Agenda for Change

The eagerly anticipated “Agenda for Change” (within the NHS) highlights once more just how far Scottish NHS dentists have fallen. The Doctors and Dentists Review Body (DDRB) amply demonstrates how they feel about dentistry and the professionals showing no improved recognition over the last two decades and no peer acknowledgement.

https://www.nhsemployers.org/pay-pensions-and-reward/agenda-for-change

We can never aspire to this but who works for nothing and how far are we prepared to be left behind? The question must be asked in relation to the act of NHS dental Items of Service (IOS) treatment because they impact hugely on everything that we and our staff do and receive.

The push towards better working terms and conditions for deserving staff has left the Statement of Dental Remuneration looking like a sorry and bedraggled postwar document which leaves practice owners and associates swimming against the tide. Pre-COVID, how might we have distributed less than £10 (for a filling) between associate, principal, receptionist, and nurse and aspired to anything like the Living Wage? It perhaps was just possible; the dentist having been prepared to carry out the dentistry for nothing. There will be no incentive to ramp up numbers mid-pandemic, obey targets or muddy the risk assessments.

The patients feel as though they are being passed from pillar to post, whilst the majority understand the predicament in which Scottish NHS dentists find themselves. Only we can allocate the priorities insofar as they may impact on the health of our patients and staff. Of course, no one wishes to work for nothing although pre-COVID, many NHS dental treatments were remuneratively meaningless as highlighted above. Post-furlough they will become what they were before the pandemic with the additional economic drag of fallow. Evidently, there will be times that we decide to act in a way that may be financially self-punitive, but these times will be sparing and only in the patient’s interests. Targets will be publicly perceived as irresponsible.

We are inextricably linked to the public sector pay review process yet denied access to the many conditions given to the public sector by right, because of year on year attritional increments on the SDR. This uncomfortably sits along with uncorrelated financial demands on both clinical and non-clinical governance.

The pressures on dentists have been exacerbated by the righteous aims regarding the “Living Wage” for all staff. As a profession, we are encouraged to be aware of our employer obligations, but the Scottish Government cannot neglect their duty (by proxy) to our staff. We can assume, since no proposals are forthcoming, that Scottish Government are not inclined to replace the existing model. We can therefore encourage our members and supporters to accept nothing without proper negotiation. The current status quo of discussion on “good terms” always ends with enforced suggestion.

Scottish Government may consider the position of struggling primary care services in relation to Scotland’s general, oral, and dental health. They may wish to take this opportune moment to negotiate in earnest as we watch more dental practices migrating more towards ‘private’ oral healthcare and sustainable business model.

Various proposals have been mooted including several within the suspended: Oral Health Improvement Plan, Childsmile, dietary/oral hygiene/fluoride advice and application, Flu jabs. There have been other suggestions such as blood pressure, diabetes mellitus checks and measures. As far as most practice owners and associates are concerned, the slate should now be wiped clean and the time to shape our practice and practise profiles is nigh, A growing minority have already made significant permanent changes to their commitments.

It is imperative that Scottish Government do not leave too few remaining when it comes to maintaining (and potentially augmenting some of) the General Dental Services. This is particularly so as more links to and from deprivation, oral health and systemic disease are uncovered. Consider the impact on community dental services, oral surgery, sedation, general anaesthetics (referral and action protocols) as they might back up on primary care. Failure to act now and instigate an actual negotiation will undoubtedly result in a compressed, disinclined and failing oral healthcare system.

We are now seeing the negative impact of COVID-19 on oral health, upon much of which we may have limited powers to remedy. As service providers to our NHS patients, this has very much become a service with the emphasis on health. And that now clearly cuts two ways.

In summary, we will continue to focus on caring for our patient’s health, but we will not be encouraged to increase risk. Nor will we return to anything like the levels of pre-COVID activity in the absence of actual negotiation.

More Posts from The Scottish Dental Association

The SDA Summit

The SDA Summit We are delighted to announce our first SDA event on Tuesday 16th of March from 12.00 – 2.30 on webinarjam. This webinar aims to inform and stimulate discussion around the promised changes to the post-pandemic SDR. If you are a dental professional and you have questions or ideas then please get in touch and book the event here. The Chief Dental Officer (CDO) has stated that he wishes to engage widely with the profession. This is a new dynamic and presents a unique opportunity for the majority of the dental profession to have a role in this

Read More »

“Scottish Dental Students Forced to repeat a year” BBC News

Scottish dental students forced to repeat a year – BBC News A massive blow to the profession as VTs repeat a year, no new graduates, EU dentists heading home and the difficulty taking on dentists out with Scotland. It doesn’t matter how long qualified you are if you have never had a Scottish NHS list number you will be offered COVID support along the same lines as the recently qualified vocational trainees. As we all know the only way NHS dentistry has survived this long is through volume of work and COVID has put a complete halt on this. We

Read More »

Consultation on SDR Reform

As you will be aware the SDR and general dental services are to be fundamentally changed. This will directly effect each one of us and our patients‘ future care. Tom Ferris (CDO Scotland) has said that there will be consultation with the profession and the SDA will ensure that we present all of your views coherently. The survey is being conducted via Scottish Dental Network. See link below. Initial SDA Consultation on SDR Reform – Scottish Dental Network

Read More »

NHS Lothian COVID-19 Update No 22 – 27th October 2020

Angus Walls, Director Edinburgh Dental Institute 4th Floor Lauriston Building Lauriston Place Edinburgh EH3 9HA Content of this update PCA and SDR 148 Patient Communication National SoP IPC guidance PPE stock and usage SARS CoV2 vaccination program   Dear Colleagues, I am sending you the most recent PCA from CDO in association with this letter, I must apologise, this should have come to you yesterday. As I am sure you are aware there was an announcement in Parliament recently that a full range of dental care would be available through NHS dental practices from the 1st November. This PCA underpins

Read More »

Agenda for Change

The eagerly anticipated “Agenda for Change” (within the NHS) highlights once more just how far Scottish NHS dentists have fallen. The Doctors and Dentists Review Body (DDRB) amply demonstrates how they feel about dentistry and the professionals showing no improved recognition over the last two decades and no peer acknowledgement. https://www.nhsemployers.org/pay-pensions-and-reward/agenda-for-change We can never aspire to this but who works for nothing and how far are we prepared to be left behind? The question must be asked in relation to the act of NHS dental Items of Service (IOS) treatment because they impact hugely on everything that we and our

Read More »

SDR Recommendations

6 October 2020 Scottish Dental Association Working Group on new SDR proposals   Preamble The Scottish Dental Association (SDA) recognises, along with almost the entire profession and the current CDO, that the pre COVID SDR is not fit for purpose for the likely future situation we face. It should be noted anecdotal evidence suggests most practitioners have felt the previous SDR was not fit for purpose for several years. To propose potential new solutions the SDA has formed a working group to briefly formulate potential new SDR options. The SDA welcomes feedback from all sectors within Scottish dentistry on this

Read More »

General Dental Services Budget Letter to Joe FitzPatrick MSP

Mr Joe FitzPatrick MSP Minister for Health St Andrew’s House Edinburgh October 4th 2020 Dear Mr Joe FitzPatrick MSP, General Dental Services (GDS) Budget On behalf of the Scottish Dental Association (SDA) and following your letter (ref: 202000055870) to Mr Graham Smith in relation to the Public Dental Service budget, we would be grateful for the following information to assist us in consideration of a realistic proposal for the new Statement of Dental Remuneration (SDR): Please detail the predicted positive or negative impact of ‘COVID support’ for General Dental Practitioners (GDPs) on GDS payments in this financial year. A breakdown

Read More »