Welcome to Hempsons’ Dental Newsbrief

2017 has certainly been a year of mixed fortunes for the UK dental profession. The continuing collateral damage caused by the UDA system in England and Wales has been heightened by the scale of the financial clawbacks from NHS contract holders – these clawbacks have become more frequent, and they are often larger. But the less obvious and more troubling consequence is that this money recovered from dental contract holders is being redeployed elsewhere in the NHS rather than being reinvested in dentistry, and is effectively a cut in dental funding.

The BDA has recently reported that a very high proportion of young dentists do not see their future working in the NHS, which at face value should be a matter of concern. Yet the cold reality is that the current system delivers more certainty and financial control for the Government in relation to the cost of primary care dentistry, than any previous system has been able to achieve since the inception of the NHS. Because of this, it serves the Government much better than it serves practitioners (or patients, for that matter).

So far the political fallout has been minimal although cracks started to appear in the second half of 2017 regarding access to NHS dentistry in some parts of the country. Right now, the Government appears to be in no great rush to bring forward long-awaited and much needed contract reforms, and meanwhile, successive years of above-inflation increases in NHS patient charges means that with each passing year, a greater proportion of the financial burden shifts from the state to charge-paying patients. Practitioners and dental practices are left to deal with the ensuing patient dissatisfaction.

After years of making the headlines for all the wrong reasons, the General Dental Council (GDC) shows signs of having turned a corner and has published arguably its most important strategic document for decades – ‘Shifting the Balance’ – and this identifies four main themes for its own development and perhaps more importantly, for repositioning itself and rebuilding confidence and trust in its performance. Two of these key themes are firstly, addressing the root causes of patient dissatisfaction and improving ‘first-tier’ complaints resolution, and secondly an end-to-end review and improvement of the much-criticised Fitness to Practise procedures, the aim being to re-focus it on the things that really matter and to make its response fairer and more proportionate. All of this is sensible and welcome, but these are early days in terms of assessing the impact.

The dental corporates are watching the Brexit developments with interest and perhaps some concern, as there is much uncertainty about what this will mean for the movement of dentists into the UK from the EU and indeed, whether EU dentists already in the UK will remain here. The GDC too has justified its freeze on the Annual Retention Fee largely on the basis of being unable to plan  with any confidence for the number of dentists working in the UK (and hence the GDC’s income) remaining the same in the next few years. Meanwhile, a number of dental practices have been sold by corporates back into private ownership during 2017 – an interesting reversal to keep an eye on.

The GDC’s ‘Enhanced CPD’ arrangements are due to be launched in January 2018, giving individual registrants more responsibility for determining their own training and development needs. Central to the changes is a requirement for every registrant to create a Personal Development Plan (PDP) and to use this as a blueprint for selecting CPD that is appropriate to their personal  situation and in particular, their area of practice. In practical terms, the requirement for verifiable CPD (ie the number of hours per cycle) has been reduced and although registrants will still be encouraged to undertake non-verifiable (general) CPD of various kinds, there will be no specific hours requirement nor any need to keep formal records of this. Similarly, there are still areas of CPD where the GDC recommends registrants to maintain a low level of regular updates, but this is not a formal requirement. There are some transitional arrangements for those whose CPD cycle straddles the old and new arrangements, but a registrant’s CPD activity is likely to be a material consideration in future Fitness to Practise investigations and hearings.

In particular, the GDC will be looking for a regular ongoing commitment to CPD rather than long periods of inactivity interspersed with an occasional ‘blitz’ towards the end of a registrant’s CPD cycle. A ‘nil’ annual declaration of CPD activity will not in itself result in further action, but registrants will need to be able to explain the circumstances which led to any such ‘CPD break’. The danger is that a registrant will in future find it much more difficult to ‘back-fill’ gaps in CPD activity at the end of a CPD cycle – or if they are unfortunate enough to find themselves facing a GDC  nvestigation midway through a cycle during which their CPD activity has been minimal.

And finally, dental practices in England – both NHS and Private – enter 2018 having been publicly recognised by the Care Quality Commission (CQC) as being the best of all the various groups of facilities inspected by the CQC in terms of meeting the required care quality and safety standards. NHS and Private Hospitals and clinics, ambulances, primary care medical GP practices, nursing and care homes, hospices, prisons and other secure centres all trail in dentistry’s wake. A good news story indeed and one which reflects well on UK dentistry.

A mixed bag of ups and downs for the dental profession and its wider team, then, and every sign that 2018 will be another interesting year.

Kevin Lewis BDS FDS RCS FFGDP
Consultant Editor, Dentistry magazine.
Professional Consultant, Hempsons

Continue reading other articles:

24 hour NHS retirement – piece of cake, right?; Is your dental practice ready for GDPR; Selling or buying a dental practice; Leasing premises – do you know what you’re letting yourself in for?; The delicate balance – ill heath dismissals.

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