Essex Local Dental Committee

Essex Local Dental Committee

Minutes of meeting held 8.3.10. 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

Website:http://www.essexldc.org.uk.

Apologies for absence: Spencer Nute, Jane Jordan, Mark Duncan and Mark Shackell.

Minutes of previous meeting: Approved. Signed by Bryan Harvey.

Matters arising: Nil.

Treasurer: Current a/c £57,636 and reserve a/c £51,458. MP reported £16,000 payment from W. Essex PCT (back-payment), but little information available as to which dentists have paid, and considerable confusion over who is allowed to vote in LDC elections (LDC Constitution not yet ratified by PCTs). Annual contributions slightly down, despite general shift from PDS to GDS contracts, and AC suggested writing to PCTs to remind them that £12 LDC levy is mandatory for all GDPs in a GDS contract. MP said that Dennis May from S.E. Essex had been helpful, and AC agreed to liaise with MP for other useful PCT contacts.

Chairman : BH welcomed new attendees Louisa Lawrence who works in Woodford Green and found us from our website (See? It does work.) and Yunus Akhalwaya who works in Braintree (Well done, Reg.), and congratulated everyone on their earlier than usual arrival required by having to vacate the premises by 8pm.

Secretarial: AC asked members to consider, as a matter of urgency, referral guidelines/patient pathway graphics/exodontia referral forms from Southend University Hospital (approved by Mr. P. Weller and Mr. T. Theodossy, Lead Consultant and Consultant Oral and Maxillo-Facial Surgery) re non-third molar exodontia/third molar/apical surgery and for patients taking warfarin and undergoing dental treatment. Concern was voiced about listed indications/pathways for referral, and Bill Abbot highlighted the wide variance of ability of GDPs in this area of expertise. Disquiet was expressed at the lack of 'specialist' practices and the potential problems for VT practices when the trainer is absent. Adam Copsey was concerned that PCTs could use these guidelines in audits trawling for 'inappropriate referrals' and thereafter as a 'commissioning tool'. It was decided to set up a working party consisting of Reg Patel, Kemi Singh and Piers Lambert to consider suggested alterations immediately and to report to AC by Wednesday evening.

Commissioning post 'ring-fencing': Although 'ring-fencing' is due to cease at the end of next year, necessitating bidding for funds against other healthcare professionals, it was felt that it may be retained, depending on the colour of the government. Bob Davey has had no success in tracing 'lost' dental funds in S.W. Essex (Time to use the 'Freedom of Information Act'? It worked with the MPs.), and £700,000 is allegedly 'missing' in S.E. Essex.

End of Year Contract Monitoring: All PCTs allow 4% deficit (provided that this is made up the following year), but differ in that some will pay up to 7% over-production, whilst others will pay none. There has even been reluctance to reimburse the patients' payments in over-production cases, although T.C. Patel was successful when he confronted his PCT.

Dental Nurse Training: Funding is available from the PCT, but candidates require NVQ Level 2 or 5 GCSEs grade A-C to apply, which rules out some Dental Nurses but bizarrely allows beauticians to qualify. AC organised a successful course in radiography at his practice over 6 days for 8 students, with funding from M. Essex PCT at £600 each for training from Stephen Green in practical techniques, producing a portfolio (e.g. 90 sets of BWs/ some Cephs) and undertaking the final examination. BD, however, had been unsuccessful in gaining funding from S.W. Essex PCT, which appears to be unaware that this money must be made available.

Steele update and PDS Plus: It is already too late for core pilots as the letter from the CDO dated 9.2.10. and received only recently by some GDPs required a response by noon 19.2.10. for 'pioneer pilots to begin this April'. Expressions of interest are now invited for affiliates to test different components of current pilots and 'whole system' options in September (PCT deadline 19.3.10.), which will run for 2 years and use a range of blended contracts with different mixes of remuneration for capitation, quality and activity, i.e. opting out of GDS and accepting PDS+ contracts (and risking up to 25% of the contract payment on the result of 'Quality Reports' by the Quality Care Commission – to be paid for by the dentist - at the end of the year). Whilst it may be possible to 'parachute' back into GDS, there is the risk that the PCT will use this as an excuse to renegotiate UDA values, etc. CF reported the very negative attitude of the BDA to PDS+ (they strongly advise checking the BDA advice note - download from www.bda.org/pdsplus - and contacting the BDA Business Team on businessteam@bda.org or 0207535 5864). For further information regarding Wave 2 Pilots contact Richard Porter on Richard.Porter@dh.gsi.gov.uk .

LDC Officials' Day: CF reported on the meeting at Hotel Russell on 4.12.09. and reminded members to view the full report on the website. The highlight of the day was the admission by Sue Gregory, the Deputy CDO (the CDO was too busy to address the UK LDC Officials), that her department had got the New Contract wrong, that they should have listened to our concerns, that they should have taken more notice of the pilots, that UDAs had not worked, etc., etc. The stunned silence was only broken by a delegate saying, 'There must be an election in the offing!' to much amusement. She went on to say that she wanted to listen to the profession now, and that pilots would be conducted properly and that notice would be taken of them. The jolly mood of the conference was enhanced by an enthusiastic presentation from Prof. Jimmy Steele, who seemed to have more understanding of General Practice than many academics, and invited GDPs to join the new pilots. Reality then descended with various speakers lambasting the appearance of PDS+ 'out of left field', and one was reminded of the much promoted 'high trust environment' promises prior to the imposition of the New Contract followed by the 'out of left field' appearance of the previously unknown UDAs. The BDA representatives were particularly scathing about PDS+, highlighting concerns about termination provisions, payment provisions, legal obligations and increased administrative burdens, and felt that only new GDPs desperate to get onto the PCT contract ladder would ever contemplate signing on the dotted line.

Eastern Region LDC Meeting: CF reported on the meeting on 15.12.09. for Essex, Cambridge, Suffolk, Bedfordshire, Norfolk and Hertfordshire representatives. A full report is posted on the website, but it is worth noting that all reps were concerned about so-called 'ring-fenced' dental funding being appropriated by cash-strapped PCT financial directors for other priorities. There were reports of PCTs being very vexed about re-attendance intervals and inappropriate referrals, and there was much amusement about Sue Gregory's 'confession' at the LDC Officials' Day (see above), as she used to be the Consultant in Dental Public Health to Beds/Herts and was well-known to those reps.

AOB: PL reminded members of the Data-rules change (see www.dh.gov.uk1 or current 'bdanews') and that practices will have to complete an online assessment and achieve level 2 (out of 3 levels) within 12 months of this assessment. BD advised of changes to forms (ethnicity, recall intervals, etc.), but MP said that existing forms had to be used first (and more ordered?). BH wondered when to employ his 'update' disk. The meeting broke up and the members were ejected on the dot at 8pm.

Next meeting: Monday 19th April 2010.

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