Weeks Later – How the CDO's Vision Looks
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- Published: Monday, 17 April 2023 08:33
- Written by Peter Ingle
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The wry observation that, “A week is a long time in politics” is attributed to Prime Minister Harold Wilson. Somewhere, within the Office of the Chief Dental Officer (OCDO) someone may be ruefully reflecting that a fortnight is an absolute age in dentistry.
A few weeks on from the BDIA Dental showcase exhibition, where OCDO confidently mapped out their achievements and the future path for NHS dentistry, things are not going to plan. At Showcase the OCDO team delivered seven presentations in their own dedicated theatre and another two keynote presentations in the larger clinical theatre. Amongst all the verbiage there was a fair amount of policy and an indication of how OCDO see the future of NHS dentistry. By way of a reality check here are just some of the events in the world of dentistry, from the fortnight after all of the earnest speeches and slides.
By the time the OCDO team had got home BUPA were preparing to announce the closure, or if there were any takers, sale, of twenty percent of their estate, some 85 practices. Many of these had significant NHS contracts. The BUPA Dental Care General Manager, Mark Allen made clear that the impossible economics of continuing to provide this, were a key factor in many of the practices selected for disposal. It is unlikely that OCDO were unaware of this impending announcement when they spoke at showcase, but is does not appear to have made them reconsider their approach to managing NHS dental care. Indeed, OCDO repeatedly made it clear that there will be at best only incremental changes to the very NHS contract which helped push BUPA to this decision.
Professor Liz Kay is one of the most respected figures in UK dentistry, a leading dental academic and dental public health specialist, and the inaugural dean of Peninsula Dental School. Amongst many other achievements, she introduced a new model of primary care based education for dental students. “Our dental system is so broken down it actually rewards broken teeth” she wrote in an article for the Express, three days after Showcase closed its doors, and a day after the BUPA announcement. Our dental system is so broken it actually rewards rotten teeth, says Prof Liz Kay | Express Comment | Comment | Express.co.uk There was little in the article that will be new to GDPUK readers but the Professor’s tone can be gauged from the her quoting BDA GDPC Chair, Shaun Charlwood’s words, that without fundamental reform “we are simply rearranging the deckchairs on the Titanic while the service slowly slips into the sea”. Yet according to the CDO speaking just days earlier, the future of NHS dental care is “as much about culture as contract” and there will be no “big bang” seeing the demise of UDA’s.
The 8.5% increase in patient charges was announced within 72 hours of the OCDO stand at ExCeL being dismantled. The OCDO team would have been aware of this as they were congratulating themselves on “putting the mouth back in the body.” It is now clear that dentistry did get special treatment, at least when it came to setting patient charges. As Eddie Crouch, BDA Chair pointed out on twitter the 8.5% hike for dentistry compares to 4.5% for optical services and was more than double the 3.2% for prescriptions.
So once again NHS Dentistry suffers worse decisions from @DHSCgovuk Prescriptions up 3.2% eye tests 4.5% and dentistry patient charges rise 8.5% One might suspect they don’t want us ? @TheBDA
— Eddie Crouch (@EddieCrouch) April 7, 2023
Meanwhile the media stories about the access crisis continued unabated. Daily stories included, DIY dentistry, a protest outside parliament, and more dire warnings from Healthwatch about access. And yet the OCDO team are focussing on getting dental teams to carry out new activities, such as blood pressure testing, admittedly where there is “capacity.”
Meanwhile, the BDA produced a helpful video to inform members about the impending £400 million of clawbacks. There are no easy answers and practices will be thinking carefully about how they manage, what in many cases will be a huge financial hit. While the CDO spoke of practices returning to the NHS, many BDA members will be pondering the viability of their businesses, and security of their own and their team’s jobs.
It has not all been bad news for practices. To provide some positive input to those facing clawback, as they consider their options, regular contributor Keith Hayes posted on GDPUK:
"If you are still wondering about whether you will be able to maintain your income after NHS.
We’re beginning to see private practices closing their books to new patients or holding waiting lists for new patients to begin treatment!"
A bold contrast to the CDO at Showcase anticipating a stream of returning dentists as their practices face gappy diaries, and private patients stay away, looking yearningly to the security and stability afforded by taking on extra UDA’s.
Teams struggling to deliver NHS dental care can at least console themselves thinking of their colleagues in private practice looking wistfully at them and experiencing FOMO. After all, if the CDO said it’s happening, it must be true.
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