Overwhelming Support For The NHS, As LDC Conference Rejects Call For Dentists To ‘Walk Away’ From Contract Negotiations

Overwhelming Support For The NHS, As LDC Conference Rejects Call For Dentists To ‘Walk Away’ From Contract Negotiations

A call for the dental profession to ‘walk away’ if NHS England doesn’t commit to abandoning the UDA as a measure of dental activity, has been rejected by delegates at the Local Dental Committee Annual Conference.

Wakefield LDC proposed the motion “This conference calls for the UDA to be abandoned as a measure of dental activity by March 2023. Without a substantial commitment to this from NHS England, we as a profession, walk away until they provide that commitment.”

The West Yorkshire-based LDC said in its supporting statement “The UDA was enforced on the profession 16 years ago. It was an untested system that had dentists chasing crude targets which had no relevance to patient care and was completely unfit for purpose.”

“Pilots have been going on and scrapped, the Steele Report has come and gone, contract reform is now a meaningless term without firm commitment and timeframes. We ask conference to support the motion that the Government commits to ending the UDA by 31st March 2023 at the latest.”

Presenting the Wakefield LDC motion at the ICC Wales, was Dr Tejaswi Mellachervu.

Dr Mellachervu told the Conference, “We know these crude UDA targets have no place in the modern healthcare setting.”

“We have aleady had sixteen years under this draconian UDA system and it’s now high time we as a profession reject any form of UDA or targets, to allow us to focus on treating our patients using a preventative approach.”

Dr Mellachervu  said “We therefore ask that that we are simply treated as fairly and as equally as any employee in primary care and funded properly to look after our patients rather than chasing targets.”

He called for any contract proposal by Government containing  targets to be rejected by the General Dental Practice Committee “And the profession as a whole.”

Dr Mellachervu added “It’s also perhaps now time to look into and endorse, alternative systems of funding outside the NHS, such as low cost family dental plans.”

But in opposition to the Wakefield motion calling for the profession to walk away from negotiations, Dr Vijay Sudra told Conference “You can’t walk away.”

The GDPC Deputy Chair said as unpalatable as the UDA targets are, “We have to be at table.” He said a large proportion of the profession  relies on NHS dentistry any many don’t work in a mixed practice environment.  Dr Sudra called on delegates to vote against the Wakefield motion.

The motion was eventually rejected with a vote against, of 60% of delegates.

Meanwhile, North Yorkshire LDC’s motion asking delegates to call for immediate changes to be implemented to the NHS contract was passed by the Newport Conference with an overwhelming 85%.

Presented by Dr Mark Green, North Yorkshire LDC’s motion said “To enable prompt changes to occur, we need to increase pressure on those that can make these changes.”

“We need to engage with our staff and most importantly, our patients via an online petition.”

The North Yorkshire LDC supporting statement said “We have heard so many times that the current contract was not fit for purpose and that they are working on a new way of providing NHS dentistry!”

“15 years later and the perfect opportunity due to COVID should have enabled a change and yet nothing has happened. If anything, it’s worse than ever.”

“We propose that by using an easy-to-use online petition we can mobilise our millions of patients and support staff to add a massive pressure on NHSE and the HMG that will hopefully invoke the necessary change that is needed urgently.”

The QR code to the patient survey can be found below.

West Pennine LDC’s proposal to call for the automatic recognition of qualifications for future applicants from the European Economic Area was defeated after BDA Chair

Dr Eddie Crouch spoke against the motion.  

Dr Crouch said “In essence I’ve got huge sympathy for a carte blanche acceptance of the qualification of dentists in the European Union.”

“The problem is that the quality of training across the European Union is not consistent.”

Dr Crouch said that while  recently in Porto at  the Council of European Dentists, he heard of real concern about the  quality of teaching at private dental schools that are prevalent across the EU.

Dr Crouch told the Conference delegates “I was told that in one particular school in Portugal, despite doing 5000 hours of training, and  five years of training, the quality assurance of the graduates of that school were really concerning, not only to other European nations, but to the Portuguese Dental Association.

Dr Crouch said that until the GDC had the ability to verify the quality of training, he recommended that the motion be opposed.

Although Wakefield LDC lost its proposal to walk away from contract negotiations, its earlier motion proposed by

Dr Tejaswi Mellachervu gained strong support from Conference delegates.

The Wakefield LDC motion said “Access to NHS dental care is every citizen’s right. NHS England must ensure that adequate funding is made available (so) that this right can be exercised without delay.”

“The current dental contract claims it provides comprehensive dental care for all, but in reality, only funds the care for 50% of the population. It is a rationed contract where those in greatest need are least able to access care.”

“This has only been exacerbated by the pandemic and statistics show year on year investment in the NHS has been falling. Conference asks that the government now finally increases the funding which the system so desperately needs, and patients deserve so it truly accessible by all.”

Dr Mellachervu told the Newport Conference that the nation was worse off with regard to access to NHS dental services than it was in 1999, when the then Prime Minister Tony Blair promised that everyone could access health service dentistry.

Dr Mellachervu asked the delegates to support the Wakefield LDC motion, calling the Government to “Now finally increase the level of funding the system so desperately needs - a minimum being at least an additional £900 million - just equal to  2010 levels of funding.”

He said such funding would give every patient a better opportunity to access dental care.

“Dentists and their teams should not have to take the blame for the difficulties the public face in accessing NHS dentistry.

Dr Mellachervu concluded “This travesty  lies solely in the hands of the Department of Health and Social Care and the Treasury. Government needs to act now.”

