Latest News from the BDA
England: Calling for changes to NHS dental contracts
6 January 2022
We are acutely aware of the difficulties being experienced across dentistry at the present time in delivering care in the face of the Omicron variant, and have once again raised these issues with NHS England and Health Minister Maria Caulfield.
Things are particularly challenging for NHS practices in England now tasked with attempting to deliver a new 85% contract target (90% for orthodontics). We condemned the NHS England decision to impose these new targets when they were announced at the end of last year.
The spread of the Omicron variant across society was already underway when these thresholds were set and the subsequent impact of the variant on the provision of healthcare, including dentistry, was entirely predictable. As anticipated, we are seeing a significant rise in staff absence, whether those staff are directly unwell with COVID, as a consequence of isolation requirements and/or an inability to access testing in a timely manner. In addition, we know that many patients are also cancelling at short notice given the prevalence of COVID-19. All of these factors are predictably having a significant and ongoing impact on practices’ ability to reach the NHS thresholds.
General Dental Practice Chair Shawn Charlwood wrote again yesterday to NHS England and we met with them this evening to reiterate our anger at the decision to persist with this unjustifiable approach and to seek a change of course. Shawn highlighted the immense damage being done to NHS dentistry and to a profession feeling battered and entirely unsupported. We have also written to Health Minister Maria Caulfield to set out our concerns on the same issue. We hope that NHS England will see sense and adopt a more sympathetic approach.
Next week, we will be surveying members about a range of issues, including your ability to deliver care in the current circumstances, and potential courses of action that we might take in relation to the future of NHS dentistry. The responses we receive will shape our dealings with NHS England. It is imperative that we get a clear indication of where the profession stands, so please look out for our survey next week.
In the meantime, we will continue to press NHS England and will keep you updated on any developments.
England: Pioneering NHS dentists thrown under the bus
14 January 2022
We have condemned the insufficient support offered to over 100 pioneering practices in England, who are being forced back to working to historic models of care from April.
These 'prototype' practices volunteered to form the test bed for new ways of delivering dentistry, to replace the widely discredited target-based NHS dental contract. In October, they were informed that regulations supporting new ways of working would not be renewed. NHS England has said that they will be offering these practices a helpline and patient leaflets to deal with the change. However, this will do little to mitigate the disruption caused.
Shawn Charlwood, Chair of the British Dental Association's General Dental Practice Committee, made our position clear: "The support offered to these pioneering practices is too little, too late. After committing years of effort their reward amounts to a helpline, a few leaflets, and the uncertainty of starting again, effectively from scratch. These NHS practices were given the time to care that all dentists require. Going back to chasing targets could take years, and there will inevitably be casualties. Patients will once again pay the price for the reckless decisions taken by government."
It has taken up to four years for practices that have left the programme in the past to revert to existing models of care. These practices therefore anticipate severe staffing problems, aggravated by already acute recruitment problems across the service. Many practices are already facing real issues with their long-term sustainability, and we believe hitting an 85% activity target is a wholly unrealistic ask during this phase of the pandemic.
The prototype systems allocated greater time to assess the oral health needs of patients and provide needed care. This reduced the volume of patients these practices could treat, and their patient base. Pledges were made to practices that there would be no detriment as a result of their participation in the programme. Reverting to the original model will now see them facing significant challenges.
There was a very real opportunity to take NHS dentistry out of a "drill and fill" activity-based system to one of prevention and care for individual patients. These aspirations have been consigned to history as NHS dentists are put back on an activity treadmill.
Looking ahead, it is likely that other NHS practices in England will have to hit 100% of pre-COVID activity from 1 April 2022 or face financial penalties. We understand that these former-prototype practices will be given leeway of hitting 90%. We will continue to push for more support to be provided to these practices, who were willing to take risks in the name of improving NHS Dentistry.
England: The practice is not the place to argue about vaccination
10 January 2022
Now that the government has brought in mandatory COVID-19 vaccination for healthcare workers in England, some practices are reporting difficulties.
The overwhelming majority of dentists and dental teams are in favour of vaccination. However, a proportion of dental staff are against the COVID-19 vaccination, some decidedly so. We advise practices to have open and constructive discussions with staff on this issue, and have provided resources to help, below. However, discussing the efficacy and safety of vaccination, with those who are decidedly against it, may prove difficult.
Mandatory vaccination for healthcare staff is now law in England. From 1 April 2022, staff without medical exemption will need to be vaccinated or the practice will be in breach of regulations and will face enforcement action. Ultimately, you should not feel obliged to argue with staff on the rights or wrongs of a law which govern dental practice. It is not your role to ensure staff give informed consent for a vaccination provided by another medical organisation.
Members can see our advice on the compulsory COVID vaccination and staff management, which includes:
Advice on compulsory vaccination and exemptions (All members can access)
Recruitment guidance (All members can access).
Letter templates are also available to Expert members for the following: