Essex Local Dental Committee

Essex Local Dental Committee

Minutes of meeting held 8.9.08. at Chelmsford Golf Club, Chelmsford, Essex.

Hon. Secretary : Tony Clough, Roxwell House, Roxwell, Essex, CM1 4NL

Tel :01245 248553,  e-mail : clogdent@btinternet.com

Assist. Secretary : Clinton Foreman,

Tel : 07718 900909,  e-mail : clintforeman@lismail.co.uk

Treasurer : Mark Preston, 90a High St, Canvey Island, Essex SS8 7SQ

Tel : 01268 683739,  e-mail : mark@essexldc.org.uk

Apologies for absence : Chris Roome, Nick Pandya.

Minutes of previous meeting : Approved.

Matters arising : Nil.

Treasurer : MP reported current a/c balance £31,780 and reserve a/c £51,016, although there are considerable outstanding liabilities (sec. expenses and dental guild rate sessions). Voluntary fund set up by Rudi Vapiwalla and Bob Davey to fight old "new contract" is to be put into better interest account as a "reserve reserve" a/c. Details of a/cs from 2004/levy payments can be found in members' section at www.essexldc.org.uk (password from MP). Contributions to Sick Dentist Fund/LDC to be discussed at next meeting..

Chairman : Nil.

Special Presentations : Anna Mitchell from SE Essex PCT talked knowledgably about "Standards for Access to NHS Dental Care". Definitions of "Clinical Priority" (Emergency/Urgent/Routine), "Time to Initial Contact" and "Maximum Distance and Travel Time" were given, along with a map of the 45 practices providing NHS treatment. A wide-ranging discussion followed, including monitoring by postcode, non-recurring extra UDA commissioning (the wide variation in UDA values and the need to get good treatment as opposed to the cheapest UDA was hotly debated), "preferred providers" (stressing the value of local commitment vs. "corporates") and PQQs (prequalification questionnaires) to confirm applicants meet criteria for a successful application. Concern was expressed over the lack of "specialist care" OOH, and the role of the Community Dental Service in this and in domiciliary visits exposed its inability to meet demand. AC suggested "add-on" contracts which would include weekend cover, and BH asked AC to write to the SHA with our concerns.

Secretatial - OHAG : AC felt that commissioning managers are making unilateral decisions and PCTs are confident to do as they wish without consulting LDC (certain PCT culprits were identified as being promoted to ever higher levels of incompetence). We need to challenge these "jobsworths", and we need to engage the new generation of dentists in this struggle (members were encouraged to bring their younger colleagues to the next meeting). AUDITS : AC has been pressing for payment + CPD + T&S for collaborative audits (Mid/W Essex have completed record keeping/infection control/perio audits which will be passed to other PCTs, and will be paid).

Smoking Cessation : BD was not enthusiastic, despite his training, as it took so much time, and AC thought it to be inappropriate given the existing shortcomings in delivering NHS dentistry. Reg Patel said that he could not get his nurses to stop, so what chance did he have with a patient for 1/2 hour for the grand sum of £15 to cover his overheads?

Dental Education : VT - Deanery requires 17 new schemes (200 new practices and/or more than one VDP per practice) to accommodate the large increase in dental students. AC suggested a cohort of existing trainers being best-placed to identify new practices/trainers, as PCTs do not understand what is required, and the annual round of re-interviewing must become bi-annual. AC said that a high degree of NHS commitment was essential, but BH felt that such busy practices might not have enough time for the VDP. CF highlighted the problem of non-recurring funding if a VDP is not replaced with another VDP (what happens to the patients seen by the VDP?), and the problem when a VDP wants to stay on as an associate and the PCT cannot provide additional UDAs. It was agreed that these issues would be discussed by the trainers with Jason Stokes (Ipswich VT scheme coordinator) and a paper put together for the Deanery. - Therapists/hygienists progressing to second year funded by PCTs, although recruitment is global, and it was felt that Essex money spent should stay in Essex. There are still issues of misunderstanding by PCTs as to what they are buying/costs to practitioners, and AC/BH expressed belief that "wet-fingered" GDPs should be involved in selection/curriculum (4 out of 12 have been expelled from last year) - AC to write to authorities. - Nurses - still not enough training places, and being on waiting lists can last years. AC to write to Deanery again.

PECs/PCTs : AC has been on Mid Essex PEC, and dentistry has not been mentioned for 6 months. CF reported that all dental advisers in SE Essex were sacked two years ago (to save money/aggravation?), and the advice now comes from the Community Dentist (David Bowry). AC to write to all PCTs requesting reinstatement (and Guild Rate payment) of dental advisers, as per recommendation by SHA that PCTs discuss their plans with stakeholders, i.e., dentists. A confidentiality issue has arisen with PCTs requesting names/addresses of patients to see if they are on more than one waiting list, but the EC17 needs to be amended so that an authorised person from the PCT can access records as well as the dental reference service, and Mark Shackell is to take this up with the CDO, Barry Cockcroft. PCTs now receive considerable information from the BSA, e.g., new patient access, proportion of UDAs to patients seen, "churning" (>70% recalled every 6 months, which is against NICE guidelines), "split" treatments, etc.

LDC Conf. : CF gave a report (see website) and expressed his disillusionment with the apathy and lack of focus on display, despite the sterling efforts of Chairman Eddie Crouch. This sentiment was echoed by Nick Barker and the other attendees. Whilst the dinner the night before was very enjoyable and the speaker excellent (Giles Brandreth), many delegates sported hangovers the next day, the motions were "no-brainers" and there was a palpable air of "whatever we decide, it won't make a blind bit of difference to the DoH...cue the failure of the Minister to turn up yet again. Should we continue to support the Conference (AC was for withholding funds), or make representations for change? Please let me know at the next meeting.

Extra UDAs : These are being commissioned in some areas, but are non-recurring and are open to abuse by PCTs opting for the lowest tender. We need to take a strong lead in ensuring that adequate standards are maintained, and it is the duty of all members that PCTs are made aware that cheap funding may well result in shoddy work that will fail and will ultimately prove to be much more costly.

AOB : CF suggested a "task force" of members (possibly VT-based) that can discuss further the points of importance raised at meetings, so that action can be taken and these issues presented to LDC meetings (e.g. Eastern Region, LDC Conference, Officials Day, etc.) and not just forgotten. Your thoughts please. AC warned that "child only" contracts would not be renewed (see Health Select Committee's Report) and that "high-value" contracts would be targeted. Please let us know if you are likely to be affected by such changes. CF reported that he is to arbitrate in two cases involving "over-production" of UDAs by associates who left before the year end and are claiming full payment, and whose work is considered to be questionable by the principals involved. Members felt that the full payment requests were unreasonable, and that work standards should be investigated. To be advised.

Next meeting : Monday 3rd November 7.00pm (to include AGM). Please bring a young/new colleague.

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