Extra UDAs Without Strings. (Terms and Conditions Apply)

Extra UDAs Without Strings. (Terms and Conditions Apply)

A few hours before scheduled questions in parliament about the NHS dental access crisis, and no doubt by sheer coincidence, the CDO has revealed yet another initiative.

In the latest CDO letter to contractors it was announced that they can deliver up to 110% of their UDA target, without needing to jump through any hoops for their commissioners. This time even the relevant regulations have been put in place, unlike last autumns “announce now, pay later” UDA changes.

Offering contractors 10% extra on their UDA allocation will make a fantastic headline for the government. Something along the lines of “We have increased the budget for NHS dentistry by 10%” is likely to be the stock ministerial response to any questions on dentistry for the foreseeable future.

Dental teams might see things differently. The existing UDA rates remain, so if a practice was not viable on 100%, upping output by 10% would just increase their losses. Many practices are struggling to meet their existing targets and face clawback, indeed this may be how this latest idea will be funded. They will hardly be in a position to deliver even more UDAs. And what of those practices that can make NHS care pay, and are confident they will hit their old target? Are the CDO and their team aware of the recruitment situation in dentistry? The recent figures from the GDC on registrations show numbers that have changed little over the last few years as demand has steadily increased.

Terms and conditions apply. The offer is for the 2022/2023 financial year. Any additional payment due will be made following the satisfactory conclusion of the year-end reconciliation for each contract.  Indeed there appear to be so many fairly obvious limitations to this latest initiative that it looks like an updated version of last years “£50 million extra for emergencies” episode. That was launched almost a year ago to the day, with dental teams rapidly seeing that it was fundamentally flawed, and perhaps set up to fail. In the event less than half the headline figure was spent on dentistry.

To underline the futility of this approach, within hours former LibDem leader Tim Farron had tweeted, “In Cumbria, we have NHS dental practices not taking on any new patients, some going private and at least one which now has no full time dentist – and I know it’s the same story right across the country. We cannot let this crisis continue.” He had gone on to write a lengthy letter to the Health Secretary, Steve Barclay, on the subject. No doubt the eventual reply will refer to the 110% UDA change in suitably misleading terms. Answering the latest commons questions, Junior Health Minister Neil O’Brien, said, “That is why we invested an extra £50 million in the last quarter of last year”

The BDA speaking of last year’s minor contract changes described them as rearranging the deckchairs on the Titanic. Today the CDO has given the band another piece of music to play to the passengers, while the ship goes down.


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