what if any changes practices should make. For many practices their first email about this will have been from a well-known compliance company, observing that, “At the time of writing, there is no further operational guidance on how to apply the guidance contained in these links, and unsurprisingly there are a lot of confused practices out there.”
A few hours later the regular Primary Care Bulletin from NHS England arrived. Buried midway in this was a link to the UKHSA updates.
At around the same time, the periodic “Your NHS dentistry and oral health update” arrived from the CDO for England, Sarah Hurley. This told readers that the UKHSA guidance had been ‘archived’, and NHS England had ‘written to systems’. A link was provided to the NHS England infection prevention and control manual. This would, ‘follow the now familiar hierarchy of control’ and ‘provide a consistent handrail.’
Monkeypox was also mentioned, readers being referred to UKHSA guidance, however, further guidance was ‘in development.’ Meanwhile, an enquiry from GDPUK to the CDO’s office sent eight days earlier remained neither replied to, nor acknowledged.
Notably, the CDO’s communique had nothing to say about how the current access crisis might be dealt with or contract reform.
There may be regional variations, but perhaps an email from NHS England and Dental East, received the same day, showed the emerging strategy for access and contract reform. This announced that Urgent Dental Centres (UDC’s) will cease from the end of June. Programme 1a of the Transformational Dental Strategy, as previously reported in GDPUK, is intended to plug the gap in emergency care, both relating to Covid-19 and, it would appear, the access crisis. Programme 1b, when ready, will make greater use of DCP’s to provide both prevention and stabilisation of high need patients. Programme 2 will provide urgent out of hours care. It is important to make clear that both programmes 1a and 2 will be funded through reallocation of up to 10% of existing contract values.
The grandiosely named Transformational Strategy, will aim to mop up untreated urgent cases at the expense of routine care, and do it within the existing budget. This could be the incremental contract reform that has been spoken of recently. As the chances of finding an acceptable formula for replacing the UDA based contract diminish, adjustments to the existing contract are the carrot held out to practices considering their future in the NHS. Just as in Wales, these are initially being offered to practices as an option.
NHS management may well be hoping that this will do enough to get the DIY dentistry headlines, and NHS dental desert stories, out of the news.
The cavalry of hygienists and therapists are about to ride over the hill, and convert all the temporary Glass ionomer, into wonderful restorations, whilst Practice owners sit on the street with their begging bowls. Hmmm
Transformation 1A
Did the maths for my (small) NHS contract. If the increased UDA value was anything significant I would be seeing about 1.5 emergencies max per week under the program.Already do more than that, just because it should be done. I don't feel I should give them any additional credit
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