CDO's Vision For English NHS Dentistry
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- Published: Wednesday, 12 April 2023 12:56
- Written by Peter Ingle
- Hits: 1934
Firstly, an apology to the Chief Dental Officer for England Sara Hurley. In previous news items this writer may have given the impression that she lacked a vison for the future of dentistry. That would be incorrect.
At the recent BDIA Dental Showcase event at ExCeL the CDO had a busy programme including a session late on the second day that provided a clearer insight into how both the Office of the CDO (OCDO) and presumably NHS England and the Department of Health and Social Care, see NHS dentistry in the future. There were a number of clear pointers, which those hoping to continue to provide NHS dentistry should consider carefully.
With the less than snappy title, “Addressing inequalities: Priorities for your ICS, your role and your opportunities to contribute – Open Forum” it is likely that very few GDP’s were amongst the audience. Indeed, combined with its location in the compact CDO Theatre, it seems that the many GDPs and practice managers at ExCeL, were not the primary target audience. They were elsewhere, attending presentations in the much larger Update and clinical theatres.
The CDO began by speaking of her ambition to raise standards. It was her belief that the arrival of Integrated Care Systems (ICS) would facilitate “putting the mouth back in the body.” She pointed out that there were 42 English ICS’s which would be able to tailor projects better to suit local needs. They would be open to “bolt-ons” to the dental service such as programmes that targeted those with diabetes and special educational needs. It was possible that some of the funding for this type of provision might not be found from the GDS pool. To help dental services get the best in the new world of ICS’s it would be helpful if LDC’s could be reconfigured to share the same boundaries. Three quarters of those in London had already done this with eleven former LDC’s consolidated to four that shared their footprint with four of the five ICS’s in the capital. The ICS’s would be looking for “added value” that could add aspects of care such as working on the periodontal health of diabetics, and yield wider health benefits. Some of her team were on hand to give examples of how dental teams could move into new areas, to the benefit of patients.
A member of the CDO team described a project he had been involved with to provide an “add on” via blood pressure testing of dental patients. He made it clear that the dental team were “case finding” and not diagnosing. Indeed, found cases were then sent not to their GP, but to a pharmacist who would then make the actual decision on whether a GP referral was appropriate. He emphasised that oral health remained their priority and that such projects were intended to be an addendum, where there was capacity.
The CDO then opened the session to Q&A. Eddie Crouch, BDA Chair, asked how ICS’s would be handling the anticipated clawback of £400 million. The CDO reminded her audience of the announcement that practices could deliver, and be paid for, 110% of their UDA target for the 22/23 year. Perhaps this might be continued for the next year, or some contracts might be rebased to help deal with inequalities. At this point the CDO looked to GDPUK’s correspondent and added with a smile that this was not official policy, and that she had to be careful what she said, “as we have a journalist” in the background.
David Cottam, Specialist in Oral surgery, and former BDA GDPC Chair, expressed his concern that ICS’s would be taking decisions on dental services without dental input. The CDO responded that dentists needed to be getting “board ready,” potentially becoming non-executive directors or chairs in the new organisations. It is, as readers will know, an area where the CDO has considerable recent practical experience.
Ian Mills, Partner in a practice in Devon, who combines work as an implantologist with his interest in dental public health, addressed the elephant in the room, when he expressed concerns over capacity. The CDO saw it being attractive to the dental team to be able to do different work and be a key part of their local community. She thought that as the economic picture remained difficult, private work might be harder to come by and they would be looking at the increased appeal of NHS work. Indeed, she thought that the coming changes in NHS dentistry might leave those in private and mixed practice experiencing FOMO (fear of missing out). Returning to the NHS they could become oral health practitioners and do more than “deal with prevention failures.” She thought dental teams would not want to say that they had failed to grasp what was available for their communities. To conclude, changes and the future of dental care would be “as much about culture as contract”
The CDO referred on more than one occasion over the event to dentistry and by implication dentists, often operating with a silo mentality. The change to ICB’s in her opinion would change that for the better, and make real progress into “putting the mouth back in the body.” A laudable ambition.
After listening to the CDO, surrounded by and speaking to, a small group largely made up of departmental colleagues, associates, and other insiders, an outsider might have observed that GDP’s were not the only silo dwellers.
BP
I wonder how many people with normal blood pressure most of the time have high blood pressure when visiting the dentist?You need to be logged in to leave comments.
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