Summary Of Other LDC Conference Motions

Delegates passed a motion submitted by West Sussex LDC, calling for the Governments in all four countries in the UK to build back a better NHS dental service. A motion from Birmingham LDC demanding a ‘holistic reassessment of expenditure’ within the NHS dental sector if significant funds aren’t invested, was also passed by Conference.

A motion proposed by Derbyshire County LDC calling for the NHS dental budget to be ring-fenced and linked to inflation was  narrowly approved by delegates.

LDC ONE

A call by Birmingham LDC to demand that the GDC weighs in on the call for urgent reform of the 2006 GDS dental contract was rejected after the Conference heard the regulator does not get involved with contractual matters.

Conference also overwhelmingly approved Manchester LDC’s motion “This conference believes that the NHS dental service is in danger of falling over due to years of systemic failure by government DHSC and NHSE.”

Delegates narrowly rejected a motion by Northumberland LDC when it urged “All practices to look to alternative methods of funding their businesses outside of the NHS.” The LDC had said that the manner in which NHS dental services are being run demonstrates that the Government is offering a comprehensive service in ‘name only.’

The motion “This conference believes that year on year increases in Patient Charge Revenue has been used as a tool to manage demand, pricing working families and the working poor out of NHS treatment” put forward by Manchester LDC was passed with 82% of the vote.

Meanwhile, a motion by Devon LDC was carried by 95%. That motion proposed that the Government makes changes to the NHS GDS so that the service is a more attractive proposition for newly qualified dentists and incentivises existing dentists currently working within the service to remain.

A motion calling four  of the countries comprising the UK to undertake a workforce survey to establish the whole-time equivalent need for dentists and team members for NHS dental practice and then fund the system appropriately, was proposed by Coventry LDC. That motion received 89% of delegate’s votes.

Northampton LDC’s  call on the NHS, General Dental Council and British Dental Association to find solutions to remove the barriers to dental nurse recruitment and retention, gained universal support.  

Wirral LDC’s call on Government to acknowledge that the whole dental team is a part of the NHS was similarly passed with unanimous support. The LDC wanted teams to access similar benefits offered to other NHS workers, such as free flu jabs and early access to COVID boosters.

But Wirral LDC’s next motion, presented by Dr Phill Brown, which called for all members of the team to be able to access similar NHS Pension Scheme benefits, was rejected after Dr Russell Gidney pointed out the enormous burden and administrative difficulties such an arrangement would impose on mixed dental practices.

North Yorkshire LDC’s call for the NHS to properly fund and support Peformer List Validation by Experience (PLVE) was supported by 94% of delegates, while Enfield and Haringey LDC’s call for UK governments to require post-qualification dentists to complete their training in an NHS Dental Foundation Training or Vocational Training environment regardless of whether they intend later working within the NHS, was rejected.

North Yorkshire LDC’s call for more funding to develop training centres outside of dental schools in areas of high need, to “better serve our undergraduates” was approved by Conference delegates.  The LDC’s motion said “This conference believes that newly qualified dentists from UK dental schools are less prepared for primary care dentistry than ever before with more reliance on the foundation year.”

Conference was overwhelmingly supportive of Birmingham LDC’s motion to demand that dental schools are mandated to use generalists in all levels of the training and assessment of UK dental undergraduates.

West Pennine LDC’s motion also attracted huge support from delegates. The motion called on dental schools and the GDC to revisit the curriculum to “Ensure graduates study and are examined in the fundamental art and science of dental care so that Foundation Training may return to the task of teaching how that knowledge is applied in primary dental care.’

A call by Norfolk LDC for the Government to appoint an independent body to manage the commissioning of primary care dental services in England, also received support from the majority of delegates.  The LDC said the body should be independent of NHSE but have membership from patient groups and the dental profession.

Devon LDC’s call for the GDPC and BDA to demand that the service cost payments for Dental Foundation Training contracts are increased immediately, with linking of the payments to inflation in future years, was approved with a huge majority.

North Yorkshire LDC’s motion “This conference calls for further retrospective changes to the 2021-22 annual reconciliation to allow delivery of 67.5% of annual UDA target and 83.75% of UOA regardless of what was delivered in each period within the year,” was passed with 94% of the vote.

Gwent LDC’s call for the “Respective nations’ governments to support dentistry to become carbon neutral,” was also passed with a large majority.

LDC TWO

North Tyne LDC’s call for Local Dental Committee’s to give annual donations ‘at a meaningful level’ to the British Fluoridation Society, was supported with 69% of the vote, while Gwent LDC’s call for the Welsh Government to begin open and transparent negotiations that include fair representation of active general practitioners gain support from 75% of delegates.

The motion from  Morgannwg LDC ‘Conference believes that NHS GDPs deserve more funded representation on government committees that immediately affect the running and the future of the GDS” gained overwhelming support.

Manchester LDC similarly gained majority support  for its motion “This conference has no confidence in the new Integrated care system to fix problems locally

with the NHS dental service as their engagement with dentistry is designed to be low level, no new monies are identified and other NHS challenges will preoccupy management bandwidth with an assumption we are akin to the GP service.”

Another Manchester LDC motion gained near unanimous support when it proposed “The new Integrated Care system cannot look to address issues of the dental service when it is institutionally designed to sideline the voice of Dental providers from all its senior boards and indeed those of wider primary care. This conference calls on NHS England to ensure that LDCs have mandated roles in ICS structures.”

Finally, the Conference approved Leicestershire LDC’s call for the BDA to publish guidance for LDCs on how they can interact with ICS bodies.

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